Tachycardia In Pregnancy/Supplements

[Emunagal]

15 week pregnant (#3) and experiencing moderate tachycardia of general resting heart rates between 110-120 bpm.

I've been following general Peat advice for years, since discovering that I have low progesterone when I had extreme hormone swings and problems breastfeeding #1.

Last bloodwork at 9 weeks: estrogen E2 3242, progesterone 86.6. TSH has been measured twice, at 5 weeks and 9 weeks approx: 3.44 and 3.15. (a little high, usually it's in the 2-3 range, if I take more thyroid to get it below 2, I also get tachycardia).
The rest is from 5 weeks: Ft4 was 12.9 (didn't measure T3 for some reason), CBC was normal, B12 was 393, K+ Potassium was 3.8, Na Sodium was 136.

I am on a lot of supplements:

Progest-E - rubbed on chest or lower abdomen, 4 drops in the morning, sometimes I add in 4 drops in the evening
T3 and T4 - although I have been taking less since I am running out of my Cytomel and have no replacement! I can't take any form of natural thyroid grains.
B50 complex - most days, plus 2-3mg of folic acid, taken at a different time, sometimes I add in 50-100mg of B6, taken at yet a different time
Magnesium - 750mg a day, taken in 250mg tabs taken about 2 hrs apart in the evening. Depending on what brand I have available (I am international at present) sometimes I take calcium separately, and sometimes the calcium is with the magnesium. I have problems with constipation and "overactive uterus" (too many, too painful Braxton Hicks that thin the cervix too early, starting already now) and mild fibromyalgia - the magnesium helps with all.
Vitamin E - 400mg
Zinc - 30mg just before bed
Thorne Vit D/K - 8 drops (4,000mg of Vit D plus the K), Vit D was only 15 at 5 weeks!!! I used to take 1,000-2,000mg nursing, obviously not enough.
Vit A 5,000IU and 1 drop Iodine, both on the neck, morning and night
TONS of salt

General diet: I eat lots of dairy, mostly in the form of yogurt and cottage cheese but I try to add in a few cups of milk as well. I struggle to get enough protein, especially since the pregnancy nausea makes me want to eat none of the meat sources! I manage to force feed myself a few organic eggs most days. I can't stand liver and as a rule don't eat shellfish in any form. If I get in anything else, it's almost always chicken or deli turkey slices, none of which is preferable but my aversion to food is pretty severe, even at this stage when it's "supposed" to be better.

I would love general advice as to what I am doing and what I can improve, and specifically any advice regarding the tachycardia.

 

[Emunagal]

I spoke with my midwife, who believes I might be anemic, thus causing the tachycardia. Indeed in previous pregnancies my hemoglobin levels dropped right about this time, and I am quite pale and exhausted. Going to do bloodwork, but expecting mildly anemic results.

I also just read Peat's article about iron, and most anemia being caused by low thyroid and excess estrogen, as opposed to low iron. I did take iron in previous pregnancies and had babies with serious jaundice issues - I have no desire to repeat that again!

So it seems the biggest question right now is: how to reduce the estrogen and increase thyroid, so as to help the anemia and tachycardia without iron???

Taking more T3/T4 and increasing the dosage of Progest-E (in either case, taking an extra dose during the day) have both caused tachycardia themselves (sudden racing heart within an hour or so of taking the extra dose), so I am nervous to increase either to help the anemia.

Also, as I noted, I am at a complete loss as to how to continue supplementing T3 once my last bottle of Cynomel runs out. I don't want to take T4 alone, and I can't take any form of natural desiccated thyroid. I am quite afraid that dropping the thyroid supplementation altogether will make my current problems even worse.

 

[InChristAlone]

I have a lot of experience with tachy, and I notice no mention of blood sugar, for me adrenaline symptoms seem to correlate with low blood sugar. Pregnancy uses up so much sugar!! Do you know how many carbs you eat a day? Maybe try tracking a few days to notice any trends in Cronometer?

When I was pregnant and didn't know anything about estrogen, I found all on my own that chewing sugary gum would quell some of the nausea and anxious feelings I would get. I know Peat mentions salty crackers. I imagine just balancing sugar blood sugar with small frequent meals would do similarly.

For liver I suggest dessicated liver pills, its better than no liver. Or try liverwurst which generally tastes much better than plain liver.

 

[Emunagal]

Fasting glucose was 88. I didn't consider the sugar correlation at all! I'll have to track that. I used to have extreme symptoms of hypoglycemia, especially in pregnancy, before I discovered Peating, but with the addition of lots of salt to my diet and other dietary changes, it's basically gone away. I'm not craving fruit in general, and I do get sugar during the day, mostly from the yogurt and the sugar I add to my nettle herbal iced tea I drink through the day. Carbs really depends on the day - generally I eat very low-carb, but sometimes I can't get much down besides bread or pasta, and generally those are whole grain.

