Hashimotos and high blood pressure

[Europe]

For years I have been on 125 mcg Eutirox and 15 mcg Cynomel T3 (split up 3 doses at 5 mcg, total 15 mcg per day). Also taking Amlodipino 5 for last 3 years. I have been feeling well, twice annual blood tests and T3, T4 always in good range, TSH has been around 0.10. Lots of energy, no pain in thyroid and blood pressure under control.

That was until middle of October when I developed high blood pressure, high pulse, slept really bad and ended up at the emergency ward 3 weeks later. They told me to check my thyroid medication and added Esidrex, another blood pressure medication. I dropped down to 100 mcg Eutirox, 5 mcg Cynomel and felt better but when I removed Cynomel I felt amazing. It was like the body went into relax mode. That only lasted for a few days until pain and inflammation in the thyroid started. I felt awful so upped Eutirox to 112 mcg, several days later I added 5 mcg of Cynomel because the pain in the thyroid was so bad. It's now been about 10 days and the thyroid still hurts and the blood pressure is higher again but not as bad as before.

How do I solve this? Keep thyroid inflammation and pain low and at the same time the blood pressure in normal range??? I am desperate 😭

Maybe up Eutirox and remove Cynomel again?

[TiggerMe Ambassador]

Welcome aboard,

It's horrible when things go a bit haywire, have you got some results along with ranges you can share so that we can see what has been going on? Ideally the more history the better added to you profile for people to refer back too

Generally any meds for lowering BP will also lower thyroid hormone levels which can also raise BP 😕

Adjusting dosing without blood tests to guide you risks adjusting the wrong way and getting in more of a pickle

Have they run any other tests for kidney, liver, cholesterol?...

[Europe in reply to TiggerMe]

Hi,

The results from July this year. The results have been the same for years as I was on the same dose of thyroid medication

TSH 0.07

T3 free 3.45

T4 free 1.12

Tot cholesterol 216 high (150-200)

HDL 63 (42-65)

LDL 139 high (0-130)

In November, 18 days after lowering the Eutirox to 100, T3 5 mcg for13 days, 5 days before test no T3 at all

TSH 0.65

T3 free 2.76

T4 free 1.12 same as before

Tot cholesterol 246

HDL 68

LDL 159

Thank you 😊 🙏

[TiggerMe Ambassador in reply to Europe]

Can you add the lab ranges as they vary, high cholesterol is suggesting under replaced

[Europe in reply to TiggerMe]

The ranges for Cholesterol are noted between the ( ) under the July results.

TSH range (0.23-5.50). 5.50 is way too high, in my opinion

T3 free range (2-2.40 pg/ml)

T4 free range (0.93-1.80 ng/dl)

I feel like my body is not in balance at the moment, maybe too much blood pressure medication, too little Eutirox. Seems like any amount of T3, even 5 mcg, gives me high blood pressure. A bit frustrating and don't know how to balance "the system ". Any help is much appreciated.

[TiggerMe Ambassador in reply to Europe]

That's a very narrow range for fT3?

But working with your July results...

Free T4 (fT4) 1.12 pmol/L (0.93 - 1.8) 21.8%

Free T3 (fT3) 3.45 pmol/L (2 - 2.4) 362.5%

T4:T3 Ratio 0.325 

Suggesting you would benefit from an increase in T4 and don't need the T3

We don't tend to take too much notice of TSH as it's rather unreliable

[Europe in reply to TiggerMe]

Sorry, Ft3 should be 2-4.40 range

[TiggerMe Ambassador in reply to Europe]

Phew... that makes much more sense 😅

Free T4 (fT4) 1.12 pmol/L (0.93 - 1.8) 21.8%

Free T3 (fT3) 3.45 pmol/L (2 - 4.4) 60.4%

Is this the level of fT4 you have felt well on in the past? Many find a fT4 50-70% is a happy place

[TiggerMe Ambassador in reply to TiggerMe]

Do you have any results for folate, ferritin, B12 and Vit D as these all play an important role

[Europe in reply to TiggerMe]

I do take extra vit D and B12 or my levels drop way too low. I also take Selenium daily to keep the antibodies low.B12 785 pg/ml (180-850)

Vit D 55 ng/ml (30-100)

Ferritina 78 ng/ml (14-233)

Foliate I don't have

[TiggerMe Ambassador in reply to Europe]

Worth adding a good B complex to support all the B's

[Europe in reply to TiggerMe]

In the past it was OK I guess. With Hashimotos I am not sure what I should feel like but I didn't have any thyroid pain and seemed to have enough energy. It's only this year I started to feel strange, I thought it was what ageing feels like, I am only 54 🙃 At the moment I don't feel well so am willing to try new things. If I remove T3 again, how much can I raise the Eutirox? Not sure how to remove the blood pressure medication because I think the different medications contradict each other....however, I am only guessing.

