Low blood pressure

[Bri941]

Recently I have been having episodes of dizziness and blackouts, landed in ER for bp beIng 77/44 . If I stand too long I sometimes pass out .  Doctors have no idea... I am not on any meds. Blood work all normal except potassium lower side of normal of 3.5 , tsh is 2.6. I don't like how I feel always like I am zoning out with head pressure.. Does anyone else had this??

[Bri941]

My B 12 was 324..

[goolarra]

If you're feeling well, FT3, FT4 and TSH should be all you need on a regular basis.  If you start getting hypo symptoms that can't be explained by thyroid labs, it might be worthwhile to test vitamins D and B-12 and both iron and ferritin.  Deficiencies of those seem to often go along with hypo.

TPOab, TGab and TSI really never have to be repeated.  Once you test positive for them, you have them for life, and actual numbers vary so much on a day-to-day basis that there's really no added information.

[gimel]

If you have adrenal problems, it will be best to get those addressed first; however, your Free T3 and Free T4 are both low in their ranges, which is frequently associated with being hypothyroid.  If you look at this listing of 26 typical hypothyroid symptoms, which ones do you have?

http://endocrine-system.emedtv.com/hypothyroidism/hypothyroidism-symptoms-and-signs.html

[Bri941]

Oh wow thanks everyone for helping me . I am getting another 8 am cortisol and DHEA check soon.

[outsmartdiseasedotcom]

Your cortisol seems to be too low. It can be due to a problem with your adrenals. Low potassium levels and low blood pressure are typical for a primary adrenal insufficiency. It has an autoimmune origin and in association with Hashimoto's disease is also called polyglandular syndrome II.

The advanced symptoms are:

Fatigue/Weakness
Poor Appetite
Weight Loss
Nausea, Diarrhea
Muscle, joint, abdominal pain
Light-headedness upon standing
Low blood sodium level
Skin darkening
Low blood potassium level

Tests:
- A.m and p.m. blood cortisol test (to check the cortisol rhythm), however 4 point saliva cortisol test that you can order in a private lab is a better option
- 24 hr urine cortisol test (to see total amount of cortisol produced)
- ACTH Stimulation Test which is also called a Cortrosyn Simulation Test is done to establish the diagnosis and can help to distinguish primary (Addison's disease) from secondary adrenal insufficiency
- CT scan of the adrenal glands may also be performed when the cause of primary adrenal insufficiency is unclear.

I have Hashimoto's and a secondary adrenal insuficiency with a very similar symptoms you are experiencing now and couldn't get diagnosed for more than 2 years. Doctors seldom check for it.

[Jlcjcp32]

Thanks for the info on Free T4 and Free T3.  I am definitely going to always have these tested.  Anything else I should test for?  How often should I get my TSI and other antibodies checked?

[Bri941]

T4 range is .82-1.77
TSH is .450-4.5
Cortisol is <5
Triiodothyronine free is 2.0-4.4

[gimel]

Need the reference ranges shown on the lab report for those tests.

[Bri941]

I am sorry I forgot to mention i do have hashimotos sInce 2010.. My new blood work
T4 free = .93 ng
TSH= 1.810 uIU
Cortisol 8 am = 0.6 ug
Triiodothyronine free =2.8 pg

[Barb135]

You might also want to ask for antibody tests to determine if you have an autoimmune thyroid issue, such as Hashimoto's Thyroiditis.  In the early stages of Hashi's, thyroid blood tests can be in the normal ranges.  

Tests to ask for are Thyroid Peroxidase Antibodies (TPOab) and Thyroglobulin Antibodies (TGab).

[Bri941]

Thanks I will ask doc for those tests!!

[goolarra]

Low BP can be a symptom of hypothyroidism.  TSH doesn't always tell the whole story.  If you want to truly rule out thyroid, ask your doctor to test FREE T3 and FREE T4.  These are the actual thyroid hormones and a much better indicator of thyroid function than TSH.  Be sure to request both these tests as FREE...there's also a total T3 and total T4, which are not nearly as useful.  You can post results if you'd like, and members can help you interpret them since just being "in normal range" isn't always sufficient.