 

[InChristAlone]

Is your pulse always 115? Do you notice it higher between meals? At night? In the morning? If you are eating very low carb your adrenaline might be very high. Like I said carbs for me were essential when I was experiencing tachy.

 

[Emunagal]

I notice it more at night. Pulse is more like 110 in daytime and 120 at night. But last night for instance, I ate a ton of pita for dinner, and it made absolutely no difference. And that was even white flour!

I do have a general problem, made worse in pregnancy, with my am cortisol peak waking me up too early, and then I can't fall back asleep. Outside of pregnancy the sugar in a yogurt or some milk with sugar does the trick to help me fall back asleep, but in pregnancy, it hasn't worked.

Maybe I'll test out having some fruit, or even better some dates, and see if that makes any impact. I will report back.

 

[tara]

generally I eat very low-carb,

That might be a key part of the trouble - could contribute to low thyroid and to nausea. I don't know much about tachycardia, but inadequate carbs tend to keep stress hormones high - maybe that plays into heart-rate as well?
When I was pregnant, I needed carby midnight snack and snack before I got out of bed in the morning if I wanted to minimise nausea. As well as lots of carbs through the day.

How's your breathing - relaxed, nasal, diaphragmatic?

 

[Emunagal]

I really doubt that the carbs are the issue. I find that I gain weight when I eat a lot of carbs, especially wheat (I do much better with spelt and oat) but I don't specifically restrict them, I just try to make sure they are properly balanced with meat and vegetables, and as much fruit as I want. Trying to get in 100g of protein a day is difficult and filling enough! Eat more carbs, and there is no room for the protein. Most days I still don't even get close to the protein goal.

In any case, I don't know if I should expect somewhat immediate results, but having extra carbs last night made absolutely no difference in heartrate. I just ended up being too full to have the eggs I need for protein. I had lots of carbs the day before as well, and this morning, and my heartrate is still 116. Almost 3 days is good enough for me to be convinced this is not the issue.

I am a singer, so I always breathe through my diaphragm instinctively, generally with my mouth shut. My breathing isn't labored or difficult, and mostly I don't notice my heart pounding, sometimes I get palpitations but with some extra B vitamins I haven't had that in days. My heart is just always racing.

 

[InChristAlone]

So you think carbs have no effect on heart rate? I do know someone who needed beta blockers to lower heart rate but hers was always like 140 or above, maybe you are just a bit hypermetabolic pregnant. But if thats the case more carbs would not lead to rapid weight gain and you'd probably be having trouble gaining weight. I'm not sure. If raising thyroid causes more heart racing I think you should eat to increase thyroid instead as there is probably a reason your thyroid is downregulated. How many calories a day?

 

[tara]

Getting enough protein while pregnant is also important. Milk, cheese and eggs seem like good sources.

I'm a bit confused - you say you have been eating a mostly low carb diet, and that you don't restrict carbs and do eat fruit to appetite. Does that mean you have a very low appetite, and that is why you eat low carb? How much are you eating? At least 2500 cal/day?
You know most women who have healthy pregnancies gain weight while pregnant - if you are trying to limit that, you could be doing real harm.
I see you say tons of salt. Are you salting and drinking to taste and thirst?

Not sure if any of this is relevant for you, but have you read Peat's article on eclampsia?
Peat has also talked about Tom Brewer as having some good ideas about pregnancy nutrition, though he probably wouldn't consider Brewer's inclusion of soy, beans and whole grains and PUFA as optimal choices.
I came across these:
The Diet
The No-Risk Pregnancy Diet

 

[Emunagal]

I am definitely not trying to diet or limit my weight gain. However, partially I think due to nausea and partially due to the fact that I just weaned #2, I'm generally not terribly hungry. I eat small, frequent meals through the day, and then generally am hungry for a more substantial meal in the evening, and then a before bed snack. I'm also very small - only five feet, and I generally don't have such an amazing metabolism even with taking thyroid, so I don't need a ton of food. I find that I am generally much hungrier nursing full time than I am pregnant. Also, the fact that my TSH has been above 3 so far during this pregnancy and I can't seem to get it down is also not helping the metabolism/hunger thing. I have no idea about calories, I gave up calorie counting at least a decade ago. I eat healthy, I eat real foods, I eat what I want, and I stop when I'm full. In any case, my weight gain so far has been a little more than I would like to see at this stage, mostly because I have been eating less healthy just to get myself to eat something.

