Thyroxine and ramipril - timing of medication

[AnotherEmma]

I’ve been on thyroxine for a while and take it first thing as soon as I wake up. I’ve been prescribed Ramipril and the pharmacist said it’s best taken in the morning around an hour after I’ve had the thyroxine. I had always thought I should wait four hours after taking thyroxine so was wondering how others were managing their timings.

[greygoose]

It should be taken at least two hours away from thyroid hormone.

Are you taking it for high blood pressure? Are you sure your high blood pressure isn't due to your hypo?

[AnotherEmma in reply to greygoose]

Thanks Greygoose. I am taking it for high blood pressure despite being pretty fit (ran a half marathon earlier this year and training for another one.) It could be due to my hypothyroidism as a recent blood test showed my tsh to be 4.5 so I have also had my thyroxine dose increased.

[greygoose in reply to AnotherEmma]

I think it's pretty likely to be due to your hypo, yes. In which case, the Ramipril probably won't help. High blood pressure is a symptom, not a disease. Blood pressure medication won't get to the root of the problem.

[AnotherEmma in reply to greygoose]

I’m starting the increased dose of thyroxine tomorrow along with the Ramipril. I’m due back to the doctors in a couple of weeks to see how things are going. Any suggestions as to what else I should be doing meanwhile then?

[greygoose in reply to AnotherEmma]

Have you had your nutrients tested? Vit D, vit B12, folate and ferritin? If not, you should ask your doctor to test those. Nutritional deficiencies will affect how well your body uses thyroid hormone.

[AnotherEmma in reply to greygoose]

Not for a while. I’ll request them. I have a new GP she seems open to listening more than the last one.

[greygoose in reply to AnotherEmma]

Well, that's good, anyway! So, when you get the results, post them in a new thread, with the ranges, and people will advise.

[AnotherEmma in reply to greygoose]

Will do. Thanks for your help.

[greygoose in reply to AnotherEmma]

You're welcome.

[Muelerama in reply to greygoose]

This is a really interesting post... I cannot understand why my blood pressure is so high yet I'm taking ramipril every morning with my thyroxine, and have been for the last 5 years... Having read your article I'm trying and your regime of taking the ramipril at lunchtime, but I'm doing mine 6 hours after taking my thyroxine.

I'm going to monitor it very carefully and report back on this thread.

I also have an issue with calcium in my blood that it has been negligible for the last 6-months ... My GP is scratching his head and has taken me off amlodipine as one of the side effects could be calcium deficiency.

We've tried it for 2 months and taking bloods and a calcium still very low.

[greygoose in reply to Muelerama]

Have you had your vit D tested? Have you had a TT? Or your parathyroid hormone tested?

Rather than reporting back on this thread, it would be better if you started your own thread, giving all your details: blood test results for thyroid and nutrients; exactly what you're taking and how much; what you take when; etc.

[Muelerama in reply to greygoose]

I had a total thyroidectomy in 1994 following papillary carcinoma.

I've also had my parathyroid checked last month and that was okay.

I will get him to check vitamin d when I do the bloods again at the beginning of February.

[greygoose in reply to Muelerama]

OK, well, when you get the results, put them in a new post, with all the details mentioned above. It's not fair to squat someone else's thread, because every time someone posts on it, they get a notification. And, if it's nothing to do with them, it can be very annoying.

[Muelerama in reply to greygoose]

Apologies, will do...ignore my last comments

[Muelerama in reply to Muelerama]

But can't understand why my BP is still though the roof..Last night's reading 198/100 😱 and the wife's an enviable 111/68 🌱

[greygoose in reply to Muelerama]

You're probably under-medicated for your thyroid. We'll know more when you've had your next blood test results.

[SmallBlueThing]

I used to take it an hour or so after levothyroxine and didn't notice any interaction, but now take it in the early evening, partly because of articles like this: rpcardio.com/jour/article/v...

No interactions reported: drugs.com/interactions-chec...

My thyroid treatment level doesn't control my hypertension. My calcium and potassium are or have been low (magnesium not yet tested), so getting my electrolytes sorted may help my BP.

[AnotherEmma in reply to SmallBlueThing]

Thanks for these links. The NHS website suggests it can be taken at any time of the day so I think i’d like to take it at bedtime just to keep me in a routine - thyroxine in the morning, Ramipril a bedtime. You mention that your hypertension isn’t reduced with your thyroid treatment. Have you noticed any improvement at all?

[SmallBlueThing in reply to AnotherEmma]

I was undiagnosed hyperthyroid 25+ years ago, and think I had orthostatic hypotension.

Lyme disease about 20 years ago, with another hyper swing and chest pain, and my BP was 180/100, and I assume at similar and higher levels until caught by an NHS health check in 2014. I also now have white coat hypertension and need to settle for at least 10 minutes for home BP readings.

I had seen a mention of electrolyte imbalances in relation to Conn's syndrome, was tested (told negative), and put on amiloride, which at last allowed fairly good control of my BP. In the meantime, my treated hypothyroidism has varied from TSH stable at about 0.5; then 2 - 3 for several months and then below range.

In summary, the drugs are controlling my hypertension. Dedicated doctors say there's no such thing as essential hypertension, just that the cause hasn't been pinpointed. I hope to suggest reasonable causes for my doctors to investigate.