# Over-medicated -> Fainting & Low Blood Pressure?



## Lopnslo2 (Jan 19, 2011)

OK, I'm re-posting under a different title because I have new information. I've been having near fainting spells lately, I feel "woozy" first, then I go weak and essentially collapsed once and have nearly passed out a few times. To complicate things, I had a pulmonary embolism 6 weeks ago, so the doc's first assumption was that it was related to this. However, everything about my heart and lungs check out, except that my blood pressure has been low. I'm typically low (120-115/60), but now I'm consistently hitting in the low 90's/50's.

I had my Hematologist run a TSH 3 weeks ago and it was low (0.35, range 0.46-4.68). I didn't ask for T3/T4, (I know I should), b/c I just wanted to "ball park" it to see if it had changed. It was 0.5 the last time my endo checked, so it is a little lower. My Endo is out of town, so I saw my GP today and she thought it was likely I was over-medicated on the levothyroxine and told me to take a 4 day "vacation" from it to see if my BP comes up and if the fainting spells stop (and to see my endo as soon as he's back!).

Anyone else have their BP go DOWN or have fainting spells in response to being over medicated?


----------



## Lopnslo2 (Jan 19, 2011)

Well I'll be...
Searching the research literature, found several like this, indicating a relationship b/w too much thyroid hormone and increased incidence of DVT's

http://bloodjournal.hematologylibrary.org/content/115/22/4344.full.pdf+html

KS


----------



## Lovlkn (Dec 20, 2009)

Lopnslo2 said:


> OK, I'm re-posting under a different title because I have new information. I've been having near fainting spells lately, I feel "woozy" first, then I go weak and essentially collapsed once and have nearly passed out a few times. To complicate things, I had a pulmonary embolism 6 weeks ago, so the doc's first assumption was that it was related to this. However, everything about my heart and lungs check out, except that my blood pressure has been low. I'm typically low (120-115/60), but now I'm consistently hitting in the low 90's/50's.
> 
> I had my Hematologist run a TSH 3 weeks ago and it was low (0.35, range 0.46-4.68). I didn't ask for T3/T4, (I know I should), b/c I just wanted to "ball park" it to see if it had changed. It was 0.5 the last time my endo checked, so it is a little lower. My Endo is out of town, so I saw my GP today and she thought it was likely I was over-medicated on the levothyroxine and told me to take a 4 day "vacation" from it to see if my BP comes up and if the fainting spells stop (and to see my endo as soon as he's back!).
> 
> Anyone else have their BP go DOWN or have fainting spells in response to being over medicated?


You should be testing your Free T-3 and Free T-4 to make dose adjustments not TSH alone.

It is likely you are hypothyroid and in need of more medication - .50 is a very low dose for a total thyroidectomy patient.

Call your GP and ask that she run a FREE T-4 and Free T-3 test and send you a copy. You need to be in control of your replacement dosages as it's alarming how many medical doctors have not a clue on how to properly dose and TSH is a diagnostic test and not good when used alone for replacement dosing.


----------



## Lopnslo2 (Jan 19, 2011)

Thanks Lovlkin
I should clarify, I'm on 137mcg of Levothyroxine, the 0.5 was my TSH level mid summer when my Endo said "OK, you're good, don't come back till December." Prior to that, I'd been having my TSH and T3/T4 checked every 6 weeks or so. The TSH test was done by my hematologist three weeks ago, and (this is funny really) was only done because we had an extra vial of blood and I said "Why don't we run a TSH, just to see where that is at?" That's when we found it was 0.3 (and flagged as low, but the bottom end of the range was 0.4 so I didn't think much of it).

I called my Endo's assistant again this morning and she said she'd be happy to have the journal article I found (but he's out of town till Monday). Cool! I'm starting to have 2nd thoughts about my Endo, but... he couldn't have known about the Factor 5 Leiden genetic disorder that increases likelihood of clotting. The genetic tests are ridiculously expensive, and the disorder is rare, so they don't do them unless there is evidence of a blood clotting disorder (such as almost dying from one like I did!).

Still, I think we need to get the word out, if you're female, on estrogen based birth control, and taking levothyroxine, to be aware of the symptoms of DVT and Pulmonary embolism. When you combine the birth control, with a genetic factor AND too much T3/T4 in your system, it forms the perfect storm for creating this life threatening condition.

Symptoms of DVT often feels like a Charley horse or muscle cramp (usually in the lower calf, but can happen anywhere in leg, or arm), often accompanied by swelling and/or tingling in the appendage. Shortness of breath and rapid heart rate often also occur (as the blood clot moves from the leg, through the heart and into the lungs). Many people feel an overwhelming sense of dread just prior to the event (they can't really explain that one, but it's common). So it can be mis-diagnosed as a panic attack, or heart attack. They can test for clotting factors in your blood (a D-dimer test), and they'll typically do a scan of your lungs to look for clots. I was lucky in that I had lots of small clots scattered about, so it didn't do as much damage as big clots will (often killing off large sections of your lungs). The frustrating thing about my case is that I had all the classic symptoms of a DVT in my leg, but the first ER waved it off, saying it was just a muscle strain, and I walked around with it for 10 days. If I'd been treated then, I never would have ended up with the life threatening PE. Also, if my TSH, T3/T4 had been monitored more closely, I probably would not have developed the DVT in the first place! 
(sigh)

That can't be un-done, but I don't want others to go through what I went through...

