Thyroid hormone absolutely does impact both your blood pressure and heart rate.
But what are you supposed to do if you feel good on your thyroid medication but you still have high blood pressure?
How can you manage high blood pressure on medications like Cytomel, liothyronine, or Armour thyroid (which are actually amazing for thyroid patients)?
If you are experiencing high blood pressure while taking thyroid medication then this article is for you.
Your goal, as a thyroid patient, should be to have a blood pressure that is no higher than 120 over 80 mmHg (1).
Let’s talk about the changes you can make to your medication to normalize your blood pressure.
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Thyroid Hormone and Your Heart
It is well known that thyroid hormone influences your heart.
And, because your heart pumps blood throughout your body, any changes to your heart rate or force of contraction can also cause changes to your blood pressure.
We also know, from plenty of studies, that maintaining a healthy blood pressure is absolutely vital to leading a long life and avoiding complications such as stroke, end-organ damage, kidney failure, and heart disease.
Doctors go to great lengths to help manage blood pressure because of these negative side effects!
So, why (or how) then does taking thyroid medication cause high blood pressure in some situations?
It has to do with how thyroid hormone interacts with cardiac tissue (heart cells).
In almost every cell in your body thyroid hormone works by entering into your cell and changing genetic transcription (2).
This process results in changes to your DNA which take weeks to kick in.
But in your heart cells, thyroid hormone activates receptors on a different part of the cell.
This means that the effects of thyroid hormone occur much faster when compared to the genetic changes that occur in other cells in your body.
Through this mechanism, thyroid hormone medication can potentially lead to elevated blood pressure even though you might feel great otherwise.
Effects of Thyroid Hormone on Your Blood Pressure
When you are hypothyroid (meaning that your body can’t produce enough thyroid hormone on its own) you may need to take thyroid medication.
These medications (you probably know them as Synthroid or levothyroxine) contain thyroid hormones and are meant to supplement whatever thyroid hormone your body can produce naturally.
If your body can only produce 80% of whatever is normal thyroid hormone for you, then we try to give you back that other 20% so you can get as close to 100% as possible.
The problem is that sometimes you can actually get more than you need.
Imagine if your body produces 80% but we give you back 40%.
All of a sudden your body is getting 120% of whatever is considered “normal” for you.
This is when side effects such as heart palpitations and elevated blood pressure tend to kick in (there are other reasons that I get into below as well).
As you take too much thyroid medication your heart may start to beat faster and harder which results in an increase in blood pressure.
This effect is regulated through calcium channel pumps (3) found on your cardiac cells (the same pumps and channels that blood pressure medications block to LOWER your blood pressure).
The more thyroid hormone that you take (beyond what is considered normal for you) the more these pumps will work, the higher your blood pressure will go, and the more symptomatic you may become.
The good news is that you can relatively easily modify your dose of thyroid medication to fix this problem.
Effects of Thyroid Hormone on Your Heart Rate
I’m mentioning heart rate here because both high blood pressure and heart palpitations tend to occur hand-in-hand.
Why?
Because thyroid medication is stimulating to both the FORCE and CONTRACTION of the heart.
If you increase the force with which your heart beats then you will naturally be increasing your blood pressure.
If you increase the contraction rate of the heart, along with the force with which it beats, then that is a recipe for a symptom known as heart palpitations.
This sensation can be uncomfortable for people and some people even describe it as painful.
But this condition needs to be differentiated from a rapid heart rate which is known as tachycardia (5).
It is certainly possible to have both heart palpitations AND tachycardia (rapid heart rate) but they don’t always go together.
In fact, most people with heart palpitations do not have tachycardia, they just feel their own heart beating.
I find that most people are often surprised when I check their actual heart rate and find the rate to be in the 70’s (beats per minute).
People with heart palpitations feel like their heart rate must be racing, but that is usually not the case.
The way to deal with heart palpitations is very similar to the way to deal with blood pressure (more info on that below).
How to Deal with High Blood Pressure From Thyroid Medication
If you are taking thyroid medication and you notice that your blood pressure is raising then that is certainly an issue.
But how do you deal with it?
#1. The first step is to take a look at your dose.
Is it possible that your dose is too high? Is it possible you are taking too much thyroid medication?
If so, then that is the most obvious and common cause of high blood pressure secondary to thyroid medication.
Excess thyroid medication results in excess thyroid hormone in your body which will overstimulate your heart.
As your heart is overstimulated with thyroid medication it will respond by increasing your blood pressure and your heart rate.
There’s an easy fix for this:
Simply reduce your dose.
You can check to see if your dose is too high by looking at your thyroid lab tests.
If your dose is too high you will most likely notice a low or suppressed TSH in combination with high free T3 or high free T4.
#2. The second step is to take a look at the type of medication you are using.
Not all thyroid medications are created equal!
