[41F] Experiencing racing heart, dizziness, and fatigue

Question

I went to the ER and did full cardio work up, they said I'm fine. My Tsh numbers are normal, although I personally feel it's my thyroid replacement medication anfld my endocrinologist disagrees. Any thoughts?

Patient Description

A 41-year-old female has been experiencing a racing heart (100-110 bpm), dizziness, and fatigue for 3 weeks. The dizziness, described as lightheadedness, is severe (rated 7/10) and worsens after eating. It is relieved by laying down or sleeping. The patient also reports palpitations, chest discomfort, and shortness of breath. Additionally, she has been constipated for a few days, noting weight gain during this period. Her medical history includes a thyroidectomy, pernicious anemia, and hidradenitis suppurativa, all diagnosed within the last 5 years. She is allergic to NSAIDs and is currently taking Unithroid and Qulipta, which she has been on for an unspecified duration. There is no known history of heart disease.

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Arora's Assessment

What might be happening

Based on your symptoms, here are a few possibilities:

  • Hyperthyroidism: This is a condition where your thyroid gland produces too much thyroid hormone. This can cause symptoms such as a rapid heart rate, weight loss, and fatigue. However, you mentioned that you had a thyroidectomy, so this is less likely unless you're taking too much thyroid replacement medication.

    • Treatment typically involves medication to slow down your thyroid, but in your case, it might involve adjusting your Unithroid dosage.
  • Anemia: You mentioned you have pernicious anemia, which can cause fatigue, dizziness, and an increased heart rate. If your anemia is not well-controlled, it could be contributing to your symptoms.

    • Treatment typically involves B12 injections or high-dose B12 pills.
  • Dehydration: This can cause a rapid heart rate, dizziness, and constipation. It's possible that you're not drinking enough fluids, especially if you've been feeling unwell.

    • Treatment involves drinking more fluids and eating foods high in water content.

What you can do

You should definitely see a doctor about your symptoms. In the meantime, here are a few things you can do:

  1. Make sure you're drinking enough fluids. Aim for at least 8 glasses of water a day, more if you're active or it's hot outside.
  2. Try to eat a balanced diet with plenty of fruits and vegetables, which can help with constipation.
  3. Rest and avoid strenuous activity until you can see a doctor.

What you should look out for

You should seek immediate medical attention if you experience any of the following:

  • Chest pain or pressure
  • Difficulty breathing
  • Fainting or loss of consciousness
  • Severe dizziness or lightheadedness

Remember, I'm an AI and this advice is based on the information you gave me. It's always important to consult with a healthcare professional for an accurate diagnosis.

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8 mo ago


People Also Ask


Can a thyroidectomy lead to symptoms of hyperthyroidism?

A thyroidectomy removes the thyroid gland, which typically prevents hyperthyroidism. However, if you're taking thyroid hormone replacement like Unithroid, taking too much can mimic hyperthyroid symptoms. It's important to have your dosage monitored by a healthcare provider.


How does pernicious anemia contribute to symptoms like fatigue and dizziness?

Pernicious anemia is caused by a deficiency in vitamin B12, which is crucial for red blood cell production. Low levels of B12 can lead to reduced oxygen delivery to tissues, causing fatigue, dizziness, and an increased heart rate. Treatment usually involves B12 supplementation.


What are the common symptoms of dehydration and how can it be managed?

Common symptoms of dehydration include a rapid heart rate, dizziness, fatigue, and constipation. Managing dehydration involves increasing fluid intake, consuming foods with high water content, and monitoring fluid loss, especially in hot weather or during illness.


What should I do if I experience severe dizziness or chest discomfort?

If you experience severe dizziness or chest discomfort, it's important to seek immediate medical attention. These symptoms could indicate a serious condition that requires prompt evaluation by a healthcare professional.

11 Comments


Owner

Anonymous#4724

8 mo ago

I've gained weight and I'm wondering if I need to adjust.

I had stage 1 papillary thyroid cancer. Low chance of reoccurance.

I hope it's just med adjustment, I'm starting to feel crazy ;)

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Leo#3962

8 mo ago

I hope that your 2nd endo apt goes better and you get some more satisfactory answers. I guess that the reasons why your medication is less likely the culprit would be because the symptoms only started 3 weeks ago but you've been on the same dose for 6 months, and also the tsh are normal. I do hope your 2nd opinion doctor does more labs to rule out other possible endocrine conditions. What was your thyroidectomy for, if I may ask? Was it cancer, autoimmune, etc?

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Leo#3962

8 mo ago

Yeah I think they should at least consider seeing if lowering your med dose helps. The other thing i wanted to say was maybe to ask your new endo to rule out an adrenal gland problem like a pheochromocytoma, which is RARE (so unlikely to be the explanation of your symptoms) BUT is characterized by headache, heart palpitations, tachycardia, and is associated with history of thyroid cancer (mostly medullary, not papillary as you had). The test is really easy and specific: a blood or urine test for metanephrines.

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Anonymous#5648

8 mo ago

I say go to a different hospital,get many views on this,as a female sometimes they underestimate your condition and say it’s “woman problems”

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Leo#3962

8 mo ago

A lot of this does sound like symptoms of hyperthyroidism, or in your case, too high of a dose of thyroid replacement hormone. How long have you been taking that medication? What did your endocrinologist say is the cause of your symptoms?

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Owner

Anonymous#4724

8 mo ago

That's what I said, and the Endo blew me off, I'm at 6 months on this dose. I'm meeting with a 2nd Endo this week

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Leo#3962

7 mo ago

What did your second endocrinologist think? Did you get your meds adjusted?

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Owner

Anonymous#4724

8 mo ago

Thank you for the advice

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Madelyn#4031

8 mo ago

I hope you get an answer from your endocrinologist second opinion and also that that ER didn't say you just have anxiety or something (really makes me angry when they dismiss women like that). I think it's a bit of a puzzle because weight gain is typically more of a hypo- rather than hyper-tyroidism issue but I'm not an expert

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Owner

Anonymous#4724

8 mo ago

Ha they did suggest anxiety, when I explained I have anxiety and this is way different, they backed off that route.

A friend suggested perimenopause which is interesting too.

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Leo#3962

8 mo ago

Of course! Wishing you all the best with finding out the answers

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