Low Blood Pressure?: Hello! Is there anyone that... - Thyroid UK

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Low Blood Pressure?

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Hello!

Is there anyone that suffered low blood pressure as a hypothyroid symptom?

Did it worsen on thyroid medication?

I’ve been reading a lot that high blood pressure is much more common and usual for hypothyroidism.

My BP randomly drops low off but on meds it is permanently low and causing pretty bad symptoms. My blood sugar constantly crashes too and I suffer with regular hypoglycaemic episodes.

They both always improve hugely when thyroid medications are stopped.

just wondering is anyone has experienced similar?

Thanks.

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51 Replies
TiggerMe profile image
TiggerMeAmbassador

For me it was linked to adrenal fatigue/ low cortisol

in reply toTiggerMe

This is my suspicion especially as it all gets so much more horrifically worse with medication!

I’m hoping to get endo to agree to a Synacthen at my next appointment but the only irritating catch is that I have to stop all estrogen/progesterone medications for 6 weeks before hand for an accurate result…which will be rubbish! :(

How did you treat you low cortisol? Did a dr help or did you go it alone?

TiggerMe profile image
TiggerMeAmbassador in reply to

I did it alone, I did have a SST which I passed though no aldosterone test included 🙄started on adrenal cortex then swapped to low dose hydrocortisone for 8-10 months swapped back and haven't taken anything for 6 weeks, just waiting for cortisol results 😬

BP still isn't high 102/70 but I don't get the dips and dizzy, flaky episodes any more

I thought your cortisol results came back pretty good except for being high in the afternoon/evening?

in reply toTiggerMe

Ah okay, that makes sense!

I did saliva cortisol but I was told this isn’t always very accurate and can be easily skewed (by things like adrenaline) (I was also taking estrogen and progesterone which can skew results)

I was really unwell that day with my blood pressure and blood sugar being dangerously low so I’m not sure it’s a reliable result unfortunately :( I imagine I was making lots of adrenaline!!

I’m going to stop the hormones for 6 weeks and then see where my blood cortisol is at.

Was your Synacthen NHS? Did they check renin and stuff too?

So maddening that they did the test but left things out…

nightingale-56 profile image
nightingale-56 in reply toTiggerMe

Interested in you mentioning aldosterone testing TiggerMe . I have recently had an aldosterone test which was .1 over the top. All my NHS Endo said was, "horrid, horrid. I wouldn't touch it with a bargepole". Is aldosterone connected with cortisol, do you know?

in reply tonightingale-56

Tiggerme knows more than me but I do believe it is related to cortisol/adrenal function.

My endo mentioned getting it checked due to my low blood pressure issues. I think low aldosterone can cause low blood pressure? So maybe high aldosterone can cause the opposite?

TiggerMe profile image
TiggerMeAmbassador in reply to

You made me go looking and this sounded like you...

Extract from... paulrobinsonthyroid.com/sym...

in reply toTiggerMe

Hm well this is interesting and also makes me think of me! :)

I defo feel there’s worth in doing some full adrenal testing to rule these types of things out. I just need to stop estrogen and progestin for those 6 weeks (and get grumpy nhs endo to agree!) I tick almost all of those symptoms aside from one or two!

Thank you!

TiggerMe profile image
TiggerMeAmbassador in reply tonightingale-56

Extract from.... paulrobinsonthyroid.com/sym...

"These are some of the clues when high aldosterone is present:

High blood pressure.

Low potassium (weakness/muscle spasms).

Numbness or tingling in the extremities.

Frequent urination."

SlowDragon profile image
SlowDragonAdministrator

yes I had very low BP and low blood sugar on inadequate dose levothyroxine

But couldn’t tolerate dose Levo over 75mcg without taking Propranolol

Propranolol had to be introduced SLOWLY as it lowers BP initially

But as propranolol blocks/reduces adrenal output it enables adrenals to rest and recover

I was then, very slowly over 2-3 years, able to increase Levo up to 125mcg

All this was under care of thyroid, pituitary and adrenal specialist endo

More on my profile

SlowDragon profile image
SlowDragonAdministrator

What’s the highest dose levothyroxine you have been on

How much do you weigh in kilo

If on inadequate dose levothyroxine, you become more hypo

in reply toSlowDragon

It gets worse the HIGHER the levo dose so really don’t think increasing doses is the answer. Plus I am subclinical so a full replacement dose is not suitable.

