Managing palpitations with hyperthyroidism means treating the excess thyroid hormone and calming the racing heartbeat safely. Arrange medical review to check thyroid levels and heart rhythm. A clinician may prescribe a beta blocker for symptom relief while thyroid treatment takes effect. Take medicines as directed, limit personal triggers such as caffeine or nicotine, and seek emergency help for palpitations with chest pain, breathlessness, or fainting.
How can hyperthyroidism cause heart palpitations?
Hyperthyroidism, also called an overactive thyroid, occurs when the thyroid gland produces too much thyroid hormone. These hormones affect how the body uses energy and can cause the heart to beat faster than usual or develop an irregular rhythm. As a result, some people experience palpitations, which means being unusually aware of their heartbeat.
The MedlinePlus Medical Encyclopedia identifies a pounding or racing heartbeat as a common symptom of hyperthyroidism. Palpitations may occur alongside other experiences, such as:
- A fast or forceful heartbeat, even while resting.
- A fluttering sensation in the chest.
- A feeling that the heart skips a beat or beats unevenly.
- Shakiness, sweating, nervousness, or difficulty sleeping.
- Reduced tolerance for physical activity because of a racing heartbeat.
These experiences can occur for different reasons, so they do not establish that thyroid disease is causing the symptoms. Hyperthyroidism can contribute to heart rhythm problems, including atrial fibrillation, an irregular heartbeat that can increase the risk of stroke. Persistent or recurring palpitations should therefore be assessed rather than managed only with home measures.
What should you do when palpitations start?
When your heartbeat suddenly feels fast or unusually forceful, stop strenuous activity and sit somewhere safe. Give yourself a chance to rest and notice whether the sensation settles. If you feel dizzy or faint, avoid walking around alone or driving. Do not take an extra dose of a prescribed medicine, borrow someone else's medication, or try to control the episode with an unprescribed heart medicine.
If the episode settles, make a brief note of when it started, how long it lasted, what you were doing, and whether you noticed other symptoms. If you can comfortably check your pulse, you may record whether it seemed regular or irregular, but do not delay getting help to measure it. These details can help a healthcare professional understand the pattern and decide what evaluation is needed.
Which treatments help control palpitations with hyperthyroidism?
Effective management usually involves two related goals: reducing the effects of excess thyroid hormone and controlling the heart symptoms while treatment takes effect. The appropriate approach depends on the cause of hyperthyroidism, the pattern of the heartbeat, your other health conditions, and your treatment history.
1. Treat the underlying thyroid problem
Controlling hyperthyroidism is an important part of reducing thyroid-related palpitations. The NHS guidance on treating an overactive thyroid describes antithyroid medicines, radioactive iodine treatment, and surgery as treatment options. Antithyroid medicines reduce the production of thyroid hormones, while radioactive iodine and surgery may be appropriate in selected cases.
The best option depends on what is causing the thyroid to be overactive and on individual health considerations. Antithyroid medicines may take several weeks or months to improve symptoms. Some causes of excess thyroid hormone require a different approach, so treatment should be selected by a qualified healthcare professional. Keep scheduled appointments and thyroid blood tests, even if the palpitations begin to improve.
2. Ask whether a beta blocker may help
Beta blockers are medicines that can reduce symptoms such as a racing heartbeat, tremor, and shakiness. The American Thyroid Association explains that these medicines may be used while thyroid hormone levels are being brought under control. They can provide symptom relief without reducing the amount of thyroid hormone produced by the gland.
A beta blocker may be prescribed alongside treatment for the underlying thyroid condition, depending on your symptoms and medical history. It is not suitable for everyone; for example, some people with asthma need to avoid certain beta blockers or require specific medical guidance. Your clinician will decide whether one is appropriate and determine the dose. Do not start, stop, or change the dose without professional advice.
3. Take thyroid medicines as prescribed
Follow the dosing instructions for prescribed thyroid and heart medicines. Do not stop antithyroid treatment just because the heartbeat feels better; symptom improvement does not necessarily mean thyroid hormone levels have returned to the desired range. If palpitations continue, become more frequent, or change after starting a medicine, contact your treating clinician so the treatment plan can be reviewed.
