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Medical Forum / Diseases and Disorders / Lupus / July 2005Palpitations
Hello all, Has anyone experienced palpitations with any medications? I am having them especially at night when I am relaxed and trying to get to sleep. I went to the doctor with it because I thought he might be giving me too much synthroid. He tested my blood and it came back that I need more thyroid. He also put a heart monitor on me for 24 hours to see if he could detect it. Of course, I did not experience until the next day sitting at work but not in bed. Anyway I did not take any other medications except my thyroid that day. Last night when I did not have the monitor on, I took a decongestant because I think I am coming down with a cold and surely, I had the palpitations last night. It feels like my heart is thudding. Not rapidly, just every once in a while I get a big thump. I also take Tylenol PM sometimes to help me sleep not together of course. Can either of them cause the palpitations or does it have to do with my thyroid problem. Remember I have hashimotos. Could it be a lupus thing. I just remember that I did not have any of these symptoms until he increased my thyroid the first time. Have been having them ever since. It can be a little scary. It doesn't hurt just is annoying and it is not fun trying to sleep to the tune of your heart beating. And yes I am still grieving over Jasper. The house has too many memories. Any ideas? Thanks, Paulette > And yes I am still grieving over Jasper. The house has too many memories. > Any ideas? Would it help if you talked about some of his best times? I've lost cats, and it helps to remember their funnier moments. Getting busy with a new cat can help, too. --Bill Thompson It is possible you could be having panic attacks. Intense feelings that your heart is thudding are part of the panic attack situation. it can often come on after a major event like loss of a loved one or other stressful life event and is very common, many people experience it at some time. Not saying thats what it is and I am glad you have seen the doctor. If it bothers you at night try sleeping on the right side or your back. This because when we sleep on our left side we hear our heart beat more loudly and this can cause the effect you describe. I have copied this off the net for you about sleeping positions: "Sleep on Your Back: It's the best position for relaxing, and allows all your internal organs to rest properly. If you must sleep on your side, do it on your right side, not your left. Sleeping on the left side causes your lungs, stomach and liver to press against your heart, causing stress on an organ that most of us find quite useful. Never sleep on your stomach. It causes pressure on all your internal organs -- including your lungs, which results in shallow breathing. It can also, as you've no doubt discovered, cause a stiff neck and upper back problems. " That can be found at http://www.ppsinc.org/insomnia/insom05.htm if you want to know more! Hope this helps, Lynne > Hello all, > Has anyone experienced palpitations with any medications? I am having them [quoted text clipped - 22 lines] > Thanks, > Paulette > It is possible you could be having panic attacks. Or could it be stress over losing Jasper? --Bill Thompson >> It is possible you could be having panic attacks. > > Or could it be stress over losing Jasper? > > --Bill Thompson Yes, of course. But panic attacks are often part of stress reactions! A panic attack happens like this: Due to some situation causing anxiety or unpleasant emotion, the body surges adrenalin, causing our heart to beat strongly and due to the increased bodily awareness that can be part of stress, we experience it very clearly. We may also feel our hands go sweaty, our scalp prickling and so on. This can cause us to feel that there might be something wrong with us like "oh no, what's happening to me?" and this makes us even more anxious and sensitive to what's going on inside us, so it becomes a vicious circle. If it is indeed a panic attack the best way to handle it is to recognise what it is and practice self talk strategies (reassure yourself that nothing terrible is going to happen, its normal, and so on,) and practice some relaxation techniques. > Yes, of course. But panic attacks are often part of stress reactions! A > panic attack happens like this: [quoted text clipped - 9 lines] > terrible is going to happen, its normal, and so on,) and practice some > relaxation techniques. That's fine to reduce the symptoms of the panic attack, but later go punch his/her lights out ! <smile - just kidding but sometimes we need to work out stress>. J > If it is indeed a panic attack the best way to handle it is to recognise > what it is and practice self talk strategies (reassure yourself that nothing > terrible is going to happen, its normal, and so on,) and practice some > relaxation techniques. i had 2 yesterday while I was sleeping. Must be the power of newsgroup suggestion. I can't remember what the first one was; it was newsgroup related. The second, I woke up, decided I'd forgotten my cat outside and flew out be bed in a major panic. When I found her lolling on the front enclosed porch, that calmed me down :-) Just a bad dream. J I do not get them relative to meds. I've had them off and on since I was 26. Have never had it checked or anything - figure it's gone on 15 years... I do however get panic attacks if I try to sleep during the day. I think it's more about trying to nap when I'm dependent on a sleep med at