Heart Pounding Palpitations From Thyroid Supplement Log

[narouz]

Quick note before I nod off.

Stopped the salt supplementing today and only used salt on food, still had the hard beating heart. So, I do not think it was salt. Also had a head ache for the second half of the day today and still do, wondering if its from lack of salt.

Took 1/8th a pill at breakfast today. Like I said, still having hard beating heart, just not as bad. Will decided in the morning how much to take.

Charlie-
Sorry about the hard heart-pounding.

Now, back to something we were talking about some weeks back:
it would be helpful to know more about just what this "hard heart-pounding" is.
You say it is NOT elevated heart RATE, right?
As you know, I've wondered if it has more to do with blood pressure.

So...when you are in the midst of these "hard heart-pounding" episodes,
I would wish for as much data as possible.
During them:
-what is the pulse rate?
-what is the temperature?
-what is the blood pressure?
-what times of day or night do they occur?
-what did you have to eat before?
-what supps did you take before?
-is there any relationship between time of taking thyroid sup and the hard heart-pounding?
-was there any clear or unusual psychological or emotional stressor preceding the HHP (from here forward!)?

 

[j.]

it would be helpful to know more about just what this "hard heart-pounding" is

when i had it, i could feel my heart beat. and it was really strong, like me heart was going to come out of my chest, and i felt every beat, and it was uncomfortable. the rate was just the usual rate. didn't take blood pressure.

 

[narouz]

...and: how to proceed...

Well, it's hard for me to see how you would be putting yourself at any great risk
by trying to continue the thyroid sup at a very low dose--which would seem to be what you are taking.

You might back down a bit...what was it?, 1/8 of a tablet twice a day you were up to?
You might back down to just 1/8 in the mornings--to see if that helps sleep,
and try to continue on that dosage for a while,
seeing if you can kinduv push through it,
thinking of it as a transition phase which will resolve.

If you are keeping records on the HHP episodes,
and if nothing scary turns up--
like way high blood pressure or pulse or temps--
then hard to believe that you would be endangering yourself.

Returning to on of our hypotheses of a few weeks ago:
perhaps you are habituated, used to a languid pulse, a state of some torpor.
And so maybe, as the thyroid begins to help you,
it feels unusual.
But that might not mean that it is bad.
Just different--and, understandably scary, of course.

 

[narouz]

it would be helpful to know more about just what this "hard heart-pounding" is

when i had it, i could feel my heart beat. and it was really strong, like me heart was going to come out of my chest, and i felt every beat, and it was uncomfortable. the rate was just the usual rate. didn't take blood pressure.

Again: I well understand and sympathize that such episodes are scary.
I would be scared too!
And I also understand how, when in the midst of such HHP,
probably the last thing you feel like doing is taking your blood pressure!
But...it would be valuable data.
If the blood pressure was off the charts...well then the fear would be justified.
On the other hand,
if that vital sign and others were pretty normal or not too weird...
then it might give one confidence to proceed--in Charlie's case with the tiny thyroid supplementing.

I remember the first time I took thyroid, it freaked me out.
I can't say if I had HHP.
Dumb...but I can't remember.
Just remember it freaked me out and I couldn't sleep.
I think I do maybe remember a little heart racing or pounding.

But my doctor just brushed it off and said stay on the dose,
it will normalize in a week or so.
...And, it did.

 

[Combie]

have you tried taurine Charlie?

 

[kettlebell]

Quick note before I nod off.

Stopped the salt supplementing today and only used salt on food, still had the hard beating heart. So, I do not think it was salt. Also had a head ache for the second half of the day today and still do, wondering if its from lack of salt.

Took 1/8th a pill at breakfast today. Like I said, still having hard beating heart, just not as bad. Will decided in the morning how much to take.

Hi Charlie,

Previously when I started having issues (Palpatations, what felt like extremely high blood pressure, anxiety) I thought it might have been the salt. I stopped the salt temporarily but nothing changed. I went back onto the salt with a vengeance and the symptoms got better (Not completely). I stopped the Thyroid-S and symptoms went.
The key thing was that getting more salt improved things. I think I have said it a few times on other threads but salt can cover the actions of Potassium and Magnesium (+ others) when there is a shortfall in those nutrients.

On another note, Are you using Thiroyd?

Considering the T4:T3 Ratio, if you are not converting the T4 into T3 over time that accumulation of T4 (Could be weeks) will cause a further suppression of the metabolism. That causes the raise in adrenaline and other stress hormones leading to the thumping heart and what feels like raised blood pressure. Some people, if things are really not working well do better on purely T3 for a while until the high levels of T4 are slowly cleared down by conversion to T3. Or even no Thyroid supplement at all but just making sure the body has what it needs for conversion. Just a thought.

