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July 12, 2023 8 min read

They say an ounce of prevention is worth a pound of cure. As with many health matters, this is particularly true when dealing with thyroid disorders. Hypothyroidism, a common condition where the thyroid gland does not produce enough thyroid hormone, can create a symphony of symptoms difficult to ignore. Fatigue, weight gain, and depression are the notes most frequently heard. Yet, when the rhythm of your heart enters the composition, it's time to pay serious attention. One question often arises, "Can Levothyroxine, a medication prescribed for hypothyroidism, affect your heart?" In this article, we'll discuss whether there indeed is a connection between levothyroxine and irregular heart rhythm.

How does levothyroxine work?

Levothyroxine, a synthesized form of the hormone thyroxine (T4), is often the first name recommended for controlling hypothyroidism (underactive thyroid), a thyroid disease where your body doesn't have enough thyroid hormone. The medication is also used to treat other thyroid conditions, such as thyroid cancer. It's a synthetic acting double for the thyroid hormone your body can't produce enough of, stepping in to restore order on the hormonal stage.

The basis of its operation is its ability to replicate what the thyroid hormone does naturally. Thyroid hormones regulate our metabolism, the process of converting what you eat and drink into energy. When you're dealing with hypothyroidism, your metabolism slows down, but levothyroxine's intervention, it speeds things back up, allowing your body to have a "normal" thyroid function. A well-paced metabolism is key to maintaining energy levels, managing weight, and maintaining overall physical health.

Is there a connection between the thyroid gland and the heart?

The thyroid gland and the heart share a web of intricate connections. They're like musicians in an orchestra playing several pieces together. The thyroid gland produces thyroid hormones that regulate your metabolism. These hormones then indirectly influence your heart rate and the efficiency of your heartbeat. They ensure the heart pumps an adequate amount of blood with each beat to meet your body's needs.

When things go awry with the thyroid gland, the heart rhythm can be affected. For example, hypothyroidism may result in a decreased heart rate and deteriorate the heart muscle, thereby limiting the heart's ability to pump blood efficiently. At the same time, the rigidity of blood vessel walls could increase. When these changes coexist, they create a perfect storm for hypertension, more commonly known as high blood pressure. On the contrary, excess thyroid hormone - either due to over-replacement or high dosage - could lead to hyperthyroidism, which might cause your heart to beat faster. One potential consequence of this effect is heart palpitations, and in more severe cases, it could lead to increased blood pressure or even heart failure if left unchecked.

Why do I experience irregular heartbeat with levothyroxine?

If you're dealing with hypothyroidism, levothyroxine should help regulate your thyroid hormone levels, which, in turn, should make you feel better. However, you might notice an irregular heartbeat while on this medication. This could be due to a few possible reasons.

1. Dosage adjustment needed

An irregular heartbeat can occur if you are taking too much levothyroxine, which can tip your metabolism into overdrive, mirroring the symptoms of an overactive thyroid gland.

Having too much thyroid hormone in your body can't potentially lead to the following:

The atrial fibrillation factor

Atrial Fibrillation (AF) is a specific type of irregular heartbeat characterized by a quivering or irregular heartbeat that can lead to blood clots, stroke, heart failure, and other complications. It's like your heart is dancing to a rhythm of its own, unable to keep up with the steady beat it's supposed to maintain.

In the context of levothyroxine, some studies show a small association between long-term treatment and an increased risk of Atrial Fibrillation. This risk appears higher in elderly patients, whose bodies might be more sensitive to excessive thyroid hormone levels. Here, the excess thyroid hormones may overly stimulate the heart, leading it to beat irregularly, which can manifest as AF. However, despite these studies, the scientific consensus is far from conclusive.

It's important to note that these potential risks are associated with 'overtreatment,' where too much thyroid hormone is administered, tipping the metabolic scales into hyperactivity. Excessive thyroid hormone can overstimulate your heart, potentially increasing your heart rate (tachycardia), causing palpitations, or contributing to an irregular rhythm.

Alterations in the structure and function of the heart

In the long term, excessive thyroid hormone can cause changes in the heart's structure and function, such as thickening of the muscle (hypertrophy), stretching of the heart chambers (dilation), and an increase in cardiac contraction and relaxation rates. This can increase the vulnerability of the heart to irregular rhythms, such as atrial fibrillation.

Excessive stimulation of the heart muscle

Thyroid hormones can enhance the sensitivity of the heart to adrenaline and norepinephrine (the body's 'fight or flight' hormones). These hormones increase heart rate and contractility to prepare the body for activity. When thyroid hormone levels are too high, the heart's response to these hormones is amplified, which can lead to increases in heart rate and irregularities in heart rhythm.

Electrolyte disturbances

Thyroid hormones negatively influence the electrolyte balance in your body. Electrolytes, such as potassium and calcium, are critical for the conduction of electrical signals in the heart that regulate heartbeat. Their irregularities due to thyroid hormone disturbance can cause irregular heart rhythms.

2. Impaired T4 to T3 conversion

The conversion of thyroxine (T4) to triiodothyronine (T3) is a critical process in the body's use of thyroid hormones. T4 is considered a prohormone as it is not as active as T3. T3 is the more potent and biologically active thyroid hormone. In other words, T3 plays the starring role when it comes to thyroid hormone activity in the body; T4, on the other hand, is largely a supporting actor endorsing T3.

Under normal conditions, when your body needs more thyroid hormone activity, it converts T4 into T3. However, in some situations, this conversion process can be impaired, leading to a higher level of T4 circulating in the body relative to T3. This condition is often referred to as 'impaired T4 to T3 conversion.' This impairment can occur due to various factors, including certain medications, nutritional deficiencies, and liver and kidney diseases.

