Is there any link between T3 and raised blood pressure?

[Zadock]

I started T3 two months ago now, and along with various blood tests my endo had requested I asked the nurse to check my blood pressure. I was alarmed to find it was 140/86, which she said was ok but to me seems far from ok! I have never had raised blood pressure before so am wondering if anyone else here has found their blood pressure increasing when taking T3? My endo says there is no connection, and I don't have a BP reading from before starting T3. I know blood pressure issues can be a symptom of hypothyroidism. My endo insists I am adequately treated (latest results show TSH 0.2, Free T3 4.15 - range 3.1-6.8, T4 13.5 - range 12-22). It could be age related? (I'm 63). I have fairly mild symptoms on T3/T4, and most of the time on T4 only did not have major problems, but am now trying to decide next steps and blood pressure is now a worry! Thanks as always for your advice.

[SlowDragon Administrator]

How much T3 are you currently taking

Was thyroid test done early morning, ideally before 9am and last dose levothyroxine 24 hours before test

Day before test did you split T3 taking last 5mcg dose approx 8-12 hours before test

FT4: 13.5 pmol/l (Range 12 - 22)

Ft4 only 15.00% through range

FT3: 4.15 pmol/l (Range 3.1 - 6.8)

Ft3 only 28.38% through range

Ft4 and Ft3 are both low

What vitamin supplements are you currently taking

When were vitamin D, folate, ferritin and B12 last tested

[Zadock in reply to SlowDragon]

Thanks SlowDragon. I’m taking 2x5mcg doses T3 (5mcg on rising on 5mcg at bedtime) plus 50mcg levo. Testing is done as recommended here. Vitamins and minerals are all good. I take D3, multi B, selenium, K2 and magnesium. Until March I had been on 75 levo for about five years but am a poor converter so wanted to try T3.

[SlowDragon Administrator in reply to Zadock]

I would either increase T3 by 5mcg or increase levothyroxine by 12.5mcg and retest in 6-8 weeks

If increasing T3 add 3rd dose mid afternoon

[Zadock in reply to SlowDragon]

Thanks SlowDragon. I’m thinking the same but am tempted to try levo increase first because I found it hard to tolerate the extra T3 afternoon dose when I tried it previously (as endo originally recommended). I suppose it’s trial and error either way. And every change needs time before we know the outcome. Thanks again.

[SlowDragon Administrator in reply to Zadock]

Yes….I can understand that’s

Do you always get same brand levothyroxine at each prescription ….which brand?

Which brand T3 are you currently taking

I am experimenting with splitting my levothyroxine as well as T3. So far ….finding it very beneficial

Re BP

Try taking BP before and after a walk

[Zadock in reply to SlowDragon]

Thanks SlowDragon. I take Mercury Pharma and always get the same brand from a small helpful chemist. (No problems with supply so far....). And Thybon Henning for the T3 which the endo supplies. I haven't tried splitting the levo so might do that. ANd thanks for the BP advice too.

[SlowDragon Administrator in reply to Zadock]

Had been splitting levothyroxine a bit for about 6 months….

Initially as 100mcg at bedtime with 5mcg T3

And rest levothyroxine around 5am (25mcg 4 days and 12.5mcg 3 days ) ….and 10mcg T3 about 6am

Plus 5mcg T3 at 3pm

Now splitting levothyroxine as

50mcg 11pm and 50mcg 5am and remainder at 3pm

…….be interesting to see what blood test shows after 8-10 weeks.

[Zadock in reply to SlowDragon]

Yes that's interesting - good luck to you.

[SlowDragon Administrator in reply to Zadock]

Would suspect you will need to increase levothyroxine back a little eventually, but perhaps try increasing T3 first

[humanbean]

There is a link between hypothyroidism and high blood pressure :

stopthethyroidmadness.com/b...

