High blood pressure and pulse following TT

[Nixynoo]

Hi there!

Please help! I had a TT done 10days ago, and since waking up from anesthesia my bp has been sky high to the degree they kept me in hosp for extra day to control with bp meds to a safe level. Bp was mildly high before op, but controlled and normal with low dose bp tablet(perindopril 4mg) Since discharge been to the doc (NHS) 4 times , and been sent back to ER twice. Bp is finally lower now that they’ve quadrupled my bp meds ( 8mg perindopril, 10mg amlodopine) but still high at around 150/115 , resting heartrate of 110 giving me hot flushes at 145 when I sit for a while .

These are my test results from ER :

TSH 14.6

T3 : 3.8

T4 :11.5

I am on 125 mg Thyroxine since first day after op ( doc insists my thyroid levels are ok and need to keep this dose)

I cant live like this eeek!! I read somewhere it might be connected to high Free T4, but cant find it mentioned anywhere else so not sure of its validity.

Please let me know if you have had something similar? And a solution? Can you gather anything from the numbers above?

Thank you!

[greygoose]

Without the ranges we can't gather anything - except that your TSH is way too high, you are very hypo, and your GP knows nothing about thyroid.

[Nixynoo in reply to greygoose]

Thanks Greygoose! Those Tsh levels were done 4 days after the op so maybe the 125mg thyroxine hasnt kicked in yet? Just read up on it - it’s saying it can take weeks for the thyroxine to be effective So I wonder if that means I’ll be like this for weeks I wonder if thats whats causung the freakishly high BP. Just phoned the dic again they want me to go back in today , pulse way too high argh.

[Nixynoo in reply to Nixynoo]

I suppose my next question is how long after adjusting dosages do you see a change in tsh numbers? Sorry, I literally have been dumped in the deepend here with loads of reading to do its seems

[helvella in reply to Nixynoo]

There are several issues here:

Some people notice taking levothyroxine within minutes. I have definitely witnessed that.

Some people seem not to notice taking levothyroxine for days to weeks.

It takes weeks for blood tests to stabilise after any change of dose - usualy quoted as around six weeks but I am sure it can vary a bit.

That does NOT mean nothing happens for five and a half weeks! You'd expect FT4 to rise and TSH to fall over six weeks - but not in a nice neat straight line. Quite possibly most of the change in the first weeks.

If your blood pressure is high, make sure that great care is used when next it is measured. a) Have it measured in both arms (one after the other); b) Neither talk nor allow anyone to talk to you while having blood pressure taken; c) Make sure your arm is relaxed and at the right height; d) Consider obtaining your own blood pressure machine and measuring it yourself in the much more relaxed environment of home.

[Nixynoo in reply to helvella]

Thank you Helvella Ok well thats given me a little hope that perhaps the thyroxine adjustments ( if thats what actually helps the blood pressure , I have no idea!) I would love to hear someone with the same issue or that had the same issue with Blood pressure And if adjusting the meds helps or not . As for the BP , All my readings are taken at home at rest with my own bp monitor , have had one for years.

[greygoose in reply to Nixynoo]

You don't say why you had a TT. I take it you didn't have Grave's. Your TSH wouldn't be that high four days after the op if you had had Grave's. You must have been hypo before the op to have that high a TSH after. The TSH doesn't move that quickly.

It takes roughly six weeks for the levo to take full effect. But TSH doesn't cause symptoms, it's just a hormone messenger to tell your thyroid to make more hormone. It's T3 that causes symptoms when it's too high or too low.

So, don't get hung up on your TSH numbers. It needs to come down to 1 or under when you're on levo, but you could be feeling much better before it gets down that far. Depends on your FT3 level. At the moment, that looks much too low, but as you haven't given the ranges, it's hard to tell. Ranges vary from lab to lab, so that's why I asked you to add them.

[Nixynoo in reply to greygoose]

Thanks Greygoose Actually they found cancer in the one half , so ended up removing the other half soon after. My thyroid levels were apparently fine before according to the thyroid surgeon when he first spoke to me. Thats why I say this is all brand spanking new territory to me - from what I gather I would have to have private tests done for full readings? and what are ranges? Sorry for being such a newbie!

[Nixynoo in reply to Nixynoo]

Perhaps the TSH was high because the first half was removed in Oct and the second in Jan, so maybe after they removed the first half in Oct , it had started climbing already?

[greygoose in reply to Nixynoo]

If I were you, I'd try and got your blood test results from before the op to see if they really were fine. Because, as I said, levels don't change that quickly. Looking at those results makes me think you were hypo before the op. Could be wrong, though.

Ranges are the numbers in brackets after the results. Without them, you can't tell if your results are too high or too low, or just right. The most usual FT3 range we see is 3.1-6.8, in which case your FT3 would be right at the bottom of the range, and therefore too low.

Considering you now have no thyroid, those three results are all you need for the moment: TSH, FT4 and FT3. No point in testing for antibodies if you don't have a thyroid! And, if you weren't hypo before the op, I don't suppose your would have low nutrients. So, private testing isn't that important at the moment.

The problem comes when your doctor starts thinking that the TSH will give him all the information he needs to adjust your dose of levo. It doesn't! Then, if you can't persuade him to do the Frees (FT4 and FT3) you would need to get private testing. But, for the moment, save your money!

[Nixynoo in reply to greygoose]

I hear you So next step is to find out original numbers , and to try and convince doc to get free T3 and 4 Thank you Greygoose Just finished with a different doc in the practice from original one, hes put me on beta blockers for now until I can see my GP friday ...hopefully can get some sleep without feeling my fast heartbeat on my pillow tonight :/

[greygoose in reply to Nixynoo]

Yes, the numbers from before the op.

[SlowDragon Administrator]

It’s perhaps more common to develop thyroid cancer if you had autoimmune thyroid disease (hashimoto’s)

Recommend you get hold of previous blood tests - see EXACTLY what was tested.....and equally important what wasn’t tested

You are legally entitled to printed copies of your blood test results and ranges.

The best way to get access to current and historic blood test results is to register for online access to your medical record and blood test results

If in UK ......GP practices are supposed to offer everyone online access for blood test results. Ring and ask if this is available and apply to do so if possible, if it is you may need "enhanced access" to see blood results.

In reality many GP surgeries do not have blood test results online yet

Alternatively ring receptionist and request printed copies of results. Allow couple of days and then go and pick up.

For full Thyroid evaluation you need TSH, FT4 and FT3 plus both TPO and TG thyroid antibodies tested. Also EXTREMELY important to test vitamin D, folate, ferritin and B12

Low vitamin levels are extremely common, especially if you have autoimmune thyroid disease (Hashimoto's) diagnosed by raised Thyroid antibodies

Ask GP to test vitamin levels NOW

Vitamin D, folate, ferritin and B12

[Nixynoo in reply to SlowDragon]

Thank you SlowDragon! I had no idea about the possibility of online access! I’ll look into that straight away. For the levels , Greygoose mentioned that because I have no thyroid only the tsh , ft3 and ft4 numbers are important?