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What Causes Blurred Vision, High BP And Migraines When Treating Hashimoto's Disease?
Question: I have Hashimoto's. A month ago I became very sick with blurred vision, very high blood pressure, a migraine headache that lasted 2+ weeks, was treated with Imetrex 3 doses which blunted the headache. Gave additional BP meds to lower pressure. Doctor did TSH and other blood work. TSH came back at 331 and T3 was very low. My endorcrinologis said he never saw anything like it. He gave me a fresh prescription of Thyroxine 125, starting to feel well enough to get up for short periods but I am still dealing with a dizzy feeling, extreme tiredness. Any thoughts?
I am a female, age 59. I'm looking for thoughts on next steps to take. Thank you.
I am a female, age 59. I'm looking for thoughts on next steps to take. Thank you.
Brief Answer:
Hypothyroidism
Detailed Answer:
Thanks for contacting HCM with your health care concerns
I am impressed by the high TSH levels. That is the highest I have ever seen. This means your body was desperately trying to increase your thyroid level to normal range. Your endocrinologist has restarted or increased your thyroid replacement medication but you have not felt back to normal.
When did you see your endocrinologist? It usually takes at least 6 weeks from a dose change to see the full effects of the increase. In my practice I recheck a TSH and readjust dose if it still not at goal after 6 weeks. From your description I think you are probably not at baseline. There is no way to more rapidly stabilize your thyroid levels. Doing it too fast can cause heart issues including heart attack.
As another thought what other medications are your taking including your new blood pressure medications. Your blood pressure medications can also cause side effects including fatigue and dizziness.
Are you also taking your blood pressure readings? I would recommend that you start taking daily blood pressure readings and recording them so your doctor can get a better idea of how low or high your pressure is. Taking a blood pressure at the doctors office helps but that is only one pressure out of weeks. It is better to have a series of blood pressure readings to better individualize your treatment.
Look forward to your answers
Hypothyroidism
Detailed Answer:
Thanks for contacting HCM with your health care concerns
I am impressed by the high TSH levels. That is the highest I have ever seen. This means your body was desperately trying to increase your thyroid level to normal range. Your endocrinologist has restarted or increased your thyroid replacement medication but you have not felt back to normal.
When did you see your endocrinologist? It usually takes at least 6 weeks from a dose change to see the full effects of the increase. In my practice I recheck a TSH and readjust dose if it still not at goal after 6 weeks. From your description I think you are probably not at baseline. There is no way to more rapidly stabilize your thyroid levels. Doing it too fast can cause heart issues including heart attack.
As another thought what other medications are your taking including your new blood pressure medications. Your blood pressure medications can also cause side effects including fatigue and dizziness.
Are you also taking your blood pressure readings? I would recommend that you start taking daily blood pressure readings and recording them so your doctor can get a better idea of how low or high your pressure is. Taking a blood pressure at the doctors office helps but that is only one pressure out of weeks. It is better to have a series of blood pressure readings to better individualize your treatment.
Look forward to your answers
Above answer was peer-reviewed by :
Dr. Yogesh D
Hello Dr. Shubert,
I saw endocrinologist on Dec 23.
Still very tired and arms and legs feel weak after moving around.
I also take Calcium supplement and B vitamins. Under treatment for psoriatic arthritis, for last 5 years. Hashimotos for 25 years, asthma for over 40 years (advair controls very well in last 6 years), I have no spleen (removed 30 years ago), no ovaries (6 years), no uterus (15 years).
Had been doing extremely well on all counts up until Headache started on November 30 then this spiral downward.
Latest BP reading is 131/80 BPM 70 lowered from earlier readings in the 150's/high 90's
Here are abnormal findings from blood work taken 12/16.
TSH 331.400 0.450-4.500 UIU/ML High Final 01
SPECIMEN WAS DILUTED IN
ORDER TO OBTAIN RESULTS.
RESULTS WERE REPEATED.
T4,FREE(DIRECT) 0.15 0.82-1.77 NG/DL Low Final 01
AST (SGOT) 43 0-40 IU/L High Final 01
ALT (SGPT) 39 0-32 IU/L High Final 01
CHLORIDE, SERUM 96 97-108 MMOL/L Low Final 01
Current Prescriptions
Advair Diskus 250 mcg-50 mcg/dose powder for inhalation
Crestor 10 mg tablet
Dexilant 60 mg capsule, delayed release
duloxetine 30 mg capsule,delayed release
Take 1 capsule(s) twice a day
hydrochlorothiazide 25 mg tablet
levothyroxine 125 mcg tablet
lisinopril 5 mg tablet
Take 1 tablet(s) every day by oral route. 12/16/2014
Nasonex 50 mcg/actuation Spray
Spray 2 spray(s) every day by intranasal route.
