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What Causes Persistent Headache After A Thyroid Removal Surgery?
Question: Thyroid removed 11/11, went off replacement medication 1/1 (getting ready for radioactive iodine), now have a full-time headache that wakes me up every morning around 5:30 AM, and my blood pressure's shot up to 174/101 (ten minutes ago). I'm taking 50 mg. losartan, it obviously isn't doing anything. Is this related to the thyroid issue?
Brief Answer:
Possible effects of hypothyroidism
Detailed Answer:
Good day.
Noted your concern. once you stop thyroxine replacement , hypothyroidism sets in. this can cause blood pressure to go up. Headache is unusua but possible with hypothyroidism . Blood pressure rise also could be secondary to headache itself.. For time being you may take paracetamol and please meet a doctor as soon as possinle to determine the cause of headache. this is important and should be done fairly soon. Losartan 50mg may need to be increased as well.
May I know the reason for radio iodine ablation. was it for a malignant thyroid nodule? ?
regards
Binu
Possible effects of hypothyroidism
Detailed Answer:
Good day.
Noted your concern. once you stop thyroxine replacement , hypothyroidism sets in. this can cause blood pressure to go up. Headache is unusua but possible with hypothyroidism . Blood pressure rise also could be secondary to headache itself.. For time being you may take paracetamol and please meet a doctor as soon as possinle to determine the cause of headache. this is important and should be done fairly soon. Losartan 50mg may need to be increased as well.
May I know the reason for radio iodine ablation. was it for a malignant thyroid nodule? ?
regards
Binu
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thyroid cancer - the thyroid itself was a mess, there were nodes throughout. It was quite a clean-out: the surgery took about five hours instead of two, and a lot was removed. I was on 25 mg losartan for somewhat elevated BP for the past two years, had the surgery 11/11 as noted, stopped medication 1/1 as noted, now I'm being awakened between 4:30 and 5:30 AM the last five days with a headache. (It's basically an all-day headache.) Two days ago doubled the dose of losartan from 25 mg to 50 mg per day, it seems to have made BP worse! Got up this morning at 5:35 - awakened by headache, took BP, it was 186/94. Ten minutes later on re-check it was 174/101; then at 6:30 it was 155/97, at 7:30 it was 150/102. Doubling the losartan did nothing, apparently.
Brief Answer:
FUNDUS check up
Detailed Answer:
sorry to hear about your symptoms. it would be a good idea to get an eye check up,especially fundus. Early morning worsening of headache is also common in anxiety. Do think you are depressed/anxious ?
FUNDUS check up
Detailed Answer:
sorry to hear about your symptoms. it would be a good idea to get an eye check up,especially fundus. Early morning worsening of headache is also common in anxiety. Do think you are depressed/anxious ?
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
No - but if I keep being awakened with a hurting head every morning at 4:30, I will be! Saw a neurologist about two years back for a month-long headache (one, not a lot of different ones) and he diagnosed primary headache, or "cough" headache, treated with Indomethacin and Propralonol, and it took a few months but it eventually went away. I thought it was coming back, but this one feels different, and of course with the BP I'm trying not use NSAIDs like Indomethacin, and while trying to clean thyroid medicine out of my system so they can do readioactive iodine I can't use a beta-blocker like Propralonol - so my head's in pain, and my blood pressure's through the roof! The BP's the big problem - is it high enough that this is the cause of the headache? And why didn't doubling the losartan do anything at all? We did that Tuesday (1/5) - I should see an effect from that in 48 hours, shouldn't I?
Brief Answer:
Low potency of ARB group drugs in smaller doses
Detailed Answer:
Sorry for the delay in reply. Why can't you use propranolol?You have used it before. Please be aware that Propranolol doesnt affect radio iodine treatment. Infact adding that would control BP and may releive the headache as well.
Coming to your question, typically blood pressure induced hypertension happens when the BP is above 180/110. Below this level, it is unlikely to cause giddiness or headache. However, headache for any reason, can rise the blood pressure. Any stress for that matter can rise the BP.
ARB group of drugs ( Losartan, Valsartan, Olmesartan, Telmisartan ) are not great pills in moderate dose for blood pressure reduction. Typically, smaller doses ( 25-50 mg of losartan) are used to reduce protein excretion by kidney and hence good for kidney protection in diabetes patients. They are not great BP reducing pills when used alone.
The BP lowering effect is maximum when we use these group of pills ( ARB group of BP pills ) in higher doses and also when used in combination with other drugs. Hence, i do not consider Losartan as a powerful BP lowering drug in the current dose used in your case. Besides, it will take several days for the full effect of BP drugs once it is started or when the dose is changed. 48 hours may not be good enough.
Low potency of ARB group drugs in smaller doses
Detailed Answer:
Sorry for the delay in reply. Why can't you use propranolol?You have used it before. Please be aware that Propranolol doesnt affect radio iodine treatment. Infact adding that would control BP and may releive the headache as well.
Coming to your question, typically blood pressure induced hypertension happens when the BP is above 180/110. Below this level, it is unlikely to cause giddiness or headache. However, headache for any reason, can rise the blood pressure. Any stress for that matter can rise the BP.
ARB group of drugs ( Losartan, Valsartan, Olmesartan, Telmisartan ) are not great pills in moderate dose for blood pressure reduction. Typically, smaller doses ( 25-50 mg of losartan) are used to reduce protein excretion by kidney and hence good for kidney protection in diabetes patients. They are not great BP reducing pills when used alone.
The BP lowering effect is maximum when we use these group of pills ( ARB group of BP pills ) in higher doses and also when used in combination with other drugs. Hence, i do not consider Losartan as a powerful BP lowering drug in the current dose used in your case. Besides, it will take several days for the full effect of BP drugs once it is started or when the dose is changed. 48 hours may not be good enough.
Note: For more detailed guidance, please consult an Internal Medicine Specialist, with your latest reports. Click here..
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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