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Amiodarone induced hypothyroidism

Heart Rhythm Conditions | Last Active: Jul 30 12:06pm | Replies (5)

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@cottagecountry

Short answer: yes. And I think your medications are at the root of your issues.
I take 9 different prescribed medications. And everyone of them has potential side effects. I know of people who have been amiodarone for over 20 years and have had minimal issues with it. I am not one of those people. Nor, by the sounds of things, are you.
Amiodarone is considered the "gold standard" treatment for arrhythmias. I won't tell you of my entire experience with amiodarone but suffice it to say that I, too suffered from raised TSH levels while on it. Not as high as yours but bad enough to impact my quality of life in a substantial way. I, too, experienced fatigue, depression, and general malaise. But now your TSH level has now dropped too low. Yes, it is still within the parameters of "acceptable" - indeed, on the low side of normal. But those parameters do not serve all of us equally as well . You might be the "exception to the rule".
Why are you still on the levothyroxine if you are no longer taking amiodarone? Or are you still on Flecainide?
If yes, can you ask for a lower dose? In Europe, cardiologists use a much lower dose of amiodarone (100 mg.) than we do here. Studies have shown the lower dose to be as effective in most cases. Especially in older patients. Perhaps the same is true for Flecainide.
Too much levothyroxine can cause palpitations. I don't know what dosage you are on but I think I would seek to have it reduced. Then have regular blood tests tracking your progress. Perhaps, if the dose is lowered, then the palpitations will resolve themselves.
As for the low hemoglobin, low ferratin stores will cause arrhythmias. I experienced an upper GI bleed, a very small one that went undetected for several months but it resulted in my hemoglobin dropping below acceptable levels. When that happens, your body starts to use up your iron (ferratin) stores to "keep the lights on", as it were. I began to experience sustained and non sustained SVTs, several hundred a day. Long story short, the GI bleed was found, iron supplements were started and, 4 months later SVTs have stopped. Hemoglobin levels have returned to normal and, after that happened, iron stores started to replenish slowly.
I expect the transfusions addressed your immediate hemoglobin issues. And that your physicians have addressed the bleeding ulcers. But I can tell you that ferratin levels take a while to replenish.
I am happy to report that my thyroid function has returned to normal and I am no longer on any type of anti-arrhythmic medication.
I have come to the conclusion that we, as patients, must advocate for ourselves. We are all individuals and what might work very well for one person, might not work as well for me....or you. It is sometimes challenging to convince our physicians of that.
All the best.

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Replies to "Short answer: yes. And I think your medications are at the root of your issues. I..."

Just as a note on the question on why I'm still on levothyroxine. I'll try to go thru the dates and medications and thyroid issues from 2/23 until 7/24. At the time I was hospitalized, 2/23 the cardiologist at the hospital introduced 400 mg. of Amiodarone, with 240 mg. Diltiazem. In April 2023 my TSH was 8.05 (in Dec. 2022 prior to fall it was 1.4), and Amiodarone was reduced to 200 mg. in August 2023. At that time my TSH was 11.11, and in October 2023, Amiodarone was discontinued by the Cardiac Electrophystiologist and he added Flecainide. The side effects during the 10 months were becoming increasingly debilitating and Flecainide was discontinued in Dec. 2023 and Eliquis was added. In Jan, 2024 the TSH was 15.3 and my primary doctor put me on levothyroxine and 5/24 my TSH was back to 1.4. In 6/24 I had the first Afib event since 2/23 and had 1 event since but have not had another in 2 -3 weeks. Recently my new cardiologist placed an event monitor on my heart and I had heart palpitations. They continue until today.

So, it's been a nightmare all the way around and I had a TSH test done 5 days ago and the result was .7. Apparently my doctor is not concerned it decreased by 1/2 but I'll be changing doctors I hope in the next month, along with a new cardiologist.

I also wanted to thank you so much for responding to my comment. I have been unable to have any real information about the events that occurred and the medications that I was taking after I fell last year. You have been so helpful, you have no idea. All the doctors and cardiologists are not very interested or receptive to my concerns when medications are damaging me and the lack of follow-up or concern is very nerve wracking. You've helped me more than you know.
Thank you again, Jo