raised blood pressure and NDT- what to do?

[lauraleeds666]

I started on NDT in Sept 2022 and felt great within a fortnight after nine months of levo doing nothing for me and about 8 years of undiagnosed hypothyroidism steadily getting worse.

My blood pressure has always been a normal 120/80 or thereabouts. In January, I got asked in the street by a health promotion team in the city centre if I wanted my blood pressure checking and I said yes. I was surprised to find it was 140/90 but put it down to a fluke. Yesterday, I had the same blood pressure check and it was 148/80. The bloke even did it twice to double check and then looked at me quizzically!

I am 41 with a BMI of 26 (slightly overweight). I have a good diet of lots of organic veggies and fruits combined with eating mostly low GI (to keep my PCOS in check). I take moderate exercise and make sure I move my body for an hour a day be that walking, swimming or a bike ride. I have moderate alcohol intake.

The only thing that has changed that could have increased my blood pressure is being prescribed NDT.

My private thyroid doctor has changed my dose a few times. After the first 6 weeks on two grains of NDT, my FT3 came back at 8.5 which is over-range (3.1 - 6.8). She recommended dropping down to 1.75 grains and 8 weeks on that dose came back with an FT3 of 5 which she said she thought should be higher so I went back up to two grains. I should add that I had no detrimental symptoms or deterioration being on 1.75 grains.

So my question to you lovely knowledgeable people is: do you think I should drop myself back down to 1.75 grains and see where my blood pressure is at after a few months at that dose? Or is it more important that I keep my FT3 in the upper part of the range?

Having raised blood pressure worried me due to the future risks it entails and the fact my whole 41 years it has been normal until this point and I've not changed my diet or exercise.

[PurpleNails Administrator]

FT3 doesn’t have to be in top part of range.  Some feel optimal when it’s lower within the range, if you felt good on previous dose adjust it back.

Have you had nutrients tested? 

[greygoose]

How long a gap do you leave between your last dose of NDT and the blood draw?

[lauraleeds666 in reply to greygoose]

Last dose at 3pm. Test usually around around 9am following morning

[greygoose in reply to lauraleeds666]

That's too long. We recommend between 8 and 12 hours. Any longer will give you a false low FT3. So, could be that you are very over-medicated.

Do you have Hashi's?

[lauraleeds666 in reply to greygoose]

Ah that's the timing protocol my thyroid doctor recommended. So next time should I take my NDT out of sequence in the evening or should I take to the blood test in the early hours of the morning? (I'm a night owl so the latter wouldn't bother me). Yes I have hashis although one of the two markers has returned to within normal range recently.

[greygoose in reply to lauraleeds666]

Well, that's up to you. If you have the possibility of doing it in the early hours of the morning, why not.

It really doesn't matter if one of your Hashi's markers has gone back into range, you still have Hashi's. Antibodies fluctuate but Hashi's doesn't go away. So, perhaps you're having a Hashi's 'hyper' swing, and that's why your FT3 is so high?

[tattybogle in reply to lauraleeds666]

just be aware that if you take thyroid bloods in the middle of the night , the TSH level may be a bit higher than you usually see in daytime tests.

if your Doctor is mainly looking at fT3 / fT4 level to adjust your dose not TSH level, then the unusually high TSH doesn't matter .. but you should be aware. in case it is commented on.

[waveylines in reply to greygoose]

No grey goose there's a slower uptake with ndt so the liothyronine guideline you are all advising on here don't apply with ndt - pharmaceutical uptake of ndt T3 is much much slower. Liothyroinine has a much faster uptake than ndt. (Diogenes)I now understand why my Endocrinologist & 2 renowned thyroid doctors recommended a 24hrs gap between last dose of ndt & blood test.

[greygoose in reply to waveylines]

Is that because the T3 is bound rather than Free?

[waveylines]

Absolutely. Diogenes has recently refreshed a post he put up 2 years ago about this.

And just be clear ndt 3 isn't released until it all nearly been decomposed but liothyronine gets into the blood stream much faster. Ndt peaks 2 1/2 days later, Liothyronine 5_6hrs. Very different.

[waveylines in reply to waveylines]

I think the upshot of this is that ndt3 consequently gives a much slower gradual release with less big sudden peaks & drops than liothyroinine...... that's exactly my experience too

[Jazzw]

Hi Lauraleeds666

I was surprised to find it was 140/90 but put it down to a fluke. Yesterday, I had the same blood pressure check and it was 148/80. The bloke even did it twice to double check and then looked at me quizzically!

