Sign-in to Ask A Doctor - 24x7
OR
Sign in with Google
Suggest Treatment For High BP And Excessive Fatigue
Question: Good evening. I am a 45 y.o. female who has had high blood pressure since the age of 16 and at the age of 35 was diagnosed with hypothyroidism. I am now taking dessicated thyroid daily 60mg. While my TSH, T3 and T4 are in the normal range, I am still feeling tired all the time and my blood pressure is still in the 150s/100s despite of the daily 10mg of Altace. I am also severely overweight with BMI over 40, yet in the presence of 1600kcal diet and regular exercise my weight loss is about 2lbs per month (not week). I am at loss how I can help myself any further. I have done stress testing, kidney function testing and sleep study and there is no apparent reason for high blood pressure and fatigue. Periodically I get bouts of sudden fatigue, to the extent that I need to have to lie down and have at least 5min quasi nap...I am generally low on ferritin due to very heavy periods but mid normal range on hemoglobin. I am completely at loss how I can help myself to lower blood pressure and decrease the fatigue because I belong to people who feel when their blood pressure rises and that fatigue is eating out the quality of life from me...Thank you!
Brief Answer:
Hormone tests
Detailed Answer:
Sorry to learn about your bothersome symptoms.
see if you can convince your primary healthcare provider to refer you to an Endocrinologist to investigate possible ' Secondary ' causes of high blood pressure.
Examples of these include Cushings and Conn's syndrome and Acromegaly. There are several other such conditions but they all require a thorough physical examination in-person.
When I see someone like you in my practice, I typically order the following blood tests in addition to a detailed physical examination:
CBC (Complete Blood Count, also known as Hemogram; includes Hemoglobin, WBC and Platelet counts)
Electrolytes (Sodium and Potassium in particular)
HbA1c (Glycosylated Hemoglobin = your last 3 months' glucose average). Also known by other names such as GlycoHemoglobin or Glycated Hemoglobin or A1c
Liver function tests (SGOT , SGPT, Albumin, Bilirubin, Alkaline Phosphatase)
Kidney function tests (BUN, Creatinine)
TSH (checks your thyroid)
Free T4 (this too checks your thyroid) Thyroid autoantibodies : Anti Thyroid Peroxidase (TPO) antibodies and Anti Thyroglobulin antibodies
25 hydroxy Vitamin D levels (ideal range 40 to 60 ng/ml = 100 to 150 nmol/liter)
None of these tests require any fasting and can be done at any time of the day.
Moreover, dessicated thyroid is not recommended by thyroid experts as it is deemed unsafe. Levo thyroxine is best
Hormone tests
Detailed Answer:
Sorry to learn about your bothersome symptoms.
see if you can convince your primary healthcare provider to refer you to an Endocrinologist to investigate possible ' Secondary ' causes of high blood pressure.
Examples of these include Cushings and Conn's syndrome and Acromegaly. There are several other such conditions but they all require a thorough physical examination in-person.
When I see someone like you in my practice, I typically order the following blood tests in addition to a detailed physical examination:
CBC (Complete Blood Count, also known as Hemogram; includes Hemoglobin, WBC and Platelet counts)
Electrolytes (Sodium and Potassium in particular)
HbA1c (Glycosylated Hemoglobin = your last 3 months' glucose average). Also known by other names such as GlycoHemoglobin or Glycated Hemoglobin or A1c
Liver function tests (SGOT , SGPT, Albumin, Bilirubin, Alkaline Phosphatase)
Kidney function tests (BUN, Creatinine)
TSH (checks your thyroid)
Free T4 (this too checks your thyroid) Thyroid autoantibodies : Anti Thyroid Peroxidase (TPO) antibodies and Anti Thyroglobulin antibodies
25 hydroxy Vitamin D levels (ideal range 40 to 60 ng/ml = 100 to 150 nmol/liter)
None of these tests require any fasting and can be done at any time of the day.
Moreover, dessicated thyroid is not recommended by thyroid experts as it is deemed unsafe. Levo thyroxine is best
Note: For more information on hormonal imbalance symptoms or unmanaged diabetes with other comorbid conditions, get back to us & Consult with an Endocrinologist. Click here to book an appointment.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
Get personalised answers from verified doctor in minutes across 80+ specialties
