Your Thyroid and the Risk of Atrial Fibrillation

by Mary Shomon Patient Advocate

If you are borderline hyperthyroid, or you have elevated thyroid hormone levels that still fall within the reference range, research has found that you are at increased risk of atrial fibrillation. Atrial fibrillation — also known as AFib — is an irregular heartbeat where your heart quivers and beats out of rhythm, sometimes triggering dangerous blood clots.

A research study published in October 2017 in the journal Circulation, evaluated more than 30,000 participants, and concluded that free thyroxine (free T4, or FT4) levels in the highest quartile of the reference range are associated with a 45 percent increased risk of AFib, compared to the lowest FT4 levels within the reference range. The second-highest quartile was associated with a 17percent greater risk, and the third-highest quartile had a 25 percent greater risk.

Thyroid stimulating hormone (TSH) levels were, however, not associated with the increased risk of AFib.

In a press release, the study’s author Christine Baumgartner, M.D., from the University Hospital of Bern, Switzerland, said:

“Our findings suggest that levels of the thyroid hormone, free thyroxine, circulating in the blood might be an additional risk factor for atrial fibrillation. Free thyroxine hormone levels might help to identify individuals at higher risk.”

In the past, research has shown that elevated FT4 levels above the reference range are a risk factor for AFib. This is the first time that elevated FT4 within the normal reference range — evidence of subclinical hyperthyroidism — is also linked to a higher risk of AFib.

About atrial fibrillation

It’s estimated that AFib affects between around 3 to 6 million people in the United States.

Symptoms of atrial fibrillation include:

  • heart palpitations

  • a racing heartbeat

  • irregular heart rhythm

  • a pounding sensation in the chest

  • weakness

  • fatigue

  • dizziness

  • shortness of breath

  • chest pain

If untreated, atrial fibrillation can lead to dangerous blood clots, stroke, heart failure, or death.

Your next steps?

The researchers called for further investigation of this important connection, and whether the thyroid hormone replacement drug levothyroxine, used to increase thyroid hormone levels and treat hypothyroidism, could prompt an AFib risk if they cause higher FT4 levels.

According to Dr. Baumgartner:

“Patients who are treated with thyroxine, one of the most frequently prescribed drugs in the United States, generally have higher circulating free thyroxine levels compared to untreated individuals. So, an important next step is to see whether our results also apply to these patients, in order to assess whether target free thyroxine thyroid hormone concentrations for thyroid-replacement therapy need to be modified.”

If you are a thyroid patient with symptoms of AFib or a diagnosis of AFib, especially if you are taking thyroid hormone replacement medication for hypothyroidism, see your healthcare provider for further evaluation.

Mary Shomon
Meet Our Writer
Mary Shomon

Mary Shomon is a patient advocate and New York Times bestselling author who empowers readers with information on thyroid and autoimmune disease, diabetes, weight loss and hormonal health from an integrative perspective. Mary has been a leading force advocating for more effective, patient-centered hormonal healthcare. Mary also co-stars in PBS’ Healthy Hormones TV series. Mary also serves on HealthCentral’s Health Advocates Advisory Board.