For instance:
It’s much more likely that you are experiencing high blood pressure or heart palpitations if you are using thyroid medication that contains T3 thyroid hormone.
Medications like Cytomel, liothyronine, and even high doses of Natural Desiccated Thyroid are notorious for causing high blood pressure and heart palpitations.
But this can often put you in an interesting predicament.
Why?
Because most people who switch to these medications often feel BETTER on them.
In fact, blood pressure is not usually something that causes any symptoms, but it is still concerning.
So, how do you reconcile the fact that you feel better on these medications and yet you are still experiencing negative symptoms?
It has to do with how thyroid hormone influences different cells in your body.
You see…
Your heart tissue is much more sensitive to thyroid hormone (especially T3) when compared to other tissues in your body.
If you flush your heart with a large amount of T3 (exactly what happens after you take thyroid medication and it is absorbed into your intestinal tract) you may experience an elevation in blood pressure.
The good news is that this can absolutely be managed and the way to do it is by reducing how quickly thyroid hormone is absorbed into your bloodstream.
Let’s stay that you are taking 10mcg of Cytomel each day.
If you take all 10mcg at once then it will be absorbed into your body about 2-3 hours after you take it by mouth.
Around that time your heart will be flushed with this hormone.
But what if you split it up into 2 or 3 doses throughout the day?
By doing this you are still getting the same TOTAL amount of Cytomel but your heart gets slightly different doses instead of getting hit all at once.
This strategy works when dealing with both heart palpitations and elevated blood pressure from Cytomel and liothyronine.
Another option is to switch to a sustained-release version of T3 medication.
SR T3 is specifically formulated to delay the release of T3 into your system, so you can still take your total dose all at once but instead of it being absorbed rapidly it is absorbed slowly throughout the day.
In order to get this medication, you will need a prescription to a compounding pharmacy from your Doctor.
#3. The third step is to consider switching thyroid medications.
What if none of these options work for you?
Your last option is to simply switch to a different medication or switch to a T4-only thyroid medication.
T4-only thyroid medications such as Synthroid and levothyroxine tend to not be associated with high blood pressure (unless your dose is extremely high).
Maintaining high blood pressure for years and years is not something that you want to do.
It is well known in the scientific community that high blood pressure leads to vascular conditions and increases your risk of organ damage and even stroke.
These consequences are usually only seen after years and years of high blood pressure, though, so don’t let them freak you out if you just noticed your blood pressure is slightly elevated.
You have a few months to play around with your medication to try and lower your blood pressure, but it’s certainly not something you want to ignore.
Taking Blood Pressure Medications
It’s also entirely possible that you may suffer from high blood pressure from an unrelated cause!
The people I am talking to in this article are those who have normal blood pressure before they start taking thyroid medication and then suddenly experience high blood pressure.
If you have high blood pressure at baseline and then it stays high after taking thyroid medication then you probably just have high blood pressure from some other cause.
What’s important here is that some blood pressure medications can interfere with your thyroid function.
Medications like beta-blockers can slow down thyroid peripheral conversion (6) which may make your thyroid medication slightly less efficient.
This can be a good and a bad thing.
If you find that you are incredibly sensitive to heart palpitations from your thyroid medication then using beta-blockers may be the only way you can use thyroid medication without experiencing heart palpitations.
But, on the other hand, taking a beta-blocker for blood pressure can negatively impact your thyroid function and potentially make you feel worse.
The moral of the story is to try and AVOID taking blood pressure medications if you have thyroid disease of any type.
This means you will need to focus on the underlying cause of your elevated blood pressure instead of trying to cover it up with anti-hypertensives.
One of the major causes of high blood pressure is insulin resistance (7) and obesity (8) (both of which can be worsened by hypothyroidism).
But, in addition to obesity, other conditions such as stress (9), smoking, a poor diet, and a lack of exercise can all contribute!
If you address insulin resistance and lose weight, there is a high chance that your blood pressure will not only improve but your thyroid function will as well.
Conclusion
Thyroid medication can definitely impact your blood pressure in a positive or negative way.
The goal when using thyroid medication is to try and normalize your blood pressure and get you back to a healthy level.
Sometimes, if you take too much medication, or if you take certain medications that contain T3, then your blood pressure might start to rise beyond normal.
If this happens to you then you can get your blood pressure back to normal by modifying your dose (or potentially switching your medication).
Now I want to hear from you:
Are you dealing with high blood pressure from your medication?
Have you been able to take any steps to reduce your blood pressure?
What has worked for you? What hasn’t?
Leave your comments or questions below!
Scientific References
#1. https://www.ncbi.nlm.nih.gov/pubmed/12698067
#2. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC329808/
#3. https://www.ncbi.nlm.nih.gov/pubmed/9064969
#4. https://www.ncbi.nlm.nih.gov/pubmed/9160219
#5. https://www.mayoclinic.org/diseases-conditions/tachycardia/diagnosis-treatment/drc-20355133
#6. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1714646/
#7. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3996172/
#8. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5038894/
#9. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3694268/
Was on Euthyrox 50 MCG. Blood pressure went out of control.