[Zadock in reply to humanbean]

Thanks humanbean. That’s interesting to read. So nothing to link the change in bp with T3. Rather a clear link with levo only. I was thinking of altering my balance of T3/T4 to see if that helped lower bp but now I don’t know what to do!

[humanbean in reply to Zadock]

I have a tendency to get hypertension (high blood pressure) but it comes and goes.

I've had to identify possible causes for myself. I also tend to get tachycardia (fast heart rate).

The factors I've discovered which seem to have an impact on both these conditions for me, and will often affect others :

1) Low iron and/or ferritin (iron stores)

2) High sugar and carb intake

3) Eating gluten (although I have tested negative to coeliac disease)

4) Insulin resistance

5) Eating grains of any kind, with or without gluten

6) Low vitamin D

7) Poor kidney health

8) Too little exercise

A link suggesting supplements that might lower blood pressure :

medicalnewstoday.com/articl...

I would ignore what that link says about folic acid. There are better supplements for raising folate if this is necessary e.g. methylfolate, but only take supplements to raise folate if levels are low.

The reasons for using methylfolate rather than folic acid are given in these links :

takecareof.com/articles/ben...

chriskresser.com/folate-vs-...

[Zadock in reply to humanbean]

Thanks humanbean. I’ll do some reading. I realise I need to get a blood pressure monitor to test at home. I’ll add it to the list of things to do!

[humanbean in reply to Zadock]

Omron is a good make - you'll see them in many doctor's surgeries.

[Zadock in reply to humanbean]

Thanks for the tip!

[Alanna012]

Mine went higher when on levo only. Doctor threatened BP tablets and statins for my high cholesterol

At the time I switched to Thyroid S

Went back for an asthma checkup about 2 months later.

Nurse check BP for me and it was still a bit borderline, but dropped since last reading.

One thing I know for sure is that T4 alone can cause issues (not saying it will, it seems to be undertreated on T4 that is the biggest risk and I was undertreated for a long time) I literally had everything going wrong, liver protein reading high, prediabetic reading high, cholesterol high, BP going high, sodium very low...

If anything I'd say you might need more T3.

[Zadock in reply to Alanna012]

Wow that’s interesting Alanna012. Perhaps I should feel grateful I don’t have so many extra problems! Pleased you found the right way forward. Forgive my ignorance but can you remind me what Thyroid S is? NDT or liothyronine?

[Alanna012 in reply to Zadock]

Thyroid S is an NDT from Thailand.

It is very effective. Unfortunately it has a lot of fillers and eventually I couldn't carry on taking it as it gave me dermatitis and quite extreme insomnia.

But it worked very well aside from that and most people appear not to have those issues with it.

I am quite upset I couldn't carry on with it as it gave me perfect labs and more energy and I lost weight, but I just couldn't keep going without the sleep.

[Zadock in reply to Alanna012]

Thanks and I’m sorry to hear that you had problems after it had worked so well. It’s such a challenge for us isn’t it? When we think we have a good solution then it doesn’t last! NDT is the one I haven’t tried yet so I’ll look into that. Good luck

[Jeppy in reply to Alanna012]

Yes my boo has crept up and just taken levoIt was a respectable ‘over 70’ before levo even though I had so many hypo symptoms

[Buzcat in reply to Alanna012]

Mine went high after being changed from Mercury pharma to Teva in fact everything went high and I became very ill my daughter was the same the only medication I was on was levothyroxine

[Zadock in reply to Buzcat]

Thanks and oh dear! My prescription says ‘not Teva’. It certainly doesn’t suit me but fortunately I discovered that quickly and reverted to Mercury Pharma.

[arTistapple]

I have not contributed yet and I have just joined and I am still trying to get to grips with the wealth of information you offer on this site. Zadock you say your blood pressure is high. It seems normal to me. In fact at 63 and everything your body is dealing with it seems remarkably good. What are you guys working with as ‘normal’?

[Zadock in reply to arTistapple]

Hi arTistapple. Well, the nurse said it was ok but in general the advice from my endo is that it should be 130/80 (some say 120/80) and above that is a risk.

