Managing Rapid Heartbeat and Thyroid Medication: A Patient's Journey

My heart is racing?

Currently, I take 250 mcg of thyroid hormone daily, but my heart rate has become very uncomfortable, averaging 120 beats per minute.
When I walk or climb stairs, it almost reaches 150.
Although I am happy to have lost 15 kilograms, I often feel short of breath and experience diarrhea.
After my surgery, I underwent a single 120 mCi dose of I-131.
During that time, I was taking care of a terminally ill family member, which resulted in my TSH levels being over 100 for an extended period.
I regret not taking better care of myself.
A few years after my family member passed away, I realized that continuing in such a low state made me feel like I could faint at any moment.
My menstrual cycle has become irregular, I feel tired every day, and my immune system is weak; I often catch colds and it takes one to two months to recover, which is very frustrating.
I really dislike the discomfort caused by I-131 and fear that if my condition worsens, I might have poor iodine absorption.
Now, I am trying to follow my medication regimen diligently, but it makes me feel very uncomfortable, and I can't sleep at night.
At least when my levels were low, I didn't feel this bad.
Am I really destined to take medication for life and endure this rapid heart rate and discomfort?

Niming, 20~29 year old female. Ask Date: 2020/11/19

Dr. Lin Jianliang reply Internal Medicine

After reading your letter, I am unable to ascertain your general condition from your description.
Given your uncomfortable symptoms, I recommend that you inform your attending physician immediately.
Discussing your situation with them will help ensure your health.

Reply Date: 2020/11/19

More Info

Managing rapid heartbeat, especially in the context of thyroid medication, can be a complex issue that requires careful consideration of various factors, including medication dosage, lifestyle changes, and ongoing monitoring by healthcare professionals. In your case, taking 250 mcg of thyroid hormone daily has led to a significant increase in your heart rate, which is understandably concerning.

Thyroid hormones play a crucial role in regulating metabolism, and an excess of these hormones can lead to symptoms of hyperthyroidism, including tachycardia (rapid heartbeat), weight loss, anxiety, and increased sweating. The fact that your heart rate reaches 120 beats per minute at rest and can spike to 150 with minimal exertion is indicative of this condition. It is essential to address these symptoms, as prolonged tachycardia can lead to complications such as heart failure or other cardiovascular issues.

Given your history of I-131 treatment and the challenges you've faced with your thyroid condition, it is vital to work closely with your endocrinologist. They can help adjust your thyroid medication dosage to find a balance that alleviates your symptoms while still managing your thyroid levels effectively. It is not uncommon for patients on thyroid hormone replacement therapy to require adjustments over time, especially after significant weight loss or changes in lifestyle.

You mentioned feeling better when your TSH levels were higher, which suggests that your current dosage may be too high for your body's needs. It is crucial to have regular follow-ups with your healthcare provider to monitor your thyroid levels (TSH, Free T4, and Free T3) and adjust your medication accordingly. Self-adjusting your medication without professional guidance can lead to further complications.

In addition to medication management, consider lifestyle modifications that can help manage your symptoms. Regular, moderate exercise can improve cardiovascular health and help regulate heart rate, but it is essential to start slowly and consult with your doctor about an appropriate exercise plan. Stress management techniques such as mindfulness, yoga, or meditation can also be beneficial, as stress can exacerbate symptoms of both hyperthyroidism and anxiety.

If you experience symptoms such as chest pain, severe shortness of breath, or fainting, it is crucial to seek immediate medical attention. These could be signs of more severe complications related to your heart or thyroid condition.

In summary, while it may feel daunting to manage your thyroid condition and its associated symptoms, you are not alone in this journey. Regular communication with your healthcare team, adherence to prescribed medications, and lifestyle adjustments can significantly improve your quality of life. It is essential to address your concerns with your doctor, who can provide tailored advice and support as you navigate this challenging situation. Remember, managing a chronic condition often requires a multifaceted approach, and finding the right balance may take time.

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