Hormones, thyroid and a fib

Has anyone noticed a connection between hormonal cycles and/or thyroid levels and their a-fib?

My first a-fib episode was about 3yrs. ago when I was using glandular supplements to support my hypothyroidism and became thyrotoxic.

After that I was off all thyroid meds for about a year,and was beginning to feel really lousey. On of the many symptoms was nonstop pvc's and sinus tach. As my levels were adjusted upwards the tach began to disappear and the pvc's were less frequent.

Fast forward to this January, I had another a-fib episode that lasted approx. five hours. Since last January, every month like clockwork I have had an a-fib episode one day during my cycle. The drs. have no explanation and my endo. says it is just a co-incidence.

I am in my late 40's and know that my hormones are beginning to shift. In fact, I tend to experience a fair amount of anxiety now, whereas I never did in the past.

So do hormonal shifts cause a-fib, can low thyroid cause a-fib, or is it just anxiety that causes a-fib?

Yes, low thyroid can cause afib, just like high thyroid. If your endo says no, it's time to find another one!

I kick up a little bit right before starting my period every month. My naturo cariologist absolutely believes hormones and afib are related - and basically, the thyroid is a hormonal gland as well. Same thing with adrenals. If you are still having thyroid problems and afib despite treatment, I'd suggest looking into adrenal problems.

I also recommend checking out stopthethyroidmadness.com - pretty vocal and seemingly out there group, but if you read deep and process it, you can get through the goop to the meat of their theories. Interestingly, on both their bulletin boards (thyroid and adrenal), there is a fair amount of discussion about afib issues as well, so for many people I'd say it's definitely related.

Lynn - As Darcy suggests, check adrenal function along with thyroid. You may find a Functional Medicine practitioner serves you better than an endocrinologist for this. That's what helped me the most in restoring my burned out adrenals to normal function. However, the thyroid issue seems to be ongoing. My thyroid test numbers are normal but I still have hypothyroid symptoms so we're working to find exactly what is out of balance. We suspect it has to do with iodine and I'm increasing my dosing to 10 mg daily and will be tested eventually. I also use small doses of Armour thyroid.

Jackie

Jackie - have you checked your RT3? We may have had this conversation already...I can't remember...I'm doing iodine too and it seems to help. But clearing out the RT3 has helped me the most - I haven't felt this well in almost 20 years!

Darcy-Where on earth did you find a naturo cardiologist? Is there an association for those? My cardio is the reason I was off thyroid meds for a year. He is employed by a large hospital group and if your TSH isn't over 5.5 you do not have a thyroid problem. Duh, didn't they change the ranges?

I have visited that website in the past, It is really on target. I guess I didn't look much at the boards. I'll have to go back and have a look. Interstingly, my EP said that more of his patients are hypothyroid rather than hyperthyroid (This was in response to my endo saying that only hyper causes a-fib)

The only reason my thyroid got addressed is because I started seeing a integrative health practitioner. My upward adjustment has been a slow process because my ferritin was down to 7 last summer. Makes me mad because the cardiologist should have caught this. My HR was running in the 90's and low 100's. Also, I suspect I have some adrenal fatigue and have been doing the B vits, C, and dessicated adrenal. My dr. is going to test dhea levels and I may supplement with that as well.

Basically, I see the endo so that someone is looking at my ranges monthly and it placates the goofy cardiologist who thinks that I shouldn't be taking thyroid hormones.

Jackie, I just finished reading a new book about that very issue. "Why do I still have thyroid issue? when my lab tests are normal." It is written by a chiropractor. One of the Drs. at Life Extension recommended it to me, he had apparently attended one of the authors seminars and was quite impressed. He makes various nutritional and supplement suggestions based on his classification system of thyroid problems. Interestingly, he says that no one with a thyroid problem should eat wheat or gluten.

May a male of the species join in? I am one of the rare guys who seems to be hypo. My TSH runs just a little high, but since I was showing multiple symptoms we tried synthroid. Settled on 25mg per day. It keeps my TSH about 5. More importantly I feel better.

Have seen no pos or neg relating to my vagal afib.

brian

Darcy - yes rT3 checked; last time slightly elevated. I may try increasing the Armour dose to see if I can change something; I get pretty close to 'hyper' territory if I take much so that's a worry for me. But for sure, something is still missing.

Lynn - I do know of that book and was going to buy it just to wave in the endocrinologist's face. As for gluten and hypothyroid issues.... all of the functional medicine teleconference/interviews I have heard on the topic of thyroid say that if the thyroid antibodies are elevated, then gluten must be avoided as it is the culprit and when stopped, they resolve. This would include those with autoimmune problems including Hashimoto's. I'm gluten free except for the rare occasion when I decide to eat a small amount of bread. I've been gluten free for about 4 years.

Brian - the guidelines for thyroid health indicate TSH should be down around 3.0. They were changed in 2002 and many doctors (and lab ranges) still aren't aware of the new guidelines.
[thyroid.about.com]

Jackie

I am certain that estrogen depletion plays a role in my afib. My very first afib episode occurred six months after my final menstrual period back in 2002. And then my afib increased from occasional to every two weeks during 2008-2009 when I took an aromatase inhibitor for breast cancer. I stopped the aromatase inhibitor (which blocks postmenopausal estrogen to undetectable levels) and within five weeks my afib returned to occasional. Estrogen affects adrenal function, parathyroid function, renal handling of bicarbonate and minerals, dopamine and other neurotransmitters, and autonomic balance - all of which can impact heart rhythm. If I wasn't a breast cancer survivor I would definitely consider using bio-identical estrogen to see if it made a difference in my heart rhythm.