[TiggerMe Ambassador in reply to Europe]

Are you on HRT as this can effect thyroid levels? Low sex hormones also feel like low thyroid symptoms 😬 Your a young'un like me so finding your sweet spot should put a spring back in your step 😁

Your July results don't suggest a drop in T3 is needed just a rise in T4, I'd suggest doing this and giving it a few weeks to see if you can then gradually lower your BP tablets

It does make me wonder if they put you on BP tablets a few years ago when you actually needed your T4 tweaking

Do you have earlier fT4 results to compare?

[Europe in reply to TiggerMe]

Good morning,

Thank you for your answers.

Yes I am on HRT since many years. Activelle now. Tried the creams but I live in a warm country and I would just sweat it away.

I found fT4 results from 1,5 years ago and it was 1,1 so still low, fT3 was 2,3.

If I am on 112 Eutirox now, how much more can I add? Maybe try 25 mcg more?

Was thinking about not taking the T3 today. When I removed it completely for a few days my whole body slowed down and it felt amazing and calm until the thyroid pain came back.

[TiggerMe Ambassador in reply to Europe]

Morning

Ok, so no change in HRT regime so that's good 😅

18 months ago

Free T4 (fT4) 1.1 pmol/L (0.93 - 1.8) 19.5% (125mcg T4 15mcg T3)

Free T3 (fT3) 2.3 pmol/L (2 - 4.4) 12.5%

July 2024

Free T4 (fT4) 1.12 pmol/L (0.93 - 1.8) 21.8% (125mcg T4 15mcg T3)

Free T3 (fT3) 3.45 pmol/L (2 - 4.4) 60.4%

So if we compare the two results it could be that a small reduction in T3 rather than stopping is a middle route whilst increasing your T4 dose, changing both at the same time isn't ideal but as things are already up in the air...

Ideally don't increase T4 by more than 25mcg and wait 8 weeks to retest so if you do this your dose would be 137.5mcg so only a 12.5mcg increase on your previous long term dose which would be a start with a good chance a further increase will be needed, often changing by 12.5mcg is a better way to sneak up on your sweet spot

Dropping your T3 from 15mcg to zero is a bit drastic we recommend only changing by 5mcg unless over replaced which you aren't and improving your fT4 is going to take a few months

[Europe in reply to TiggerMe]

Thank you. I'll try that. So will be on 137.5 Eutirox and keep T3 at 5 mcg for now and retest in 8 weeks. I have found many (most) doctors don't understand Hashimotos or thyroid problems well at all, hence the drastic reduction .

Blood pressure is OK this morning and I slept well, that helps a lot.

Fingers crossed 🤞 all improves.

Thank you very much 🙏😊

[TiggerMe Ambassador in reply to Europe]

Sounds like a plan, yes most GP's are hopeless and you need to be the expert... everything is so much better after a decent nights sleep isn't it 🤗

[jgelliss in reply to TiggerMe]

Personally everyone has their Optimal FT4. I personally feel my best at FT4 at 1.4-1.5. It took me a long time to figure it out. You might have to see where your Frees feel the Best for you.

[TiggerMe Ambassador in reply to jgelliss]

Could you give that as a percentage? I like mine at 50-60% as I'm also on a combination of T3&4... hopefully Europe taking small steps will come across her sweet spot on the way up

[jgelliss in reply to TiggerMe]

Percent wise I wouldn't know. But the FT4 is more on the higher side. Many are happy at FT4 at 1.2. I need personally FT4 at 1.4-1.5. These measurements are based on USA labs.

[TiggerMe Ambassador in reply to jgelliss]

Using the same range as above (if that is standard USA?) that would be 54-65%

1.2 would be 31% which is on the low side for most but then this is without considering fT3 levels and all the other factors

(% is International so helps others following this thread)

[jgelliss in reply to TiggerMe]

Thank you for figuring out the percentage. For some reason I don't know how to. For my FT3 I'm fine with 3-3.1. I would assume that when I had my own thyroids that must have been my set points. I need my FT4 at a higher range.Thank you again Tiggerme.

[TiggerMe Ambassador in reply to jgelliss]

I'm cheating 🤗... Free T3 (fT3) 3.1 pmol/L (2 - 4.4) 45.8%

healthunlocked.com/thyroidu...

[jgelliss in reply to TiggerMe]

This is very interesting. Would you know please how I can figure this out for myself. I never understood it when it was first bought on to the forum. Thank you in advance.