KS


----------



## Andros (Aug 26, 2009)

Lopnslo2 said:


> Thanks Lovlkin
> I should clarify, I'm on 137mcg of Levothyroxine, the 0.5 was my TSH level mid summer when my Endo said "OK, you're good, don't come back till December." Prior to that, I'd been having my TSH and T3/T4 checked every 6 weeks or so. The TSH test was done by my hematologist three weeks ago, and (this is funny really) was only done because we had an extra vial of blood and I said "Why don't we run a TSH, just to see where that is at?" That's when we found it was 0.3 (and flagged as low, but the bottom end of the range was 0.4 so I didn't think much of it).
> 
> I called my Endo's assistant again this morning and she said she'd be happy to have the journal article I found (but he's out of town till Monday). Cool! I'm starting to have 2nd thoughts about my Endo, but... he couldn't have known about the Factor 5 Leiden genetic disorder that increases likelihood of clotting. The genetic tests are ridiculously expensive, and the disorder is rare, so they don't do them unless there is evidence of a blood clotting disorder (such as almost dying from one like I did!).
> ...


Just to clarify; you are saying T3 and T4. We are saying FREE T3 and FREE T4.

There is a huge difference.

Free T3 and Free T4 are the only accurate measurement of the actual active thyroid hormone levels in the body. This is the hormone that is actually free and exerting effect on the cells. These are the thyroid hormones that count.
http://www.drlam.com/articles/hypothyroidism.asp?page=3

I hate that you are having so many medical issues. That has to be frightening. Keeping you in my thoughts and prayers.


----------



## Lopnslo2 (Jan 19, 2011)

Yup, I mean FREE T3/T4, sorry... Just figured we were all on the same page.
KS


----------



## Lopnslo2 (Jan 19, 2011)

My Hema get's some points back in her "good" column. First, my "checkup" was fine, don't know my PT/INR yet, but given the last ER scans showing that my PE's are "resolved" she's checking me off and passing me back to my GP for maintenance. What impressed me was that I took her the journal article that indicated excess Free T4 (what Levothyroxine is), can cause clotting, and she actually paid attention to it! (Turns out it was in an "Important and well respected" journal in her field). AND since they always draw an extra vial of blood (just in case new tests need to be run), I asked could we test Free T4 and T3 and she agreed. She said she couldn't do anything with the result, but that doesn't bother me. My GP or Endo can deal with it. It's just good to know that I'll know soon if my Free T4 is too high since my Endo just blew me off about it, and essentially said my fainting spells can't be due to being over medicated and the Levo couldn't have contributed to the clotting and that it wasn't even worth looking at! Tomorrow is apt with GP AND more house shopping. One just went for sale in the neighborhood we LOVE, at the right price and it looks like it has everything we want. It would sure be nice to be closer to both work and my doctors!

Thanks again EVERYONE for all your support!
KS


----------



## Andros (Aug 26, 2009)

Lopnslo2 said:


> My Hema get's some points back in her "good" column. First, my "checkup" was fine, don't know my PT/INR yet, but given the last ER scans showing that my PE's are "resolved" she's checking me off and passing me back to my GP for maintenance. What impressed me was that I took her the journal article that indicated excess Free T4 (what Levothyroxine is), can cause clotting, and she actually paid attention to it! (Turns out it was in an "Important and well respected" journal in her field). AND since they always draw an extra vial of blood (just in case new tests need to be run), I asked could we test Free T4 and T3 and she agreed. She said she couldn't do anything with the result, but that doesn't bother me. My GP or Endo can deal with it. It's just good to know that I'll know soon if my Free T4 is too high since my Endo just blew me off about it, and essentially said my fainting spells can't be due to being over medicated and the Levo couldn't have contributed to the clotting and that it wasn't even worth looking at! Tomorrow is apt with GP AND more house shopping. One just went for sale in the neighborhood we LOVE, at the right price and it looks like it has everything we want. It would sure be nice to be closer to both work and my doctors!
> 
> Thanks again EVERYONE for all your support!
> KS


It is very good to hear from you and we will all be interested in the results of your thyroid panel.

Hope you get the home that you desire!


----------



## Lopnslo2 (Jan 19, 2011)

Update:
Saw my GP today and he agreed with my Hema that it was time to see a cardiologist to deal with the fainting spells. He also agreed that my thyroid meds may be causing arrhythmia's that in turn may be causing the fainting spells. He is expediting things by having me pick up a holter monitor tomorrow so that we have that info to look at for my appointment with the cardiologist (next week). How cool is that?
KS


----------



## Andros (Aug 26, 2009)

Lopnslo2 said:


> Update:
> Saw my GP today and he agreed with my Hema that it was time to see a cardiologist to deal with the fainting spells. He also agreed that my thyroid meds may be causing arrhythmia's that in turn may be causing the fainting spells. He is expediting things by having me pick up a holter monitor tomorrow so that we have that info to look at for my appointment with the cardiologist (next week). How cool is that?
> KS


I am glad to hear this. I do hope nothing is wrong heart-wise but it does have to be ruled in or out. "It's a process!"

You take care and have a restful and relaxing weekend!


----------



## Lopnslo2 (Jan 19, 2011)

Well, my Free T3, Free T4 theory is out the window...
Got my test results back and they are:
FT3=2.8, range 2.4-4.2
FT4=1.37, range 0.78-2.19
The Free T3 is a little low, but the FT4 is smack dab in the middle, so it doesn't appear that I can blame these for my fainting spells...
DRAT!
That would have been an "easy" fix (relatively)
KS


----------



## Andros (Aug 26, 2009)

Lopnslo2 said:


> Well, my Free T3, Free T4 theory is out the window...
> Got my test results back and they are:
> FT3=2.8, range 2.4-4.2
> FT4=1.37, range 0.78-2.19
> ...


In a way you might be able to blame these. You are undermedicated. FT3 should be in about 75% of the range given by your lab. If your thyroid hormones are out of whack, a myriad of things can go wrong.

Your Free T3 is below the mid-range of 3.3. THAT is not good.

Also consider cortisol, glucose and ferritin.


----------

