Thyroid, blood pressure and heart: I have an... - Thyroid UK

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Thyroid, blood pressure and heart

Kai_63 profile image
15 Replies

I have an underactive thyroid and take 100mcg Levothyroxine daily.

During a holiday abroad when I got an upset stomach (not related to the thyroid), I blacked out/fainted. I also more generally feel lightheaded when I stand too quickly etc. The cardiologist has done various tests including CT scans and tilt table test. This showed that my blood pressure, while usually OK (114/72), drops very quickly when I faint. Luckily my heart works quickly for me to regain consciousness.

The cardiologist is doing another CT scan with contrast as he thinks I may possibly have a narrowing of arteries. I'm female, a size 8 or 10, good diet and basic exercise and in my early 40s, so this is surprising!

I wanted to find out if any of my blood results point to my thyroid not working properly, which would therefore be impacting these other things? I suspect it is because that's been my experience with other ailments in the past!

Blood test shows:

TSH of 4.52 (range 0.27 to 4.20) mU/L

Free T4 15.6 (range of 12.0 - 22.0) pmol/L

Free T3 4.1 (3.1 - 6.8) pmol/L

Ferritin 49 (range 13-159 ng.ML) - I think this is on the low side?

Thanks

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Kai_63 profile image
Kai_63
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15 Replies
bantam12 profile image
bantam12

You need a dose increase because your TSH is much to high, normally 1 or below is where people feel best. That could well be causing your problems.

Kai_63 profile image
Kai_63 in reply to bantam12

Thank you, yes that's what I thought. Apologies as I also meant to say that an endocronologist also told me my body doesn't convert T3 well. I couldn't take it before as I was trying to get pregnant but will consider that now.

SlowDragon profile image
SlowDragonAdministrator

Recommended on here that all thyroid blood tests should ideally be done as early as possible in morning and before eating or drinking anything other than water .

Last dose of Levothyroxine 24 hours prior to blood test. (taking delayed dose immediately after blood draw).

This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip, best not mentioned to GP or phlebotomist)

Is this how you do your tests?

Your results show roughly equal % through range of FT4 and FT3....but both are too low

FT4 only 36% through range

FT3 only 27% through range

Useful calculator for working out % through range

chorobytarczycy.eu/kalkulator

Considering your size, your 100mcg dose should be giving better results

Do you always get same brand of Levothyroxine?

Do you have Hashimoto's?

Do you have gut symptoms?

Poor absorption is perhaps an issue

Important to regularly test vitamin D, folate, B12 and ferritin

Ferritin is on low side. Ask GP to do full iron test for Anaemia

Low vitamin D extremely common in UK, but especially if you have dark skin

Kai_63 profile image
Kai_63 in reply to SlowDragon

Thanks for your detailed reply. Usually yes I have the blood test first thing in line with all the things you've said. This time the cardiologist asked for it and I did it in the afternoon. That means that, if anything, my test would have shown even worst results I think?!

An endo said I may have a gluten intolerance (e.g. I tested positive for one of the genes). I have increased my intake of yoghurt/cheeses etc to help with good bacteria though. I'm Asian so have increased Vit D over past few years, same with vit B. (I've also upped my iron intake since the blood test). Basically yes to poor vit absorption and I've been doing my best to increase all of those vitamins following endo advice.

Same brand of Levo every time. Never been tested (?) or told I have Hashi - how do I find out?

SlowDragon profile image
SlowDragonAdministrator in reply to Kai_63

TSH drops through the day. Its highest very early in morning.

If antibodies are high this is Hashimoto's, (also known by medics here in UK more commonly as autoimmune thyroid disease).

About 90% of all primary hypothyroidism in Uk is due to Hashimoto's.

GP or endocrinologist should have done this when you were first diagnosed. See if you can find historical test results

Link about antibodies and Hashimoto's

thyroiduk.org.uk/tuk/about_...

thyroiduk.org.uk/tuk/about_...

NHS will only test TG antibodies if TPO antibodies are high.

Most Hashimoto's patients have either high TPO and high TG antibodies, or just high TPO antibodies. But a significant minority have just high TG antibodies. If only have high TG antibodies it can be struggle to get Hashimoto's diagnosed

20% of Hashimoto's patients never have raised antibodies. An ultrasound scan of thyroid can be helpful

healthunlocked.com/thyroidu...

The fact your endo is talking about gluten intolerance suggests cause of your hypothyroidism is confirmed as autoimmune thyroid disease (Hashimoto's)

Links about Non Coeliac Gluten sensitivity (NCGS) and autoimmune disease

ncbi.nlm.nih.gov/pubmed/296...

