Thyroid UK
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Concerned about rising blood pressure

I've perused the threads here on hypertension. I was diagnosed with Hashimoto's Thyroiditis two years ago this coming October. Since I also was diagnosed with adrenal fatigue, T3 was initially prescribed for me. It was OK, though my primary complaint this entire time and in the time preceding my dX was joint pain. I am coming to accept that I may have arthritis as a secondary condition, as autoimmune diseases seem to go hand-in-hand together.

A few months ago I started taking Nature Throid. My protocol was to start from basically an extremely low dose then up the dose by 1/4 to 1/2 grain every two weeks. This all seemed to go along swimmingly, aside from starting out at 1/2 a grain per day, which caused my body no end of aches and pains. But I survived that.

I'm now up to 1 grain in the morning, 3/4 grain in the afternoon. In the past two weeks I've been experiencing what could be hyperthyroid symptoms--itchy skin, night sweats, headaches, my menstrual period disappeared where it was consistently every 28 days (I'm 49 and going through perimenopause). And then I visited an orthopedist about my joint swelling. The assistant took my blood pressure and it was through the roof (for me), around 153/98, with a heart rate of about 60. I've never suffered from high blood pressure before, so this freaked me out. I purchased a wrist cuff (Omron) and have been using it religiously for about a week. It's clear that my blood pressure is higher than it should be, averaging about 140/86.

I'm concerned. Is it possible that I am on too high a dose of NDT? I've already stepped it back to 3/4 grain per day since two days ago and am prepared to give it up entirely and go back to T3 or nothing, if I have to.

Here are my last two lab tests, from before NDT and about 4 weeks into NDT.


Ferritin 48 (15-150 ng/mL)

FT3 3.1 (2.0-4.4 pg/mL)

Reverse T3 12.4 (9.2-24.1 ng/dL)

TSH 0.772 (0.45-4.5 uIU/mL)

FT4/THyroxine, Free, Direct 0.93 (0.82-1.77 ng/dL)

Thyroglobulin antibodies 587.3 (0.0-0.9 IU/mL)

Thyroid peroxidase ABS16 (0-34 IU/mL)


Ferritin 45 (15-150 ng/mL)

Iron Bind.Cap. (TIBC)292 (ug/dL 250-450)

UIBC195 (ug/dL131-425)

Iron, Serum97 (ug/dL 27-159)

Iron Saturation33 (15-55%)

FT3 2.7 (2.0-4.4 pg/mL)

Reverse T311.8 (9.2-24.1 ng/dL)

TSH 0.159 (0.45-4.5 uIU/mL)

FT4/THyroxine, Free, Direct 1.09 (0.82-1.77 ng/dL)

Thyroglobulin antibodies 655.8 (0.0-0.9 IU/mL)

Thyroid peroxidase ABS 14 (0-34 IU/mL)

BTW, my creatinine, BUN/creatinine ratio, and eGFR (all kidney function blood tests) were checked in February 2016 and they're in the normal ranges.

Does anyone have any ideas? Should I stop NDT and go back to T3? I am going to continue monitoring my blood pressure. I have a doctor's appointment set up with a new doctor in mid August.

Thanks in advance.


14 Replies


Your iron is very low. Optimal is >70. Are you Supplementing ? .

What dose T3 where you medicating previous ? ?

NDT can be intolerant of iron//nutrient deficiencies encouraging high antibodies. You need to raise slowly enough so your body accepts the hormone but quickly enough to keep TSH suppressed so discouraging antibodies.

Your TGAb were very high anyway and are probably much higher now as you sound as if you are having a Hashi attack. You are probably still UNDER medicated but may not be able to raise dose further with low iron.

Elevated thyroid antibodies can impair good thyroid hormone function by decreasing T4-T3 conversion and the sensitivity of the thyroid hormone receptors, meaning no meds will work well.

What about Vit B12, folate and Vit D ? ? What are your cortisol levels like ?


Low Iron & NDT


Thanks for the reply. I am supplementing iron daily with Spatone. My B12, D, and folate are fine, actually they were off the charts for a time so I had to dial those supplements back.

I was on 10 mcg T3 compounded. My antibodies have come down considerably--they started at >1000. Unmeasurable.

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Gosh ..poor you.

Are you taking active measures to lower them ? ? .. (g/f diet, etc )

Iron can take ages to raise and I don't supplement iron so can't really advise but I read Spartone may not be enough for big deficiencies.

You could post another question re iron sups or type it into the search box above.

10mcg T3 is equivalent to 30mcg T4. If your NDT grains are equivalent to 100mcg T4 you are now medicating equivalent 175 mcg T4 ? ? ...(unless your grains are smaller doses ).

10mcg T3 isn't much but if that was your dose you must be OVER medicating now.


10 mcg of T3 wasn't enough to eliminate all of the hypo symptoms, specifically joint aches. That's why I moved to NDT. NDT is also covered by insurance, whereas my compounded T3 costs $50/month.

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Don't forget that in NDT the T4 will also convert to T3 as well


Too much vitamin D can cause hypercalcemia but maybe if you have a look at


Spatone doesn't contain enough elemental iron generally let alone to raise your ferritin levels as it only contains 5 mg.

The RDA for women is 15mg daily if they are menstruating and 8mg if you are post-menopause. If you have a deficiency/low levels it is recommended to take around 65mg per day for 6 months to see an increase. (Though the amount you should take for the first 6-8 weeks depends on how low your initial level is.)

This is why ferrous fumerate (67-70mg of elemental iron per tablet) is advised. However for those who find they have consistent bowel problems ferrous gluconate is recommended. It is far more expensive than ferrous fumerate and you normally have to take 2 or 3 per day to get the right dosage of iron.

One thing to be aware of is that when taking iron tablets is that the vitamin C tablets taken along side it can cause bowel problems instead of the iron.

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Have you tried going gluten free?

What about vitamin d levels?


I don't eat gluten, nightshades, dairy, or soy, and as of this writing I've also given up salty snacks and red meat.

I tell people all the time that food is trying to kill me.

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Have you had your PARATHYTOID checked . Id suggest checking your Calcium , PTH, ANA , CRP and ESR levels . Do you know what your calcium levels are ?


I'll look at my labs again, but I'm pretty sure I had calcium checked and it was normal. Worth revisiting, though.


The more I think about this, the more I wonder if dietary calcium (for a couple of months have been taking a multivitamin with 4000%+ of recommended daily intake). To make a long story short, I have problems with calcium. I have idiopathic (at this point) bulging joints in my fingers and feet, in addition to chronic yet sporadic shoulder and knee pain. I used to take supplementary calcium but stopped taking this, along with removing nightshades and dairy from my diet, and the joint issues and pain resulting from these issues decreased significantly. As of today I'm not taking the multivitamin to see if this helps at all.

Any idea if there's a connection to rising blood pressure and excess calcium?


Even though your free t4 t3 fall within range,It's likely that you are experiencing hyperthyroid symptoms given your Tsh. I've had hyper symptoms with tsh of .6 and more recently .2, even though t3band t4 were normal. I think you' re doing the right thing cutting back on your NDT dose. You may not know for a month or more if it's the right amount.


Thanks, I'm feeling like my own ultimate guinea pig. All the time.


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