I don't adhere to any low carb diet, rules or restrictions - I think the problem may be in defining "low carb." I live in international, I don't involve myself in any of these crazy diets and Paleo basically doesn't exist here. Compared to most of the people I know eating tons of bread, pasta, etc. I eat very low carb. I'll have a sandwich with bread, but I prefer an egg salad with raw carrots if I can't find spelt bread, which is pretty often. As I said, since I try to avoid wheat whenever possible since it doesn't agree with me, and there isn't so much spelt available in so many forms where I am, I end up eating pretty low carb, but I am not AVOIDING carbs per say - for instance, yogurt has plenty of sugar and carbs in it, and I eat tons of yogurt a day! And yes, since I don't have such a crazy appetite, getting in the protein is hard enough, so I don't want to fill up on a bowl of whole wheat pasta when I need to fit in protein. Generally I only eat heavy carb meals when I am so nauseas nothing else will go down, or I am particularly craving something (like tonight all I wanted was pasta with cream sauce, so OK - and by the way, my bpm went way UP after that meal!).

Yes, salting to taste and drinking to thirst. Somehow I need so much salt that even when I add it in significant quantities, I still don't taste it, and almost no matter how much I add to cooked foods, I still need to add it to the final product. And if I have even a small amount of sugar without some salt at the same time, suddenly I'm in the bathroom like crazy and everything I drank goes right out the other end. And my blood sodium levels are on the lowest side of normal (136 is the bottom of the spectrum), and my blood pressure is always on the low side! But it's fixed my headaches for the most part, and the dizziness, lightheaded, fainting, shaking and other hypoglycemic symptoms I used to have. I drink 3-4 liters of combined water, milk, OJ, etc. a day. Even more, my midwife said the fact that I always carry the top percentile of amniotic fluid and the extreme Braxton Hicks, and others like a very dry tongue (she's an herbalist too, gonna have to believe her on that one) are signs of dehydration, even though I drink an incredible amount.

I have no idea if carbs help or don't help other people or in general, but this doesn't seem to be helping me in the least. I need help figuring out how to get my thyroid up, the anemia better, and the estrogen down, which seems to me to be more protein, not less. These last few days I've been eating more carbs my total protein count is crazy low, maybe I've been getting in 50g a day. Maybe. And most of that is from the cottage cheese alone. By the time I am done with a bowl or two of pasta, forget about anything else.

 

[tara]

If you have been nursing up till recently, it makes sense that you would have needed more food to support that.

Peat has also talked about Tom Brewer as having some good ideas about pregnancy nutrition,

Tom Brewer was focused on avoiding severe pregnancy dangers such as eclampsia and toxemia that are more likely to arise when mothers are malnourished.
I'd recommend taking a look at those pages.

Hard to know without firmer numbers, so I may be wrong, but it looks as though your lowish appetite may be leading you to undereating. I agree with you about it being important to get protein too.

 

[InChristAlone]

In general when we talk about carbs around here it's mainly fruit, sugar, potatoes, masa harina, and some people seem to do okay with rice or sourdough. I'm curious why adding a small amount of sugar would cause you to urinate?

Yes after a big starchy meal heart rate can go up. My heart rate was in response to anxiety attacks mostly and in your case it seems to be a more systemic issue. Maybe the liver would really help.

 

[peatra]

15 week pregnant (#3) and experiencing moderate tachycardia of general resting heart rates between 110-120 bpm.

I've been following general Peat advice for years, since discovering that I have low progesterone when I had extreme hormone swings and problems breastfeeding #1.

Last bloodwork at 9 weeks: estrogen E2 3242, progesterone 86.6. TSH has been measured twice, at 5 weeks and 9 weeks approx: 3.44 and 3.15. (a little high, usually it's in the 2-3 range, if I take more thyroid to get it below 2, I also get tachycardia).
The rest is from 5 weeks: Ft4 was 12.9 (didn't measure T3 for some reason), CBC was normal, B12 was 393, K+ Potassium was 3.8, Na Sodium was 136.

I am on a lot of supplements:

Progest-E - rubbed on chest or lower abdomen, 4 drops in the morning, sometimes I add in 4 drops in the evening
T3 and T4 - although I have been taking less since I am running out of my Cytomel and have no replacement! I can't take any form of natural thyroid grains.
B50 complex - most days, plus 2-3mg of folic acid, taken at a different time, sometimes I add in 50-100mg of B6, taken at yet a different time
Magnesium - 750mg a day, taken in 250mg tabs taken about 2 hrs apart in the evening. Depending on what brand I have available (I am international at present) sometimes I take calcium separately, and sometimes the calcium is with the magnesium. I have problems with constipation and "overactive uterus" (too many, too painful Braxton Hicks that thin the cervix too early, starting already now) and mild fibromyalgia - the magnesium helps with all.
Vitamin E - 400mg
Zinc - 30mg just before bed
Thorne Vit D/K - 8 drops (4,000mg of Vit D plus the K), Vit D was only 15 at 5 weeks!!! I used to take 1,000-2,000mg nursing, obviously not enough.
Vit A 5,000IU and 1 drop Iodine, both on the neck, morning and night
TONS of salt

General diet: I eat lots of dairy, mostly in the form of yogurt and cottage cheese but I try to add in a few cups of milk as well. I struggle to get enough protein, especially since the pregnancy nausea makes me want to eat none of the meat sources! I manage to force feed myself a few organic eggs most days. I can't stand liver and as a rule don't eat shellfish in any form. If I get in anything else, it's almost always chicken or deli turkey slices, none of which is preferable but my aversion to food is pretty severe, even at this stage when it's "supposed" to be better.