200/130. Had an allergic reaction to the medication. TSH was 6.54. After 4 eeeks 1.92. Then reaction started. Also had heart palpitations. Dr has stopped the Thyroid meds for a month. I’m a bit worried. What can I use?
Hi Pietru,
In the United States, there are no fewer than 8 different thyroid medications but I’m not sure if that is also true in your Country. I would check with your Doctor for alternatives and then switch to one that is not Euthyrox.
I have been on 100mg levothyroxine for 20yrs. 6 months ago, my GP reduced it to 87, saying my BP was too high. I feel so tired all the time. Although my BP was elevated, it’s now on average 120/80… but my heart rate is always very low. Like, between 47 and 58. I hate walking up stairs or hills. I used to be very active, I was a runner, but stopped due to feeling so tired. I now do regular yoga instead. Should I believe I’m on the correct dosage? Do I need a second opinion? Last November, when I was unwell, I walked up lots of stairs and fainted when I reached the top. In the mornings, I feel drained even after a good 8 hrs sleep.
Hi Jane,
You can determine whether or not your dose is optimized by looking at your thyroid lab test results as well as your thyroid-related symptoms. I would also recommend checking out this article for tips on how to optimize it if needed: https://www.restartmed.com/how-to-optimize-thyroid-medication/
OMG…For the past 3 months my blood pressure has been elevated and I am experiencing rapid heart beat…I am taking C-T3/T4 12.5mcg/50 mcg SR capsules.
My T3 labs just came back high and my TSH came back low…EXACTLY what you described…I just started a full workup with a cardiology doctor (just did my stress test yesterday, doing a calcium CT today, and then a 24 hour monitor and then an echo) because I have been so stressed out over my blood pressure going up despite being controlled on Benicar 20 for over 5 years (genetics).
I am going to tell my Dr to reduce my T3 and hopefully this will solve my blood pressure problems and my rapid heart beat…My blood pressure yesterday was 140/73 and my heart rate (when it jumps up..its kinda all over the place) gets over 100 bpm… 🙁
Thank you so much for this information…!!
Hi Vivian,
You’re welcome! I’m glad you found it helpful. By reducing your dose you should most likely see your blood pressure improve.
I am on NDT (145mg total) split into 3 doses a day after trying T4 only for several years, couldn’t convert it. My TSH is 0.012 FT3 3.9 and FT4 1.15. My blood pressure and pulse are always high 153/78 with a pulse of 86. My doc shrugs off the very suppressed TSH but always wants to put me on blood pressure meds. Also found out last year I have a left branch block in my heart… which is also being shrugged off. Any suggestions for me? Thanks.
Oh my goodness!
Almost dito to Vivian’s story.
I started taking Armour in March of this year. Although I feel better overall and have lost 15 pounds, with help of exercise because of feeling better,I have been experiencing palpitations and have higher blood pressure. My PCP says drink more water,eat better and exercise. I am 5’11” 192 lbs.
My cardiologist,new since palpitations,has happily ran every test costing me thousands of dollars without any diagnosis.
Neither doctor have thought or at least mentioned to me that these palpitations could be caused from Armour medication.
I love the idea of splitting my doses to 3 Xs a day verses all 3~ 15mg at once in AM. I will be discussing this option as well as other options you have mentioned in your blog.
I am 55 years old and have assumed that heart problems come with the package of growing old and going through menopause. Shame on me! Ask more questions, push your doctor for more information and options. No more settling.
Thank You Dr. Childs
Hi Nancy,
Glad you found it helpful and thanks for sharing! Keep us updated on your progress. The more information you guys share the better!
Thank you, thank you ever so much. I have been dealing with hypothyroid issues for over 15 years now. Your information has been Psychologically satisfying. I can now strive better to fix the issues. I wish you were my doctor. I am working to find someone with your knowledge and skills in oc ca. I’ll keep you posted on my progress. Your work is most appreciated.
Hi Marina,
You are very welcome! Keep us updated on your progress and let us know if you are able to find a doctor in your area.
I am taking 5mcg of Cytomel per day due to low T3. Since then at random times I will experience high bp/tachycardia. Normal for me is around 123/77 p 68. Then I will spike 153/95 p 134. Then 30 minutes later I will drop back down again. This roller coaster makes me feel terrible. I want to just come off the meds. I feel much better without them.
Hi Sherry,
It’s certainly possible that you are over medicated. You should be able to find out with some simple lab tests.