ProAir HFA 90 mcg/actuation aerosol inhaler
Restasis 0.05 % eye drops in a dropperette
tramadol 37.5 mg-acetaminophen 325 mg tablet
triamcinolone acetonide 55 mcg nasal spray aerosol
I saw endocrinologist on Dec 23.
Still very tired and arms and legs feel weak after moving around.
I also take Calcium supplement and B vitamins. Under treatment for psoriatic arthritis, for last 5 years. Hashimotos for 25 years, asthma for over 40 years (advair controls very well in last 6 years), I have no spleen (removed 30 years ago), no ovaries (6 years), no uterus (15 years).
Had been doing extremely well on all counts up until Headache started on November 30 then this spiral downward.
Latest BP reading is 131/80 BPM 70 lowered from earlier readings in the 150's/high 90's
Here are abnormal findings from blood work taken 12/16.
TSH 331.400 0.450-4.500 UIU/ML High Final 01
SPECIMEN WAS DILUTED IN
ORDER TO OBTAIN RESULTS.
RESULTS WERE REPEATED.
T4,FREE(DIRECT) 0.15 0.82-1.77 NG/DL Low Final 01
AST (SGOT) 43 0-40 IU/L High Final 01
ALT (SGPT) 39 0-32 IU/L High Final 01
CHLORIDE, SERUM 96 97-108 MMOL/L Low Final 01
Current Prescriptions
Advair Diskus 250 mcg-50 mcg/dose powder for inhalation
Crestor 10 mg tablet
Dexilant 60 mg capsule, delayed release
duloxetine 30 mg capsule,delayed release
Take 1 capsule(s) twice a day
hydrochlorothiazide 25 mg tablet
levothyroxine 125 mcg tablet
lisinopril 5 mg tablet
Take 1 tablet(s) every day by oral route. 12/16/2014
Nasonex 50 mcg/actuation Spray
Spray 2 spray(s) every day by intranasal route.
ProAir HFA 90 mcg/actuation aerosol inhaler
Restasis 0.05 % eye drops in a dropperette
tramadol 37.5 mg-acetaminophen 325 mg tablet
triamcinolone acetonide 55 mcg nasal spray aerosol
Brief Answer:
Need more time at least 6 weeks
Detailed Answer:
Hi,
Thanks for contacting me again with more information.
I see that you just saw the endocrinologist last week. At that time he increased your thyroid medication. Increasing the thyroid medication will take at least 6 weeks to be effective. There is no way to speed up the process. If we try increasing the dose of thyroid medication too quickly we can actually cause heart attacks or heart failure. So your fatigue and muscle weakness may take that long to improve. Even then at the end of 6 weeks you may still need adjustments in your medication. So you will need to be patient. In the mean time I can suggest trying light exercise like walking, eating a good well balanced diet and getting plenty of good rest or sleep.
I also think you should continue all your other medication as they will help maintain your blood pressure and help with depressive symptoms. If at the end when your TSH is back to normal and you still feel tired and fatigued your antidepressant maybe the culprit. Cymbalta can cause fatigue as well as many other antidepressants including SSRIs like celexa. You may need to talk to your doctor about an activating type of antidepressant like Wellbutrin. Wellbutrin has more of a stimulating effect for depression and may help better with fatigue issues.
I hope I answered your questions. Please contact me again if you have any further questions or concerns.
Regards,
Need more time at least 6 weeks
Detailed Answer:
Hi,
Thanks for contacting me again with more information.
I see that you just saw the endocrinologist last week. At that time he increased your thyroid medication. Increasing the thyroid medication will take at least 6 weeks to be effective. There is no way to speed up the process. If we try increasing the dose of thyroid medication too quickly we can actually cause heart attacks or heart failure. So your fatigue and muscle weakness may take that long to improve. Even then at the end of 6 weeks you may still need adjustments in your medication. So you will need to be patient. In the mean time I can suggest trying light exercise like walking, eating a good well balanced diet and getting plenty of good rest or sleep.
I also think you should continue all your other medication as they will help maintain your blood pressure and help with depressive symptoms. If at the end when your TSH is back to normal and you still feel tired and fatigued your antidepressant maybe the culprit. Cymbalta can cause fatigue as well as many other antidepressants including SSRIs like celexa. You may need to talk to your doctor about an activating type of antidepressant like Wellbutrin. Wellbutrin has more of a stimulating effect for depression and may help better with fatigue issues.
I hope I answered your questions. Please contact me again if you have any further questions or concerns.
Regards,
Above answer was peer-reviewed by :
Dr. Raju A.T
Brief Answer:
Good luck
Detailed Answer:
good luck and I hope everything works out for you
Good luck
Detailed Answer:
good luck and I hope everything works out for you
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. Prasad
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