The predominance of Hashimoto thyroiditis represents an interesting finding, since it has been indirectly confirmed by an Italian study, showing that autoimmune thyroid disease is a risk factor for the evolution towards NCGS in a group of patients with minimal duodenal inflammation. On these bases, an autoimmune stigma in NCGS is strongly supported

ncbi.nlm.nih.gov/pubmed/300...

The obtained results suggest that the gluten-free diet may bring clinical benefits to women with autoimmune thyroid disease

nuclmed.gr/wp/wp-content/up...

In summary, whereas it is not yet clear whether a gluten free diet can prevent autoimmune diseases, it is worth mentioning that HT patients with or without CD benefit from a diet low in gluten as far as the progression and the potential disease complications are concerned

Lactose intolerance is also very common with Hashimoto's.

ncbi.nlm.nih.gov/pubmed/240...

Lactose intolerance was diagnosed in 75.9 % of the patients with HT

read.qxmd.com/read/24796930...

These findings show that lactose intolerance significantly increased the need for oral T4 in hypothyroid patients.

Kai_63 profile image
Kai_63 in reply to SlowDragon

Wow lots to take in here, thank you so much. I am mildly lactose intolerant but that's because I gave up milk for a year and then found I could only drink it when warmed up or in other forms (yoghurt, cheese, butter etc all fine).

Sounds like my TSH is probably higher than shown in that case. I'll have a look at test results re antibodies.

Thanks again!

SlowDragon profile image
SlowDragonAdministrator in reply to Kai_63

If lactose intolerant you might need lactose free Levothyroxine

Only lactose free UK tablets are Teva - but they upset many patients

Alternatively there's liquid Levothyroxine. It's expensive so they don't like to offer it.

thyroiduk.org.uk/tuk/treatm...

thyr01d profile image
thyr01d in reply to SlowDragon

Hi SlowDragon and apologies to you Kai_63 for interrupting your post, but the reply from SlowDragon is so interesting.

Please SlowDragon could you tell me more, pm if you think better, about gluten intolerance and Hashimoto's? I have Hashis and TSH was >95 (top of range - now on T3). My endo who is super and caring has said that my thyroid can therefore be considered to be doing nothing. For two years I was gluten free and noticed no improvement, now eating it again and seem no worse. Does the fact that my poor thyroid seems to be unable to do it's job now mean there can be no further ill effects relating to thyroid hormones whether or not I eat gluten? Many thanks for taking the time to read this.

SlowDragon profile image
SlowDragonAdministrator in reply to thyr01d

Did you test TPO thyroid antibodies before going gluten free and then test again before starting back on gluten?

Sometimes reduction in TPO antibodies might be the only result of gluten free diet. Though antibodies fluctuate anyway. But many people find slow steady drop in TPO antibodies on gluten free diet

Did you see any improvement in vitamin levels or needed less vitamin supplements, while gluten free?

Vitamin D, folate, ferritin and B12 all need to be optimal

thyr01d profile image
thyr01d in reply to SlowDragon

Sorry again Kai_63 to be still in your post. Thanks SlowDragon for your reply. The TYP thyroid antibodies test came back not raised twice, then I think raised the third time when tested by endo (though I'm not absolutely sure they tested, they were already certain I had Hashi's before testing at all). Either way, the not-raised would have coincided with eating normally and raised with gluten-free. I didn't notice any change in vitamin levels either way. Ferritin struggles along usually bottom of the range and does not improve with T3 (as endo hoped) nor on prescribed ferrous fumarate. Really though I'm asking if the thyroid is pretty well 'destroyed' as in producing almost nothing (endo said TSH >95 = coma level), is there anything to lose from having gluten?

SlowDragon profile image
SlowDragonAdministrator in reply to thyr01d

Only you can say.....we are all individual

Personally I get terrible symptoms from even tiniest accidental crumb of gluten.....

Getting ferritin levels up would probably help you more.

thyr01d profile image
thyr01d in reply to SlowDragon

Any ideas how I could get the ferritin up? I have really tried and have spirulina every day - it ruins my breakfast!!! :)

Santolina profile image
Santolina in reply to Kai_63

malabsorption: I now take BioCares digestive enzymes along with L-glutamine. Makes a huge difference to thyroid uptake.

Chippysue profile image
Chippysue

I highly recommend Dr Jack Wolfson’s book the paleo cardiologist, and to follow him.

Please research ct scans with contrast before having one.

Kai_63 profile image
Kai_63

Thank you, will do!

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