Hello Dr. Childs and thank you for this info. During some recent examinations, I have been found to have elevated diastolic BP and this is worrying me very much. My BP can be something like 130/100, 140/105. I tend to get nervous when having it measured. But so far the nervousness has impacted the systolic BP more, not the diastolic one. I am takind 75 mg of Tiche (the Italian version of Tirosint as gel capsule) and I will do some examinations to see if it is not too high for me. I also have IR and elevated body weight, too.
How dangerous can the elevated diastolic BP be?
Thanks a lot for your info.
Hi Dr. Childs,
So happy I found your information! I’ve been on NP Thyroid for years and just recently needed an increase in Nov of 2018. I started feeling better after a few weeks but palpitations started with the increase and went away until a few days ago and now they are back. I’ve had a high BP for about a year or so and never even considered it could be the type of thyroid med until I found this article. It all makes perfect sense!! I just had my TSH read today and it was elevated at 14 on the TSH scale. I’m concerned about taking more of the NP Thyroid by it is already causing side effects and I’m taking 120 mg. Would you suggest taking Synthyroid bc it’s mostly T4 and doesn’t have the side effects? Thanks again for this information. It gives me peace of mind.
Hi Gregory,
T4 can certainly still cause side effects but it tends to be more tolerated compared to T3 medications. As long as your body can convert the T4 to T3 then you should be fine to use T4.
Thanks for the feedback. Very helpful .
Hi Dr. Childs,
My husband has Stage 1 HTN and just started taking diltiazem ER 180 mg/day. Recent Free T3 1.4; Reverse T3 11. The ratio is 0.127. Height 5’9. Wt 199.
Would starting Cytomel 5 mcg qd be appropriate? Your thoughts on the use of a CCB along with thyroid meds?
My bp was always normal and now elevated after orexin. I take just 25 mcg.
I found this article to be extremely helpful. Yesterday I went to my PCP, increased rapid heart rate of 100 and blood pressure increase of 155/71. I am currently taking 20mg of Cytomel and my T3 test was 3.5. I am also taking 60mg of Armour Thyroid. After reading a lot of your blogs, we are changing my Thyroid medication to Synthroid and lowering this T4 med to 88mcg. My PCP has also ordered the T3 Cytomel from a compounding pharmacy as the slow or extended release. I hope these changes reduce my BPM and my blood pressure.
I am also taking your Adrenal support supplements for my high cortisol and they have helped my energy a lot. Thank you for your blogs and podcasts, very helpful and I have learned a lot.
Hi Sue,
Glad you found it helpful! And it sounds like you are heading in the right direction.
What can you do if you cant convert but t3 gives you high heart rate? T4 alone does not help.
I find this very helpful, I had Graves and was allergic to PTU so had removal of thyroid so forced to take meds. Went on Synthroid and seems like I have had high BP issues since then. It is worse than ever now, my quality of life is not good and I am tired of the battle trying to get thyroid meds right and all affects each other so much 🙁 I have tried all the natural and Synthroid but reading here, it may be the T3?? Can you take Synthroid and a time released T3? I take nature throid in the AM and at noon and BP is terrible!! I feel awful!! I take BP meds don’t help and side effects from them are horrible …desperate for help 🙁 I am out of options and no one here seems to be able to help manage me through this…was thinking of Mayo clinic I am so desperate
Hi Daphne,
Yes, you can combine Synthroid and SR T3 together. I also probably wouldn’t expect much from mayo but you are welcome to try it. Most people falsely believe that there are better doctors at these institutions but you will only find more of the same (unless you have a really rare cancer or genetic condition).
I am on 75mcg of Levothyroxine and have high b/p. I have tried 3 b/p meds at this point: 5 mg Lisinopril (caused coughing), 25mg Atenolol (did nothing) and 5mg Amlodipine (caused GERD). I am now on 25mg of Losartan without any significant change, but only 1 week in.
As a Kaiser patient I have found having the conversation of the hypothyroidism B/P link to be futile. While I appreciate my dr being receptive to the side effects the meds cause, it’s concerning I can’t get my b/p under control. Would it be advisable to talk to my dr about spitting my dose of Levo? As a side note, my non-fasting TSH in Feb was 3.9 and two days later they retested and it was 2.6 while I was fasting.
