Thyroid Hormone Level Linked To Atrial Fibrillation

An article I just read in Duke Medicine's Health News publication indicated the following: "Too much Thyroid hormone (hyperthyroidism) can trigger the development of atrial fibrillation (AF), and too little hormone (hypothyroidism) is associated with a lower risk of AF, found a Danish study published online on November 27, 2012, in the BRITISH MEDICAL JOURNAL. The observational study followed 586,500 adults who had their first thyroid function test between January 1, 2000 and January 1, 2010. By December 31, 2010, 2.9 percent--more than half of whom were women--had developed AF. The researchers discovered that the risk began to drop as soon as thyroid levels rose above normal, even before the deficit could be detected with a normal thyroid function test or symptoms appeared. The risk of AF increased proportionately as thyroid levels increased: 4.6 of those with hyperthyroidism developed AF. This finding suggests that thyroid levels should be checked in people who develop atrial fibrillation, with higher-than-normal levels as a possible underlying, treatable cause."
I assume this study was done on the general population, not ThyCa patients.
However, as most ThyCa patients thyroid hormone is kept in the hyperthyroid range post TT, I wonder if those patients who develop heart palpitations or other heart issues should be tested for atrial fibrillation?

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Why hyper thyroid...I was always kept in "normal" range till I had an unfortunate recurrence just at my 5yr mark. Now I am technicaly Hypo.
Assuming your thyroid cancer led to a total thyroidecromy...such case having no thyroid your meds would make someone with a thyroid hyper.
Hyper thyroidism in a patient with out a thyroid is not a good place as your pituitary gland must be secreating too much tsh supporting some residual thyroid tissue with should NOT be anywhere in your body!
On the samw note it could potentialy stimulate any residual cells to grow. This would also be bad as your thyroids cells Were diseased. That puts you at risk for recurrence in the thyroid bed or a matistis anywhere else for that matter. Hyper is a bad sign of recurrence for that same reason.
So normal to low is the goal.
I pray your not truely " hyper" thyroid. Because id about the consequences of that before AF.
Find out please.. best wishes!!!
I'll be looking for your reply you've got me worried about you now.
;-) < hugs>

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When your TSH is suppressed, you ate considered hyperthyroid. Some physicians don't consider someone hyperthyroid unless the Free T 4 is elevated. It is a well known fact among the medical community that hyperthyroidism increases the risk of A Fib. This is true for people with or without a thyroid gland. It all had to do with thyroid hormone acting on the heart, or more specifically the cardiac electrical system.

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All true ..and intresting ,..I unfortunately have no feeling of hyper and I'm defiantly Hypo with suppressed tsh...no energy..if my heart jumped from anything other than a pounding heart from trying to get up a flight of stairs ao exhausted be thrilled LOL. It wouldn't surprise me if both would strain your heart.
<3 Kelly ;-)

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Thank you for your response, Drmommyof2.

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Kelly72471, my TSH is .17 and I feel fine. Thanks for your concern.

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My Tsh is .05 and some days my heart is pounding out of my chest. Sometimes it is so bad I cannot take another step and need to lay down to slow it down. Seeing my pcp this week, it is uncomfortable and happening more and more. My endo says I am fine and not to come back for 8 months. Maybe AF & being over supressed has something to do with it??? Interesting

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Wow...I'm so glad I decided to read this thread. Just last Friday, I went into AFib which promptly converted to VTach and was hospitalized for 5 days. I had just had my labs done (pre-appointment on Monday) and the hospital ran a TSH (which was .07. I missed my drs. appointment, of course but after reading this I'm wondering what the rest of my thyroid levels look like. I have to reschedule my appointment with her as I had to undergo cardia cath while in the hospital (all was ok there). I do not want to go into AFib or VTach again..it sure was no fun! So now I really feel it's imperative I get to her and we can work this out. Can you tell me where you read this article??? I want to take with me to my appointment. Thank you!!!!

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I also would like to get a copy of this article. My tsh is .01....I am very high risk thyca patient and I occasionally have palpitations and I then cut the next dose in half and that seems to stop the palps. Because of my high risk thyca I guess this is a risk/reward situation.

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I subscribe to a newsletter from Duke Medicine titled HEALTH NEWS. It discusses Doctot Perspectives On The Medical Headlines. This article is from February 2013 Vol. 19 No. 2 issue under Internal Medicine News Briefs (page 3 & 4). Single copies may be ordered by calling 800-671-1555 and are $5.00 each. Subscriptions are $39 per year in the US and $49 in Canada.

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Being over suppressed and at the hyper end can make one have the same symptoms as hypo. Not everyone who is hyper will have tons of energy, and be losing weight. Being hyper can cause fatigue, poor sleep, tremors, palpitations, inability to exercise, or even walk because of fatigue or shortness of breath or palpitations, increased sweating, night sweats, weight gain, I creased appetite, hair loss, some or all of these and more symptoms, not to mention A Fib. You should not need to take an article to your Endo, if you had AFib and you are hyper she should know it is related. That is something you learn in medical school. I'm just an OB/GYN and I know that.