I’m 53kg but even 75mcg pushes ft4 over range so full replacement dose is not the answer :( I’ve trialled every dose from 12.5-100mcg and they’re all awful getting significantly worse the higher the dose.

My bp and blood sugar are more stable without any medication at all.

I don’t have high heart rate so feel propanolol wouldn’t help in my case and likely make things worse :(

SlowDragon profile image
SlowDragonAdministrator in reply to

I always had LOW heart rate and propranolol made it lower

Even if “only subclinical” …..and TSH of 7 is definitely hypo

once you start on Levo invariably will need to increase to around full replacement dose

Levo doesn’t top up your own thyroid, it replaces it

which brands of Levo have you tried

Are you dairy free and/or gluten free

Presumably as you have PCOS you have Hashimoto’s

Had ultrasound scan of thyroid

in reply toSlowDragon

I don’t have a low heart rate. I don’t have hashimotos. US of thyroid was completely clear and normal.

I trialled levo for over a year. You recommend a full replacement dose? Even though my ft4 on 75 is over range? (Blood test protocol followed)

I have tried 3 different brands and they’re all the same.

I also don’t think for me it does ‘ fully replace’ as t4 is so easily pushed far too high and over range.

Have been gluten and dairy free for a decade before but made absolutely no difference and I already suffer with lowish BMI so have added it all back in.

I agree that TSH of 7 is high BUT my frees are largely mid range or higher so looking at those they don’t seem very hypo.

My t4 has always happily sat around 16/17 even when my Tsh was normal.

SlowDragon profile image
SlowDragonAdministrator in reply to

I have tried 3 different brands and they’re all the same.

Which 3 brands

Tried liquid levothyroxine?

Did you also try adding SMALL dose of T3 alongside levothyroxine

Eg reducing levothyroxine to 62.5mcg and adding 2.5mcg T3 three times per day

in reply toSlowDragon

Wokhardt, accord, teva.

Haven’t tried liquid as think it will just cause the exact same reaction.

Tried adding small dose of t3 as you describe above and made everything significantly worse still.

I’ve been adjusting doses/combinations for well over a year and it all cause severe worsening of symptoms.

in reply toSlowDragon

Also are there any links you can share that talk more about thyroxine replacing rather than topping up thyroid hormone please?

I’d read differently and that subclinical dosing can be more difficult as often less medication is needed.

Just hoping to learn more! :)

humanbean profile image
humanbean

This link might interest you :

stopthethyroidmadness.com/b...

Edit : If you aren't familiar with STTM you should know that it is a website which is very anti-T4 and is only pro-NDT. I find this a very limiting stance.

in reply tohumanbean

Thank you! I am familiar w STTM.

Problem is for me that adding t3 to levo or trialling t3 only makes my bp and blood sugar drop further and makes things much worse, not better.

I don’t feel like t3 is the answer unfortunately and I’m doubtful NDT would be any different (and if anything it’s more limiting as the ratios are fixed!) it’s on my list of things to try as a last resort but I strongly suspect something else is causing raised TSH and as adding in any thyroid hormones worsens things significantly :(

If the bp and bg issues were hypothyroidism, surely I would feel some benefit from adding in thyroid hormones?

humanbean profile image
humanbean in reply to

You would only get a benefit from adding in thyroid hormones if your levels, when untreated, are too low for you. If having higher than optimal levels of thyroid hormones felt good then people with hyperthyroidism would never seek treatment.

Personal anecdote... I have, on occasion, found out that I'm taking slightly too high a dose of thyroid hormones. But when that has happened I've found that the discomfort of doing so creeps up on me fairly slowly. And I might feel great in the early days/weeks, but eventually it backfires on me.

in reply tohumanbean

Interesting to hear your experience!

