Blood pressure and heart rate on levo...is GP wrong?

I was recently told to lower levo from 200 to 175 mcg daily based on the following lab results:

TSH 0.01 (0.27.-4.2)

FT4 24.9 pmol/L (12-22)

FT3 5.7 pmol/L (3.1-6.8)

BUT back then, I was on biotin and had taken levo about six hours prior to having blood drawn in the doctor´s office (I was not informed of this in advance). Apparently, T4 levels will peak 5-6 hours after taking levo which is why you should leave 24 h between levo and labs.

Anyway, slight hypo symptoms have come back since reducing levo, like cold feet, increased hair loss and fluid retention. Also, problems controlling my blood pressure even with meds. A few months ago, my blood pressure medication (perindopril arginine) was raised from 5 to 10 mg daily but my blood pressure will not go below 150/90. Also, my heart rate is pretty fast; around 100 bpm. I was recently put on 50 mg of atenolol to help with that but, although my heart rate has slowed down, it feels like the fluid retention is getting worse. For instance, I notice that I ring I normally wear without problems no longer fits, and my finger are beginning to look like sausages. It would seem fluid retention is one side effect of older beta-blockers such as atenolol.

New lab results after eight weeks on 175 mcg of levo and after two weeks off biotin (leaving 24 h between levo and labs):

TSH 0.05 (0.27-4.2)

FT4 19.1 (12-22)

FT3 4.9 (3.1-6.8)

I think that is quite a drastic drop in FT3 levels after a 25 mcg decrease...?

My doctor now wants me to lower levo to 150 mcg daily to see if it can have a positive effect on my blood pressure, and he also wants me to stay on atenolol and possibly even raise it to 75 mg daily.

When I asked if high blood presssure is not a symptom of HYPOthyroidism, he said no, that is what you would expect in HYPERthyroidism...???

He also said that if you take less than 100 mg of atenolol daily there is no risk of fluid retention. When I asked what could have caused this recent increase in fluid retention, he asked me if I eat a lot of salt...I use Celtic sea salt, never table salt.

Has anyone else had problems with blood pressure control and heart rate when on thyroid hormone replacement, and found a solution? I am not convinced my doctor seems to know what he is doing...I agree it´s not good for my heart to beat so fast, but I am not sure atenolol is right for me. But I doubt that my heart rate is caused by drug-induced hyperthyroidism...

[tattybogle]

not sure it will help , but you might find the 'pulse pressure' bit's on this post interesting...healthunlocked.com/thyroidu....

[Hidden in reply to tattybogle]

Thank you, it´s an interesting article, but it seems to focus solely on the TSH and ignore the actual thyroid hormones. My TSH has never correlated with how I feel...