Tell your healthcare professional about all medicines, vitamins, and supplements you take. Some supplements can interfere with thyroid blood test results. For example, the Mayo Clinic's guidance on hyperthyroidism diagnosis and treatment notes that biotin can affect thyroid test accuracy. Ask whether you need to change the timing of any supplement before testing rather than stopping it on your own.
What daily habits may help reduce palpitations?
Lifestyle changes can support medical treatment, although they cannot correct excess thyroid hormone on their own. Pay attention to factors that seem to occur before an episode, and discuss persistent symptoms with your healthcare professional.
- Review caffeine intake. Coffee, energy drinks, strong tea, and other caffeinated products may be worth limiting if you notice a consistent connection with palpitations.
- Avoid nicotine. Smoking and other nicotine products may contribute to a racing or uncomfortable heartbeat.
- Notice alcohol-related symptoms. If palpitations seem to follow alcohol consumption, record the pattern and consider avoiding alcohol while discussing your symptoms with a clinician.
- Make time for rest. Gentle relaxation, a regular sleep routine, and manageable daily activities may help with stress and restlessness while thyroid treatment is underway.
- Avoid pushing through symptoms. If exercise brings on a racing heartbeat, dizziness, or unusual breathlessness, stop and seek medical advice about safe activity levels before resuming strenuous exercise.
The NHS guidance on heart palpitations identifies caffeine, smoking, alcohol, and stress among potential triggers. However, when hyperthyroidism is contributing to palpitations, avoiding triggers alone may not be enough. Focus on changes that are relevant to your experience rather than assuming that every trigger needs to be eliminated.
What tests and follow-up might be needed?
A healthcare professional will consider when the palpitations occur, how long they last, whether the heartbeat feels regular, and whether other symptoms appear at the same time. They will also review your medical history, current medicines, and previous thyroid test results. An examination may include checking your pulse and blood pressure, along with looking for other signs that can be associated with hyperthyroidism.
Blood tests commonly measure thyroid-stimulating hormone (TSH) and thyroid hormones such as T4 and T3. An electrocardiogram (ECG), which records the heart's electrical activity, may be used to assess the heart rhythm. Additional heart monitoring or other tests may be considered if the symptoms and initial findings indicate a need for further investigation.
Follow-up is important because treatment decisions may change as thyroid hormone levels and symptoms change. Your clinician may adjust medication or investigate another cause if palpitations continue despite improving thyroid results. Older adults may have less typical symptoms of hyperthyroidism, making blood tests and assessment of heart rhythm particularly important when concerns arise.
When should you seek urgent medical care?
Do not wait for a routine thyroid appointment if palpitations are accompanied by warning signs. The NHS recommends emergency assessment when palpitations do not go away or occur with concerning symptoms.
- Chest pain or pressure occurring with palpitations.
- Shortness of breath that is new or concerning.
- Feeling faint or actually fainting during an episode.
- Palpitations that do not settle, particularly when accompanied by other symptoms.
Seek emergency care immediately if any of these situations occur. Call your local emergency number and do not drive yourself if you feel faint or unwell. If a warning symptom has stopped by the time you seek help, obtain urgent medical advice rather than assuming the problem has resolved.
Arrange a prompt medical appointment if palpitations keep returning, become more frequent, last longer than a few minutes, or interfere with daily activities, even when there are no emergency warning signs. A new or changing heartbeat pattern deserves attention, especially if you have a known thyroid condition or a history of heart disease.
Managing palpitations over the longer term
A practical management plan combines appropriate thyroid treatment, symptom monitoring, and follow-up of heart rhythm concerns. Keep a record of episodes and bring an up-to-date list of medicines and supplements to appointments. Ask your clinician what changes in your symptoms or test results should prompt an earlier review, and when it is safe to return to your usual level of physical activity.
Palpitations can improve as hyperthyroidism comes under control, but the timing differs according to the cause and treatment. Persistent symptoms may need additional assessment even when thyroid tests are improving. With an individual treatment plan and appropriate follow-up, many people can manage thyroid-related palpitations more safely and return to their regular activities as their condition improves.