See I am convinced that my body is perfectly happy when t4 is 16-17 as soon I push it higher things get bad. Same with t3- feel best when it’s sitting around 4.5-5.5

It why I question if something else is wrong and impacting the TSH.🤔

It why I question an adrenal problem as I read the symptoms can be very similar to hypothyroidism and caused a raised TSH. 🤔

humanbean profile image
humanbean in reply to

Then aim to get your T4 and T3 where you feel happy and comfortable and ignore your TSH. That's what I do. :)

Although I don't have an official diagnosis I have self-diagnosed Central Hypothyroidism. I always ignore my TSH as a result. My pituitary is squashed flat and I don't trust it.

in reply tohumanbean

This is the issue though I feel rubbish without thyroid meds but much MORE rubbish with them so there must be something else going on 🤔 :(

humanbean profile image
humanbean in reply to

The only other things I can think of are :

1) Non-optimal vitamins and minerals

The usual ones :

B12, folate vitamin D, ferritin

and the less often mentioned ones :

Zinc, copper, iron, selenium, iodine, potassium, sodium, magnesium, vitamin E, Vitamin A, Vitamin K2

2) Non-optimal cortisol

.

Just some random comments on the subject of optimal nutrients...

1) Not all nutrients have a known optimal level. When that happens I just assume that mid-range is a safe and non-damaging level for most things.

2) Some excess vitamins and minerals are excreted by the kidneys. Things can go wrong if the kidneys function poorly.

Magnesium is a good example. It can build up if kidney function is poor. But the situation isn't completely bad :

kireports.org/article/S2468...

3) When I supplement a vitamin or mineral I try to get info on problems and symptoms related to deficiency and toxicity of the thing I'm supplementing, as well as looking for side effect info of anything I'm taking. This isn't guaranteed to be perfect as a strategy. For example, I found out that extremely low iron can cause severe chest pain but it is rarely mentioned anywhere. I think I found out from drugs.com in the end. But when I complained of the chest pain and doctors found that I wasn't having a heart attack I was asked if I was "anxious". I discovered soon after that "non-cardiac chest pain" is assumed to be caused by a mental illness. When I improved my own iron levels my bouts of chest pain stopped happening.

If I had waited for doctors to fix me up I would still be waiting.

in reply tohumanbean

I don’t think it’s vitamins or minerals either sadly.

All my key ones are optimal or as good as and I’ve noticed zero improvement.

I have a test to do for zinc, magnesium and selenium. (Magnesium prev tested and always fine)

Sodium and potassium are fine but on occasion I have tested with low sodium and high potassium (but this was always gleefully dismissed as only ‘slightly’ out of range)

I’d be surprised if a low level of a vitamin or mineral would cause the severity of these huge dips in bp and bg (they can be so bad that people around me want to call an ambulance) they happen suddenly and randomly, surely they’d be low all the time if I was deficient in something🤔

humanbean profile image
humanbean in reply to

but this was always gleefully dismissed as only ‘slightly’ out of range

Frankly, I think that is appalling! Sodium and potassium are extremely important for good health. They control a lot of what goes into or out of cells and disturbances of either level could cause all sorts of problems. If you are deliberately keeping your salt intake low, you might want to raise it a little.

en.wikipedia.org/wiki/Sodiu...

Sodium deficiency (hyponatremia) : en.wikipedia.org/wiki/Hypon...

Sodium toxicity (hypernatremia) : en.wikipedia.org/wiki/Hyper...

Potassium deficiency (hypokalemia) : en.wikipedia.org/wiki/Hypok...

Potassium toxicity (hyperkalemia) : en.wikipedia.org/wiki/Hyper...

in reply tohumanbean

Interesting! I did quiz them on this but I was told that essentially because salt was only a point too low and potassium a point too high…it didn’t really matter 🙃

I’ve been increasing my salt intake cos I heard it can help low blood pressure. It helps slightly I think, especially salty water!

Guess I’ll try to follow up with them about looking at this further!!

in reply tohumanbean

I also take combined contraceptive pill and notice this electrolyte imbalance is much much worse/wonkier when it is stopped 🤔 it’s so bizarre

TiggerMe profile image
TiggerMeAmbassador

Oh! Could it be a histamine issue 💡... shop-dr-becky-campbell.mysh...