Hi Dr. Weston,
Thank you so much for the opportunity to ask you thyroid questions. I am a 63 year old female, however, very active with weight training, yoga, Pilates and hiking. I have been healthy most of my life and was never taking any medications. About 2.5 years ago my primary doc placed me on thyroid meds, although I never had any symptoms, maybe anxiety, but I thought that may have been due to being HSP(Highly Sensitive). I didnt’ really notice any difference in the way if felt being on NatureThryoid. My primary doc transitioned her office into a boutique that was significantly expensive. I chose another physician that changed me to Levothyroxine. It was okay for about 6-8 months although I noticed my BPM when exercising was high…blamed myself for not doing enough cardio. On a trip out of state to visit my mother, (beginnings of COVID) back in mid Feb. I noticed that I was experiencing Tachycardia. HB was really high, up to 170-BMP without exercise. Contacted my primary and she cut my dosage from 88 to 50 mg. That helped some but still experiencing the high BPM’s during exercise. Fast forward to a month ago. I traveled to Estes Park Co from Austin Tx to be with husband during this outbreak. I was super-stressed out and fearful. I had been in quarantine for 8 weeks. My first time out I went to the grocery store. I had been having a headache for a week. I thought I should take my BP, it was 168/95. I went to the ER and when they took it , it was 188/98. They gave me Amlodipine 2.5 mg. And Ativan. My primary agreed with the Amlodipine but not the Ativan. I don’t take the Ativan any longer. The 2.5 mg made my BP go down to 88/60. , so I cut in half. Still BP was 90/62. Cut that in half and when I did that my Primary said to just stop it. I then decided to take 1/4 of the 250 and titrations down to 1/8. today I took my BP and it was up again to 168/94. I just had my labs done but have not seen the results. Also my BPM continue to be high when exercising or hiking an incline , 155/85. Could I be taking too much Levothyroxine? Sorry for the long-winded question.
I can’t believe I stumbled onto this website while researching side effects of taking Synthroid. I was on vacation recently and ended up making two trips to ER due to erratic blood pressure (spiking to 175 and then back down to the 130’s) accompanied by dizziness and nausea. All my tests turned out normal except blood pressure. I was put on a low dose blood pressure medication which helped a little but the dizziness and nausea continued. I have a followup appointment with my PC physician in a few days, but based on everything I am reading, thyroid medication is the culprit. I’m taking 50 mcg of Synthroid which I’ve been on for three months. Prior to that I was on generic levothyroxine for several years, and have had heart palpitations but no symptoms as severe as I’ve had recently.
My thyroid levels appear normal, so would you suggest splitting the dosage in half, taking one in the morning and the other at night?
Thank You,
Sandy
Hi Sandy,
High blood pressure CAN be caused by thyroid medicine but it’s certainly not the only cause. It’s not clear based on what you’ve shared here whether your thyroid medication is affecting your blood pressure or if it’s due to something else.
Why would my doctor say he would not lncrease my levothyroxine because my petuitry gland was high I can’t seem to get an answer I have never felt well on levo I have palpitations high sporadic blood pressure heart flutters other doctor told me I was borderline I am 78 years old I feel I don’t need to be on them please can you help
I am on 112 mg of levoxyl and experiencing high blood pressure. Should I split the dosage or lower it. When taking 100 mcg. my tsh.was 6.89. After raising it to 112 it is 1.89 but having blood pressure spikes. Also I take telmisarten for blood pressure. I would appreciate your advice.
Pam
Hello,
I recently started synthroid after 3 years of trying to make NDT work but always ended up with tachycardia and high blood pressure. I knew it was the medication because I have always had really low blood pressure and great resting HR. My last labs showed my tsh still somewhat elevated so my doctor increased from 112 to 125mg. In the first week I was fine but for the past two days I have had high heart rate again and high blood pressure. When would you advise I could get blood work to find out if the medication is too high? Do I need to wait the full 6 weeks? This anxiety, high heart rate and high blood pressure is so scary! Thanks for all you do! I have found reading your articles so helpful.
I am 47, My blood pressure continues to rise and my thyroid is out of control. I am currently taking 105mg of Armour (1 month) and Lisinopril/hctz 20-25mg (1 week). My blood pressure is 159/110-73 bpm. I am worried our of my mind that my blood pressure will not decrease. I have gained 110 pounds since having my thyroid removed in December 2016. I was recently at the ER (3 weeks ago) for back pains and body swelling, I was told that I had a small fluid build up and possible congestive heart failure (beginning stages, although test were negative). I am constantly changing medications because I am unable to find what makes me feel good and stops the weight gain. My blood pressure has been maintained for years with Bisoprolol/hct 2.5/6.25mg and before the weight gain, I did not take any medication. I am severely depressed with weight gain, worries of my heart stopping and a thyroid storm. PLEASE HELP! I am clueless. My endo and pcp are not very helpful and I am out of options.
Hello. I was taking 88mcg Levo for 6 days and 1/2 on the 7th. Suddenly my level went up. Doc switched me to 88mcg Levo everyday. I’ve become anxious and had stomach probs ever since. My pressure has been reading 138/98 off and on and I was ALWAYS 120/70 my whole life. I do not feel well but she’s insistive. Any insight?
