Okay, well, now I'm more confused more than anything... I woke up at 4 AM to my throat feeling swelled.... stayed calm.... took my blood pressure and checked heart rate and blood pressure was off the charts.... like 130/128.... thought i was hallucinating and maybe it was heart rate at 128 so retook a few minutes later and bp was at 130ish over 119 and heartrate mid 90's.... Immediately took a Propranolol 10 mg (since I have these left over still) and went into ER. Had labs drawn in ER and they told me that I was fine and something must have triggered my heartrate, possibly anxiety... REALLY? Anxiety in my sleep? Seriously? I don't agree.... but anyhow, here were my labs from the ER.... they refused to run my Free T3 but judging from my labs, my numbers haven't moved except the TSH.

ER Labs from today:
Free T4: 0.8 (range 0.6-1.1)
TSH 0.65 (range 0.34-5.60)

Looks like I'm still hypo judging from labs in ER so why the sudden onset of increased heartrate and the high blood pressure? The ER doc said there was NO WAY my pressure was that high and my monitor needs to be reset but it's always shown my blood pressure normal 130/60 range and I usually check it once a day or once every other day.

Any ideas?

Hi:

So sorry this happened. How long ago did you stop the beta blocker? It's too bad the lab values reference ranges for the Free T4 is different from one another. It would be easier to compare the differences between the two. Because mid range for the July 20th Free T4 is: 1.295 and the mid range from the ER trip is: 0.85. It's difficult to compare unfortunately. The only thing I would say that perhaps you are dipping more hypO?

Too bad the ER refused to run the Free T3. It would definitely may help to pinpoint the problem.

Do you remember feeling like this not too long ago that you were woken up out of a sleep like this? I thought you mentioned these episodes before?

I can be sleeping and get anxiety/panic attacks. This will happen to me if both of my Free Ts were higher than the mid range levels.

{{{hugs}}}

Hi MMZ. Yes, these episodes are all too common for me and seem to always land me in the hospital. Usually, it's when my T3 shoots up... ARGH. I saw my endo today also and she said she thinks that I'm just too hypo for my body and we are "testing" remission and going off the PTU officially as of today. She said to use the beta blocker on a just as needed basis for now and we'll retest in about 5 weeks and ultrasound me and if I feel any worse sooner, to call her office so I can be seen again. I will run my Free T3 this Friday on my own thru LabCorp and see where it's at. My blood pressure has never risen to as high as it was... the endo thinks that my body is just adjusting after being hyper for so long and that I may possibly be in remission and not need the PTU anymore which may be causing me to go to hypo for my body. I did ask for some synthroid and she didn't think it would be a good idea for me since I am so sensitive to the slightest change and that may send me hyper. She said we will try going off the PTU for the next few weeks and see where my levels are.... if my tsh keeps rising and my Free T4 doesn't move much, then she'll consider it. She did do an ultrasound of my thyroid in the office today and found that there's fluid (she mentioned a pocket of blood) sitting in front of my thyroid and that may be the culprit to my issues. She said either that or the nodule on my thyroid . She said we'll know soon enough if going off the PTU raises my levels to hyper faster than anticipated. I'll have another complete ultrasound at my next visit.

Have you ever heard of fluid accumulating in front of the thyroid?

Be careful with the betablocker when you're hypo. Again, always go by your Doctors recommendations, of course, but i was told not to take a beta blocker when hypo by my own doctor, so be sure to keep track of how it makes you feel.

You could ask Elaine about her thoughts on the fluid accumulating in front of the thyroid?

{{{hugs}}} :-)

I've read these posts totally fascinated as I try to figure out my labs and make sense out of the numbers. I have a question. My Cardiologist wants me off of the Beta Blocker, toprol xl 50 mgs, but as I try to taper off, I feel so hyper. I was rx'd it after diagnosed with Graves.I don't know if it's the BB or my thyroid that causing this "old" weird feeling. Should I keep taking the BB? My GP prescribes the BB; my endo prescribes my Synthroid (soon to be Armour) and my Cardio says stop the BB, "You don't have heart disease, you shouldn't be on Toprol"! This is nuts!

I took many months to taper off the beta blocker I was on. Some people need more weaning times than others. I have seen people been weaned off so fast that they had hypER symptoms. Doctors do not always realize that we all have different needs.

