Effect Of Levothyroxine On Blood Pressure In Patients With Subclinical Hypothyroidism: A Systematic Review And Meta
- 1Department of Endocrinology, Affiliated Hospital of Yanan Medical University, Shaanxi, China
- 2Department of Endocrinology, Shanghai University of Medicine & Health Sciences Affiliated Zhoupu Hospital, Shanghai, China
- 3Department of Cardiology, Shanghai University of Medicine & Health Sciences Affiliated Zhoupu Hospital, Shanghai, China
Background: Patients with subclinical hypothyroidism have elevated blood pressure, but the effect of levothyroxine therapy on blood pressure among those patients is still unclear. This study aimed to assess whether LT4 therapy could reduce blood pressure in SCH patients through a systematic review and meta-analysis.
Methods: PubMed, Embase, Cochrane Central Register of Controlled Trials , and Web of Science were searched. Randomized controlled trials assessing the effect of LT4 therapy on blood pressure or prospective follow-up studies comparing the blood pressure level before and after LT4 treatment were included, and the mean difference of systolic blood pressure or diastolic blood pressure was pooled using random-effect meta-analysis.
The findings suggest that LT4 replacement therapy can reduce blood pressure in SCH patients, which needs to be validated in more clinical trials with larger samples.
Treating Secondary Hypertension Due To Hypothyroidism
When it comes to treating secondary hypertension, the good news is that you can usually treat high blood pressure by treating the condition causing it. In the case of hypothyroidism, you may be able to improve blood pressure by taking thyroid hormone replacement medication. Additionally, lifestyle changes meant to improve your thyroid health may also lead to better blood pressure readings .
If you have high blood pressure, it will be important to monitor your blood pressure based on your doctor’s recommendations. Tracking is especially important for instances where you are managing your thyroid and blood pressure medication if you have been prescribed for hypertension. Your doctor may treat your hypothyroidism before giving you medication for blood pressure, as thyroid hormone therapy may be just what you need to normalize blood pressure levels.
To find out if hypothyroidism is behind high blood pressure readings, take an at-home thyroid test to get an idea of your thyroid function. Even subclinical thyroid dysfunction can affect blood pressure, so always consider your thyroid health when dealing with hypertension.
Avoid Gluten In Your Diet
Gluten is a type of protein commonly found in barley, rye, or wheat. It triggers the cells in the gut to release zonulin, a protein that can damage the tight junctions responsible for holding the intestines.
If the junctions break, leaky gut occurs. Avoiding gluten in your diet for high blood pressure and thyroid can help keep your gut in good shape, preventing the interruption of hormonal activities in the body.
Upon doing groceries, check the labels for gluten.
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Salt Is Beneficial If You Have Low Blood Pressure And Hashimotos Hypothyroidism
Natural salt has benefits that include trace minerals and being free of chemical additives found in conventional salt. If you have low blood pressure, eating plenty of salt is especially important to boost blood flow to your tissues and brain. A blood pressure of 120/80 is considered healthy and if the upper or lower number deviates by 10 your blood pressure is in an abnormal range.
Low blood pressure is associated with adrenal fatigue. The adrenal glands produce stress hormones and help regulate blood pressure. Many people today have fatigued adrenal glands thanks to chronic stress, poor diets, chronic inflammation, and more. Symptoms of adrenal fatigue include constant tiredness, low blood sugar, and low blood pressure. Adrenal fatigue and low blood pressure are common in many people with Hashimotos hypothyroidism. If you dont work to manage these conditions, it will be more difficult to manage your thyroid condition as well.
In addition to salt, certain nutritional compounds support adrenal function and thus healthy blood pressure. Ask my office for more information on how to support healthy blood pressure.
Metabolism Of Thyroid Hormones And Their Effects On The Cardiovascular System
Triiodothyronine is the biologically active form of thyroid hormone derived from 5-monodeiodination of thyroxine in all tissues outside of the thyroid gland, particularly the kidney, liver, and skeletal muscle. The basal metabolic rate is affected by fT3 via altering oxygen consumption, substrate requirements and tissue thermogenesis . Thyroid hormones have direct and indirect cellular effects on the cardiovascular system. In hyperthyroidism systemic vascular resistance decreases as fT3 dilates resistance arterioles of the peripheral circulation, which results in the fall of the effective arterial filling followed by stimulation of renin release and activation of the angiotensin-aldosterone axis .