Blood pressure is supposed to go up and down a bit during the day. I really don’t think that random “in the street” blood pressure checks are necessarily helpful (maybe to spot people whose blood pressure is outrageously high?). If you’d been busy, walking around lots, a bit tired etc, your BP would be up a bit. And that would be normal, honestly.

While the top number matters, the bottom one is probably more important. In recent years health professionals have gradually lowered the number they consider to be “normal”. A cynical person might conclude it had something to do with pharmaceutical companies wanting to monetise a perfectly normal situation. 90 isn’t ideal but it’s really not that big a deal so long as it isn’t happening all the time. It’s not that high.

Industrial machines that are used to take multiple blood pressure readings need calibrating from time to time. Plus the cuff used needs to be the right size. You’d be surprised how many health care professionals don’t know this. If those in the street folk are using the same machine over and over, it’s probably not as accurate as it could be.

So I wouldn’t read too much into random BP readings—I wouldn’t assume there’s an issue or even that it has anything to do with your NDT dosage.

If you’re worried, get yourself a blood pressure machine to use at home (one that goes around your upper arm, not one of the wrist kinds) and test yourself when you’ve been sitting calmly for a while. They aren’t usually very expensive—£20-30. If those readings are high then there might be something to follow up with your GP. But I have a feeling there won’t be.

[lauraleeds666 in reply to Jazzw]

Thanks, that's a good suggestion to get my own BP machine. It caught me off guard because like you say I just put the first reading in January down to walking a round a lot in town and didn't worry about it but then when it was almost 150 again this week I found that worrying as I've always been a 120/80 girl. I wouldn't approach my GP about it because then I would have to confess I was being prescribed NDT elsewhere and all hell would probably break lose 🤣

[Brightness14]

I started to get higher BP back last year. I bought a BP monitor they are very low cost and then you can sit down and rest then take your BP and HR I take mine most days I use Hawthorn extract capsules twice a day and my BP has now returned to normal 120/80, Hawthorn extract has been used for hundreds of years for lowering BP

[lauraleeds666 in reply to Brightness14]

Oh thanks I will look into that. What do you think was the cause of your raised BP?

[Brightness14 in reply to lauraleeds666]

I have an ear tumour which is being removed in June. BP alters throughout the day so if you are worried your GP would be able to give you a monitor which would read your BP throughout the day and night. I only found out about Hawthorn after the GP gave me BP medication which made me feel ill. I goggle it and found out the German GP's always give Hawthorn extract first. The Germans are much more into natural health than in France and the UK. I have been on it since August now just two a day. It's also good for the Liver and Kidney too.

[arTistapple]

Hypothyroidism can lower your ‘resting pulse’. This means that from time to time, depending on your body’s requirements (out walking and shopping say) BP can be raised slightly to allow for this. It’s temporary. You don’t get your blood pressure taken standing up at the doctors surgery, they like you to sit pretty quietly and don’t even speak to you. Was that the circumstances of your test in the street? In my view a raise of 20 on top and similar on bottom is entirely passable in the circumstances you describe. In fact the guy might have been looking at you quizzically because it was the best BP he had seen all day. Always check your pulse at the same time as your BP. Our NHS does not care a hoot about pulse but Eastern medicine consider it more important than BP. It’s a much clearer indicator of ‘health’. AND do not let GPs gaslight you by saying it’s wonderful you have a low pulse - you must have been an athlete. It’s nonsense, hypothyroidism is often accompanied by very low pulse rates.

[lauraleeds666 in reply to arTistapple]

The test in the street checked heart rate and mine was 75 which is normal for me. The circumstances of the test in the street was that I was asked to sit down and to put my arm in the sleeve of the machine where it tightens around the arm. When the reading came back the same both times I got asked what medication I was on and then something about making sure I didn't have too much salt in my diet.

[arTistapple]

Yes 75 is a good pulse rate. Re:salt. This is a very superficial comment. It sounds a bit more scaremongering than helpful. You obviously care about your health and that is the most important thing. I would say don’t get too caught up in the blood pressure. It can have entirely the opposite effect keeping too close an eye on it. Just take it from time to time, noting what you have been doing/not doing around it. OR you take it at a very regular time when you know what’s happening with your ‘activities’ so you can have a reasonable comparison to work with.