Tricky little beastie to spot but I have to be mindful of histamine

Looking back at your history and a year ago you were actually feeling good on 75mcg and this was when your folate, ferritin and iron were still shocking...

Here are my bloods after taking 75mcg levo, I’m doing mostly better but wondering if it is worth asking for another increase?

Should I try 87.5mcg or 100mcg?

For ref I am 5”5 and around 53kg.

Thank you so much! (Results below)

Tsh 2.63 (0.27-4.2)

Ft4 19.9 (11-21.2)

T3 not tested.

Serum vit b 12 632 (197-771)

folate 6.3 (3-20)

Vit d 143 (50-150)

ferritin 43 (13-150)

Last dose levo taken 24 hours before test and fasted :)

in reply toTiggerMe

I think tbh ‘doing mostly better’ was more referring to the fact that I wasn’t having so much constipation. But 75mcg was causing speech issues, mobility issues and I hadn’t twigged that having diarohea was not an improvement.😬 My ft4 was far too high on that dose in my opinion. This was at a point when I hadn’t twigged that there was a connection of levo thyroxine and these eps of low bg and bp.

I had lots of other symptoms that I had wrongly attributed to other causes but actually they all disappear when levo is stopped. I was unable to work. But without levo I can manage ok.

I also had screamingly high prolactin and SHBG on that dose (anand any levo dose) and it was flattening my testosterone and causing issues. (I seem to have high prolactin and SHBG only on levo and this always normalises when stopped) high SHBG seems like a sign of overmedication?

All my vits and mins are optimal now (or as good as!) and it is no easier to tolerate levo and the issue persists. :(

TiggerMe profile image
TiggerMeAmbassador in reply to

So it seems you are better off without treatment and have mid range frees just a slightly raised TSH which could have been affected by the contraceptive pill? Perhaps you just needed to sort out your low vits and mins and not tamper with thyroid hormones? How are your symptoms now you aren't taking any T4?

Very lean people tend to have higher SHBG or could be high oestrogen, adrenal or pituitary connection, interesting that you have PCOS but very low testosterone?

in reply toTiggerMe

So this is where it’s complicated….

I only have LOW testosterone on levo. It is high when not taking any medications (the pill keeps it in check)

I am better off without thyroid meds but my health is still poor (symptoms are still there but less severe w/o levo)

My Tsh is still at 7, even w it’s optimal vits. This is the case on and off contraceptive pill. My estrogen just stays low in range off of the pill and never does much of anything.

I don’t think the pill is causing the thyroid issues plus it’s not really an option for me to stop it long term as the low bp issues are worse off of it. :(

TiggerMe profile image
TiggerMeAmbassador in reply to

I know very little about PCOS but you'd think that your oestrogen needs raising to balance things out with testosterone?? 😵‍💫

I wonder if you wouldn't be better trying Metavive as this releases hormones more slowly into the system? Or NDT is your Endo for or against?

in reply toTiggerMe

I’ll look up metavive but I am really convinced I don’t need extra thyroid hormones and there’s some other wonkiness at play. I think I need to rule out adrenal issues first.

I know a bit about PCOS and like hypothyroidism… a lot of my issues don’t seem that typical of PCOS. Endo also seemed puzzled by this. High estrogen is v common with PCOS but mine isn’t. I doubt they’ll give me anything for that. And a lot of the other treatments for PCOS can lower blood pressure and blood sugar so obviously not ideal for me at the moment :(

(Spirolactone, metformin etc)

in reply toTiggerMe

I have a doctor who will/can prescribe NDT but keeping this as a last resort cos it’s crazy pricey and I’m unconvinced that it’ll be any different to other thyroid hormones for me :(

in reply toTiggerMe

edit: sorry just to say I had a full thyroid panel a few weeks after this one and t4 was over range on 75mcg.

I think because everyone was telling me it would get worse on levo before it got better I was fooling myself and questioning my smyptoms a lot. But in actual fact the higher the dose the worse things got.

I will look into histamine - I’ve read a bit about it but need to learn more!

