Sign-in to Ask A Doctor - 24x7
OR
Sign in with Google
What Causes High BP, TIA And Cold Sensitivity In An Elderly Man?
Question: My husband is 68 years old. In XXXXXXX of 2015 He had to go to the ER because his blood pressure was so high. In the course of checking him over the because they thought he was having a stroke they discovered he had had a TIA some time. He is having a hard time with his nerves, his stomach and I believe his thyroid. He takes Xanax, Rimron,Zolpidem for his nerves and sleep. He is being seen by our primary care physician and a pysciatrist. My question is about thyroid. He complains constantly about being cold. Sometimes so bad all he can do is sit in recliner covered up. Neither Dr is doing anything. Is it his nerves? Could it be his thyroid. I think he needs a peroxidase antibody test. Hashimoto's thyroiditis runs in family his father had it.
Brief Answer:
Thyroid
Detailed Answer:
An inadequately treated under-active thyroid condition ('hypothyroidism') can result in such cold sensitivity.
The treatment of hypothyroidism is levo thyroxine. I see he is on it already. However the dose needs to be right to achieve target blood test results. Generally I use a TSH goal of 1 to 2.5 but this is best individualized by his endocrinologist in-person based on findings of physical examination and comprehensive assessment overall.
If the TSH remains high, then the levo thyroxine dose needs to be adjusted to keep the TSH and Free T4 in target ranges in a steady and stable manner.
Hashimoto's thyroiditis is one of the main causes of hypothyroidism. Antibody tests for it are included below.
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)
Calcium
HbA1c (Glycosylated Hemoglobin = your 3 month glucose average)
Liver function tests (SGOT , SGPT, Albumin, Bilirubin, Alkaline Phosphatase)
Kidney function tests (BUN, Creatinine)
TSH
Free T4
Anti Thyroid Peroxidase (TPO) antibodies
Anti Thyroglobulin antibodies
25 hydroxy Vitamin D
Thyroid
Detailed Answer:
An inadequately treated under-active thyroid condition ('hypothyroidism') can result in such cold sensitivity.
The treatment of hypothyroidism is levo thyroxine. I see he is on it already. However the dose needs to be right to achieve target blood test results. Generally I use a TSH goal of 1 to 2.5 but this is best individualized by his endocrinologist in-person based on findings of physical examination and comprehensive assessment overall.
If the TSH remains high, then the levo thyroxine dose needs to be adjusted to keep the TSH and Free T4 in target ranges in a steady and stable manner.
Hashimoto's thyroiditis is one of the main causes of hypothyroidism. Antibody tests for it are included below.
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)
Calcium
HbA1c (Glycosylated Hemoglobin = your 3 month glucose average)
Liver function tests (SGOT , SGPT, Albumin, Bilirubin, Alkaline Phosphatase)
Kidney function tests (BUN, Creatinine)
TSH
Free T4
Anti Thyroid Peroxidase (TPO) antibodies
Anti Thyroglobulin antibodies
25 hydroxy Vitamin D
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