Impaired T4 to T3 conversion can potentially contribute to an irregular heartbeat. Here's why: taking levothyroxine primarily raises T4 levels in the blood. If the body is unable to adequately convert this extra T4 into T3, it may instead convert T4 to Reverse T3 (RT3), an inactive form of thyroid hormone that does not contribute to thyroid hormone activity.

This could effectively increase the level of thyroid hormones in the body (T4) without proportionally increasing thyroid hormone activity (T3). In other words, the heart is now dealing with an excess of prohormone that it can't efficiently use due to the conversion issue, potentially leading to cardiac instability. The enhanced circulation of unconverted T4 might lead to an increase in the heart rate or irregular heartbeat.

However, it's important to remember that impaired T4 to T3 conversion as a cause for arrhythmias in patients taking levothyroxine is not straightforward and depends on many factors, including individual patient physiology.

As with any medical condition, it's crucial to regularly connect with your healthcare provider to monitor the situation, adjust the medication as needed, and discuss the best course of treatment. Always remember the old saying: knowledge is power - the more you know about your body and the way it responds, the better equipped you are to maintain your health.

What you can do to combat irregular heartbeat while taking levothyroxine

Why do I experience irregular heartbeat with levothyroxine?

While the scenarios mentioned above outline the potential causes, it's vital to remember that their occurrence is the exception rather than the rule. The vast majority of patients taking levothyroxine do not experience arrhythmias, especially when treatment is carefully monitored and adjusted to fit each individual's needs. But if you're still wrestling with this condition, what are your options? Here are some steps you can take to alleviate the situation.

Routine health check-ups

Routine blood tests to monitor your thyroid-stimulating hormone (TSH) and T4 levels offer invaluable information to your physician for adjusting levothyroxine dosage. If they find out that your thyroid hormone levels are too high, they might lower your dose. If these tests reveal that your thyroid hormone levels are in excess, a dosage reduction might be in order. Furthermore, if the tests show a slight increase in your TSH levels indicative of subclinical hypothyroidism, it could lead to a decision to halt your medication entirely.

Regular EKG screenings can also help detect any abnormal heart rhythms, aiding in early detection and treatment of potential complications.

Taking the Correct Dosage

It's vital to adhere to the dosage recommended by your healthcare provider. Some individuals might be inclined to increase their levothyroxine intake in the belief that it can stimulate weight loss. However, it's crucial to remember that levothyroxine is not intended to serve as a diet aid but as a medicine to manage hypothyroidism. Overuse can lead to health complications, so always follow your prescribed dosage. Overdosing can push your metabolism into overdrive and mimic symptoms of an overactive thyroid gland. This can, in turn, lead to heart problems like palpitations and high blood pressure.

Healthy living matters

Embracing a healthful lifestyle can augment the efficacy of your treatment. Regular physical activity, balanced nutrition, and good sleep habits can work wonders. It's equally essential to pace your physical activities and manage stress, as both can trigger conditions like chest pain and arrhythmias.

Managing coexisting conditions

If you have other health conditions like diabetes or liver disease, diligent management is crucial. A healthier overall body function can significantly improve its response to thyroid treatment.

Limit Caffeine Intake

Caffeine, being a stimulant, can exacerbate symptoms of an overactive thyroid gland, including heart palpitations and high blood pressure. Consider limiting or avoiding foods and drinks with high caffeine levels.

Switch to Natural Desiccated Thyroid (NDT)

If you find the side effects of levothyroxine too hard to manage, or you're not achieving the desired results, it might be worth discussing with your doctor the possibility of switching toNatural Desiccated Thyroid (NDT). NDT is a natural alternative to synthetic thyroid medication sourced from the thyroid glands of animals. It's said to have a mix of both T4 and the more active T3 hormone, potentially offering a closer match to the hormones your body naturally produces. Some patients report better symptom control and fewer side effects on NDT.

There's a variety of NDT brands available, each with its unique formulation. In the U.S., Armour Thyroid and NP Thyroid are among the most widely recognized NDT brands. Yet, the Internet also grants access to a multitude of NDT products. You can now buy desiccated thyroid online, such as VitaliThy. Aside from the critical T4 and T3 thyroid hormones, the NDT supplement VitaliThy brings a little extra to the table with its inclusion of Spica Prunellae Siccus extract, Ashwagandha extract, and Selenium Yeast in its formulation. Such diverse offerings allow you to select the NDT product that best fits your body's requirements and your healthcare provider's recommendation.

The final Word

The connection between levothyroxine and irregular heartbeat certainly exists, but it's also a navigable part of the journey when treated with due care and the right strategies. For the majority, levothyroxine serves as an effective solution to hypothyroidism. Regular communication with healthcare providers, strategic monitoring, and implementing necessary lifestyle changes help keep one's thyroid functioning and heart rhythms in check.

However, if conventional treatments aren't giving you the results you desire, or if side effects are becoming difficult to manage, Natural Desiccated Thyroid (NDT) may provide an alternative. Derived from animal thyroid glands, NDT provides a more natural thyroid hormone blend consisting of both T4 and the more potent T3.

Across the U.S., Armour Thyroid and NP Thyroid hold the spotlight as well-known NDT brands. The digital world also opens the door to a range of NDT options available online, like VitaliThy. VitaliThy, a natural desiccated thyroid you can buy online, provides T4 and T3 hormones. Plus, it also includes unique ingredients such as Spica Prunellae Siccus extract, Ashwagandha, and Selenium Yeast, adding a distinctive note to its formulation.

In essence, navigating the therapeutic realm of hypothyroidism requires recognition of potential risks and adaptation to changes. While levothyroxine serves as an effective general treatment for hypothyroidism, NDT may offer another tune to dance to, paving the way to a healthier, more balanced symphony of life.

Wojciech Majda
Wojciech Majda

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