TiggerMe profile image
TiggerMeAmbassador in reply to

In the next post you had been on 87.5mcg for 1.5 weeks... this test isn't any use and just misleading as your dose wouldn't have had time to settle...

I’ve been on 87.5mcg dose for 1.5 weeks… I had some bloods last week and for some reason they also did my thyroid bloods which are below:

TSH 2.73 (0.27-4.2)

FT4 21.3 (11.0-21.2)

in reply toTiggerMe

Ah no sorry I mean I stopped sharing my results and posting on here so much so they aren’t on here! I will try and dig them out!

TiggerMe profile image
TiggerMeAmbassador in reply to

How come you ended up on 87.5mcg after that?

in reply toTiggerMe

Because everyone was telling me here that I felt bad because I wasn’t on a high enough dose so I got an increase hoping it would help… it took a along time to make sense of my symptoms and the connections

I think the ‘it all gets worse before it gets better’ advice kinda made me stick with it!

TiggerMe profile image
TiggerMeAmbassador in reply to

So by this point had your poor conversion been flagged up? If your fT4 was already above range no one here would suggest taking more they would have suggested the need for a little T3...

You do need a full replacement dose but that might need to be a combination and yes things do very often get worse before they get better hence the 6-8 week minimum

With the various bits I've picked out of what you have shared here I would think 62.5/75mcg T4 with 5mcg T3 in a single dose am when your cortisol is in a good place would be my guess combined with a low histamine diet

Overdoing histamine had exactly the effect you describe, shaky, low glucose and BP and a hot/cold sweat then feeling utterly drained and like I'd been poisoned 🤢

in reply toTiggerMe

I tried adding in t3 last year and it was a thousand times worse than levo alone.

I couldn’t walk because I was in so much pain. I could barely eat. Hypotension/glycaemia worse still and my hearing was severely impaired too.

I always did the 6-8 weeks but things never appeared to settle and just stayed rubbish for me. On any thyroid meds my bg drops dangerously low (2.5-2.7) and it takes hours to raise so it just doesn’t feel safe/ the right thing to do.

*I really do feel like I’ve tried every combo of levo/lio going and how/when to take it and it all produces the same debilitating affect which is why o suspect there’s something else going on.

TiggerMe profile image
TiggerMeAmbassador in reply to

Do you eat beef, olives, avocado, cheese anything matured or leftovers?

in reply toTiggerMe

Not a big fan of any of those tbh. I have occasional olives (maybe every few weeks, same with cheese!)

in reply toTiggerMe

But should they get so much worse that you are collapsing and passing out at random? Cos that doesn’t seem normal to me :(

in reply toTiggerMe

But if it was histamine wouldn’t it be just as bad without thyroid medications?

I feel it’s significant my symptoms become significantly worse on any thyroid med dose and I’m completely unable to function 😔

TiggerMe profile image
TiggerMeAmbassador in reply to

I didn't have a histamine, dairy, nightshades intolerance until I started on levo so perhaps it triggers these issues as hormones would never normally go via the gut 🤷‍♀️

in reply toTiggerMe

I’ll do some googling and see what I can find out.

But that also leaves the question of why my prolactin and SHBG sky rocket on levo?

They always normalise after stopping so I know it is directly linked to levo and lio…and those hormone levels were not an issue previously (on or off the contraceptive pill)

Milburn13 profile image
Milburn13

Thanks for mentioning blood pressure.After eventually getting my BP up to 120/60 on thyroid meds, over the last few weeks my BP has dropped to 95-105/47-53 and blood sugar went up. I also had some dizzy spells, blurred vision and extra fatigue! My GP told me to take extra salt which I was doing and I think I had too much but it still didn't bring my BP up. So I've just stopped taking my progesterone pessary and my blood sugar is back to normal range and my BP is going up. It's never simple is it? Hope you find a way to get better.

in reply toMilburn13

No it’s so annoying that everything is so complicated!

I take progesterone and estrogen but never had issues with low blood pressure until the last couple years so I don’t think it’s that…if anything my bp is worse without it. But we’re all so different!

Salt helps me a little too but barely touches the sides really. :(

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helvellaAdministrator

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