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Old 05-14-2012, 04:25 PM   #1
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Graves disease and Blood Pressure

Hello:

I was diagnosed with Graves disease about 2 months ago. I went to the Endo today and she said that all of my thyroid levels are back to normal. I'm taking 7.5 mg. of methimazole per day in one dose. 6 weeks ago my blood pressure was 120/98 today it was 90/68. I don't remember (I'm 38 years old) ever having a blood pressure reading that low. The doctor said there was nothing to worry about, but I think that's a pretty fast drop. Should I worry? Anyone else have that happen? Thank you.

Labs on March 15, 2012 and May 10 labs in bold:
Thyroid Peroxidase ABS (antibodies) 108 (normal range < 35 ) did not test
T3, Free 5.0 (normal range 2.3-4.2 ) (5/10/12 Dr. didn't test this time)
TSH 0.01 (normal range .40 - 4.5 ) (5/10/12 - .75)
T4, Free 1.5 (normal range .8 - 1.8 ) (5/10/12 0.9)
Thyroglobulin ABS <20 (normal is <20 ) did not test this time

Last edited by saucylee; 05-14-2012 at 04:26 PM.

 
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Old 05-14-2012, 05:01 PM   #2
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Re: Graves disease and Blood Pressure

Some of the time, low BP can be a sign of being hypo.Your FT4 might be too low for you also. Your first lab your FT4 wasn't even out of range, just your FT3 was. The meds have made your FT4 fall too much I would think.You probably need a dose decrease at this point. Do you have any symptoms?

 
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Old 05-14-2012, 05:21 PM   #3
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Re: Graves disease and Blood Pressure

Thanks for the reply The only new symptoms I've noticed is sluggishness. I seem to want to nap all the time. This definitely wasn't the case when hyper. She wants me to return in 2 months and she thinks that by that time we will be able to reduce my dosage to 5mg once per day. I'm thinking I will lower it now, and just watch for hyper symptoms.

 
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Old 05-15-2012, 08:36 AM   #4
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Re: Graves disease and Blood Pressure

I agree with Brans, your FT4 is probably too low for your body's needs. (it's near bottom) sluggishness is typical hypo.

I suspect your doctor is dosing you based on TSH, which can be suppressed due to antibodies. antithyroid medication should be dosed based on FT4.

Were you ever tested for TSH receptor antibodies or TSI antibodies?

hang in there

 
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Old 05-16-2012, 07:05 AM   #5
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Re: Graves disease and Blood Pressure

Hi Lisa:

The only tests I have taken are the ones listed in my original post. I'm not sure if either of the ones you asked about are one of the tests that I took. I did ask my doc about the drop in my T4 but she kept saying that everything was "normal". She told me to come back in 2 months and gave me an order to Test just TSH and Free T4 only a week before that appointment. I feel that there is more we should be testing for, but she is very short with me when I ask questions.

Thanks for the replies!

Last edited by saucylee; 05-16-2012 at 07:20 AM.

 
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Old 05-16-2012, 07:49 AM   #6
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Re: Graves disease and Blood Pressure

The tests Lisa asked about are the only tests that confirm/rule out Graves'.

The two antibody tests you did have really don't tell you much of anything. The Thyroid Peroxidase Antibody test is really a marker of thyroid inflammation and *usually* a sign of autoimmune thyroid disease. It could also be a sign of thyroiditis.

Based upon your starting labs, you should have never been told to take an anti-thyroid drug. Your FreeT4 level was nicely in-range and your FreeT3 level was a bit over-range.
This is usually treated with just a beta-blocker.

Now, your FreeT4 level is at the bottom end of the range and would be considered hypo by a thyroid-savvy doctor. Unfortunately, it seems that your doctor is like many - she is looking at your "normal" (aka in-range) FreeT4 level and declaring you normal.

Your starting FreeT4 level was the type of level healthy people have (if not higher).

Low BP is a symptom of hypothyroidism and I suspect you are dealing with other symptoms as well. If you aren't dealing with any other symptoms, yet continue on that 7.5mg dose for another two months, I'm sure you will develop more. And, if you do indeed have Graves', your antibody levels will increase due to the stress of being hypo. Well, antibody production is what causes Graves' in the first place.

Your doctor is supposed to be providing you a service and it certainly doesn't seem like she knows how to do this.

I highly suggest you find another doctor to care for you. I also suggest that you get a copy of "Thyroid for Dummies" so you can get an idea about thyroid function, the various types of thyroid diseases and the appropriate tests your doctors should be running.
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Old 05-16-2012, 09:39 AM   #7
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Re: Graves disease and Blood Pressure

Wow, this information is very eye opening! It's scary enough to be diagnosed with Graves disease, but even scarier to know that doctors have not given me the correct tests. One thing I forgot to mention is that I was first diagnosed by my primary. She immediately put me on 15 mg. of methimazole (1 5 mg tab every 8 hrs). When I finally got in to see my Endo, 4 weeks later, she was surprised that the dosage was so high and lowered me down to the 7.5 mg. per day. Yesterday, I also got the results of my radioactive iodine uptake test. My result after 6 hrs was 42.5% and the result after 24 hours was 42.9%. She said "normal" is under 35%. Do these results point to Graves? Also, when I took the uptake test, I had only been off of the 15 mg. of methimazole for 5 days. I'm now looking for a new Endo in the San Francisco bay area. Thanks again for all of your replies.

 
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Old 05-16-2012, 11:49 AM   #8
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Re: Graves disease and Blood Pressure

The uptake scan can imply Graves' - the only way to confirm it is with that TSI blood test. There are other thyroid conditions that can cause elevated uptake.

If you read some of the other threads on here, you will discover that mismanagement of thyroid disease is rampant. It doesn't matter if the person is dealing with Graves' or Hashi's (the most common cause of hypothyroidism).

If you took a peek at my signature, you noted that I started my thyroid disease journey with Graves'. I joined the 20% of Graves' patients that go hypo after remission. The hypothyroidism can be temporary but, just like the hyperthyroidism I first had, the hypothyroidism needs to be treated.

I saw 3 clueless endos when I was on anti-thyroid drugs (methimazole) and my GP proved clueless as well. I didn't find a thyroid-savvy doctor until one month after I unknowingly entered remission.

Mismanagement happens because doctors erroneously look at TSH (a pituitary hormone) when they should be looking at the actual thyroid hormone levels (FreeT4 and FreeT3) to judge thyroid status.

In addition, many doctors don't understand the autoimmune component of thyroid disease so they don't run the right tests.

It's a sad state of reality - the personal stories sticky thread covers some of it.....the petition we were talking about on here last week shows that it's a worldwide problem.

But, all is not doom and gloom - there ARE thyroid-savvy doctors out there but, you need to know how to recognize one.

Patients who achieve wellness work towards understanding their disease and are proactive with their care.

We can help you along the way.
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Last edited by sammy64; 05-16-2012 at 11:54 AM.

 
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