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Is Fluctuating Heart Rate Upon Adjusting Eltroxin Dosage Associated With A Thyroid Storm?

Posted on Thu, 15 Jun 2023

Question: Hello Doctor. Am 27 year old married female. I've been taking eltroxin for the past one year. In January end this year, when I had my tsh level checked it was 3.3. I was already taking 88 mcg that time. After that test, my doctor increased the dose to 100. For the past few days, am experiencing fast heart rate around 100 to 105 beats per minute with little chest comfort. Last week when I took the test, my tsh was 1. My doctor reduced the dose from 100 to 88 again. I'm still having heart palpitations. Today I skipped the dose and felt much better without heart palpitations. Please suggest me the dose of eltroxin. Am afraid that what am experiencing now could be thyroid storm. Please advise. Thank you.

Answered by Dr. Minal Mohit (16 hours later)

Brief Answer:
Less likely to be a thyroid storm.

Detailed Answer:

Hi,

You were doing good with thyroxine 88 mcg, TSH 3.3 uIU/ml is also acceptable unless you are planning a baby or you are already pregnant. Now, as the dose was adjusted to bring you closer to the target of 1, maybe palpitation and tachycardia were drug induced. Skipping the tab for one day will have more psychological benefit rather than physiological. Palpitation will continue for some days till the balance is achieved, as thyroxine moves very slowly in either direction.

Watch for a few days, you may take tab Inderal if it is troubling you a lot, continue tab thyroxine at 88 mcg, recheck your thyroid profile in 6 weeks and let me know.

Hope I have answered your query. Let me know if I can assist you further.

Regards,
Dr. Minal Mohit, Endocrinologist

Above answer was peer-reviewed by : Dr. Kampana

Follow up: Dr. Minal Mohit (18 minutes later)

Can I take 75 mcg instead of 88?

Answered by Dr. Minal Mohit (3 hours later)

Brief Answer:
You may, but it might not help you.

Detailed Answer:

Hi,

You were doing good on 88 mcg, reducing the dose will worsen the situation.

Hope I have answered your query. Let me know if I can assist you further.

Regards,
Dr. Minal Mohit, Endocrinologist

Above answer was peer-reviewed by : Dr. Remy Koshy

Follow up: Dr. Minal Mohit (1 hour later)

Ok doctor. I have one more query. Of late, in the evenings my temperature raise from 99 to 99.6...isn't it like a low grade fever?. i suffered from typhoid a month ago... but cured now.

Answered by Dr. Minal Mohit (26 hours later)

Brief Answer:
Hyperthyroidism can cause such a rise in temperature.

Detailed Answer:

Hi,

Hyperthyroidism can cause a rise in temperature, and otherwise, also, body temperature is generally more in the evening. Please do not worry, all these should settle in 15 days time.

Hope I have answered your query.

Regards,
Dr. Minal Mohit, Endocrinologist

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Above answer was peer-reviewed by : Dr. Arnab Banerjee