tried armour- had severe heart palps, tachycardia?? anyone else

Question

Hi All,
I need some help!!! I am borderline hypothyroid, with nodules in remaining lobe of thyroid.( normal TSH, very low T4, low T3). Dr. put on low dose of synthyroid. It helped fatigue, but synthyroid seemed to cause severe insomnia. I pleaded for a trial of armour and my endo finally consented  because my T4 was better, but T3... still very low.
  Started on 1/4 grain armour  first day - heart palps and tachycardia THRU THE ROOF!!!!!! It was still going strong thru the night. On 2nd day I cut the 1/4 grain in half, only took 1/2 ( which was 1/8 grain). Still had some palps and tachycardia.... tried for 3 more days and felt HORRIBLE- chest hurt, achey and my skin started to feel like it was itchy, crawly feeling.
  Stopped and went back to synthyroid.
 I talked to PCP and compound pharmacist who I both trust... they advised I may be one of those people who cannot tolerate T3- I have a heart condition- SVT which had been fairly stable til now. I am devastated because I have read soooo many wonderful stories of armour and thought it might be my answer. 
  Any ideas are welcomed.... I just want to cry or is it SCREAM!!!! Is there a better synthetic brand anyone recommends????

gimel · Answer

Assuming that those are your latest test results, you are a long way from being optimal for Free T4 and I expect also Free T3.  I say the latter because your T3 test was for Total T3, not Free T3.  You should make sure they always test for Free T4 and Free T3, not Total T4 and Total T3.  The Frees are the biologically active portions of the Totals.  You should also make sure to always get a copy of the lab report and then it is a good idea to note on there how you were feeling at the time and what meds and supplements you were taking and the dosages.  That info provides a good tracking method and very good reference.

T3 meds act quickly so it is a good idea to split doses of any meds containing T3, in order to even out the effect over the day.  Also be aware that it is best to defer your morning dose until after blood draw for thyroid tests, in order to avoid false high results.  

From your reaction to the small dose increase, it may be that splitting the dose will help avoid that.  Also, with those test results it could also be that it is just your body acclimating to the new dose.  You clearly are in the hypo ranges for your test results.  For most people Free T4 is best at the middle of the range, at minimum, and Free T3 in the upper half of the range, and adjusted higher as needed to relieve symptoms.  

There are several other possibilities for a reaction when raising med doses.  Those are low cortisol and low ferritin.  Since hypo patients are so frequently low in Vitamin D, B12 and ferritin, I would start by testing for those.  D should be 55 min. , B12 in the upper end of the range, and ferritin should be about 70 minimum.  The best test for cortisol is the diurnal saliva cortisol test done at 4 times during the day.  Doctors typically won't order this test, and instead, order morning serum cortisol, which is much less definitive, but might be a good place to start.

gimel · Answer

So you started on 1/4 grain of Armour and increased to 1/2, correct?  Also please post your thyroid related test results and reference ranges shown on the lab report.  When were you diagnosed as hypo?  Was the cause diagnosed as Hashimoto's Thyroiditis?  What other symptoms do you have besides the arrhythmia and feeling shaky and light head?

goolarra · Answer

Let me see if I can push the comment I just made out.

goolarra · Answer

If you are prone to tachycardia, as I am also, starting meds may very well wreak havoc with it.  I have SVT (WPW syndrome), and mine was well-managed without meds until starting thyroid meds also.  However, I wasn't borderline hypo, so I had no choice but to tough it out.  

Please post labs with reference ranges.  Ranges vary lab to lab and have to come from your own lab report.

What symptoms are you experiencing from being hypo?

Do you know if you have Hashi's?

missouri505 · Answer

I just took my first dose of Armour and had terrible tachycardia during the day and worse at night, had no sleep because of it. I have had tachy in the past but it was well managed without meds since I found all the triggers and avoid them. I only took 1 dose of 30 mg and I cannot wait to get this out of my system. I had tachy all day and night the first day with hot flashes, creepy feeling skin, excessive dry mouth, scratchy throat and chest pain. My thyroid is only borderline hypo and I have 2 nodules on it that were biopsied benign. I think I will just live with the hypo symptoms rather than have the tachy so bad. I also had problem when on low dose of Levothyroxine. 

