2.5 years post-ablation and now getting ectopics

Hi all,

Haven't been on the forum for a while...

I had PAF for around 6 years and had an ablation in 2014. I've been AF-free ever since and it's been bliss...

But 3 weeks ago I went to A&E (ER) with palpitations and a HR of around 120bpm. I think it was just ectopics, but anxiety made them worse and the hospital doctors all agreed it was not AF, which was a big relief!

My HR settled down after 2.5mg bisoprolol and eventually the ectopics settled down too. I continued on the bisoprolol for 2 weeks without incident until I saw my GP.

He agreed to see how it went without beta-blockers so I came off them and was ok (other than a slightly raised HR) until yesterday when the ectopics returned.

I am hypothyroid and have been self-treating with Nature-Throid since around June 2016 (the thyroxine my GP prescribes makes me feel terrible). I had been prescribed Armour in the past by a private doctor, so I was cautious with it and followed Stop The Thyroid Madness advice for increasing slowly etc.

I also have adrenal fatigue, so I have to be careful with T3 as it reacts with adrenaline and can cause a raised heart rate.

So... I decreased the Nature-Throid from 2gr to 1.5gr when the initial ectopics started... and then to 1gr when I had a raised heart rate a week or so ago.

Yesterday, the ectopics started again out of the blue. I took 1.25mg bisoprolol but it didn't do much, so later on I took another 1.25mg at around 7pm. The ectopics settled over the evening and were mostly absent overnight and until around 1 pm today.

I haven't taken any Nature-Throid at all today, so it can't be the T3 causing the problem today, although I know that messing about with my medication too much could cause problems too...

The last couple of days have been pretty stressful for other reasons, which I'm sure isn't helping. And I feel rather flushed, although I'm not sure why.

I take various supplements including CoQ10, magnesium, potassium and taurine which have kept any ectopics in check until now.

Any suggestions please?

Thanks in advance,

Sally

Armour has more T3, so it will increase your T3 which can cause a fast heartbeat and palps. I had Graves disease and had my thyroid nuked, I have been on Synthroid since then. At one time I was feeling a little tried and increased my Synthroid that led to my getting AF. You have to be very careful with Thyroid meds, I never play around with the dosage, I get my T4, T3 and TSH checked before any change to my meds, they are powerful.

I don't know anything about Nature thyroid but 2 grams or 1.5 grams seems like a high dose to me. Do you know what your t4, t3 and tsH is, all your thyroid numbers? If you do, could you post them. Do you know what your Potassium and Mag. levels are? I cannot take any potassium supplements, I tried at one time and got runs of AF, so that is one supplement I will not touch, I get my potassium from food and my lab values are good for Potassium.

Liz

Just taking Magnesiuim on a regular basis is not enough, until you max out the amount you are taking then back off a bit you won't get the full benefit to get rid of the ectopics, and help your ablation last. I use Magnesium Glycinate. Beta Blockers give me lots of missed beats, keep in mind that the BB along with the stress of missed beats probably sapped a good amount of your Mag

Hello Sally - I'm sorry you are still struggling. This would appear to be related to thyroid and adrenal issues which result from stress issues over time. It's always emphasized that it's important to address and correct adrenal dysfunction before doing too much with thyroid because often, not doing so causes problems. I checked back to your earlier posts and Shannon's responses to you in this one. [www.afibbers.org]

I've had both adrenal dysfunction which is now normalized and also hypothyroidism that has been somewhat tricky to resolve and apparently has to do with some complications due to the aging process.
I didn't see if you had posted your age.

Synthroid is synthetic thyroid hormone and contains only T4 and those who can’t convert T4 to T3 are typically prescribed Armour thyroid which is a combination of T4 and T3. Armour dosing should be kept very low in those with arrhythmia for the very reasons you are noting... the extra beats and outright arrhythmia. Testing should always include Free T3 and Free T4 along with thyroid antibodies since going by TSH alone is not a true measurement of thyroid function. Many naturopathic physicians prefer Nature-Throid rather than Armour.

