Constant heart palpitations, worse at night, low folate?

[Ragdollmother]

Over the last few weeks I’ve been getting increasing heart palpitations, to the point that at night I can’t sleep at all as my heart is flipping about all night , beating hard and fast, then beating slower, and I’m dizzy and slightly breathless.

It happens during the day too and I’ve had a few near fainting episodes, I’m extremely light headed all the time.

Gp did bloods that came back low folate so I’m on 5mg folic acid daily. My b12 was lower end of normal but Gp totally unconcerned despite strong family history of pernicious anemia /b12 deficiency.

A 30 second ECG showed nothing of concern so I’m waiting for a 24hr one next although may have to go private for that as it could be a few weeks away on NHS and I honestly feel like I am dying.

I don’t know if low folate would cause such severe symptoms?
I’m 40 and possibly perimenopausal , but again would that make me feel like this ?

I am searching for anything that can help me feel better :(

I started taking magnesium glycinate and this really helped me.

I see you have already seen your GP. How long do these episodes last? You say you have them at night - try sleeping propped up, and avoid sleeping on your left side. Avoid caffeine, and alcohol.

it may be that you do have an underlying problem but your GP can't see it because you're not having it when you see them, or it may be that you are stressed and the extra adrenalin in your system is causing the palpitations. I have paroxysmal atrial fibrillation, which just means a type of out of sync heart rhythm that happens sometimes but not all the time. It is a serious problem for which I take medication, but most of the time it doesn't bother me at all. However I can have a similar feeling if I'm having a panic attack, or sometimes I will wake from a nightmare and my heart is racing. I find the more I am aware of it, the worse it feel, so I know that I will be hyper-aware about anything that doesnt feel right.

My DH bought me a Kardia finger monitor some years ago - it wasn't cheap, around £100 at the time so it is likely to be a lot more now. It means I can check what's happening with my heart if I feel unwell and it reassures me sometimes that although I'm feeling as though my heart is racing there isn't actually anything wrong, except that my heart rate is up, which can be for any number of perfectly normal reasons. For the times that it tells me that I am having an episode of atrial fibrillation I can keep an eye on how long that is happening, and if it doesn't stop after a while I call 111 and they tell me to go to A&E. However, for me, that is usually around 10 hours as it usually goes away on its own way before then.

the last time I had a 24hr monitor it showed absolutely nothing abnormal at all even though I have been diagnosed with a problem so it may well be the same for you. Try keeping a diary of when you feel like this. What you ate/drank beforehand, what you were doing at the time, were you stressed, relaxed, lying down etc. It may show you whether there are any triggers, and help to understand what it is that makes you feel that way.

So - just for the moment - avoid caffeine and alcohol, sleep propped up and not on your left side, avoid stressful situations and keep a health diary.

Keep up with your folate, and look after yourself.

Thank you @DilemmaDelilah

I definitely find sleeping on my left side is a no no at the moment. I am going to try the propped up position tonight.

I am not entirely sure how long the episodes last for because at night they genuinely seem to go on for hours. I am seeing every hour on the clock at the moment. In the day time they can last from several minutes to hours long. I’m exhausted and dizzy from it all.

I also feel breathless especially when I speak.

I gave up caffeine a month ago and don’t drink alcohol anyway, and still no difference. The palpitations have got worse over the last week or so.

Prior to this I have not been going through anything particularly stressful in my life, which makes me pretty certain it’s physiological. I have suffered with anxiety in the past but it has never presented like this.

Do you mind me asking what test /diagnostic confirmed your AF?

Whenever I try to read up about folate deficiency it is always interwined with B12. The fact your B12 is low too makes me think you need some form of supplement for that as well. The heart palpitations is more B12 than folate but your other symptoms fall under both. Out of curiosity what were your results compared to the lab ranges if you don't mind sharing? Oh, and low iron also causes palpitations.

www.nhsinform.scot/illnesses-and-conditions/nutritional/vitamin-b12-or-folate-deficiency-anaemia/#symptoms-of-vitamin-b12-or-folate-deficiency-anaemia

In most civilised countries low b12 even if ‘in range’ paired with symptoms results in treatment. Unfortunately many GPs here are rubbish and inflexible. I would go back and fight it out for b12 supplementation.

I had this massively at the start of perimenopause and after loads of checks said there was nothing physically wrong solved it with industrial amounts of high quality magnesium- in bath as well as supplements. Apparently you use loads in the menopause.

@Ragdollmother I rang 111 when I was feeling particularly unwell and they sent me to A&E where I was put on a heart monitor and has the usual ECGs. If you are having prolonged episodes perhaps that is what you should do. As an aside, I needed a magnesium infusion that time.

Any particular type of magnesium?

Was your thyroid checked when you had your bloods because I've got overactive thyroid and my heart does exactly what yours does, and it's always worse at night. Do you have a tired/wired feeling?