Lynn - yes, they did change the numbers, but I didn't think 5.5 was acceptable in any of their ranges! Sheesh! Just be careful if you get back on T4 - if you have an RT3 problem, T4 will only make it worse.

I think my naturopathic cardiologist is the only one in the country (US). He was granted the use of the title "cardiologist" because he did a residency at Columbia and then trained at the AZ Heart Hospital and AZ Heart Institute. He trained with all the guys in my EP practice, which is interesting to me. He got me off flec and beta blockers within a few months, which were severely affecting the quality of my life.

At any rate, he is AMAZING and has changed my life. I went in thinking my problem was afib and quickly realized my afib was just a symptom of a bunch of other things going on. He's in Arizona, btw, so if you're anywhere near here...he does phone consults too, although you might have to see him first. He has TONS of patients who fly in for a week and see him/do treatments during that week and then go home to be followed up via phone.

I was a 7 in ferritin too. My EP and cardiologist all missed that one...scary...

Jackie - have you tried just taking T3? I know that can be risky with afib, but some people on the stopthethyroidmadness boards (yahoo boards, Lynn - you have to subscribe for access) swear by it. My doc is not jazzed about doing that so I just started armour instead and we'll see how that goes.

This stuff is such a puzzle...

Lynn - I've used the bioidentical hormones for many years before, during and after my afib journey. In theory, hormone imbalances may be contributory but I never felt it was or was not to any great extent. Actually, it was felt at the time my afib began it was because I didn't have enough estrogen since my menopause was by surgical intervention, unfortunately.

Darcy - No... not just T3. No one wants to tinker with that and I'm certainly not keen to see if it triggers more afib or not.

Jackie

Darcy-I would be interested to know what approach this cardio. took to balancing your system.

As far as T3 here is my story. A couple of years ago after the cardio had me quit the glandular supplements from my chiro (had been off 10 months after having THS of <.01...first a-fib episode) I had been feeling real lousey, my TSH was over 4.0. I began supplementing with Thytrophin ...cardio was ok with this because it had T4 removed. However, I later found out that it didn't have T3 removed. I went to an integrative dr. who perscribed extended release T3 which had to be compounded. This was done because my T3 was too low. As time went on I gave up the Thytrophin and they ended up increasing my T3.

I was really scared each time they increased it because my HR was running very high, but each increase brought the rate down. So over the past year I have went from 10 mcg of ER T3 once each day to 10 mcg. T3 4x per day. Now I have 25 mcg of synthroid added in.

To make a long story short, if your T3 is too low and everything else looks good don't be afraid to try extended release T3.

Another male Hypo here. I now take a small amount of Synthroid and my last TSH was 2.2 (it was 4.0). The thyroid issue is related to my ectopics and occasional flutter, though it may not be direct. I experienced cold extremities and sore, tired legs which led me to the endocrinologist. It is related to the heart issues because I also had to lower my beta blocker dose (which exacerbates my cold extremities.) When that happened, my heart got out of sync.

Since my TSH is now in the normal range, and I still experience cold extremities, I'm trying to get off beta blockers altogether by using diet. So far I have not had enough improvement to drop the beta blocker.

The direct link between hyperthyroidism and AFIB is well established. But I have not found documentation to link AFIB with hypothyroidism. Anyone know of any on-line articles making that link?

Bill - Synthroid only supplies T4. If you can't convert T4 to T3, then even though your numbers are in the range, your thyroid function may not be optimal.... as evidenced by your symptoms... cold extremities.

If you haven't measured your basal temperature - do a Google on Broda Barnes MD and his book about hypothyroidism. This indicates that the only true indicator of thyroid function is the basal temperature and most websites on this topic will describe how to take it yourself every morning and learn where you stand.

Very often, iodine deficiency is the culprit. David Brownstein, MD, has written a book Iodine - Why you need it and why you can't live without it...or something similar to that title. He explains why without enough iodine, the thyroid often still doesn't work right even with hormone replacement. You can be tested for iodine deficiency with a 24-hour urine collection. I believe he explains it in the book.

Jackie

Life Extension Foundation publishes optimal ranges for all kinds of blood work on their website, including thyroid.

I know that their range for T4 is 1.3 - 1.7, and for T3 is 3.4 - 4.2

If you dr. only tests tsh find another dr. to help you with your thyroid issue.

The Free T3 and Free T4 are the meaningful tests. This means it is free to function and if it's not 'free' then it's bound and not helping with function.

The complete thyroid profile will include the T4 and T3, the Free T4 and T3, TSH, Reverse T3 and the thyroid antibody tests....Thyroid peroxidase antibody (TPOAb); Thyroglobulin antibody (TgAb); Thyroid stimulating hormone receptor antibody (TRAb)

Without the complete profile, you won't get the whole picture.

Jackie