Hello Dr. Childs
The information was very helpful. I am 63, and started BP meds many years ago. About 10 years ago, I started getting palpitations so they added a beta blocker. As of now, I am just on a beta blocker to control BP and palpitations. 5 years ago, I developed SVTs after death of my father. So I have had blood pressure issues for some time. However, I have complained about my thyroid for years and until 2 years ago when we relocated I finally found a doctor who agreed that my thyroid was too slow. So started Nature Thyroid. Since I had ‘heat issue’ we started slow and worked up to 90mg. But my free T3 and free T4 numbers are still not optimum and my hair loss which has been gradual for years…is worse. So two months ago, my doctor increased NT another 15 mg. I will be getting blood work soon. However, hair loss is increasing and I feel ‘shaky’ and short tempered with the increased dosage. And unfortunately, my BP is going up. 150/90 today. So I think I have reached my limit on thyroid meds and need to lower it. I read that Beta Blockers reduce T3 absorption. If so, how do I get enough T3 without raising thyroid meds too high and how do I keep BP down? I was hoping once I optimized my thyroid levels, the hair loss would stop. But thinking my thyroid meds and/or BP meds are making the hair loss worse. I wish I could get off of both meds but I know that is not possible. fyi, my SVTs have gotten better once I started thyroid meds. Is there a different combo of thyroid meds that may help that do not increase hair loss or raise BP?
I had a thyroidrectomy 10 years ago due to papillary cancer. About 2 years ago I switched from Synthroid to Armour because I had so much anxiety. About 3 months ago I changed my dosage of Armour from 90 mcg daily to alternating daily with 120 mcg and 90 mcg. The 90 mcg was not enough. Now Im experiencing hypertension 1 with as high as 200 blood pressure. When I did a blood test 6 weeks ago, my thyroid numbers were perfect, and I was feeling great! And yes, I had previously had high blood pressure, no higher than 158 though. I will follow your advise about taking twice a day. I’m seeing my doctor tomorrow, and have already started blood pressure medicine. Thank you
I’ve been on NDT since 2006. I took a 4x cortisol test in November due to symptoms. All were borderline. My t3 blood test was a point in a half over range so I reduced by almost half. BP problems started in October and I can’t seem to get it under control. I know I need hydrocortisone but it just makes my BP go higher.
All your information is so helpful and there is so much to know and understand. But thank you for giving your time to educate us. My primary just diagnosed me with Hashimotos. I’m 64. In the 90’s my primary then said I had hypo – put me on lowest dose of Levothyroxine and I had terrible side effects. Just like you said they go by TSH being a little high – nothing else. She tried another T4 – same side effects – felt like heart attack, depression, , etc. I felt fine with no meds so didn’t take anything. Now 2021: My TSH was 7.06 in Aug ’20 – 11.39 first of march ’21 – 4.91 last of March ’21. T4 and T3 are normal ranges. Thyroid Peroxidase Antibodies are 283 & ICMA is 55.7 – have not received reverse T3 or Anti-Thyroglobin Antibodies test back yet. I have been on Metotoporal 25 mg – for a few years now. So just like you said most primary doctors, she – put me on Levothyroxine last week – told me to take 1/2 of a 25 mg pill. So I did. by 3rd day – I was dying! I felt I had bugs crawling thru my legs and arms – chest feels like a ball in there – pressing hard & heart beating so fast. So I stopped medication after 3 doses!!! . My question is if your TSH isn’t way out of whack (cept the 11.39) one time – and my T4 – T3 – are normal – wouldn’t taking thyroid meds send your body into a state of shock? Giving you that 120% dose? How do you treat the high Antibodies & (ICMA) without putting TSH – T4 – T3 into having throw me into over dose? . I’m not understanding that. And with high Blood pressure and on medication for that – I”m glad I found this article – to learn T3 isn’t your BP friend. Before going on Levo – I tried Selenium supplements – but that made me SICK and feel terrible. Everything I try that says is support for the Thyroid – makes me feel like I’m having a heart attack – makes my hands ice cold and me feel like a mack truck hit me. When I don’t take anything – I feel pretty good – plenty of energy – just my hair thinning out – can’t loose weight – bad anxiety. So how to do you fix these issues? Now I’m scared to even try T3 meds “IF” my Reverse T3 – ends up being high. Don’t know why it has taken so long for those results. I’m pill shy now. Scared to death to take anything cause of how horrible it makes me feel just with 1 – 2 – doses.
I’m on T3 only and my blood pressure is low but my heart rate is elevated. I was told to increase the T3 and my systolic is as low as 71 and diastolic around 54-65. Raising the T3 has no effect on my blood pressure. I thought that taking more T3 would increase blood pressure. I’ve been dizzy and fatigued.
Hi Janiece,
It should increase your blood pressure but it doesn’t always, it could also be a dose issue.
Hello,
What if a patient is taking Synthroid and is still experiencing hypertension? Is there a cause for this issue? My mom (68) is diagnosed with Hashimotos and will often times have varying lab results for her thyroid despite being on Synthroid for years. She’s is taking no other medication besides vitamins D and progesterone hormone therapy. The hormone therapy is recent and the high blood pressure was still prevalent before she started the hormones. Is there a recommended combination therapy to allow her to keep the benefits of Synthroid while treating her high blood pressure?
