High blood pressure...would appreciate input!

I just had my third GP appointment in less than three weeks.

I've had high blood pressure for years. It was first discovered back in 2000 when I was diagnosed with Hashimoto's. I was then told it would normalise once my TSH normalised on levothyroxine.

However, it never fully has so, back in 2013, I was put on blood pressure medication. It was during an extremely stressful period (work wise) and my BP was 180/120.

I spent the next three years on perindopril 10 mg daily and my blood pressure normalised (the lowest reading ever was 119/79).

Then, my GP moved away and, for some reason, I did not start looking for another one...I just kept putting it off. I have not taken any blood pressure meds for a little over a year.

Three weeks ago, my BP came back at 170/98. I was told to come back a week later and it was about the same (171/95). Today, it was 170/92.

The new GP said this puts unnecessary strain on my heart, and that I should go back on perindopril, starting on 5 mg for a month to see if that is enough. If not, she will put me on 10 mg daily.

She expressed great concern about my suppressed TSH (<0.01 for years). She had never heard of any other thyroid drug than levothyroxine so googled NDT and then said (after reading about it for a minute or so): "This could very well have caused your high BP".

I know most doctors are ignorant when it comes to thyroid disease and unconventional treatment such as NDT, so I don't really care about that. At least she agreed to let my hormone doctor in Belgium remain in charge of my thyroid hormone treatment and did not try to force T4 on me. Too many doctors have done that over the years.

However, I cannot help but wonder about my blood pressure...I know hypoT can cause hypertension, but am curious to find out if others have continued to suffer from it even after optimizing treatment?

I have tried to find out if perindopril will mess with thyroid function/meds but cannot find any specific info on that...I know that beta blockers can mess thyroid levels up.

Of course, the doctor asked today if I eat a lot of salt...the thing is that I have constant salt cravings since going off all adrenal support (prescription and supplements). I will carry out a diurnal cortisol saliva test on Sunday and sent it to the lab on Monday. If the results show I have low cortisol, I will have to consider whether I should go back on Medrol (prescribed by my hormone doctor for adrenal fatigue) or try adrenal cortex instead. Anyway, I know that low cortisol can cause salt cravings. I try to only eat celtic sea salt, and avoid ordinary table salt, but maybe that does not really make a difference...? Also, I drink a lot of sparkling water and I know it contains sodium. Would it be a good idea to go off it for a while?

[magsyh]

High estrogen, low progesterone will also effect your blood pressure. I have lowish cortisol and my private doc told me it's the progesterone that is balancing my cortisol and without the progesterone I would have a seriously low cortisol. My blood pressure goes way up at the docs just with stress. At home it's low normal so buy your own monitor you may be surprised. Progesterone relaxes the blood vessels estrogen narrows them. I also take magnesium glycate which keeps blood pressure in check also eating plenty fruit and veg.

[Hidden in reply to magsyh]

Thanks so much! You’re right, my BP was not dangerously high, just a little elevated, so I should monitor things at home for a while before taking meds.

[Hidden]

OK, so I got my labs back and used an online calculator to find out my E/P ratio. It came back as 27.03 (estradiol 37 pg/mL, ref luteal phase 21-312; progesterone 1.0 ng/mL, ref luteal phase 1.2-15.9). A healthy E/P ratio is said to be 100-500, and to drop at around 50 around (peri)menopause. I interpret this to mean that I am currently estrogen dominant, and that could explain some recent symptoms such as weight gain (a lot of abdominal fat) and swollen, tender breasts.

My question to those of you who have been in this situation: did you go off estrogen, or simply raise your progesterone? I have been taking 100 mg of Utrogestan for 25 days a month, but know some take 200 mg instead and that should raise my P levels. But, if I don't need estrogen at all, I don't want to stay on it.

At the same time, my E levels seem lowish (37 pg/mL, ref luteal phase 1.2-15.9, ref menopause <28). So my E levels are close to menopausal on HRT, and would probably be below range without HRT...

I also had a new test this year: bioavailable calculated testosterone. It looks very low to me: 0.06 ng/mL (ref <0.25)...well, I guess I will find out when I see my doctor in a few weeks!