Are Our Resting Heartrates In The Normal Range?

[futurehope]

Hi,

I'm in the middle of "tweeking" to take the right amount of thyroid hormone to keep me from getting hypothyroid. I do not have a thyroid and I need the hormone.

What do you consider your normal resting heartrate when not sitting or vertical? Can POTS people use resting heart rate as an indicator of thyroid function since our heartrate tends to go up so easily?

I guess I'm trying to understand if our resting heartrates are normal compared to normal people without POTS? Or are our resting heartrates usually high?

Thanks in advance.

[EarthMother]

I have this vague memory that basal body temperature can be used to help gauge how your meds are working.

My resting pulse doesn't seem to a good indicator of how my thyroid is working (or not working). I'm hashi-thyroid and go up and down all the time. Sometimes my weight is a good indication. If I'm eating the same foods and I keep putting on the pounds, odds are my thyroid is a bit low.

Good luck getting your dose tweaked.

~EM

[futurehope]

I have this vague memory that basal body temperature can be used to help gauge how your meds are working.

My resting pulse doesn't seem to a good indicator of how my thyroid is working (or not working). I'm hashi-thyroid and go up and down all the time. Sometimes my weight is a good indication. If I'm eating the same foods and I keep putting on the pounds, odds are my thyroid is a bit low.

Good luck getting your dose tweaked.

~EM

Thanks for your ideas about weight and basal body temperature. I kinda thought that just observing heartrate in POTS people in not enough.

[ramakentesh]

I wouldnt rely on heart rate for other problems if you have POTS - the end result of all forms of POTS is increased sympathetic drive to the heart - increased heart rate as a reflex mechanism or in some cases as a result of increased sensitivity to beta stimulation bceause of faulty reuptake of NE, supersensitivity or other factors potentiating NE sensitivity (reduced neuronal nitric oxide).

[tilly]

I thought that 60 - 100 is now cosidered the normal ... i have "ist/pots" and thyroid disease ..... and my heart rate is all over the place when i am sitting still it will still keep going up /down even the doctors have seen it is erratic ( is this how yours is ?) .... mine will keep fluctuating beween 78/104 whilst sitting or lying down and im not even moving ..... and when i stand and move around its up 120/30/40/ and it also gives burst up to 130/40 for no logical reason when i am still ? ...... and obviously greater again if i try to do any activity .........

Most days my resting hr is 100 ....

I also have thyroid diseas and take only 25mg tyroxine ... i am always tired and when i have my b/test done it is still only just in the reference ranges . and my doctor never want to increase the dose ... i have always thought it may be they don't iincrease it because of the tachy ?

tilly

[futurehope]

I'm starting to wonder about all this. For whatever reason (thanks Ramakentesh), our heartrates can change. Doctors realize how sensitive we are to getting tachycardia. They get nervous about increasing our thyroid dose because of this.

I know my endocrinologist was so worried about the tachy that I had to talk him into increasing my synthroid by pointing out to him my TSH readings over the past ten years and that they had been between 1.? and 2.? I talked him into the higher dose because 1) my TSH was way out of range for me (7.?) 2) I was disgusted with feeling dead all the time 3) my weight was picking up rather rapidly.

Okay, so the first thing I notice about the increased synthroid is that once I get out of bed (getting up in the AM is difficult), I actually feel alive and am able to think. Now, that's fun. Secondly, my heartrate is increased when sitting, though it can be anywhere from 77 to 97 depending on what my body feels like doing at the moment.

So, like I said in my original post, I don't really want to "report" this increased heartrate to my doctor just yet because I enjoy "feeling like a human", more "with it" and maybe my sensitive body needs to adjust to the higher dose?

It's been about three weeks. You know, it's not improbable that once I are getting the proper dosing of synthroid, that maybe I need a wee bit of adrenal hormone as well? Nobody seems to know how to treat me and doctors get nervous about "upsetting the applecart", so they would rather do nothing than potentially help me to feel better.

I knew that the dead feeling I was experiencing, along with hair loss, weight gain, etc. was not right. It was a good thing I had all my notes from ten years back as to my thyroid test results.

We are mysteries written inside an enigma - what I mean is, doctors would rather not touch us than create more problems.

Too bad. I really feel that we could be feeling much better than we do if they only had the guts and resolve to improve our quality of life.