Although you’re still young, it could be perimenopause. I’m much older than you but these symptoms were some of my first major ones before I went on HRT. Worth checking in with your GP if nothing else is helping.

I had similar irregular symptoms, and after two Holter monitors failed to pick up what was happening I was given an ILR - implanted loop recorder - which monitored and transmitted my heart irregularities to the cardiac team. It’s a tiny ( like a squashed aaa battery) inserted under your skin under a local , took about 10 minutes from start to finish. The results of it were a bit scarey, sometimes my heart was stopping for eight to 10 seconds - though always starting again 🙂. My ILR was replaced with a pacemaker which also monitors my heart activity but also reminds it to start again.

If you are still getting symptoms but the holter isn’t showing what is happening then a ILR could be the next step for a proper diagnosis.

@Ragdollmother I could have written your post, I actually started my own similar one! I know this is a bit old but how are you? Did you get any further in your diagnosis? I am 41 and was also wondering about perimenopause.

Like you, I feel breathless, but I feel it at rest too and when talking. I feel light headed and when I take my BP, it's low.

Nights aren't great. I feel like my heart is 'jumping' around, especially as I'm lying down . Last night it was also beating hard and fast.

I'm low in Hb, ferritin and vit D but waiting on b12 and folate to be checked.

I've been like this since mid Dec and I can't think of anything else, the anxiety around this is taking over all my thoughts...

@Ragdollmother sorry to pester but was hoping to hear back from you

Sorry, had to change password etc as I hadn't logged in for a while.

I'm 40 and I 100% think it is perimenopause, but GP is reluctant to help other than give me antidepressants. I'm too young for peri according to them!! I am still getting the palpitations, and I noticed they are worse a few days before my period. I try not to focus on them too much (they are horrible though) but I have been sleeping better since starting magnesium glycinate. I had a 24hr ECG and it was normal apparently.
I still get breathless without doing anything and i'm very lightheaded a lot. GP says its anxiety - I can assure you it wasn't anxiety when it started but the symptoms are so hideous I am anxious now!
I've been taking folic acid now for 2 months and not really noticed a difference, I also had some B12 jabs privately and I'm taking vitamin D.

I think if you can get your vitamin levels back up you may see a difference , but you may also need to explore perimenopause too. It's a tricky when so many symptoms relate to peri and vitamin deficiencies at the same time.

Please push for a full diagnosis. So often women are instantly told anxiety/menopause, whereas men have a full investigation. MRI is key for spotting issues like inflammation and any diffuse scarring.

I had this with low folate, it went about three weeksa after I started taking the folic acid the GP prescribed.

This.

my exact same symptoms were put down to anxiety/menopause.
/grief until I went to gps and saw a doctor I don’t normally see and got sent straight to a and e after a particularly bad episode.

i was then diagnosed with something wrong with electrical impulses in my heart and is apparently something I’ve had all my life (consultants looked at every ecg I’ve had since I was 16) and sent to the Liverpool heart and chest hospital where I may have to have a small op to correct. I’m on meds now to control it.

please push for further testing

@Ragdollmother I appreciate you responding to me, thank you.
You say "I still get breathless without doing anything and i'm very lightheaded a lot." This is exactly me. Have you checked your bp when you feel like this? I think mine coincides with lower than normal bp.

I also take magnesium now which helps me to sleep but I find falling alseep the hardest as this is when my palpitations kick in the most, particularly the heart beating slower/flipping/jumping which you describe in your first post. Do you get this when falling asleep?

I have terrible HA and cannot stop worrying about this, although I also think peri has something to do with this. Still waiting on further tests.

@Abcde0839 I haven't had a folate test. How does folate deficiency develop? Is it diet related?

Have you had a ferritin check? It's secondary to the usual iron check.

My BP was normal when taken at the surgery so it isn't related to that but I am always very dizzy standing up from sitting. I was given propanolol for the palpitations which helps slightly but adds to the dizziness. A vicious cycle.
If your BP is low it could explain your lightheadedness. And GP unlikely to give you beta blockers if that is the case but I would push for 24hr ECG.
I totallt agree about the night time palpitations they are awful. Try sleeping slightly propped up on your right hand side - i've been doing that and it makes them a bit less noticable.

I had these symptoms and like @DilemmaDelilah I was diagnosed with Atrial Fibrillation. I think I was lucky that it was caught on an ECG at hospital and not put down to anxiety. I take daily medication which helps and have also bought a KardiaMobile portable ecg device. It gives my heart rate and whether I am in AF (I know when I am but it's good to have it confirmed).

@SchrodingersTwat2 my bloods showed low ferritin at 15, but that could be causing the dizziness/light-headedness and low bp?

I had this before I started HRT. My palpitations would wake me up.

@Theextraordinaryisintheordinary did you also get breathlessness?