According to earlier studies heart failure develops in 616% of patients with hyperthyroidism. Patients with preexisting hypertension or with risk factors for coronary artery disease have a more pronounced risk for developing hemodynamic changes leading to chronic heart failure. A relatively frequent complication of hyperthyroidism, atrial fibrillation, is an independent predictor for the development of chronic heart failure .
We have previously shown that in patients who had undergone thyroidectomy for differentiated thyroid cancer, increased aortic stiffness and impaired diastolic function can be detected during induced overt hypothyroidism, which is part of the diagnostic follow-up procedure .
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Subclinical Hypothyroidism And The Heart
Subclinical hypothyroidism is biochemically defined as a TSH level above the upper limit of the reference range with normal thyroid hormone levels. Severity of subclinical hypothyroidism is further defined based on the elevation in TSH levels, where mildly increased serum TSH levels range from 4 mIU/L to 10 mIU/L, and anything above 10 mIU/L indicates severely increased TSH levels.6 The reported prevalence of subclinical hypothyroidism depends on several factors, such as iodine supplementation, age, and race. In the United States, the prevalence of subclinical hypothyroidism is reported as 4.3% in the NHANES III study and as high as 9.5% in the Colorado study.19 The annual risk of progression to overt hypothyroidism is reported at 1% to 5%, depending on TSH levels and thyroid antibody status. Up to 60% of patients with subclinical hypothyroidism can return to euthyroidism over 5 years, again based on TSH levels and antibody status.19 As described earlier, cardiovascular changes of arterial compliance, diastolic blood pressure, endothelial dysfunction, and hyperlipidemia that are noted with overt hypothyroidism can also occur in subclinical hypothyroidism.19
Too Little Or Too Much Of This Crucial Hormone Can Contribute To Heart Problems
Located at the base your throat, the butterfly-shaped thyroid gland releases hormones that affect every organ in your bodyespecially your heart. Thyroid hormone influences the force and speed of your heartbeat, your blood pressure, and your cholesterol level. As a result, a malfunctioning thyroid gland can cause problems that masquerade as heart disease or make existing heart disease worse.
An estimated 6% of people in the United States have thyroid disease. Most of themabout 80% have an underactive thyroid, or hypothyroidism. When thyroid levels drop, all the systems in the body slow down, triggering a range of symptoms that include fatigue, weight gain, cold intolerance, constipation, and dry skin. But these symptoms are very common in people as they grow older, including those with normal thyroid levels.
More than half of people with normal thyroid function have symptoms of hypothyroidism, says Dr. Jeffrey Garber, an endocrinologist at Harvard-affiliated Beth Israel Deaconess Medical Center and medical editor of the Harvard Special Health Report Thyroid Disease. In addition, some people over age 60 with low thyroid levels dont have the classic symptoms. Thats why recognizing hypothyroidism can be particularly tricky, he adds. Certain factors make people more likely to have thyroid problems.
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Can Hypothyroidism Cause Low Blood Pressure
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Hashimotos Hypothyroidism And Low Blood Pressure
Hashimotos is an autoimmune disease that causes low thyroid symptoms. Proper functional medicine management requires supporting thyroid function, balancing the immune system, and dampening inflammation and autoimmune attacks on the thyroid. Doing this is one way to better manage adrenal fatigue and low blood pressure.
For more advice on supporting thyroid function, adrenal function, and blood pressure, contact our team.
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Hypothyroidism And Low Blood Pressure Health Risks
Most people worry about high blood pressure, and with good reason as it portends numerous health risks. However, low blood pressure brings a different set of problems, such as reduced brain function and increased mortality risk. If the upper or lower number deviates by more than 10 from 120/80, it pays to be aware low blood pressure may be affecting your health.
If you have Hashimotos hypothyroidism but are not managing it with functional medicine, you may have additional problems with poor blood flow and oxygenation, which compound the problems of low blood pressure.
Blood pressure pushes blood through about 100,000 miles of veins, arteries, and capillaries in the body, carrying oxygen, nutrients, immune cells, hormones, neurotransmitters, and other vital compounds.
