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What Causes Prolonged Elevated Heart Rate After Exercise?

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Posted on Mon, 15 May 2017
Question: Heart rate takes longer to normalize after exercise lately.
doctor
Answered by Dr. Sagar Makode (3 hours later)
Brief Answer:
Likely due to deconditioning or thyroid supplements

Detailed Answer:
Hello,
sorry for late reply.
Firstly, recovery is considered slow if heart rate decreases by less than 18 beats after 1 min or less than 42 beats after 2 min of complete cessation of strenuous exercise. Strenuous exercise means your heart rate should reach 85 percent of maximum heart rate the individuals with your age group can achieve, which is equal to 85 percent of 220-46, which is equal to around 150 beats per minute.
So you see if it's abnormal or not.
If it's abnormal then as you already underwent stress echo, structural heart diseases are ruled out. So Other option could be due to unaccustomed activities or thyroid hormone. As thyroxine is a known stimulant to heart, it will raise both resting as well as exercise heart rate. So that implies need to repeat tsh after 3 more weeks (to complete 6 weeks after last dose change) and decrease the thyroid dose. Then you preferably maintain tsh between 2-5 rather than less than 2.
Hope this clears your doubt and get back if you have any more queries.
Above answer was peer-reviewed by : Dr. Yogesh D
doctor
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Follow up: Dr. Sagar Makode (30 minutes later)
Currently TSH is .97.
Went from 14 to 4 in 2 weeks on 50mcg. Then raised to 75. TSH Went down to 3 in 2 more weeks. Then 2 weeks later, it was at .97.
Reduced to 50 again 3 weeks ago. Has TSH tested a day ago but results aren't in. I used to Strenuously exercise a lot. Since beginning these drugs I have reduced due to these symptoms and anxiety about them.
Please advise.
doctor
Answered by Dr. Sagar Makode (23 minutes later)
Brief Answer:
See the description

Detailed Answer:
Probably, you are taking thyroid in excess dosage. After you start thyroxine supplements, tsh should be repeated after 6 weeks and dose should be changed after 6 weeks only, because it takes tsh to decrease.
Your tsh of 14 is mildly elevated, dose of 25 or 37.5 should be sufficient. We don't want tight control of tsh. So now just wait for recent tsh report and if tsh is less than 2 then decrease dose to 25 and repeat tsh after 6 weeks only.
High thyroxine is probable cause for your concern. And no need to worry, it's not at all life threatening. All the best.
Above answer was peer-reviewed by : Dr. Yogesh D
doctor
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Follow up: Dr. Sagar Makode (11 minutes later)
Thank you for your time.
doctor
Answered by Dr. Sagar Makode (3 minutes later)
Brief Answer:
You are welcome

Detailed Answer:
You are welcome.
Note: For further follow up on related General & Family Physician Click here.

Above answer was peer-reviewed by : Dr. Yogesh D
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Answered by
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Dr. Sagar Makode

Cardiologist

Practicing since :2013

Answered : 1867 Questions

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What Causes Prolonged Elevated Heart Rate After Exercise?

Brief Answer: Likely due to deconditioning or thyroid supplements Detailed Answer: Hello, sorry for late reply. Firstly, recovery is considered slow if heart rate decreases by less than 18 beats after 1 min or less than 42 beats after 2 min of complete cessation of strenuous exercise. Strenuous exercise means your heart rate should reach 85 percent of maximum heart rate the individuals with your age group can achieve, which is equal to 85 percent of 220-46, which is equal to around 150 beats per minute. So you see if it's abnormal or not. If it's abnormal then as you already underwent stress echo, structural heart diseases are ruled out. So Other option could be due to unaccustomed activities or thyroid hormone. As thyroxine is a known stimulant to heart, it will raise both resting as well as exercise heart rate. So that implies need to repeat tsh after 3 more weeks (to complete 6 weeks after last dose change) and decrease the thyroid dose. Then you preferably maintain tsh between 2-5 rather than less than 2. Hope this clears your doubt and get back if you have any more queries.