Anyone with fluctuating diastolic bp?

[liekki]

Greetings from Finland to all you Forumites!

First post, but I've been lurking here a while...

I'm a 45 year old male and I was diagnosed with hashimotos in 2017. I was on t4-monotherapy for more than two years and I'm currently on a combination treatment trial since I didn't feel well with just t4. I was physically fine with monotherapy, mostly, but lacked all motivation and was quite depressed from time to time.

I started monitoring my bp in the fall of 2018, and it became apparent that my diastolic bp was more elevated than systolic. Typical resting values would be 123/95, so systolic seems ok but diastolic is a bit worrying.

Now, I've had hashitoxicosis spells before, last was back in october, and now that I have t3 on the side, I've noticed that my bp fluctuates when I'm on t3, be it endogenous or exogenous.

At times, my bp can be almost perfect at 120/82 and then it goes back up to my regular mean values of 123/94 a little while later. This may happen even during the same session I'm taking readings on, so just few minutes apart. This didn't happen on monotherapy, unless I was mildly thyrotoxic like I was last october.

It seems to be just diastolic pressure that jumps about, systolic may vary also but to a markedly lesser degree.

I'm pretty sure it's not an issue with my bp monitor or my technique.

I guess my question is, do you think this is a hormonal issue or maybe something wonky with my heart? To me it seems as if my body is trying to correct my bp now that it has all the hormones needed to regulate things on a cellular level. Perhaps a neurological thing, impulses going to and fro on a timely manner for once?

Oh, and I'm on 125 mcg levo/ 5 mcg Lio at the moment, so dose of t3 is almost homeopathic. And I have no idea how long I have suffered from hashimotos, since I was almost asymptomatic. I'd guess fifteen years minimum? Long enough to sustain some damage, perhaps.

Thank you in advance, if anyone should share their experiences!

[mauschen]

Hi,

Can I ask if you take other medications?

[liekki in reply to mauschen]

Hi there, mauschen.

No other medications, no herbal remedies or any of the sort.

[mauschen in reply to liekki]

In that case, you should go to your local doctor and ask for a 24h blood pressure monitor. This will give the doctor a better idea of how your BP reacts to every day events and also during sleep.

[liekki in reply to mauschen]

That's a good idea, but I reckon I'll have to wait till I'm stable on the new treatment. I think that my thyroid is still "leaking" occasionally, which complicates things quite a bit.

Thank you for your input. I wish there had been more suggestions from people, but I guess this is not a common issue then, and by now this thread is pretty much buried.

Have a nice weekend!

[SlowDragon Administrator]

Welcome to the forum

If you have been lurking awhile ...you know we are going to ask

Have you got recent blood test results you can add?

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)

If/when also on T3, make sure to take last 1/2 or 1/3rd of daily dose 8-12 hours prior to test, even if this means adjusting time or splitting of dose day before test

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 your doctor to test vitamin levels

Taking almost any dose of T3 with substantially reduce TSH. Can leave you more hypo if not adding enough

[liekki in reply to SlowDragon]

Hullo!

Yes, I should have anticipated that someone would ask about results, silly me! Unfornately I'm only three weeks in on my trial, so I don't have any relevant test results to give.

I'd guess that my T4 should be stable now, since I lowered my dose about a month ago, and I've been titrating T3 up ever so slowly since I seem to be a bit sensitive to it. I've been feeling mostly fine.

I've no idea about vitamins and such, I don't know if it's routinely tested at all over here. And personally I find hypothyroid issues confusing as is, and if I need to start paying attention to vitamins also...

Well, at least my eating habits are healthy... mostly... Hopefully that covers it!

[SlowDragon Administrator in reply to liekki]

So you need thyroid levels tested after 6-8 weeks on constant unchanging dose

Hashimoto’s is as much a disease of the gut as the thyroid

You can have the best diet in the world and still be deficient in vital vitamins

Ask your doctor to test vitamin D, folate, B12 and ferritin

Vitamin D likely to be low living in Finland !

Are you on, or have you tried strictly gluten free diet?

Helps thousands of patients improve symptoms.

Before cutting gluten get coeliac blood test just to rule it out

ncbi.nlm.nih.gov/pubmed/286...

Vitamin D deficiency is frequent in Hashimoto's thyroiditis and treatment of patients with this condition with Vitamin D may slow down the course of development of hypothyroidism and also decrease cardiovascular risks in these patients. Vitamin D measurement and replacement may be critical in these patients.

endocrine-abstracts.org/ea/...

Evidence of a link between increased level of antithyroid antibodies in hypothyroid patients with HT and 25OHD3 deficiency may suggest that this group is particularly prone to the vitamin D deficiency and can benefit from its alignment.

ncbi.nlm.nih.gov/pubmed/186...

There is a high (approx 40%) prevalence of B12 deficiency in hypothyroid patients. Traditional symptoms are not a good guide to determining presence of B12 deficiency. Screening for vitamin B12 levels should be undertaken in all hypothyroid patients, irrespective of their thyroid antibody status. Replacement of B12 leads to improvement in symptoms,

[liekki in reply to SlowDragon]

Thank you for your input. I may have to throw some money at the problem and get vitamins tested at some point.

I do feel that majority of my lingering problems have gone away with the addition of T3 and possible deficiences don't play that big a part in my health, since I feel generally really well on combo treatment. And I felt just fine physically even on T4 only, it was just that my brain didn't do very well with it.

At the moment I'm just a bit perplexed about the bp issues (since I cannot find anything on it on google) and a little worried that there might be something wrong with the heart itself. Never had any other problem with it, though, been going strong for 45 years. And I'm not sure if the fluctuations are really a problem anyway, it just doesn't seem to be normal either.

But I guess if it's a neurological issue it certainly could be attributed to some deficiency, and that would actually be preferable since it's fixable with some supplementation.

[Justiina]

Hi fellow Finn 😊

I am not medicated but I seem to have the same problem and it is mostly affected by iron, B12 and folate and electrolytes.

You could be lacking something else which would be quite normal with Hashimoto.

My thyroid has been acting out and recently what I think could have been caused by hashitoxicosis felt worse because of other factors I mentioned above.

[liekki]

Heippa, Justiina.

I really wouldn't want to start messing with vitamins, but perhaps I should be paying more attention to them.

I've had minor gut issues before but they have been basically solved by now, especially after adding T3.

[Lanky1]

Hi, this is my exact problem. My diastolic is hugely fluctuating - but it was low when I had my 24 hour test. Having another next week. Diastolic goes from 100 to 85.

[liekki in reply to Lanky1]

Hi, Lanky1.

So, I'm not entirely alone with my issue.

Are you on t3? My dbp starts to jump around about four hours after dosing and my bp eventually settles to about 120/80 for a few hours after. So I'm basically normotensive twice a day for a couple of hours at a time.

I'm still quite confused about this and I don't know it's signifigance.

[Lanky1 in reply to liekki]

No I’m not on t3. In August my 24 hour bp was great. I’m having another next week and I know it will be super high - just a few months later! I don’t want to just be put on blood pressure tablets but I have a feeling that’s the route the doc will take!

[Lanky1]

Hi. Are you still here? Have you made any progress? I’m still struggling - turns out my diastolic bp is impacting my heart. It jumps around so much but I still haven’t found anyone who can help.