Hi Abril,
Not really, you just sort of have to play around with what works but do try to avoid beta blockers if possible. Hypertension is often associated with metabolic syndrome, so if her blood pressure is related to that then it is potentially reversible.
Hello,
I was recently diagnosed with Hashimoto’s, currently take Unithroid @ 100mcg dose.
I had 3 unrelated dr appts recently and at all 3 my blood pressure was high 144 / 88.
My most recent labs show a low TSH but T3&T4 in normal ranges.
What would be my best corse of action? Thanks
Hi Linda,
I would make sure to rule out other causes of high blood pressure first!
Wow this article is amazing. Thank you! The link between thyroid meds and blood pressure does not seem to be widely understood! My naturopath PCP really dropped the ball with my care. I think I’m on the right path now with a new MD PCP who seems to know what she is doing.
Hi Wendy,
Glad you found it helpful!
This is a helpful article. My family doctor referred me to an endo, and I’ve been on 112 mcg for a year now. Presently, I take 100mcg for 5 days a week and 112 mcg for 2 days a week. I believe having kept the dose so high for so long may have caused my BP to spike to an average reading of 158/85 since September 2021. Interestingly, it returns to normal when I take my daily walk. Otherwise, once I’m sitting around I get high BP readings. I do have other issues (sleep apnea) which may be causing the spike but I will explore splitting the dose. I recently switched from taking the medication to the evening from the early morning which has allowed me to sleep longer. Thanks for the advice.
Hi Darrel,
It’s more likely to be related to your sleep apnea but it’s plausible your dose is also playing a role.
Hi, I take 75mg of levothyroxine with a recent TSH of 3.39.
My blood pressure is 140/90.
I’m not overweight, my salt intake is normally below 1500, I don’t smoke or drink, and walk daily.
My doctor said is starting to think I may nee to go on BP medication.
Do yo think a slow dose of my medication could help?
Hi Kevin,
I’m not really sure what you mean by a slow dose of medication. Can you clarify?
Great article. Had optimal blood pressure. Was on 225 mcg of Synthroid after a total thryoidectomy. Blood pressure was fine, but horrid symptoms. Could hardly function through a day.
Now on NDT. Feel fantastic (so appreciative) but has caused my blood pressure to go from approximately 118/68 to as high as 153/86. The change came right with the switchover and has not let up..
This is so frustrating Dr..Childs to feel so great on NDT and have this happen. I thank you for writing almost that exact sentence in your article. Please know how comforting your straightforward acknowledgements are for us all.
And I only have one kidney (donation) so I can not make any errors in judgement. There is no way I can go back to t4 only – it was unbearable for me.
Thoughts?
Hi Lisa,
You will want to check to make sure you are not taking too much T3 as that is the primary driver of high blood pressure. There are many other conditions that can cause hypothyroid symptoms that may be contributing to your current situation. If those issues are resolved then you may be able to lower your dose and maintain your symptoms while normalizing your blood pressure.
I have totally different experience with T3. When I was on T4 only I had faster hart rate (but not above 100) and my systolic was sth about 117. Not too much but I usually had lower numbers. Had not very strong heart palps. When I received the prescription for T4/T3 combination (convertion problems which was not resolved by any suplement or treatment, end-stage hashimoto) my heart actually slowed down, despite the fact that I had more energy. I have been on those meds with dose adjustments for 4 years, with one period without T3 cause I was ale to convert t4 for a while, and t3 always calms my heart. (I am taking 15 mcg T3 – one morning dose). I do experience elevated bp reading but it’s always anxienty driven and the average reading is still more hypo than hyper.
Hi Martha,
It could have just been that your dose of T4 was too high for your body, or it could be that you are more sensitive to T4 (which does happen). Either way, though, thank you for sharing your experience!
Thank you for the reply. It’s actually true that just before adding some t3 I was very sensitive to T4 adjustments, yet still felt hypo.
I have one question about heart sensivity. Can it change and does heart tissues just simple become sensitive over time? Because I do remember periods when I did woderfull with single T4 and mineral suplements. I will be devastated if the same thing happens to T3 because now I feel so much better and the perspective of high bp little scare me.
My mom had a partial thyroidectomy many years ago and after that was put on levothyroxine sodium, daily oral dose 50 micrograms, 1 pill per day.
She’d always had low blood pressure before all that.
But now, she seems to have highly varying blood pressure depending on who measures it and when, systolic number ranging anywhere
from 105 to 160. This state of affairs has developed over about 1 year. Diastolic number does not vary nearly as much.
These variations can occur over just 1 day.
We do not know what is going on.