night. I can be drifting off, here a small sound (like dog snorting or a bird squawking outside) and suddenly my heart starts pounding as if I've heard a gunshot. needless to say - I don't try to nap much anymore. All that started when I went on Neurontin several years ago. I came off the drug after 6 months but the nap panic has never gone away and the sleep at night has never gone back to normal. :( > I do not get them relative to meds. I've had them off and on since I was > 26. Have never had it checked or anything - figure it's gone on 15 years... [quoted text clipped - 10 lines] > drug after 6 months but the nap panic has never gone away and the sleep at > night has never gone back to normal. :( Sorry to hear about your sleep problem. I too get very tired during the day and feel as if I just have to sleep, often 3 or more times a week. I can go into a really deep sleep in the afternoon. What you describe about just dropping off to sleep and waking up in a panic is something I have also experienced at night (you say its only during the day for you). My freind who is healthy also has it. I have read a bit about it and in my case I believe it is "night terrors" I wake all of a sudden, usually not long after I have dropped off to sleep, sometimes saying something out loud. Often I have a very vivid dream, which seems very real when I wake up. For example there is a huge spider on the pillow. Another one is that I have forgotten to take a vital medication, without which I might die very soon! Needless to say night terrors are not an illness and although less common in adults they do occur in healthy people too, and are thought to be a sign of overtiredness. > What you describe about just dropping off to sleep and waking up in a panic > is something I have also experienced at night (you say its only during the > day for you). I would have it at night if I didn't take the Ambien. But I am otherwise dependent on that med. The times I have run out or forgotten to take it, i have had the same feelings and my bladder spasms have ramped up. > My freind who is healthy also has it. > I have read a bit about it and in my case I believe it is "night terrors" I [quoted text clipped - 3 lines] > pillow. Another one is that I have forgotten to take a vital medication, > without which I might die very soon! I have had this experience. I used to have these much more intensely when I was being weaned off amitryptiline. I will say that I don't miss anti-depressants at all. Though the Ultram I take has a mild serotonergic effect and may contribute to the problem. > Needless to say night terrors are not an illness and although less common in > adults they do occur in healthy people too, and are thought to be a sign of > overtiredness. hmm... I also had them when I was pregnant soooo many years ago. Especially in my later months. I sure was tired then! :) But I was more tired *after* had her and for the following 18 years plus a little. :) My daughter had horrible nightterrors that she did not awaken from. At first you would think she was awake but then realize that in her blood-curdling screams she was completely unaware of my presence. Well, unaware in the conscious sense. I would stumble into her room (nothing like being awakened at 3 a.m. by piercing screams from a 4 y.o.) and sit on the side of her bed, trying to calm her and get through to her. Then she would just kinda flop back on her pillow and be soundly asleep with no recollection of the nights events. She has outgrown some of this though she was put on a medication briefly a year or two ago that stirred up some of this again. Ambien of all things. I guess we could surmise that it's more common in children because all of the connections are being formed and the receptor/transmitter system isn't quite mature? I'd love to learn more about the development of the Reticular Activating System which has a lot to do with sleep cycles and maybe explains the odd childhood patterns. She also had a tendency to sleepwalk as she got older and eventually stopped doing this (again, except during that week or so she tried Ambien.) That stuff had her halucinating and everything else. For me, it's a Godsend. For her, a nightmare. babbling as I'm trying to wake up now. Been very tired today -I think because of day after day of storms. I love this weather but it's stressful on dog and of course worrying about hubby getting caught in the flash floods here. Some folks were not as fortunate as we were and had their homes flooded again. We've had some very strange weather ever since summer 2001. Several years ago at the point in my life when I was experiencing profound fatigue I also had palpitations. Between the fatigue and the heart stuff I kept thinking if I were to fall asleep I might never wake up. Saw a cardiologist and, in addition to numerous other tests, was put on a 30-day Holter monitor. The heart stuff turned out to be innocuous PVCs (premature ventricular beats). Over time I managed to pull out of the extreme fatigue and the PVCs stopped also. (The fatigue is still around, just not quite so overwhelming.) Does any of this relate to your situation? cp > Hello all, > Has anyone experienced palpitations with any medications? I am having them [quoted text clipped - 22 lines] > Thanks, > Paulette ooh.. PVCs will make give you that sudden, one big THUD! feeling in your chest. First time I had those it scared the tar out of me. It was a few months before I had to quit working from the pain and exhaustion of the disease. I would feel fine, then it would be like my