 

[narouz]

Charlie-

Another possible cause:
the weird Thiryod or Thyroid-S you're taking--
it has a LOT of fillers and additives.
I doubt it, but...not impossible.

You're taking such a small dose of NDT, Charlie,
you could consider switching to a low dose of the Nutri-Meds.
Maybe start with, like, a 1/4 of a capsule (my Bovine is in caps...is your Porcine?).
At any rate, figure on 1/2 strength and take the equivalent of your 1/8 dose.
See how that goes for a while.

How are your temps/pulses running these days?

Hang in there!

 

[charlie]

Charlie-
Sorry about the hard heart-pounding.

Now, back to something we were talking about some weeks back:
it would be helpful to know more about just what this "hard heart-pounding" is.
You say it is NOT elevated heart RATE, right?
As you know, I've wondered if it has more to do with blood pressure.

I have been watching my blood pressure closely, it does not go up during these episodes. Pulse does not go up either.

So...when you are in the midst of these "hard heart-pounding" episodes,
I would wish for as much data as possible.
During them:
-what is the pulse rate?
-what is the temperature?
-what is the blood pressure?
-what times of day or night do they occur?
-what did you have to eat before?
-what supps did you take before?
-is there any relationship between time of taking thyroid sup and the hard heart-pounding?
-was there any clear or unusual psychological or emotional stressor preceding the HHP (from here forward!)?

My resting pulse is around 68-70 right now.
My temps are 97.2 when I wake, then, very soon after I eat breakfast it quickly jumps up to 98.8 usually.
After lunch, I am around 99.0-99.4
After dinner usually 99.2-99.6
Pulse, always around 68-70.
Palpitations happen anytime, but get worse after coffee, or if I get excited, or, when I try to go to sleep.
I always take my coffee near thyroid supplement, so yeh, its near that time.
No more then usual stressors that I can think of.

I am thinking its RT3, or, simply too much thyroid supplement. My temps are rocking, but, my pulse is definitely not following suit. Although, before I started all this my pulse was in the 50's and my temps where in the 96's.

when i had it, i could feel my heart beat. and it was really strong, like me heart was going to come out of my chest, and i felt every beat, and it was uncomfortable. the rate was just the usual rate. didn't take blood pressure.

Same way as I would describe it.

If you are keeping records on the HHP episodes,
and if nothing scary turns up--
like way high blood pressure or pulse or temps--
then hard to believe that you would be endangering yourself.

Returning to on of our hypotheses of a few weeks ago:
perhaps you are habituated, used to a languid pulse, a state of some torpor.
And so maybe, as the thyroid begins to help you,
it feels unusual.
But that might not mean that it is bad.
Just different--and, understandably scary, of course.

Yeh I dont think there is much danger, I am not worried about it. Its just annoying as heck.

I dont think that hypothesis is correct though. It feels like a nervous heart beat if that makes any sense.

have you tried taurine Charlie?

I have it ordered hopefully it will get here soon.

Hi Charlie,

Previously when I started having issues (Palpatations, what felt like extremely high blood pressure, anxiety) I thought it might have been the salt. I stopped the salt temporarily but nothing changed. I went back onto the salt with a vengeance and the symptoms got better (Not completely). I stopped the Thyroid-S and symptoms went.
The key thing was that getting more salt improved things. I think I have said it a few times on other threads but salt can cover the actions of Potassium and Magnesium (+ others) when there is a shortfall in those nutrients.

On another note, Are you using Thiroyd?

Considering the T4:T3 Ratio, if you are not converting the T4 into T3 over time that accumulation of T4 (Could be weeks) will cause a further suppression of the metabolism. That causes the raise in adrenaline and other stress hormones leading to the thumping heart and what feels like raised blood pressure. Some people, if things are really not working well do better on purely T3 for a while until the high levels of T4 are slowly cleared down by conversion to T3. Or even no Thyroid supplement at all but just making sure the body has what it needs for conversion. Just a thought.

I dunno man, I am honestly lost but still searching the solution. I have a dr's appointment soon as hope to test for RT3. Maybe RT3, maybe too much thyroid, I dunno.

Yes I am on thiroyd. Might switch out though.

Charlie-

Another possible cause:
the weird Thiryod or Thyroid-S you're taking--
it has a LOT of fillers and additives.
I doubt it, but...not impossible.