[Buzcat in reply to Zadock]

I was being told my BP was fine by the nurse and GP at the practice one GP refused to do my BP he said his monitor was broke in a health centre they have more than one monitor bought my own monitor and went to pharmacies and had it done it was high don’t know why nurse and GP were saying it was fine when it wasn’t all due to a change of brand of Levothyroxine.

[Zadock in reply to Buzcat]

Oh dear! And was it ok if you changed back to the original brand?I hope so.

[Jeppy]

Boo being BP!Ha

[greygoose]

TSH 0.2, Free T3 4.15 (3.1-6.8) 15%

T4 13.5 (12-22) 28.38%

My endo insists I am adequately treated

You need a new endo if that's his idea of 'adequately treated'. Your Frees are still saying hypo. So, it wouldn't be surprising if you had highish blood pressure, because that can be a hypo symptom.

What were you taking when those bloods were done?

[Zadock in reply to greygoose]

Thanks greygoose. I was taking 50mcg levo and 10mcg T3 so the tests are recent. Done as the protocol advised here. My T3 has improved a bit with T3 (it was bottom of range) and T4 has dropped from top of range. (I think percentages are the other way round actually. Sorry as it’s kind of you to add them!). I had faith in this endo but feel knocked sideways after my consultation today. I don’t know what to do next.

[greygoose in reply to Zadock]

No, they're the right way round. When taking T3, the FT4 drops, and is usually lower in range percentage-wise than the FT3. But, the FT3 is too low, and that's the one that counts most. Most hypos need it at least over 50%. So, as I said, not surprising if you have the hypo symptom of high blood pressure. Or, higher than your usual.

Do you always take your T3 on an empty stomach an hours before eating, etc. just like levo?

[Zadock in reply to greygoose]

Thanks and yes, as you say T4 has dropped (now 15 % through range) and T3 is 28% through range. It seems that hypo symptoms can include raised blood pressure but there is evidence of a link between T4 only treatment and raised blood pressure (see humanbean’s reply above). I leave an hour before eating after my morning dose and a gap of two hours after eating before my nighttime dose.

[greygoose in reply to Zadock]

Yes, there may be a link with T4 only treatment. But there's also a link with hypothyroidism. And, you are still hypo with those levels.

[Evej13 in reply to greygoose]

greygoose do you have any references for hypothyroidism causing high blood pressure? My gp insists hypothyroidism always causes low blood pressure and hyperthyroidism high blood pressure. I would like to show her some research. Thanks!

[greygoose in reply to Evej13]

lol Yes, they always think that. They think there is a rigid dividing line with 'hypo' symptoms on one side, and 'hyper' symptoms on the other. But, so many symptoms can be of both. Weight gain/loss, for example. Hypos can gain weight, but they can also lose it. So can hypers.

But, no, sorry, I don't have any research papers on the subject. You could try writing a new question asking just that in the title, so that those that can help you will reply.

[Evej13 in reply to greygoose]

Found one!

ncbi.nlm.nih.gov/pmc/articl...

[greygoose in reply to Evej13]

Oh, well done!

[radd]

Zadock,

We can not know the whole reason for your elevated BP but being under medicated is most likely more of a contributory cause than introducing T3.

FT3 is just 28% through range and you would probably feel better if levels were raised a bit. FT4 levels are just 15% through range so increasing Levo would raise both FT4 & FT3 levels.

I assume you are still medicating 50mcg Levo + 10mcg T3. This low dose of Levo would be inadequate for many members even with the addition of a little bit of T3.

[Zadock in reply to radd]

Thank you radd. Yes I’m taking what you say. It seems logical to increase levo so that’s what I’m going to do very gradually and see if it helps and I feel better. If so I then have the challenge of getting my endo to agree! He doesn’t seem to make a connection between T3 and lowered TSH? I had such high hopes of a ‘T3 friendly’ endo. Thanks for your advice.