I have spoken with an Electrophysiologist about an ablation for the tachy but have not had it too bad until I took this. I would like to not have to do the ablation if I don't have to.

sick and tired 47 · Answer

Stella,
Here are copies of my labs-

May  2008 - on no thyroid meds then
Free T4  -   .8      ( range.8-1.5)\
Total T3   - 88.0    ( range 82.-179.)
No Free T3 done
TSH - 1. 4            ( range .5- 4.5)

Aug 2008- NO meds.
Free T3- 304  ( range 230-420)
Free T4-.  .9   ( range .8- 1.8)
Total T3 -  94   (range  97-219)
TSH- 1.32    ( range .40 -4.50)

Dec 2008     On 37.5mcg of synthyroid x 2months
 
Total T3 - 97  ( range 97-219)
Free T4 - 1.3   ( range .8- 1.8)
TSH- 1.46    ( range .40-2.70)
 Incidentally my ferritin was low 12/08, now on iron supplements, and my DHEAS was VERY high- I am not on any DHEA supplements. Going to retest in two months- ?? lab error.

Thanks for any help ALL!!

goolarra and anca77,
Thanks for the encouragement. I don't know if I will try the armour again. I have a REALLY bad SVT attack this weekend... the first in a while and am still having heart palps and chest  pain. Not sure if it was related to Armour, but not taking any chances right now.. I feel terrible. 
  Next week I go back to the cardio for results of my holter monitor. I don't want to go on meds again, especially worried about low BP, lower heart rate would be great for a while- mine is always 90-100 or higher.
  It is SO frustrating and I tend to be always searching for the answer to make this just go away!!! It took over two years for any endo to even agree to give me thyroid meds, 1 1/2 years for a EP cardio to finally diagnose my SVT... was told it was anxiety, menopause, stress, you have heard all those things too I am sure. Thanks again for your responses.

Magpieannie,
The Drs. can say there is NO correlation between thyroid and heart, but the posts here prove otherwise. I NEVER had a problem with my heart til thyroid issues started. I would advise you to take your daughter to a electrophysist cardiologist... they special in electrical activity of heart. They have the knowledge, a regular cardio does not deal in that area- this is from my experience.

Interesting is an old post from 2006 on palps  and thyroid disorders., it was interesting.

goolarra · Answer

I can tell you from personal experience that Synthroid can cause , or cause an increase in, heart arrhythmias even when your labs are in "normal range".  My T3 and T4 just barely make it into "normal", and my TSH is still in the 20s.  My hypo symptoms have all gone away, but the levo still wreaks havoc with my SVT.  I'm on a beta blocker now for the SVT.  Before going on that, I was having tachy episodes 10-12 times a day, my labs were even more dismal than they are now, and I was only taking 25 mcg of levo!  I'm an adult woman and not tiny!!!

My PCP kept denying the cause/effect relationship between the levo and the SVT.  My new endo seems to understand this cause/effect quite well.  As he said, people who have never had an arrhythmia start having them on levo, so, if you're prone to them anyway, you suddenly become much more complex.  You need to find someone (another endo?) who feels comfortable managing your daughter's care as a WHOLE person.  The PVCs could be coincidental to the Synthroid, but I'm betting not.

Good luck.

goolarra · Answer

Stella has a good suggestion on the dosages.  Also, can you post your whole history of TSH, Free T3 and FreeT4 lab results?

You have been on Synthroid for such a short time (2 months?) that it has barely had time to get into your system.  Unfortunately, adjusting thyroid meds is trying on the patience.  Six weeks between each adjustment...ugh.  However, there's no avoiding it and no rushing it.

Speaking as someone with SVT, I would suggest that you speak to your endo, tell him the Armour didn't work really well for you, and ask him if, in light of that, he wants to increase your dosage of Synthroid.  T3 and arrhythmias really do not mix well.  It sounds like he's doing the right thing.  If you read the information insert from the Synthroid (about as long as your arm and not as wide), you will see that the recommended starting dose for somone 1) over 50, or 2) with a history of heart arrhythmias, or 3) who has been hypo for a long time should be 12.5 to 25 mcg.  This gives your body time to adjust.  I can't emphasize enough that my PCP started me out at 88 mcg (even though I qualify for all three above), and it cost me a year of backing off then increasing very, very slowly and lots of SVT.  I wish she had had the good sense to start me off slowly. You can always think about adding some synthetic T3 or trying Armour down the road, but you should give the Synthroid more of a chance to work before you start experimenting. 

I know it's hard to be patient  when you're exhausted, but believe me, the time you spend gradually increasing your meds until you feel well is worth it.  I know we hear lots of horror stories about people who don't do well on synthetics, but the fact of the matter is that lots of people (most) do extremely well once they get on a correct dose.  Switching to Armour, adding any kind of T3 at this point is just going to confuse the issue and waste more time and try your patience even further.  The first line of therapy for hypo is synthetic T4 only.  IF this doesn't work for you (once your labs are normalized) and you don't feel well, then you can try other things.

stella5349 · Answer

What were the dosages from when you were on SYnthroid and then when you went to Armour? 

Do you knwo the mcg's w/ Synthroid you were on and the Mg's from Armour?