[TiggerMe Ambassador in reply to jgelliss]

If you choose one of the calculators and just input your results and ranges it does the clever bit 😅

[jgelliss in reply to TiggerMe]

Thank you ❤️.

[Europe in reply to TiggerMe]

Hi, as you were so helpful before I hope you don´t mind me asking your thoughts about why I still feel awful.

I tried to up the dose of Levo but every time I tried, I got increased heart rate or high BP again so I have basically stayed on 125 levo and 5 mcg of T3. I have horrible pain in the thyroid again and is that due to reducing the thyroid medication too much in the beginning? Just out of interest because I felt so bad I did a blood test (yes i know I should have waited longer but when you don´t feel well you do things....) Anyway, 2 weeks on 125 levo and 5 mcg T3. Date 3 January

FT3 3.45 (2-4.4) same level as previously when I was taking 125 levo and 15 mcg T3

FT4 1.46 (0.80-1.80) strangely this level is higher with less medication!? before 1.12 range

TSH 0.82 (0.23-5.50) I guess this is better as it used to be 0.07 but maybe this is the cause of the thyroid pain?

Just in the last week or two the BP seems to be steady and as I had so much pain in the thyroid I have added an extra 6.25 mcg a day of Levo in the last 2 days and pulse and BP seem to hold up ok.

I think the magnesium and potassium have helped with lowering the BP and after what I read they are supposed to help. Where do I go from here? I think keeping the TSH low has helped keep thyroid inflammation low all these years as I have had no pain for 12 years. Should I maybe try to take and extra 5 mcg of T3 a day (total 10 mcg) and stay at 125 levo...... Having high BP is equally as horrible as pain in the thyroid and feeling like I am getting the flu. 😞

[TiggerMe Ambassador in reply to Europe]

Do you keep the timings the same for each blood test, fasted, water only before 9am? 24 hours after last dose of T4 and 12 after T3? Always taking on an empty stomach 4hours away from other supplements and Amlodipine

Latest results... 125mcg T4 & 5mcg T3

TSH 0.82 mIU/L (0.23 - 5.5) 11.2%

Free T4 (fT4) 1.46 pmol/L (0.8 - 1.8) 66.0%

Free T3 (fT3) 3.45 pmol/L (2 - 4.4) 60.4%

T4:T3 Ratio 0.423 

So with the recent 6.25mcg T4 increase I'd suggest sticking with that and waiting a full 6 weeks to see how it has settled

I'm not really knowledgeable about BP other than suggesting Vit C is important and can help lower it

[Europe in reply to TiggerMe]

Yes always the same procedure, amlodipino in the evening, thyroid meds in the morning 2 hours before breakfast. Yes 24 hours between thyroid meds and blood test and fasting. As I only take 5 mcg T3 and can't divide it any smaller I take it in the morning with Levo so more than 24 hours between t3 and test the next morning.

Seems like the thyroid is producing more hormones with less medication 🤔

I hope I feel better soon 😞

[TiggerMe Ambassador in reply to Europe]

I'm thinking your body is just a bit up in the air with several large changes and really needs some time to settle, with your fT3 at 60% 24 hours after last dose it suggests 5mcg of T3 is enough

Have you ever had a scan of your thyroid?

[Europe in reply to TiggerMe]

Hi, Yes I get yearly thyroid scans and everything has been OK until I developed high BP in mid October.

Thank you for taking your time. 😊

[jgelliss]

My sympathy for you. With my personal thyroid journey since TT I found that many times the thyroid doseages are not faulty. What I did learn subsequently was that nutrients eg vitamin D/K2, Iron/Ferritin, B12/Folate,Magnesium are a tremendous factors that play a big role in our thyroid meds to work Optimal for us. Dr's either don't know or don't share this vital information. Instead we keep thinking that it's our thyroid dose that is off. We have to be pro active in our wellbeing.Best wishes for fast resolutions.

[Europe in reply to jgelliss]

Thank you. I've been on this up and down journey for more than 12 years. Mostly been fine and this blood pressure problem is a recent and unwanted addition. I do keep an eye on my vitamin levels and other things as I know it's all connected. I am also hoping for a speedy solution. 😊

[humanbean]

You might find this link of interest :

stopthethyroidmadness.com/b...

It is possible that some non-prescription supplements might help your blood pressure - there are many websites that discuss these :

healthline.com/nutrition/su...

verywellhealth.com/herbs-an...

medicalnewstoday.com/articl...

heart.org/en/health-topics/...

active.com/nutrition/articl...

[Europe in reply to humanbean]

Thank you. I have been on combined T3 and T4 treatment. I'll read through all of the links. 😊