High blood pressure strains blood vessels. However, low blood pressure means not enough blood is getting to capillaries and tissues, particularly in your hands, feet, and brain. This deprives those tissues of sufficient oxygen and nutrients. You may have chronic nail fungal infections and cold hands and feet if so.
Blood Pressure Changes In Subclinical Hypothyroidism
Hypothyroidism has been generally considered as a cardiovascular risk factor, as discussed above, stressing the need of routine screening for thyroid function especially among female patients with coronary heart disease or patients with known cardiovascular risk factors . Subclinical hypothyroidism is a common entity, characterized by elevated TSH-levels and fT4 and fT3 levels in the normal range.
The association between elevated blood pressure and overt thyroid disorders has been thoroughly investigated and well-established, while the question whether subclinical changes in the thyroid function present potential risk for the development and maintenance of hypertension are still under debate. Some studies detected positive correlations of subclinical hypothyroidism and hypertension in women however, the same results were not confirmed in men . A number of clinical studies assessed the relationship between subclinical thyroid dysfunction, both hypo and hyperthyroidism, and endothelial dysfunction , arterial wall thickening , atrial fibrillation , and left ventricular hypertrophy . A study involving more than 10.000 children and adolescents found a positive correlation between elevated serum TSH levels and both systolic and diastolic blood pressure however, this correlation was not established with hypertension . Upon these findings, one can presume an association between subclinical hypothyroidism and elevated risk for the development of hypertension.
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Recognizing And Treating Hypertension
Hypertension does not usually cause any symptoms unless there is a hypertensive crisis, which is rare. Given this, its unlikely youll notice any warning signs. Many, in fact, are surprised to learn of the diagnosis after their healthcare provider uses a blood pressure cuff during a physical examination as a matter of routine.
Your healthcare provider may also recommend that you monitor yourself at home, especially if you have other hypertension risk factors. You can purchase a blood pressure cuff for self-checks or visit a local pharmacy or community center, which may have one available for you to use.
If you are diagnosed with hypertension, there are effective prescription medications that can control your blood pressure.
Because thyroid disease, thyroid treatment, and thyroid replacement medications can all interfere with your blood pressure, you may need the dose of your blood pressure medication adjusted as your thyroid function changes during your cancer treatment and after your recovery.
Functional Medicine Tips For Low Blood Pressure
If you have signs and symptoms of low blood pressure and adrenal fatigue, consider an adrenal saliva test. This test measures levels of the adrenal hormone cortisol throughout the day. This gives you a more precise therapy target and follow-up testing will let you know if your protocols are on the right track.
Everyone knows a person with high blood pressure should avoid salt, but adding some good quality sea salt to your diet may help boost low blood pressure. In fact, you may be one of those people who craves salt.
A nutritional compound that can help raise low blood pressure is licorice root extract, or glycyrrhiza, which can extend the life of cortisol in the body and improve blood volume and electrolyte balance.
Of course, its important to address what is causing adrenal fatigue. Adrenal fatigue is always secondary to something else. One of the most common causes is eating a diet that causes low blood sugar. Eating a good breakfast, skipping sweets and sweet drinks, minimizing starchy foods, and eating regularly enough to sustain blood sugar are helpful strategies.
These are also vital strategies to help you better manage Hashimotos hypothyroidism.
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Is There A Relationship Between Thyroid And Blood Pressure
Hypertension is caused by hypothyroidism in 3 percent of patients with high blood pressure. Hypercholesterolemia and an increase in fatty acids are also associated with low thyroid function, thus increasing the risk of cardiovascular disease. Thyroid hormone supplementation does not always lower blood pressure.
Data Extraction And Quality Assessment
The following information was extracted independently by two investigators: first author, year of publication, study design, country, sample size, ethnicity, definition of SCH, treatment dosage of LT4, mean TSH level at baseline, change in TSH during treatment, TSH measurement methods, hypertension status of SCH patients, treatment duration as well as blood pressure before and after treatment. Two authors independently assessed the risk of bias of included RCTs using Cochrane risk of bias tool, which mainly included randomized sequence generation, treatment allocation concealment, blinding, outcome data completeness, and selective outcome reporting . The risk of bias in prospective studies comparing the blood pressure level before and after LT4 treatment was assessed using the Newcastle-Ottawa Scale . Studies with scores < 6 were defined to have suboptimal quality.