You're taking such a small dose of NDT, Charlie,
you could consider switching to a low dose of the Nutri-Meds.
Maybe start with, like, a 1/4 of a capsule (my Bovine is in caps...is your Porcine?).
At any rate, figure on 1/2 strength and take the equivalent of your 1/8 dose.
See how that goes for a while.

How are your temps/pulses running these days?

Hang in there!

Fillers, I doubt it but am considering the nutrimeds path. I have the porcine ones.

Temps up at the top of this post, temps are rocking, pulse is lagging, heart is a thumping.

 

[Ray-Z]

I think Kettlebell is on target.

I've experienced the heart pounding Charlie has described. IME, the pounding is almost identical to what I used to experience after running hard. I'm therefore inclined to think that adrenaline is a cause (though not necessarily the only one).

IIRC, in Ray Peat's most recent interview on KMUD, he noted that high stress hormones can awaken you at night with a pounding heart. (I'm sure lots of us have experienced this phenomenon pre-Peat or in early stages of Peating.) If sufficiently high stress hormones can make the heart pound at night, they seem likely culprits for some of Charlie's daytime episodes. :2cents

In any case, hope you feel better soon, Charlie.

 

[charlie]

Oh yes, forgot to mention I do think its adrenaline. So I am really leaning towards the RT3 then.

I think I will try and order some T3 tomorrow and go with straight T3 for a few weeks and see what happens. Stinks that I have to wait at least a couple weeks till it is delivered though.

 

[j.]

Were you having palpitations before supplementing with thyroid? If so, as narouz said, maybe taking a different brand will fix it.

 

[charlie]

No, this started after supplementing thyroid.

 

[narouz]

Oh yes, forgot to mention I do think its adrenaline. So I am really leaning towards the RT3 then.

I think I will try and order some T3 tomorrow and go with straight T3 for a few weeks and see what happens. Stinks that I have to wait at least a couple weeks till it is delivered though.

My last round of lab tests,
my doctor said my rt3 was high
which meant to him I was taking too much thyroid supp.
No weird heart-beating for me, though.

It is very interesting to me that the HHP
is Not associated with elevated Pulse or elevated Blood Pressure.
That is a nice data point.
One wonders what could make heart pound hard
if it is not high blood Pressure or high Pulse.

Is the HHP characterized by irregular beating, Charlie?

Another angle:
Because, so far, you haven't found a way to Measure the phenomenon,
maybe:
your heartbeat is normal,
but your emotions/perceptions are abnormal?
In other words,
maybe you have episodes where your normal bodily sensations
appear/seem/are perceived as magnified.
In other other words:
maybe your functions are normal,
but your perceptions are intermittently magnified.

Would you say the HHP is associated with anxiety?
Can you say which comes first, which my be the cause and which the effect?
Does the anxiety precede the pounding,
or does the pounding make you anxious?

 

[charlie]

Narouz I am heading to slumberville and will answer tomorrow.

Let the HHP commence.

 

[narouz]

Narouz I am heading to slumberville and will answer tomorrow.

Let the HHP commence.

I hope not.

The thing about the T3 approach for your HHP:
-Peat said that approach made his heart STOP briefly every six seconds
(or something like that)
-I wouldn't think that too much T4 would make your heart pound hard;
the typical thought on too much T4 is that is inert;
some--and Peat notes this but doesn't embrace it--think too much T4
may slow the metabolism--
seems like that's the opposite kind of direction from HHP.

Sleep peacefully and with a softly beating heart!

 

[j.]

when i had palpitations, the rhythm was sometimes regular, sometimes irregular. but i didn't have anxiety. it was more annoying than anything. i didn't go to the ER or anything like that.

 

[Ray-Z]

The thing about the T3 approach for your HHP:
-Peat said that approach made his heart STOP briefly every six seconds
(or something like that)

Sounds potentially important to me, although I'm not sure about the relationship between arhythmia and Charlie's pounding heart.

-I wouldn't think that too much T4 would make your heart pound hard;
the typical thought on too much T4 is that is inert;
some--and Peat notes this but doesn't embrace it--think too much T4
may slow the metabolism--
seems like that's the opposite kind of direction from HHP.

I respectfully dissent from the assertion -- also made elsewhere in this forum -- that Ray Peat doesn't think excess T4 can slow the metabolism. Peat's article, "Thyroid: Therapies, Confusion, and Fraud" (http://raypeat.com/articles/articles/thyroid.shtml), includes the following passage.

