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Suggest Treatment For Hyperthyroidism And Anxiety

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Posted on Sun, 12 Mar 2017
Question: I am 39 yr lady with chronic stress systems for last 14-15 years. Had pcod, had hyperthyroidism that got over corrected after 2 yrs and i discontinued electroxin. Then started having migraines and was put on prothiaden 50 mg . Also had intermittent High bp. Am on prothiaden 50 mg at bedtime and Aten 25 for bp in the morning last 3 yrs. nov 2016 had thicked uterus lining for which i had a dnc done. Again hormonal imbalance was the likely cause. My period cycles are regular last 3 times post dnc. However the bp fluctuates drastically.

Had an ambulator put for 24 hrs . Results are as follows:

Avg daytime 138.3/85.4
Avg nighttime 100/22.2
Diff in day/ night avg. -17.1/-22.6

Sys bp min 101, XXXXXXX 252!!
Dia bp min 53 XXXXXXX 196!!
Heart rate 50 XXXXXXX 98

These readings look alarming to me.

Also got an mri brain done 3 yrs ago and it said acute is hemiec foci on the left side. Im wondering if this has a connevtion.

All night readings are very low , while the day readings are alarmingly high.

Can u pls advice if i am sustebile to a stroke and what really is happening

doctor
Answered by Dr. Geeta Sundar (8 hours later)
Brief Answer:
Blood pressure is normally lower at night. This is called nocturnal dipping

Detailed Answer:
Hi XXXXXXX welcome back. I reviewed you previously.
Blood pressure is normally lower at night. This is called nocturnal dipping. Yes your fluctuations are more.
I will suggest you switch to metoprolol XL 25 at night and Amlodipine 2.5 in the morning. Metoprolol is more safe for the heart, sugar and lipids than Atenolol. By adding a small dose of Amlodipine your fluctuations in blood pressure and pulse can be controlled.
Can you tell me your latest TSH, B 12, Vitamin-D and lipid values?
Prothiaden should definitely be withdrawn although very gradually.
You are young and should get into a vigorous exercise program to combat your anxiety.
I think there is still a minor hormonal imbalance, fluctuating Blood pressure and anxiety.
If you take care of your lipids and blood pressure, your chances of stroke are low.
Please revert back.
Regards




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Above answer was peer-reviewed by : Dr. Raju A.T
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Answered by
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Dr. Geeta Sundar

Internal Medicine Specialist

Practicing since :1975

Answered : 1329 Questions

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Suggest Treatment For Hyperthyroidism And Anxiety

Brief Answer: Blood pressure is normally lower at night. This is called nocturnal dipping Detailed Answer: Hi XXXXXXX welcome back. I reviewed you previously. Blood pressure is normally lower at night. This is called nocturnal dipping. Yes your fluctuations are more. I will suggest you switch to metoprolol XL 25 at night and Amlodipine 2.5 in the morning. Metoprolol is more safe for the heart, sugar and lipids than Atenolol. By adding a small dose of Amlodipine your fluctuations in blood pressure and pulse can be controlled. Can you tell me your latest TSH, B 12, Vitamin-D and lipid values? Prothiaden should definitely be withdrawn although very gradually. You are young and should get into a vigorous exercise program to combat your anxiety. I think there is still a minor hormonal imbalance, fluctuating Blood pressure and anxiety. If you take care of your lipids and blood pressure, your chances of stroke are low. Please revert back. Regards