I would be very cautious about self-dosing. It would be best not to add more but try for less to see where your heart remains stable. I hope you are able to get this sorted out so your heart is calm again soon.

As Tom C notes, it’s very important to maximize your magnesium as well.

Jackie

Thanks for your replies

Elizabeth - Nature-Throid is measured in grains, with 38 mcg T4, 9 mcg T3 per grain. I have used natural thyroid before without problem and potassium is not a problem for me, but thanks for the suggestions.

TomC - thanks for the reminder about magnesium & betablockers. I had become a bit lax with the magnesium but will work on building it up until I'm taking enough again.

Jackie - I'll have a look back at Shannon's response. Thanks for the link. I've been trying to get my adrenals fixed and thyroid meds optimized since I was diagnosed 13 years ago! Despite numerous private doctors and protocols I have yet to manage it (I'm 54 now).

I cannot function on T4 alone no matter how much I take - my brain just won't work, I ache all over and am just exhausted all the time. I'd rather take nothing at all!

I know it's a fine balancing act with Nature-Throid and arrhythmia, but I had been OK on it for 7 months. I have to get my own thyroid tests privately as the NHS mostly only tests TSH and T3 testing is practically unheard of! Grrr!

There's been a TON of stress in my life since we moved house 2 years ago, with financial issues and a troublesome court case, which probably isn't helping my adrenals at all... I often get adrenaline rushes in the middle of the night, which are usually calmed down with a few sips of salted orange juice (a trick learned from Dr Raymond Peat). Weird but true!

I haven't taken any thyroid again today and my heart is calm. I may start again at 1/2 grain in a couple of days. And I guess it might be worth adding in some plain T4... I need to find a new private doctor really, but it's so expensive!

Sally

Sally - I'll try to find some of the reports I have read about the necessity to fix adrenal function first before working on thyroid issues. It makes sense. Send me a PM if you want information on the type of nutrients I used to healthy up the adrenals.

I'm glad you are using the Nature-Throid... it is said to be the best option since Armour changed formulations several years ago and caused problems in many. You are still young at age 54 so you should have better response time to 'shore up' adrenal function... but it does take specific nutrients and continual diligence.

The adrenaline surges in the middle of the night are often connected to what you eat in the evening meal and how that affects your glucose levels later on. That's how I learned I had adrenal burnout. I wasn't able to sustain from an evening meal at 6 pm and go all night on that meal. I needed to have a specific sustaining snack about 2 hours before bedtime... so glucose didn't drop. I also needed to be mindful during the day to eat small meals...always with healthy fat and protein... .low or no carbs to help regulate steady blood glucose levels. I worked at a stressful job (by appointments) and often when people were late or the patient needed additional treatment, the stress of keeping to a schedule was overwhelming to my system, apparently, and so I'd have Afib later on but not typically while I was working (thankfully). The point is, stress really can cause afibbers a lot of problems.

Just so you know... and we are all different in requirements.... when I took Armour thyroid, I had to keep lowering my dose from 1 grain or 60 mg until I was down to 1/4 grain or 15 mg. daily. Otherwise, my labs indicated I was right at the borderline for going hyper-thyroid.... I then cut that back to 15 mg every other day and still was right on the border...so that's when my doctor had me stop completely. And coincidentally, about that time I also began having a lot of aflutter.

Handy conversion chart: [centraldrugsrx.com]

Jackie

Interesting stuff, Jackie. So you're no longer hypothyroid? I'm wondering if that is what is happening with me as I have been taking my temperature on and off for the past few days and it is higher than normal. It was actually 37C earlier today which is unheard of for me! I'm usually around 36.3.

That's useful info re adrenaline surges - I will have to look at having a bedtime snack.

I eat healthy fat and protein, but I don't do well at all with low carbs. I think I have an explanation for that and I'm working on it.

I'd be interested in your adrenal nutrients so I'll pm you in a bit.

Sally