Will increasing T4 improve my blood pressure?

[svbd0308]

Male, 65, hypothyroid for 13 years. Type 2 diabetes, high blood pressure, afib. Five weeks ago I switched from Armour to Liothyronine/thyroxine, slow release. I asked for the change since Armour caused my blood pressure to go up to 160s-170s/78,  my A1C increased from 6.3 to 6.8, and I had more incidents of afib. Since taking the new meds, my BP has gone down to 144/68. I sleep better and feel less jumpy. I still have brain fog.

Blood work results received yesterday. Doctor now wants to change my compounded meds from Liothyronine/thyroxine 4/40mcg to 4/50mcg. I’m concerned about the increase in T4 since I presume I don’t convert well. Is this change a good idea?

Free T4: 1.19ng/dl  [reference range: .82-1.77] Previous results: 1.16 ng/dl
Free T3: 3.0 pg/ml [reference range 2.0-4.4]   Previous results: 4.1 pg/ml
TSH: 8.37 [reference range .45-4.5]
Reverse T3: 14.6 ng/dl [reference range 9.2-24.1]

Meds: Losartan, Kombiglyze XR. Supplements: B12, Vitamin D3, Vitamin C, fish oil, magnesium, zinc.

[gimel]

Prior test results for D, B12 and ferritin?  I should have also asked what was the reason you were diagnosed as hypo originally?

Taking your morning dose before the blood draw will cause falsely higher thyroid levels.  Even the AACE/ATA recommend delay of med until after blood draw.  So you should make sure to do that in future, unless your new compounded med is truly slow release.  Then it won't matter much.  

Even though you did take your morning dose, your FT4 was only at 32% of its range, and your FT3 was only 42% which are borderline low for many hypo patients.   You said your blood pressure improved with the change in med. I have also found that my BP is raised shortly after taking my T3 med, but it is only temporary.    So the slow release type would not be expected to affect a BP test as much.

I think that if you get your FT4 and FT3 levels adequate you might be very surprised at how many symptoms are improved.  Hypothyroidism can cause all kinds of unsuspected problems including blood pressure issues.  As for A fib, I don't believe your thyroid levels are anywhere near high enough to be a major cause for  that.  

Since you appear to need a dose increase I would not be concerned about the increase in T4 in your med.   I would make sure to continue to increase dosage enough to get your FT4 and FT3 levels to  the middle of their ranges, and see how that affects you.  

[gimel]

Some general questions  for which answers will help us to respond.  What was your daily dosage of Armour?  If you split the dosage, what amount did you take and when during the day?  Did you delay your morning dosage until after the blood draw for thyroid tests?  What are your Vitamin B12 and D3 levels?  Have you been tested for ferritin, the storage form of iron that is readily available for use by the body?  How much of the new med (4/40) are you taking daily?

[svbd0308]

I was taking two doses of Armour: 30 mg in the morning before breakfast, and 15 mg at dinner.
The dosage of the new compound meds is 45 mg total, slow release, which I take once a day in the morning.

I did take my medication the morning of my blood test at my doctor’s direction. I was concerned taking the meds would give a false picture of my thyroid levels.

I was not tested for B12, D or ferritin this time around so I’m not sure what the current levels are.