Managing Hyperthyroidism: Is a Decrease in Heart Rate Normal?

Q: Managing Hyperthyroidism: Is a Decrease in Heart Rate Normal?

Hello： If your heart rate has decreased, you can generally continue taking the medication. <br>Hyperthyroidism rarely resolves in just one month; you should return for follow-up appointments and consult your attending physician. <br>Thank you for your message!

Hyperthyroidism with decreased heart rate?

Hello Dr.
Hsieh,
I would like to ask about hyperthyroidism medication (carbimazole 10mg).
After taking two tablets a day for a month, I reduced the dosage to one and a half tablets per day on January 12.
Now my heart rate has decreased from 80-90 bpm to 60-70 bpm.
Should I schedule an earlier follow-up appointment, or is this considered normal, and can I continue taking the medication?

Emily, 50~59 year old female. Ask Date: 2016/01/19

Dr. Xie Rongyuan reply Internal Medicine

Hello: If your heart rate has decreased, you can generally continue taking the medication.
Hyperthyroidism rarely resolves in just one month; you should return for follow-up appointments and consult your attending physician.
Thank you for your message!

Reply Date: 2016/01/19

More Info

Managing hyperthyroidism effectively often involves monitoring various symptoms, including heart rate, as thyroid hormones significantly influence cardiovascular function. In your case, the decrease in heart rate from 80-90 beats per minute (bpm) to 60-70 bpm after adjusting your carbimazole dosage is noteworthy and can be interpreted in several ways.

Firstly, it is essential to understand that hyperthyroidism typically causes an increase in heart rate (tachycardia) due to elevated levels of thyroid hormones, which stimulate the heart and increase metabolic activity. When treatment with antithyroid medications like carbimazole is initiated, the levels of thyroid hormones in the body begin to decrease, which can lead to a normalization of heart rate. Therefore, a reduction in heart rate to the range of 60-70 bpm can be a positive sign, indicating that your hyperthyroidism is being effectively managed.

However, it is also crucial to consider individual variations in response to medication. A heart rate of 60-70 bpm is generally considered within the normal range for adults, but if you experience any symptoms such as dizziness, fatigue, or palpitations, it may indicate that your heart rate is dropping too low, which could necessitate a reevaluation of your treatment plan.

In terms of whether you should return for an earlier follow-up appointment, it is advisable to consult your healthcare provider. They can assess your overall clinical picture, including any symptoms you may be experiencing, your thyroid function tests, and how well you are tolerating the medication. If your heart rate continues to decrease or if you develop any new symptoms, it would be prudent to have a check-up sooner rather than later.

Additionally, it is important to monitor other signs of thyroid function, such as weight changes, energy levels, and mood, as these can also provide insights into how well your treatment is working. Regular blood tests to measure thyroid hormone levels (TSH, Free T4, and Free T3) will help ensure that your medication dosage is appropriate and that you are not becoming hypothyroid (an underactive thyroid), which can also lead to a lower heart rate.

In summary, a decrease in heart rate after reducing your carbimazole dosage can be a normal and expected response to effective treatment of hyperthyroidism. However, it is essential to remain vigilant for any symptoms that may arise and to maintain open communication with your healthcare provider regarding your treatment plan. Regular monitoring and adjustments to your medication will help ensure that you achieve optimal thyroid function and overall health.

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