Also - can you lest the labs you had last right before the switch? Did you have a lab after your switched? 

You may have been off in dosages and that - comparing the lab work - may have simply just been wrong. 

Post that information and let's see what all this looks like.

magpieannie · Answer

My daughter is 8 and was born without a thyroid gland. She was recently diagnosed with Premature Ventricular Contractions or PVC's in the right ventrical of her heart. She feels it as a racing,hard heart beat when she begins to exercise. She takes.88 micrograms of synthroid which has not been increased in over two years. Her blood work shows she's in"normal range" so her endo. keeps her on the same dose visit after visit, even though her weight is up, along with many other signs of being hypothyroid! Her endo. says her thyroid levels wouldn't be the cause of the PVC's because they have consistently been in the normal range. I just don't see how the two could not be connected.! Something is suddenly causing this, and my gut tells me that it has to have some relation to synthroid and to not having a thyroid gland. Her little body is not getting something that it needs. Please let me know what you think,and anyone else who might be reading this who might have ideas,please let me know your thoughts on this.

anca77 · Answer

Yes, I can tell you that for me it was worth going thru all those symptoms while getting adjusted to the Armour. Sometimes I was feeling like I have something ‘strange’ in my body, that does not belong there. Maybe it was the fact I knew Armour is made out of pig gland (maybe just crazy).

Anyway, only after I start combining the two, at my doctor’s idea, I start feeling better. Now everything its OK, having the energy, symptoms gone. 

Maybe you should use a synthetic T3 (Cytomel, I guess) in combination with the Synthroid. There are more T3 medications there, see what your doctor will recommend. And if you do not have any results with this doctor, find another.

goolarra · Answer

I completely understand your frustration.  I've spent the past year trying to make my PCP happy by increasing my levo dose, only to pay with lots of tachy.  My new endo seems to have a much better grasp of the situation.

Lots of people have really good luck with Armour; it has its passionate supporters.  However, there are also lots of people who do really, really well on the synthetics (once their levels are adjusted properly).  Don't get discouraged because it didn't work out well for you.

I find that every time I increase my levo dose, my tachy increases.  I'm glad to hear that you've had a different experience.  It gives me hope that my hypo and tachy might come to terms with each other.

My electrophysiologist told me that the atenolol could make me tired, but I didn't find that it did.  If you decide on a beta blocker, be aware that when you first start taking it it can lower your heart rate and BP significantly.  However, this evened out for me after a short time.  I called my EP just after I started because my HR was pretty consistently in the low to mid-50s, and my BP was 80-something/50-something.  It didn't take long for it to even out though, and HR is usually 65-70 and BP 110-120/70-80.  I started out at 25 mg atenolol (very low dose) and have had to increase to 37.5 after increasing levo.

Your cardio is probably right - levo tends to bring out the SVT.  I know I've had it all my life, but it was well under control until the levo.

As far as I know, the maneuver I'm talking about doesn't have a name (possible?).  It sounds similar to Valsalva (what I just read on the internet), but not exactly the same.  You start by taking a deep breath and holding it.  Then you push, bringing pressure onto your vagus nerve which runs down the neck and thorax and into the abdomen.  Pressure on this nerve slows the HR.  I usually try to envision this big breath squeezing my heart and telling it to calm down.  You hold it as long as you can and then exhale.  My HR sometimes goes back to normal while I'm still pushing, but more often it goes back to normal once I've let out the breath and taken a couple of normal breaths.  My HR can go from 200+ to 70-80 in less than a minute when I do this.  For me, it's best to do this as soon as possible after the tachy starts.  Not much fun at a party!!!  Excuse me while I go calm my heart down...

I agree with anca77 that the key to managing thyroid meds and tachy is to start out slowly and then increase slowly but consistently.

I know it feels lonely out there.  When I first joined this forum, I posted a question about levo and tachy.  I got very little response.  Add to this that my PCP kept telling me I was nuts if I thought the levo was causing my SVT to increase.  It didn't matter to her that I felt fine in terms of the hypo and had no hypo symptoms, she wanted my blood work "right" and really didn't care about the SVT at all.  She just kept telling me to take more levo.  Help!

