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Levothyroxine & Atrial Fibrillation

Mr. H, a 78‑year‑old patient, arrives clutching his pill bottle and anxiously explaining that his heart has been “fluttering” ever since his levothyroxine dose was adjusted. He worries the medication is “too strong” and fears it may trigger atrial fibrillation. You review his symptoms, recent labs, and dosing history while reassuring him that his concerns are valid and worth evaluating. As you assess, you consider whether he may be edging toward subclinical hyperthyroidism from overtreatment. How would you address his fears while determining whether his levothyroxine dose needs adjustment to reduce AFib risk?

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