I would love general advice as to what I am doing and what I can improve, and specifically any advice regarding the tachycardia.

Not sure if you are still here but I'm curious as to how things went for you. I had a TSH over 3 and miscarried. I'm treating that right now. I am mostly curious about your vitamin A intake. Was it animal-product-based vitamin A or beta carotene? I have benefitted a lot from animal product based vitamin A (as Peat recommends) in the past, but my understanding is that high doses of it during pregnancy can cause neural tube defects. I would love to find the appropriate balance so I don't get too little, though. Beta carotene isn't nearly as good!

 

[Emunagal]

Happy to update! Nothing really helped the tachycardia - it eventually got better but I don't have a specific solution as to "why." I did avoid simple starches and loaded up on potatoes and protein, and increased progesterone, and it did balance.

Vitamin A - I don't get much from animal sources. I use Nutrisorb A, also recommended by Peat. It's retinol palmitate, NOT beta carotene (which is never recommended). Peat has a whole explanation about how much Vit A to take a day - 5000IU is fine for someone with hypothyroid, cold climate, not a lot of outdoor exposure (Vit A breaks down in the sun). The hotter the climate/season, the stronger the thyroid, the more time spent outdoors - the more you need. Generally I aim for about 1000-1500IU a day in pregnancy. Also Peat notes to always take it with Vitamin E!

Also to my knowledge you do NOT need to worry about the birth defects with the Nutrisorb A, dosed appropriately, applied on the skin. All that scary research is for synthetic Retinol-A and other acne medications using a totally different, synthetic form of Vitamin A that is swallowed in pill form - not retinol palmitate. As we see many times, Big Pharma LOVES researching a synthetic version of something and then applying that across the board to the natural forms too in order to keep people away from what will heal them eg progestins (really acts like estrogen) versus progesterone.

 

[PeatInspired]

Happy to update! Nothing really helped the tachycardia - it eventually got better but I don't have a specific solution as to "why." I did avoid simple starches and loaded up on potatoes and protein, and increased progesterone, and it did balance.

Vitamin A - I don't get much from animal sources. I use Nutrisorb A, also recommended by Peat. It's retinol palmitate, NOT beta carotene (which is never recommended). Peat has a whole explanation about how much Vit A to take a day - 5000IU is fine for someone with hypothyroid, cold climate, not a lot of outdoor exposure (Vit A breaks down in the sun). The hotter the climate/season, the stronger the thyroid, the more time spent outdoors - the more you need. Generally I aim for about 1000-1500IU a day in pregnancy. Also Peat notes to always take it with Vitamin E!

Also to my knowledge you do NOT need to worry about the birth defects with the Nutrisorb A, dosed appropriately, applied on the skin. All that scary research is for synthetic Retinol-A and other acne medications using a totally different, synthetic form of Vitamin A that is swallowed in pill form - not retinol palmitate. As we see many times, Big Pharma LOVES researching a synthetic version of something and then applying that across the board to the natural forms too in order to keep people away from what will heal them eg progestins (really acts like estrogen) versus progesterone.

THANK YOU! I have been trying to find this information because I know that Ray Peat says it's ok to take vit A during pregnancy! But I couldn't figure out whyyyy.

BTW how did the rest of your pregnancy/delivery go?

 

[Emunagal]

IMPORTANT: I accidentally left out some zeros in the comment above. I took 10,000 - 15,000 IU a day in pregnancy. Have done so with all 3 pregnancies.

Overall everything was OK. Pregnancy is very difficult for me, as is nursing, and the Progest-E helps a lot but there is only so much to do. But beautiful baby girl thank G-d, and she is definitely worth it!

I will say that the Progest-E overall is a lifesaver. It helps me with preterm contractions (minimize them), helps with postpartum fluid retention and engorgement, and helps to ward off the intermittent bleeding problems I have with nursing before I start cycling again. Not only does it not affect my milk supply, if I don't take enough, my supply tanks! Right now I am taking 3 drops 4 times a day which is just enough to keep up supply and ward off the breakthrough bleeding. I just wish I could figure out how to get out all the estrogen in my cells from all the things I did wrong before I found Peat. It's been 5 years and I would have thought I would not still have such estrogen problems still, but I do.