[EarthMother]

My first step in "treating my thyroid disease right" was to leave the endos and their egos behind and find a knowledgable PCP who would titrate my meds for me based on how I felt rather than rely soley on the lab values.

Sometimes, in my case, when my pulse is running high, I'm dropping pounds and I feel like I am jumping out of my skin ... I actually NEED MORE thyroid meds. It sounds contradictory and you can imagine the look on my doctor's face when I asked the first time. But for me with Hashi, more thyroid hormone taken synthetically will shut off my autoimmune response and my own body's transient over production. But finding an endo who would experiment with me was impossible.

Thyroid treatment is far from an exact science, as some would like us to believe. And because it takes 4-6 weeks to level up (or down) on a new dose, we need to be patient and persistent to discover what works for us. Moreover with POTS, anything can happen in 4-6 weeks, so its hard to discern all the contributing factors.

Finding the right doctors who are willing to step outside the box and into the enigma of our potshole is our Best hope at getting a comprehensive treatment plan that is fluid and flexible to our changing needs.

May each of us find the dream team we seek.

[futurehope]

Sometimes, in my case, when my pulse is running high, I'm dropping pounds and I feel like I am jumping out of my skin ... I actually NEED MORE thyroid meds. It sounds contradictory and you can imagine the look on my doctor's face when I asked the first time. But for me with Hashi, more thyroid hormone taken synthetically will shut off my autoimmune response and my own body's transient over production.

I can understand your thinking. My thyroid was removed for cancer and the lower they could keep my TSH, the happier they were because they did not want the thyroid stimulating hormone to "stimulate" the cancer cells. So I've been kept relatively hyper for years.

Finding the right doctors who are willing to step outside the box and into the enigma of our potshole is our Best hope at getting a comprehensive treatment plan that is fluid and flexible to our changing needs.

If you don't mind my asking, is your good PCP "outside the network" of insurance? Usually, when a doctor is outside the network and you pay them directly out of pocket, they spend more time with you. Do you consider your doctor a holistic practitioner? Is he/she publicized as a holistic practitioner? Thanks in advance.

I believe that the doctors working for money paid from the insurers are much more "by the book" and unwilling to deviate from protocol. Also, they have a set amount of time allotted per patient and do not wish to deviate from that.

[EarthMother]

My PCP is in network, not what you would call a holistic practitioner. I simply lucked out 10 years ago when I found him. And i've gone through hoops to try and keep health insurance that will cover him. This year Blue Cross cancelled their contract with my entire hospital and all the physicians in my network!! So seeing him is a challenge ... his medical group has offered to charge the Blue Cross patients the in-network fees even though they are currently not being reimbursed fully by the insurance company. As I said, I just lucked out. But I did so with considerable perseverance and walking away from several 'specialists' who refused to accept me as a partner in my health care planning.

As I recall, when I interviewed my current pcp, I had Mary Shomon's (thyroid guru) list of questions to ask a propective physician. The important one for me was finding someone who would sat YES when I asked "Would you be willing to titrate my thryoid dose based on how I feel, rather than lab tests alone."

Because my PCP is a family practioner, I think he has a better overall sense of the individual as a complex interconnected set of systems and symptoms. My experience with some specialists... is that they see you through the narrow lense of their specific specialty. And even in that, you have to fit the mould of their other patients because what worked for them must work for you too.

[futurehope]

Thanks, EM. The problem I have with "interviewing new docs" is they, by definition, spend 1 1/2 hours going over everything to do with your health history because they feel that is the only way they will get to know you. So they end up getting paid for an extended OV, when really I only want to interview them... It's tiring going through those long ov's.

For those who care, I asked some questions of a second endocrinologist in my endo's practice about my high resting heartrates which have occurred since increasing my synthroid dose. He said to wait until it's 4 weeks to test. He won't do anything now (especially since my exercise heartrate is normal, I suppose). I asked him why my Free T4 was high even though my TSH was high? He didn't know but said I'm not the only one like this.

The TSH meant the most to him because that is how my brain is responding to the hormone - whether my brain thinks I'm high or low. It's okay for me to go below 1.0 TSH according to him because of my history of thyroid cancer.

If I'm between 1.5 - 2.5 I'm happy. I was up to 7.? TSH which could not have been helping my situation (HYPOthyroid that is)?!

All for now. I'm off to live my POTsy life with more questions than answers...... What else is new?