Anyway, good luck with your cardio.  I hope you find something that works for you soon.  There's lots of stuff out there; you just have to find the combo that works for you.  You will!  Let us know how it's going and let me know if you discover anything a fellow SVT sufferer might find interesting.

sick and tired 47 · Answer

anca77,
 Thanks.for your post. I am not sure if I want to try again.... I will give it a week or two and decide.
  Interesting you said itchy skin... on the 3rd day I started feeling itchy ( did not mention that in my post) and it remained several days after I stopped the armour. It was worse on my arms and torso,  like a light red rash, felt like my skin had something crawling on it... is that too wierd??? It lasted for several days after stopping the armour.??  
Tell me after going thru all you did do you feel MUCH better than on synthetic alone? ?Was it worth it?
  Thanks again, I am sorry for your troubles but glad I am not alone and crazy!!!
Good luck to you!

anca77 · Answer

I can not say I have the same medical problems you have (the heart related ones), I do have some problems, but I had similar reactions when I start taking Armour (palpitations, itchy skin, really strange feelings that I can not describe). Initially I was taking Levothyroxine but my TSH was still high plus I was having hypo symptoms. To make a long story short, now I take Synthroid 75 mcg in the morning and then 30 mg of Armour at 11 AM and another 30 mg of Armour before 4 PM. Combining the two is the best solution for me. It took me about 6 weeks for the reaction caused by Armour to go away, I have two EKGs this time as I was having palpitation, chest pains, front and back, sore throat, itchy skin and other. 

I can not tell you to go back to Armour but it takes a while for the body to adjust, plus you have to start with low dosage and then increase every two weeks until you get to the optimum dose.

sick and tired 47 · Answer

Thanks goolarra,
  I am just frustrated because all the info I have read made armour sound like the dream solution.
  My T3 is still low. My TSH is in normal range     ( always was) but very low T3 , T4, since thyroid lobectomy.

     My endo said the T3 would make my heart race, but agreed to let me try armour. I started synthyroid 3 months ago.

As for me since I have started synthyroid my heart palps, tachycardia are better with each increase- and I have not had a true SVT attack low T4 ,T3 since thyroid lobectomy. So no one would treat til last endo. ( this 4th one).
. Just lots of chest pressure, sob, and when I exercise my heart rate goes real high in the first minute of starting. 

  I .tried verapamil, cardizem, did not help just made me SOOOO tired, and l really lowered my BP so I was dizzy and lightheaded all the time.  My old cardio put me on flecanide but my PCP disagreed... thought it was to harsh a drug and asked for a 2nd opinion. New cardio suggested I just hang in there... but I go back next week to discuss.Beta blockers, other meds.. ect.- I am open for ideas. I am just afraid of that exhaustive feeling and low BP again. I was  hoping once I got my thyroid at optium levels this would get better. I never had a real problem til I had thyroid issues. 
 
   The cardio has suggested I have had the SVT  ( could never do caffine, sudafed ect... my heart really raced) and the thyroid issues brought it out. I am not sure what happened... just know I want my life back... this is NO fun.
  As for the tip to slow the heart I am very  interested. I know the valsalva manuever for when I have the SVT attack but sometimes my heart rate is just fast and can't get it slowed down. I  just started biofeedback - it is supposed to eventually teach me to slow my heart down. I hope it works,I hate meds.
 Thanks for your help...- I have felt I am the only person who has hypothyroidism and PSVT, and  tachycardia.

goolarra · Answer

I have SVT also due to a congenital heart defect (Wolff-Parkinson-White syndrome).  It was completely under control without medication until I became hypo and started taking levothyroxine.  Then it went WILD.  I had to back off the dose until I was taking 25mcg and very gradually work my way up.

T3 is not recommended for anyone with heart arrhythmias, unless it is unavoidable.  Armour has a ration of T4:T3 of 4-5:1.  The healthy human thyroid produces T4:T3 in approximately a 20:1 ratio.  You get an awful lot of T3 if you take an adequate dose to keep your T4 up.  If you really suspect you need some T3, it would probably be best to add it as a synthetic (Cytomel), and to start off with a baby (literally) dose until you see how it effects your SVT.

I was just switched from generic levo to Levoxyl by my new endo.  It's only been about five weeks, but I have had a really good month (knocking on wood here) in terms of the SVT.  I don't know if it's the Levoxyl or the fact that I think I've found a doctor who understands my problems and how they interact. 

You don't say how long you've been on Synthroid.  It's also not recommended to start adding T3 until your T4 is stabilized.  

I also think any of the levo's I've taken (generic or brand name) cause me insomnia.  I used to sleep like a log, and now I'm up 2-3 hours almost every night, so awake it's an effort to keep my eyes closed.  Maybe we should start a club ;-).

Do you know the technique for stopping the tachycardia?  It was recommended to me by my electrophysiologist and really works.  I'll be glad to describe it if you're interested.  Also, I am now on atenolol (a beta blocker) to control the SVT.  This really helped. 

Hang in there...it takes a while for all this to stabilize.  Also, finding the right doc who knows that SVT and thyroid meds are mutually antagonistic can be a challenge.  My PCP kept denying that my increased episodes of SVT were caused by the thyroid meds...wrong!

tried armour- had severe heart palps, tachycardia?? anyone else

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