heart raced a little, then hesitated, then THUD. I never sought treatment but my boss (MD) said it was probably PVCs and *most* of the time they are benign in nature. What a strange feeling though. And I haven't had them since I quit working and have been able to control my fatigue/rest pretty well. > Hello all, > Has anyone experienced palpitations with any medications? I am having them [quoted text clipped - 5 lines] > Of course, I did not experience until the next day sitting at work but not > in bed. That's why there's a 72 hour monitor test. > Anyway I did not take any other medications except my thyroid that > day. Last night when I did not have the monitor on, I took a decongestant [quoted text clipped - 6 lines] > have any of these symptoms until he increased my thyroid the first time. > Have been having them ever since. Excessive thyroid hormone intake is one of the causes of palpitations. http://www.medicinenet.com/palpitations/page4.htm I forget offhand the exact "normal values" for TSH. It's around 0.5 through 5.0 As I recall, Zinn's doctor keeps her at the higher end of that range (around 4.5). That's where she and he agreed that she felt better. My doctor was keeping me at the lower end of that range (around 1..2 - 2.0). That's where he and I agreed that I felt better. You don't say what your lab value was before the change (and the normal ranges on the lab report). You don't say what your lab value was after the change (and the normal ranges on the lab report). You don't say how much he increased your thyroid hormone. Here the Synthroid only comes in certain strenghts, so I have to sometimes switch to one that comes in the correct strength. (and vice versa). They only increase (or decrease) my thyroid medication by 0.25 at a time. Maybe you should ask for a 72 hour halter monitor test. Wait for that test result, then sit down with him and look through the past thyroid lab reports and talk with him about where your "best" thyroid hormone replacement level might be. Hugs J > You don't say how much he increased your thyroid hormone. > > Here the Synthroid only comes in certain strenghts, so I have to sometimes > switch to one that comes in the correct strength. (and vice versa). > They only increase (or decrease) my thyroid medication by 0.25 at a time. Correcting major goofup: Thyroid hormone medication changes should only be made in increments of 0.025 mg So my last thyroid pill was 0.150 mg My new prescription is 0.175 mg If your medication is in another measurement (other than mg), I don't know how to translate from one to the other. And they say to always take it at the same time of the day. J > Last night when I did not have the monitor on, I took a decongestant > because I think I am coming down with a cold and surely, I had the > palpitations last night. It feels like my heart is thudding. PS Most of our over the counter cold and sinus medicines, have a warning on them that they can affect persons who have thyroid conditions. I quit using them years ago or look for one that doesn't have a warning about such or ask the pharmacist which is safe for those who have thyroid conditions. Decongestants don't prevent colds. They decongest the sinuses. I use steam and Vicks inhaler, if my sinuses get congested, unless there's an infection. I have a lot less troubles with sinus troubles since I got rid of allergens in my environment (dust, dust mites, carpets, perfumes, scents etc. (whatever you're allergic to) Hugs J Hi Paulette, My first thought was the same as the one J mentioned here. There is a warning about cold meds/thyroid. I once asked a pharmacist friend about the importance of it. He questioned me on whether or not my thyroid was well regulated at that time. So, if you are still in the thyroid med adjustment stage I would stay clear of any over the counter meds, unless your doctor says it is okay. Best to be safe, especially when you are noticing palpitations. > > Last night when I did not have the monitor on, I took a decongestant > > because I think I am coming down with a cold and surely, I had the [quoted text clipped - 14 lines] > Hugs > J Hi, I don't know much about thyroid medications and problems except in very general terms. But did you know caffiene is in some medications and can cause palpitations - like when you have a lot of strong coffee. Personally I avoid over the counter medications. Our doctors' surgery has a policy of never issuing prescriptions for colds. Some of the cough medicines sold here in UK have real following of people who are addicted to them, because of some of the ingredients which give you a nice sleepy feeling! Andy, (waves to Andy in the next county) ever heard of that one? > Hi Paulette, > My first thought was the same as the one J mentioned here. There is a [quoted text clipped - 28 lines] >> Hugs >> J >Hi, >I don't know much about thyroid medications and problems except in very [quoted text clipped - 6 lines] >nice sleepy feeling! >Andy, (waves to Andy in the next county) ever heard of that one? [next-but-one by 7 miles!] waves back... Yes, although I forget which ingredient it is. Personally, I recommend Islay malt whisky for colds etc - it has no effect whatsoever on the disease but it makes you forget the symptoms ;)  SignatureAndy Taylor [Chair, N E Lupus Group] See http://www.northeastlupus.org.uk for more! Thanks everyone for all the kind words and information. My 24 hour monitor came up with zilch. And he increase my medicine to 0.135. I think PVC's is what I am having. I get a sinking feeling just before then "THUD". I was