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Tip for stopping palpitations: bear down hard as long as possible (like you are constipated) and keep your mouth shut. Also my husband (now in a-fib) would be in a full palpitation for several minutes and I would fill the sink with cold water. He submerged his face for as long as he could while holding his breath. It stopped the palps immediately. Later we tried cardioconversion (using paddles) to correct his heart rhythm but it didn't work and they explained it has to do with a messed up signal box.

I have had a total thyroidectomy. I am on 200 mcg/mg? of Synthroid and have angina as of Oct. 31st. Went to hospital, had heart cath which was okay so was put on angina meds - 1,000 mg twice a day. Assuming I am hyper and was losing weight but now have gained a lot of weight. Still eating the same so why?

Hope the tips help anyone who has palpitations. Grammy

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I have had palpitations occasionally for over 30 years, usually able to get em to stop by the valsalva maneuver (bearing down) or splashing cold water in my face (mammalian diving reflex).

I had my TT last March and in May developed sudden Atrial Fibrillation that would not stop with my usual techniques.
I was in the hospital for 8 hours while the did blood tests and thought maybe it was from my new Synthroid dose of 188mcg.
But, my TSH was 15.3 I was very HYPO.

I finally converted with IV Lopressor after Cardiazem did not work after 2 doses.

My TSH is being brought down slowly because everyone is afraid of me getting AFib again, even though I explain that I got it while my thyroid med dosing was too low.

Meanwhile, just back to having occasional palpitations, nothing dramatic...

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I know I am wired different and have a drug interference but now this sings my song!

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Thanks very much for the info on the article. Yes, she will probably know all about it...but I would like to take it to her anyway. I quit going to Endos quite a while ago and found myself a good holistic dr who specializes in Thyroid. I had 2 heart attacks while I was on that horrible drug "Synthroid". But never told I had Afib just chronic angina which has been well controlled with meds and nitro spray. Thank God I had a defibrillator put in 8 yrs ago because at least it alerted me that there was a problem. They gave me Cardiazem too via IV...I received 3 doses but it did nothing to stop what started as Afib...flipped to VTach. They finally put me on Amiodarone..and that finally did the trick. Did not have to be cardio-converted thank goodness! Well, it will be interesting to see what my labs were 2 weeks ago when I had them drawn for my every 3 month appt with holistic dr. Even taking my Natur-throid it was probably out of whack as I had been fighting a bronchitis that just wouldn't quit...so I was already tired! If I knew then what I know now..there is no way I would have let them do a TT.

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Correction to my original post above should have read: "4.6 percent..."
Also, I wrote the WRONG PHONE NUMBER for ordering single copies of back issues or subscribing to Duke Medicine's HEALTH NEWS newsletter.
The correct phone number for SUBSCRIPTIONS is:
800-571-1555. Sorry for the error.

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I have SVTs even without the Thyroid meds. They had to up my dose of looted dot to deal with it. I am also in surgical monopause after oopherectomy. It's ridiculous. It is a constant risk reward mess.

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@Kelly72471: You wrote, << Hyper thyroidism in a patient with out a thyroid is not a good place as your pituitary gland must be secreating too much tsh supporting some residual thyroid tissue with should NOT be anywhere in your body! >> You have it backwards. Hyperthyroid is the correct treatment for patients who have had thyroid cancer. The T4 is kept high, it sends the message to the pituitary to NOT send much (at all) TSH into the body. That keeps the TSH low. Since you say your TSH is low, you are suppressed and therefore hyper, regardless of any symptoms you do or do not have. I'm glad you aren't having symptoms other than low energy. The symptoms of hyper and hypo actually can overlap a lot. I've been both and neither is good.

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Reminder to all: if you are seeing a cardiologist (or any doctor beside your thyca endo) make sure you follow your thyca endo's advice pertaining to your thyroid replacement med. dose. There is a reason why we are kept "hyper" for up to 5 years. On the other hand, some not so well-versed endos keep us really hyper/over-over supressed (below 0.1 TSH). That is not good, either.
Take care,
Angel

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cabro: thanks for the correction.....her comment confused me!

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@thirdtime: You're welcome. I kind of generalized, but that's basically the idea. I think that the presence of excess T4 is registered by the pituitary, so that it does not send out much TSH (not needed). If our T4 is low (inadequate dose) then the pituitary would send more TSH (Thyroid Stimulating Hormone) to the (now non-existent) thyroid telling it to produce more T4 for the body to make up for the shortage. The higher level of TSH would then be detectable in the blood. We have to check TSH so we can lower or raise T4 "manually" (dose changes) to keep the pituitary from sending out much TSH. It's a loop. That's how high doses of T4 (suppression) help drive down TSH and lower the risk for recurrence. Oversimplified, but that's the idea.

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