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Does hypothyroidism cause increased heart rate?

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The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.

Medically reviewed by

Dr. K. Shobana

Published At January 25, 2021
Reviewed AtJuly 4, 2023

Patient's Query

Hi doctor,

I have a high TSH of 10 mIU/L with increased heart rates. My ECG is normal and my blood pressure is high with a level of 160/100 mm Hg. After ten minutes, it was 140/90 mm Hg. I want to know whether a hypothyroid patient have an increased heart rate. I am taking Thyronorm, Multivitamin tablets, and Iron tablets.

Hi,

Welcome to icliniq.com.

Your tests show that you have subclinical hypothyroidism. It means that you have elevated TSH (thyroid stimulating hormone) with T3 (triiodothyronine) and T4 (thyroxine) within normal ranges. TSH is produced in the pituitary gland inside the cranium near the brain. This hormone affects the thyroid gland in the neck to produce T3 and T4 hormones. When there is a malfunction of the thyroid gland, the pituitary gland senses it and it produces excessive TSH to act on the thyroid and so it produces more T3 and T4 hormones. If the thyroid gland succeeds in producing adequate hormone, then the condition is called subclinical hypothyroidism and if it fails, it results in a condition called frank hypothyroidism. Studies suggest that subclinical hypothyroidism can turn into frank hypothyroidism over time and so medications are started at the subclinical stage. As you are taking thyroxine, I suggest you do a thyroid function test after six weeks of starting Thyroxine and so the dose can be adjusted. Regarding blood pressure, it is dynamic and it keeps on changing during daytime and night and while doing different activities. Mere anxiety of checking blood pressure can increase blood pressure. Anxiety while visiting a doctor can elevate blood pressure. So it is always advised to check blood pressure after five minutes if the first reading is high. If the second reading is lower than the first, then it is still out of range again. Then again third time, the blood pressure has to be checked after five minutes. Then the two lower readings are averaged and it indicates the actual blood pressure. This might have happened in your case. Medications to reduce blood pressure are never started by reading a single high blood pressure readings. If the blood pressure remains high for several weeks even after following a healthy lifestyle, lowering salt intake, exercise, losing weight, and stress management, then medication is started. Once it is started, the dose is adjusted for several days to weeks by repeated checking of blood pressure. Heart rate usually keeps changing during different activities. Even during breathing, heart rate changes. When we take the air, the heart rate rises and when we put our air, the heart rate drops. This variation is seen clearly on ECG (electrocardiography). This is normal. Stress, fear, anxiety increases heart rate and rest decreases it. Hypothyroidism decreases heart rate. As you have subclinical hypothyroidism, it means that your T3 and T4 are normal and your heart rate is not influenced by TSH alone. Slight anxiety can increase heart rate. Do fasting lipid profile to see cholesterol levels in blood and if it is higher, then medicines have to be taken to control it. Try to do regular exercise, reduce salt intake, increase water intake, reduce weight even if it is within normal range as cutting weight has a good effect on blood pressure control.

Patient's Query

Thank you doctor,

I want to know how to reduce heart rate. Sometimes I have heaviness with less oxygen supply. When I check for oxygen, the level ranges from 96 to 97 mm Hg. I keep thinking about this always. I have fear regarding what to be done while having an increased heart rate. I feel to have less oxygen and increased heart rate.

Hi,

Welcome back to icliniq.com.

Heart rate can rise due to exertion such as lifting heavyweight, climbing stairs, and while walking briskly. This occurs normally to those who do not use such levels of exertion. It is good to increase the level of activity over days to weeks and so the body gets adapted to the heart rate and it does not get raised. You know professional athletes have a heart rate of around 50 beats per minute at rest and when they play sports like soccer, their heart rate gets raised up to 90 to 100 beats per minute on heavy exertion. The second cause can be due to intake of Thyroxine. Normally it does not cause an increase in heart rate but sometimes when it is taken for a long time without adjustment of dose, it can result in an over dose of thyroxine and it leads to a faster heart rate. This is the reason for repeating the thyroid test after six weeks of starting the medicine. Do further repeating of tests according to the levels and dosages. Overthinking and being overcautious can result in anxiety and stress. It alters the stress hormones in the body and the body reacts to these hormones and so the heart rate gets increased. When the heart rate rises, count your pulse rate for a minute and assess whether it is regular or irregular. Think the reason against the cause such as fear, stress, fever, and exertion. Low hemoglobin can also increase heart rates. Sit, relax and drink two glasses of water. After twenty minutes, count your pulse rate again. If it is high again, then you can do an ECG. Regarding shortness of breathing, it is a common subjective feeling observed when the lungs are normal. Such feelings arise while on anxiety. If you have a cough and fever then a chest x-ray is necessary. You have low vitamin B12 levels. It occurs commonly in vegetarians. Vitamin B 12 is not present in vegetarian diets but it is abundant in meats. You can adopt a nonvegetarian diet along with a vegetarian diet. The other option is to take vitamin B12 supplements.

Patient's Query

Thank you doctor,

I am taking a nonvegetarian diet. I did an ECG and it was normal. Does heart rate increase due to blood pressure?

Hi,

Welcome back to icliniq.com.

Both are independent of each other but factors that increase blood pressure can increase heart rate too. It increases adrenaline at the same time. Stress hormones are also called fight, fright, and flight hormones. Sudden anger, fear, and running can raise stress hormones in the body, and stress hormone increases blood pressure and heart rate. It is natural and normal.

Patient's Query

Thank you doctor,

Sometimes I feel to have less oxygen supply to the body. When I measure it, it ranges from 96 to 97 mm Hg. How to know that my oxygen supply is good without measuring it?

Hi,

Welcome back to icliniq.com.

If you feel that your oxygen supply is less, then you can assess by looking at your lips, the underside of the tongue, nails, and sometimes finger tips. In patients who have less oxygen in the blood, the lips turn blue or purple. It happens on the underside of the tongue and nails and it is called cyanosis. Heavy cigarette smokers have less oxygen supply in their blood and their lips are black or blue. If there is no cyanosis, it means that the oxygen supply is normal.

Same symptoms don't mean you have the same problem. Consult a doctor now!

Dr. Muhammad Zohaib Siddiq
Dr. Muhammad Zohaib Siddiq

Cardiology

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