doing this before Jasper died but it has happened more often since then. Don't know if its stress related or not. One thing, I have tried to move on with Jasper's death. Sunday I adopted a little pound Kitty which I named Ginger. She picked me. I was actually there to see another cat that looked almost identical to Jasper. But that was where the similiarity ended. The chemistry was just not there. But little Ginger Kitty was in my face saying" I'm the one". The first night she was already sleeping on our bed like she was a natural for our house. The lady that was her foster mother, said it was phenominal and that usually cats that have been through a lot, hide under the bed for a week. I guess it was meant to be. Hopefully, Ginger will help me heal my heart, emotionally as well as phyically. What bothers me is that I have taken this so hard. I cried more over Jasper than my mother's death. Maybe because I didn't get to say goodbye and I can't even find pictures of him, like he never existed. That will not happen again. There will be plenty of pictures of Miss Ginger. Love to you all, Paulette Stress can cause PVC's!!! Oh, yes! That might not be scientific but I've heard the doctors say it more than once. Hope you are feeling better. ((HUGS)) Bev > Thanks everyone for all the kind words and information. My 24 hour monitor > came up with zilch. And he increase my medicine to 0.135. I think PVC's is [quoted text clipped - 19 lines] > Love to you all, > Paulette > Thanks everyone for all the kind words and information. My 24 hour monitor > came up with zilch. And he increase my medicine to 0.135. what medication measurements > I think PVC's is > what I am having. I get a sinking feeling just before then "THUD". I was > doing this before Jasper died but it has happened more often since then. > Don't know if its stress related or not. I don't like the sound of that thud. As I mentioned there's a 72 hour halfter monitor test (which is better). It's a nuisance having it on longer and taking notes when events are felt, but it's better for intermittent heart problems. And in my opinion, he increased the med "too high, too fast". I was told no more than 0.025mg (milligrams) each time and then a recheck of thyroid levels within 3 months. (however, I don't know what medication measurements you are using. What was your TSH reading before he increased the medication dose? And how were you feeling (generally) before he increased the dosage? Hugs J J, I have not been to my Rhumy since I went into remission 20+ years ago, for which I don't think is the case now. Anyway, I have been seeing my GP for whatever problems I have been having. I am thinking I may need to go back to him. He is expensive but at least I have insurance now for which I did not back when I first came down with it. My thoughts with all of my various symptoms, at least being a lupus pro (hopefully) he could look at what is going on with me , (thyroid, sciatic nerve problem, PVC's, side hurting, etc) he could look at it with Lupus in perspective. What do you think. Is this a logical idea? I have had a CT scan, colonoscopy, electromiogram for my sciatic, all kinds of stuff and I just don't feel right. This fluttering feeling in my chest is giving me the willies. No telling when I will be able to get an appointment. Could be next year sometime. I would have to bring a list to make sure I did not miss any questions and I guess I would have to make sure he had copies of my records. Or get them for myself and bring them with me. One of the reasons I left is because of his ole battle-ax crew of die-hard nurses, hounding me for money for which I did not have and also could not take the emotional upsets they were giving me everytime I went there. It was not pleasant. It would put me into a flare everytime. Surely things have changed since then. They really didn't know their patients problems did they or all they cared about was collecting money. Sorry for going down memory lane.... What do you think? Paulette > > Thanks everyone for all the kind words and information. My 24 hour monitor > > came up with zilch. And he increase my medicine to 0.135. [quoted text clipped - 20 lines] > Hugs > J > I have not been to my Rhumy since I went into remission 20+ years ago, for > which I don't think is the case now. [quoted text clipped - 22 lines] > > What do you think? Hi Paulette, maybe it's not a bad idea to have a rheumy see you and get your medical records. He could look at your thyroid test results and other scans etc, but why a year? Have you tried calling? Maybe they'd squeeze you in sooner or put you on a waitng list. On the one hand if you don't need medication for Lupus maybe it's not worth bothering a rheumy;' on the other hand, I don't think seeing a rheumy after 20 years is unreasonable just for a checkup; be prepared for bloodwork and take all your medicines with you. This website (Australian, which I trust),does mention a thud and says not all are dangerous <http://www.betterhealth.vic.gov.au/bhcv2/bhcarticles.nsf/pages/Heart_arrhythmi> This type of heart arrhythmia typically feels like a skipped beat, followed by a heavy thud. The occasional palpitation is nothing to worry about, but consistent irregularities of the heart beat should be investigated by a doctor.' Two categories of arrhythmia Heart arrhythmia is categorised into two types: * Tachycardia - this is when the heart beats too quickly. Most episodes of tachycardia are experienced in the upper chambers of the heart, or atria. Those that occur in the lower chambers, or ventricles, are