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What Causes High BP After Levothyroxine Usage?
Question: I was diagnosed with hypothyroidism approx 4 years ago. TSH jumped from 3.0 to 10 during the previous year. Began taking levothyroxine .25 mcg at that time. Dosage has been increased to 1.25 mcg. Still having symptoms such as hair loss, intolerance to cold, fatigue, weight gain, dry skin and hair, etc. After last increase, my blood pressure increased as well. Normal BP for me has always been anywhere from 90-110 systolic and 60-75 diastolic. It went up to 173/110. Went to ER and they diagnosed me with anxiety. Gave me a prescription for lorazepam. Took it when I got home. Three hour later, BP was 185/113. A friend told me that her BP was elevated after taking levothyroxine and her Dr. discontinued it.
Brief Answer:
Thyroid
Detailed Answer:
Thyroid problems can cause blood pressure elevations too.
It can occur when the the levothyroxine dose is excessive. The only way to detect this with certainty is to do a blood test for TSH and free T4. Fasting is not necessary. It is preferable that you do not get the blood sample taken right after your morning levothyroxine dose.
The same blood test result will also give a very good idea if the dose is inadequate.
That being said, it is unlikely for extreme blood pressure elevations like the ones you are reporting to occur solely from mild to moderate thyroid problems.
It would be worth checking thyroid antibodies in the same blood sample for anti TPO (thyroid peroxidase) and anti TG (Thyroglobulin) antibodies. These will enable us to know if your hypothyroidism is the permanent type. Sometimes there is temporary 'bruising' of the thyroid gland called thyroiditis and it recovers to normal within months. TSH can rise to 10 during a phase of recovery in this condition.
Positive antibodies typically indicate the need for lifelong replacement with levothyroxine.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thank you Doctor. I want to make sure I understand this correctly. Because my condition is considered mild to moderate, it's less likely the etiology of the hypertension, but possibly too high a dosage of the levothyroxine? My question is... If too high a dosage would be the cause of the hypertension, would I still be experiencing the symptoms that I am? I know every medication has some type of side effects. I am just very concerned because I don't want to have to take medications to counteract side effects from other medications. Also, what are your thoughts on Armour or dissecated thyroid meds? I realize that approximately 90% of people have no issues with the levothyroxine. Is it possible that I'm in the 10% that have issues with this standard of care?
Brief Answer:
Follow up
Detailed Answer:
To answer your second question first, armor/dessicated thyroid is deemed unsafe by thyroid experts. Levothyroxine alone suffices for everyone with hypothyroidism, based on current evidence based guidelines.
Regarding blood pressure, first check your blood levels of TSH and free T4. Only if these are severely off , can one expect some blood pressure derangement.
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
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