My TSH is .29 and my t3 and t4 are in normal range. This was after lowering my medicine dose. Once he lowered it my period came closer together, hair fall, water retention, swelling eyes etc.. and my bp is now high.
Can I be hypo with those labs and can being hypo cause high BP? My BP was normal 3 months ago.
Hi Nicole,
You can be hypothyroid with a low TSH, yes. And it’s also possible for hypothyroidism to cause high blood pressure but it is not common.
I had my thyroid gland in 2004 due to cancer and since have been challenged with hypertension and heart issues. I was on Eltroxin on high does up to 175mcg until 2019 where it was reduced to 150 due to feeling hyperactive, jittery and having palpitations. Right now I am on Synthroid 75 and still having extremely high bp with angina. I am also on a beta blocker which doesnt seem to help me anymore. Any recommendations? I await some results on the tsh, which was reading less than .01 with free T4 at 17.98 in Dec when I was on Synthroid 88
Hi Sher,
If you are looking for natural recommendations then I would recommend this bundle: https://www.restartmed.com/product/thyroidectomy-rai-bundle/
I know this is an old post but…
I’m on 28mcg of SR liothyronine and 50mcg of levoxyl. My BP went up after being increased from 22mcg to 28mcg of the T3 med. (I went from 110/70 to 130/89) my heart rate is in the 70s, no palpitations. My BBT is FINALLY 97.0!!! I don’t want to get off the thyroid meds- wouldn’t my other vital signs be affected if the dose was too high? My free T3 on 22mcg was 3.0, and my free T3 after 2 months of 28mcg was 2.6!! But my BP went up so IDK
Hi Autumn,
Not necessarily. Basal body temperature is not really the best way to determine thyroid medication dosing but it can be helpful when combined with other measures such as your symptoms and other thyroid lab tests.
Just a side note, but from my research, T3 will tend to raise systolic pressure and lower diastolic, and thus widen pulse pressure, if you look at many of your comments, that is exactly what you see when people are overdosed.
Hi Darin,
It’s been a while since I’ve looked at the research regarding T3 use and blood pressure but I will revisit it. Thanks for sharing.
I have been on synthroid and cytomel for 30 years. My dosage has been changed many times as my numbers have fluctuated. However, my TSH went down to .01 about 6 months ago and my endocrinologist said I was fine. I ended up having an autoimmune reaction which led to a seizure. Then he finally lowered my dosage. My blood pressure went from 120/80 to 133/91. It has to be from too much synthroid and/or cytomel. How long does it take after reducing synthroid to reduce my high blood pressure? That bottom number scares me. Also, maybe time for a new endocrinologist?
In my 30s my TSH (no meds) was 11,6. I started taking L-Thyroxine and wanted a very low TSH. I took 125 mcg for 2 decades. (Being on a high carb diet.)
Being in my 50s (menopause) suddenly I got super-high BP (240). It took a while to think of L-Thyroxine. Lowering the dosage helped. I even fully stopped taking it.
But I felt extremely week and got constipation. The latter is solved by only 12,5 mcg.
3 month ago I started a low carb diet. My BP got normal after 3 days.
I started Ketovore – then Keto – now LC (carbs approx. 50g).
Suddenly I’m having hypertension again (150). I’m having sleeping problems. Maybe it’s due to hypertension.
I need blood work. I’d like to know how/if the LC diet has in impact on the thyroid. Dr. Bikmann and Phinney mention that LC makes the thyroid more sensitive. That’s against mainstream – I know.
Today I took 37,5 mcg.
And Ramipril. But I want to avoid it, of course.
I could go Keto again – but it’s difficult long term.
Greetings from Germany!
Hi Irene,
Low carb diets have been shown in both patient experience and research studies to negatively impact thyroid function. You can learn more here: https://www.restartmed.com/carnivore-diet-thyroid-problems/
It is frustrating that we can only get 20mcg doses of liothyronine in Australia. Since starting on liothyronine (as well as continuing a lower dose of levothyroxine), I now have high systolic blood pressure that varies during the day. On the odd occasion during the day it has actually been low. I break up the tablets. Have just cut down to see what happens. I wasn’t doing well on T4 alone but my blood pressure was fine.
My Reverse T3 is high again, as is my T4 slightly high so I have halved my 100mcg levothyroxine, again to see what happens.
I asked to try slow release T3 but my doctor didn’t know the medication and suggested NDT. Still on instant releaseT3 but will ask again. Will speak to the pharmacist that prepares it to see whether they think the supplements my doctor has me on would interfere with absorption.
Would you have an opinion on taking slow release T3 whilst also taking supplements throughout the day? (Calcium and iron are not amongst them.)
Hi Gayle,
I think SR T3 can work for some people, for sure. You can learn more about my thoughts on it here: https://www.restartmed.com/sustained-release-t3/