more serious. Arrhythmias in the ventricles are associated with sudden cardiac death, particularly if the ventricles are reduced to quivering rather than beating. This is called 'ventricular fibrillation' or VF. It should be noted that tachycardia is normal after vigorous exercise. * Bradycardia - this is when the heart beats too slowly. Usually, bradycardia is caused by problems within the sinus node, the specialised cluster of cells in the heart that regulate the heart beat. In severe cases, there may be a problem with the electrical 'cabling' of the heart; intermittent signals can cause the heart to beat very slowly. It should be noted that people who are physically fit may have a slow 'resting heart rate' and therefore a normal bradycardia. Some cases of arrhythmia can be traced to certain medications or drugs, including: * Appetite suppressants * Beta blockers * Caffeine * Cocaine * Amphetamines * Nicotine in cigarettes * Some asthma medications * Thyroid medications. Serious disorders Heart arrhythmia can be a symptom of more serious underlying disorders, including: * Previous heart attacks that have scarred the heart tissue * Heart valve or heart muscle abnormalities * Congenital heart disease * An overactive thyroid gland * Problems with the sinus node, the natural pacemaker of the heart. Medical tests If you are troubled by persistent irregularities of heart beat, you should consult with your doctor for a thorough medical examination. Recommended tests could include: * EGC or electrocardiogram monitors your heart rate and rhythm. * Chest x-rays may also be taken. Two other people here attributed it to fatigue but they didn't mention being on thyroid medication. So if you aren't taking that sinus medication on a regular basis and can rule out the items listed above and still are getitng the palpitations and thuds, if you're getting too much thyroid medicine, you'll be getting too much for a long time until you see the rheumy. If you're getting the right stuff and you have a ... I'm sorry, I really don't know the right thing. The thing is with heart muscle is prevention of problems, not waiting till damage has occurred. On the other hand I don't want to scare you either unnecessarily or cause you to have more doctor's appointments and tests for nothing. I think the answer lies in your thyroid bloodwork results. your level and what the normal range says on the report. I just got a thyroid test today. TSH and Free T4. The doctor I asked had been nasty to me last winter and a few months ago, so I wasn't sure I wanted to go back there, but I did and this past appointment went well, BUT he skipped over my most recent diabetes test result and showed me an older test result, which makes me wonder why. Doctors do weird things. Hun, you do what you think best and I'll support your decision. (sorry for the long post) Hugs J Well I did it, I made an appointment. And surprisingly it is on Aug 11. I figured I would have to wait a long time. I told her about my heart problem, maybe that alerted her to give me a better one. He will be surprised to see me after all these years. He was great, his nurses weren't. But the lady I talked too was very friendly. Maybe some have retired by now. LOL. I am going to get all my records to give him a background on what has gone down the pike since then. She said I wasn't even on their records anymore unless its on microfiche or something. At least I have insurance now. We were first married with one child and it like to have done us in then. I hope he will listen to me and not come up with an answer before I'm finished talking. Let you know how it turns out. Thanks, Paulette > > I have not been to my Rhumy since I went into remission 20+ years ago, for > > which I don't think is the case now. [quoted text clipped - 35 lines] > This website (Australian, which I trust),does mention a thud and says not all > are dangerous <http://www.betterhealth.vic.gov.au/bhcv2/bhcarticles.nsf/pages/Heart_arrhyt hmi> > This type of heart arrhythmia typically feels like a skipped beat, followed by a > heavy thud. The occasional palpitation is nothing to worry about, but consistent [quoted text clipped - 69 lines] > Hugs > J > Well I did it, I made an appointment. And surprisingly it is on Aug 11. I > figured I would have to wait a long time. I told her about my heart problem, [quoted text clipped - 7 lines] > listen to me and not come up with an answer before I'm finished talking. > Let you know how it turns out. Good for you, Paulette. Have the records, but be aware that doctors often stop listening after the first few words, so have a list of questions: I'm here for 5 reasons: (Paulette hands him the list) 1) I want to know if my thyroid is causing my palpitations and if I should be on a lower dose of thyroid medication - please look at my labwork. 2) review of my current medications (separate the ones that you take daily from the ones that you only take on the occasional basis). 3) review of my Lupus situation because I respect your opinion. ( discuss any lupus symptoms that you feel are troublesome. If you feel otherwise fairly good, perhaps there'll be nothing on this list.) 4) when should I see you next? one year? 5 years? or when? Then let him decide if he's going to do bloodwork or any scans (as long he doesn't overdo or redo the same ones that you've just recently had, because that's a waste of time and your energy). I think those would be my questions. Let us know how you made out, hope all goes well, Hugs J |
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