The serum's high ratio of T4 to T3 is a pitifully poor argument to justify the use of thyroxine instead of a product that resembles the proportion of these substances secreted by a healthy thyroid gland, or maintained inside cells. About 30 years ago, when many people still thought of thyroxine as "the thryoid hormone," someone was making the argument that "the thyroid hormone" must work exclusively as an activator of genes, since most of the organ slices he tested didn't increase their oxygen consumption when it was added. In fact, the addition of thyroxine to brain slices suppressed their respiration by 6% during the experiment. Since most T3 is produced from T4 in the liver, not in the brain, I think that experiment had great significance, despite the ignorant interpretation of the author. An excess of thyroxine [i.e. T4], in a tissue that doesn't convert it rapidly to T3, has an antithyroid action. (See Goumaz, et al, 1987.) This happens in many women who are given thyroxine; as their dose is increased, their symptoms get worse.

I have experienced the anti-metabolic effect of excess T4 Peat describes. The effect can occur not only in people taking pure T4 but also in some people taking NDT whose livers cannot convert T4 to T3 at an adequate pace. After taking a dose of NDT, I typically experienced a momentary uptick in metabolism from the T3 in NDT and then got slammed by the excess T4, experiencing fatigue, difficulty breathing, hyperventilation, freezing extremities, and so forth. And as I increased my dose of NDT, these hypothyroid symptoms worsened.

I'm not commenting on the rest of the paragraph I quoted from you, Narouz. I am just criticizing the claim about Peat's views.

Edited for clarity.

 

[narouz]

The thing about the T3 approach for your HHP:
-Peat said that approach made his heart STOP briefly every six seconds
(or something like that)

Sounds potentially important to me, although I'm not sure about the relationship between arhythmia and Charlie's pounding heart.

-I wouldn't think that too much T4 would make your heart pound hard;
the typical thought on too much T4 is that is inert;
some--and Peat notes this but doesn't embrace it--think too much T4
may slow the metabolism--
seems like that's the opposite kind of direction from HHP.

I respectfully dissent from the assertion -- also made elsewhere in this forum -- that Ray Peat doesn't think excess T4 can slow the metabolism. Peat's article, "Thyroid: Therapies, Confusion, and Fraud" (http://raypeat.com/articles/articles/thyroid.shtml), includes the following passage.

The serum's high ratio of T4 to T3 is a pitifully poor argument to justify the use of thyroxine instead of a product that resembles the proportion of these substances secreted by a healthy thyroid gland, or maintained inside cells. About 30 years ago, when many people still thought of thyroxine as "the thryoid hormone," someone was making the argument that "the thyroid hormone" must work exclusively as an activator of genes, since most of the organ slices he tested didn't increase their oxygen consumption when it was added. In fact, the addition of thyroxine to brain slices suppressed their respiration by 6% during the experiment. Since most T3 is produced from T4 in the liver, not in the brain, I think that experiment had great significance, despite the ignorant interpretation of the author. An excess of thyroxine [i.e. T4], in a tissue that doesn't convert it rapidly to T3, has an antithyroid action. (See Goumaz, et al, 1987.) This happens in many women who are given thyroxine; as their dose is increased, their symptoms get worse.

I have experienced the anti-metabolic effect of excess T4 Peat describes. The effect can occur not only in people taking pure T4 but also in some people taking NDT whose livers cannot convert T4 to T3 at an adequate pace. After taking a dose of NDT, I typically experienced a momentary uptick in metabolism from the T3 in NDT and then got slammed by the excess T4, experiencing fatigue, difficulty breathing, hyperventilation, freezing extremities, and so forth. And as I increased my dose of NDT, these hypothyroid symptoms worsened.

I'm not commenting on the rest of the paragraph I quoted from you, Narouz. I am just criticizing the claim about Peat's views.

Edited for clarity.

Thanks, Ray-Z.

I've seen the quote before,
but I had in mind another quote--have to dig it up--
where Peat says something like:
"Most people do well on a combination T4/T3 supplement (NDT or synthetic combo),
but some people feel better when the proportion more closely resembles the human 3:1."
Isn't that approximately right?

As I said above, Peat does not seem to recommend pure T3.
Well--he said he had a bad reaction to it personally.

I guess I mangled it,
but I didn't mean to suggest that Peat recommended T4 only therapy.
I agree that he would say that that would likely lead to anti-metabolic effects.

What I meant to express was that Peat seems to think combo T4/T3 works well for most--yes?
Whereas he has reservations about T3-only therapy.
And definitely thinks T4-only is a loser.