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Hyperthyroidism: Excess Thyroid Hormone
The opposite problem, hyperthyroidism, or too much thyroid hormone, is far less common, affecting less than 1% of the population. But it, too, can harm the heart.
The classic symptoms include sleeplessness, heat intolerance, excess sweating, weight loss, extreme hunger, and loose bowels. Excess thyroid hormone also causes the heart to beat harder and faster and may trigger abnormal heart rhythms. One is atrial fibrillation, a disorganized rhythm in the heart’s upper chambers. A related symptom is palpitations, a sudden awareness of your heartbeat. People with hyperthyroidism may also have high blood pressure. In a person with clogged, stiff heart arteries, the combination of a forceful heartbeat and elevated blood pressure may lead to chest pain or angina.
Functional Medicine Strategies For Low Blood Pressure
If you have low blood pressure and symptoms of adrenal fatigue, consider an adrenal saliva test. This test measures cortisol levels throughout the day â cortisol is your primary adrenal hormone. The results let you better target your therapy and doing a second and third test tell you if your protocol is working.
Although people with high blood pressure should avoid salt, quality sea salt can help help raise overly low blood pressure. In fact, many people with low blood pressure find they crave salt.
A nutritional ingredient that can raise low blood pressure is licorice root extract, also called glycyrrhiza. It extends the life of cortisol, which can help improve blood volume, electrolyte balance, and blood pressure.
However, the most important thing is to address the cause of adrenal fatigue as it is always secondary to something else.
One of the most common causes of adrenal fatigue is low blood sugar or blood sugar instability caused by eating too many sweets and starches, skipping meals, or under-eating. Eating a healthy breakfast, avoiding sweets and sweet drinks, reducing starchy foods, and eating regularly enough to sustain blood sugar are helpful strategies.
These are also important strategies to help better manage Hashimotoâs low thyroid.
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Thyroid And Low Blood Pressure
Thyroids Metabolism, Weight Gain and Your Thyroid
Enduring from hyperthyroidism? One of the primary reasons numerous people are struggling with hyperthyroidism is due to an autoimmune condition called Graves disease. It stimulates your thyroid gland in such a manner that the gland starts producing more TS3 and TS4 hormones.
Thyromine Review Must Read Before You Buy Thyromine!
I am a routine individual of Thyromine. I am writing this to share my experience with others who experience hypothyroidism or overweight triggered by hypothyroidism. I was a person of hypothyroidism from the age of thirteen. In the beginning my doctor suggested a medication as well as it worked well. However it lasted just for some time.
How to Treat Graves Disease Naturally
If you have actually been identified with Tomb Disease, wish to stay clear of taking medicine if at all feasible, and also do not also want to consider treating your condition with radioactive iodine, after that the details you will review can be life altering. I am a licensed healthcare expert and also was directly identified with Tomb Disease. Knowing that this is a major autoimmune thyroid condition, I truthfully wasnt certain if I would rely upon all-natural treatment methods, also though I without doubt have a natural frame of mind.
Thyroid Health and DiseaseHypothyroidism DietNatural Remedies For Hypothyroidism
Reduced Blood Volume & Cardiac Output
Hypothyroid conditions frequently result in an overall decreased about of blood volume and related decreased cardiac output . This decreased blood volume triggers the kidneys to raise blood pressure.
Reduced blood volume paired with the decrease in available T3 explains the prevalence of diastolic hypertension in hypothyroid patients: lower blood volume results in less blood to pump around, so while the vessels are not as flexible, there is not as much blood being pushed per pump of the heart.
Systolic blood pressure increases, but not as much in relation to diastolic pressure increases. The constant pressure from the blood volume on further restricted vessels is revealed by the diastolic pressure. Over time, without adequate treatment for the hypothyroid condition, both numbers will continue to elevate.
Blood pressure is independent of TSH levels: actual thyroid hormone levels are the indicator. The mechanism for systolic hypertension in hypothyroid disease isnt quite understood, yet.
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