{{{hugs}}}

I remember the endo telling me that when you're hypo, your bp goes up. Mine did when I was hypo, but some have higher bp when hyper. If you have a fast pounding pulse and heart rate, that usually is hyper. It could be your thyroid is dying out and you may have bursts of thyroid hormone that make you feel hyper once in a while but usually the chest pain is a hypo sign. I think what the doc told you is good, stay off the ptu for a few weeks and see what happens. I would ask Elaine about the ultrasound and the rest of it, see what SHE says. I wonder if a TT would be better for you? If your thyroid is in rough shape....maybe.

Hi Beazer- Why don't you ask your endo to switch your Toprol xl to Lopressor. It's the same drug but in the generic form and not in an extended release form so you will be able to lower your dose by splitting tablets and you may not feel the effiects of coming off the bb so much as you do now. Brans- when I was hyper, my blood pressure was always normal but my heart rate was erratic or high.... so my bp being high this morning out of nowhere sent red flags that something was wrong.... I only took the one propranolol this am since I knew my heartrate was high. I see a surgeon on Friday to get an opinion on a thyroidectomy. I hate this disease.... I cried when I was told I may be in remission and cried today at the thought that I'm SO darn confused . I just want a NORMAL or as close to normal life again.... It's so frustrating. And it's so hard to try to keep smiling while everyone around you looks at you and you don't look sick but you feel TERRIBLE on the inside..... ARGH!

I think I am going to ask for a switch. I know the XL is timed release, but the tablet is scored so I've been cutting them to 25/25. That isn't good because you can never get it just right and you get the burst of med right off the bat. I'm also on Xanax, generic, for the anxiety - always been a major problem for me, now I know why. I went ahead and took the 1/2 toprol and I feel better. This med is very hard to get off of

When I first started down this road and was in the insanity stage, with bulging eyes and the lower leg rash as well, my endo put me on the PTU three times a day - How do you stand the taste? I have a pretty strong stomach and I just couldn't stand the smell or taste of the pills. RAI sounded much better when I found out no more of those pills, now I don't know. I've been very confused (literally) since my new endo upped my synthroid to 88mcg. something is not right.

Hi Beazer- To stop taking the beta blocker, you want to ween yourself off slowly.... switch to lopressor so it isn't time released anymore then divide your dose into two doses daily (if you take 50 mg, take 25 mg every 12 hours) for a week, then the following week, taper to half the dose but still divide it into two daily doses again, and the following week, take just your night dose (since the thyroid is more active at night) and skip morning doses, the next week, take it every other day, then the next week, try skipping 2 days... if you feel you need it, take it again but keep trying til you are able to stop. I went thru the same thing with my beta blocker.... Of course, speak with your doc about it also....

To my support group:

I heard back from Elaine already.... I had posted the same as here and updated the same as here today and this is what she wrote back:

"Hypothyroidism causes a rise in diastolic blood pressure (bottom number), and hyperthyroidism causes a rise in systolic blood pressure. Your labs suggest hypothyroidism and this could very well be the cause. Hypothyroidism also causes sleep disturbances, particularly waking too early and it can cause anxiety. That must have been a frightening experience for you, and I hope you're now feeling better."

"I'm glad you're stopping PTU and re-evaluating things. In hypothyroidism, thyroid cells enlarge in their efforts to trap more iodine and this can cause swolling or goiter. Hypothyroidism also causes fluid retention or myxedema (waterlogged appearance of skin). It seems your thyroid hormone levels have been too low for your body's needs and all your effects are related to this."

Beazer- I forgot to add that I crush my PTU up and take it in apple juice or orange juice..... it helps mask the taste although still bitter, it's bearable.

Doesn't it seem that, except for the labs, hypo and hyper symptoms seem to mimic each other? When I'm hypo, like right after RAI and the titerating of the synthroid, my lower back hurt terribly and I could sleep forever, with hyper, I bounced out of bed and never stopped moving for the whole day. I needed help to sleep at night, lost 40 lbs in 3 months. I also have pre-tibial myxedema in my lower legs along my shins which is getting better. Apparently, if you have this, you may also have TED, I do, you can also have the skin problem and not have TED. I hit the jackpot on all of it. My eyes are the worst, double vision, pain, extreme photophobia, but my eye doc says he's seen much worse. Thank you for listening and for the lopressor information. I'm not sure I can go without the BB totally. I need something to help with the heart palps. Thanks again.

I always took my PTU with grapefruit juice...it masked the bad taste of PTU very well. Big Hugs...Kathy

scorpiogirl:

Thanks for letting us know what Elaine says. Does make sense about the fluid in front of thyroid.

{{{hugs}}} :-)