Now, back to Charlie's situation with the HHP.
He's been using a NDT, combo T4/T3.
I would think that Peat might think that Charlie might well experiment
with increasing his T3 proportion,
although I doubt Peat would see that as a remedy to Charlie's HHP.
And--now I could be wrong!--I wouldn't think that Peat would think
that Charlie should be doing a straight T3--would you?
He might not be flat-out against it, but...I don't think it would be his recommendation,
in the context of Charlie's HHP.

Here's why:
Charlie's HHP symptoms would seem to me to point toward possible intermittent metabolic excess,
not metabolic sluggishness.
And it is metabolic sluggishness that will often occur with (straight) T4 therapy,
or possibly, in some, with a combo supplement too high in T4.
So I'm skeptical of a hypothesis that Charlie's HHP is caused by too much T4.

Sorry if my expressions were sluggish.
I'm a bit sleep deprived and travel-weary.

 

[narouz]

Ya know,
now that I think about it,
the reasoning in my last post might be mistaken.

Just because Charlie's heart is beating hard
(or he perceives it that way),
shouldn't lead me to conclude, necessarily,
that that points to metabolic excess.

When I used to have these hardcore sweating attacks--
quite embarrassing in a formal work environment
with a soaked shirt front :? --
I assumed until fairly recently
that it was due to too much thyroid supplement.
You know...because sweating came across to me as metabolic excess.

But now, from experience with higher supplement dosages,
I believe my sweating bursts were caused by too little supplement.
And a little bit of anxiety/panic colored those bursts, too.

So...hmmm....
Maybe Charlie's HHP could be caused by thyroid hormone insufficiency,
and...
that could possibly be caused by too much proportion of T4 in his combo NDT supplement.

Peat never communicated that possible wrinkle to you, did he Charlie?

So Ray-Z...are you a T3 nibbler?

 

[Ray-Z]

I've seen the quote before,
but I had in mind another quote--have to dig it up--
where Peat says something like:
"Most people do well on a combination T4/T3 supplement (NDT or synthetic combo),
but some people feel better when the proportion more closely resembles the human 3:1."
Isn't that approximately right?

As I said above, Peat does not seem to recommend pure T3.
Well--he said he had a bad reaction to it personally.

I guess I mangled it,
but I didn't mean to suggest that Peat recommended T4 only therapy.
I agree that he would say that that would likely lead to anti-metabolic effects.

What I meant to express was that Peat seems to think combo T4/T3 works well for most--yes?
Whereas he has reservations about T3-only therapy.
And definitely thinks T4-only is a loser.

Now, back to Charlie's situation with the HHP.
He's been using a NDT, combo T4/T3.
I would think that Peat might think that Charlie might well experiment
with increasing his T3 proportion,
although I doubt Peat would see that as a remedy to Charlie's HHP.
And--now I could be wrong!--I wouldn't think that Peat would think
that Charlie should be doing a straight T3--would you?
He might not be flat-out against it, but...I don't think it would be his recommendation,
in the context of Charlie's HHP.

I think we're mostly in agreement.

The essential point of my post was that Ray Peat thinks that excess T4 -- meaning T4 hanging around tissues that cannot readily convert it to T3 -- is antimetabolic. This statement is a statement about excess T4, and not about T4-only supplements per se. Excess T4 could come from a T4-only supplement or from NDT. If the liver cannot convert T4 to T3, either of these two types of supplements could cause excess T4.

Hopefully we agree about the above statements.

With that background in mind, it's clear, as you say, that a T4-only regimen is not such a hot idea. (Deplorable pun intended.) For the reasons above, it also seems clear that NDT alone might not be desirable for some people, because if the liver converts sufficiently little T4 to T3, some of the T4 in NDT is suppressing rather than aiding metabolism.

As you correctly point out, it does not follow from this line of reasoning that someone who can't handle the amount of T4 in NDT must use T3 alone. (In Danny Roddy's collection of emails from Ray Peat, Peat points out some practical disadvantages of using T3 alone, including that troubling observation about heart stoppage.) Such a person could get synthetic T3 and T4 (or T3 and a T3/T4 combo) and gradually increase the ratio of T3 to T4 until symptoms are relieved, perhaps at a ratio significantly higher than the T3/T4 ratio for NDT.

I haven't seen Peat recommend a T3-only regimen, except to test someone's response to thyroid. I've only seen him recommend regimens containing both T3 and T4. (At the moment, I don't use any supplement containing T4 except sometimes for a little NDT before exercise, but I'm not claiming Peat has endorsed my approach.)