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My endocrinologist claims my heart problems can’t be caused by Hashimoto’s, since my thyroid is still working perfectly, so I asked my cardiologist and he said that the thyroid may indeed play a role in it, as Hashimoto’s first implies hyperthyroidism. Can Hashimoto’s cause symptoms such as tachycardia and benign arrhythmia? How high is the chance I develop thyroid disease and need to take medications? Will it get worse for my heart condition when I start taking hormones?

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I worked few years as a nurse and I think that hashimoto's does not first imply hyperthyroidism, although some patients with positive antibodies may develop hyperthyroidism this is not the norm. Positive antibodies are often associated with a destruction of thyroid gland tissue and loss of thyroid function. The palpitations are also uncommon in hashimoto's. It is possible however, I have seen a few patients with borderline hypo from hashimotos who experience palpitations with anxiety and starting a low dose of thyroid hormone did help. The tachycardia can sometimes worsen in patients with normal thyroid function tests that start thyroid hormone treatment, so there is hesitation to do this. However for a young, healthy female with a structurally normal heart as you are, a trial of thyroid hormone at a low dose could be tried and stopped if the situation worsens.
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