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Recently Diagnosed Hypertension with hypothryoidism.

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I am 35 years old weighing 88 Kgs. Recently diagnosed with Hypertension. My Thyriod TSH values were 7.20. I was taking Telmaxx 25 for High BP and eltroxin 50 mcg for Thyriod.I was taking eltroxin for the last three months. The recent blood test showed less TSH value of 0.06 and uric acid level of 9.20. Now the BP is normal so the Doctor changed my medication to telsite 40mg and have advised me to reduce dosage of eltroxin to 25mcg. I would like to know whether I should stop eltroxin and also what is the reason for such high fluctuation in TSH levels. Also, am I on the right medication?

Category: Endocrinologist

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Category: Diabetologist
 19 Doctors Online

Hello and thankyou for approaching DoctorSpring with your query.
I have gone through your case, and will try and explain it to you.
Your TSH level was high, which is why the doctor started you on 50mcg Eltroxin which may have been slightly on the higher side. Over the 3 months it caused your TSH levels to drop. Since your TSH levels have dropped to 0.06, I would advise you to stop the Eltroxin right now. And repeat the Thyroid profile test in 3 months. Depending on the values at that time you can start on a low dose of Eltroxin. The reason for this fluctuation was the dose of the eltroxin tablet. Nothing to worry.

Regarding your B.P, you were on Telmaxx which is a combination of two drugs- telmisartan and metoprolol. Since your B.P is normal the doctor has lowered the medication to only telsite 40 mg which is only telmisartan.

If your uric acid levels are 9.20mg/dl, your levels are slightly high. For now I would advise you to cut down on eating organ meats (liver , brain), red meats (beef, lamb) and some seafood items like sardines, herring scallops. Avoid drinking beer. This should help your uric levels come down. You can re-test your uric acid levels in 3 months.

I hope this has helped. Feel free to follow up.


Patient replied :

Doctor, Thanks for your advice. I would like to know if the BP levels are normal can i discontinue medication.What are the side effects of telmisartan medicines and is it safe for prolonged use since I am 35 years old only. I also get mild headache is it due to the telmisartan medicine.Is jogging advisable for person with high BP. Last week I checked my blood pressure it was 130/80. How often should I check my blood pressure.



If your BP levels are staying normal (ie less than 140/90) you can consider stopping the medications under the supervision of Doctor. Telmaxx is generally safe, but since you are young and if you are able to control your blood pressure with exercise, diet and salt restriction you can consider stopping it.

Discuss this with your Physician. Remember the low BP is because of the medication. So you need to be on follow up and need to keep track of the medication.

Hope this helps
Feel free to ask followups
Thank you

Patient replied :

Dear Doctor,

I was taking Telsite 40 mg. The BP levels were 130/80 so I started taking half of the tablet for the last three days. Yesterday I checked my BP the levels were 140/90. I am also having mild headache. So, should I continue with the Telsite 40 mg? Pls advice.

Yes in that case I would advise you to continue with Telsite 40mg. This shows that your B.P is within the normal range because of the medication.
Continue the medication regularly unless the dose is changed by your physician after a few B.P measurements. Do not skip your dose. Right now its in control because of the medication.

I hope this has helped.

Patient replied :

Dear Doctor,

I have done my Thyroid test and the TSH level has again gone up to 7.85. With the telsite medicine my BP levels were 140/90 so I have again started taking TELMAXX 25 and now the BP levels is 116/86. I would like to know following :

1. Whether I should again start eltroxin?
2. Is telmaxx 25 safe for prolonged use.Sometimes getting a feeling that I am not getting enough air. At times also not been able to take deep breadth.Shall I undergo any test to ensure that the breathing is normal.
3. I am getting frequent burps.
4. My resting heart beat rate is 55(when i take pulse rate immediately after getting up in the morning.).
5. At times I also feel pressure in the left hand while walking.

1.You have a milder form of hypothyroidism. So I suggest the following:
If your Anti-TPO Antibodies are positive (which you need to test), you can start a dose of 25mcg Thyroxine.
Otherwise, If Anti-TPO negative, I suggest you repeat TSH after 3 months and look for progression of disease, and start treatment if TSH rises above 10mIU/l.

2. TELMAXX 25 is safe for prolonged use in a any individual who tolerates the drug and has healthy organ function. That is if you have a normal liver and kidney function, no heart disease, you do not have to worry. About the difficulty breathing, do you suffer from asthma?
If not, it is most likely a side effect of Metoprolol. It might wear off with continued use. So I advice that you wait and watch for a week. If it does not get better or gets worse in the meantime, you can consult your Doctor for a change in medication.
NB: This drug should not be discontinued abruptly. If it has to be stopped, it should be done gradually and under Physician supervision. Also, this is not safe during pregnancy.

3. The frequent burps is due to Dyspepsia. You can take care of this by taking an OTC like Prilosec 20 mg, once on waking up, for about 14 days.

4. Resting heart rate of 55 is normal in athletes and fit individuals. If your earlier pulse was more than this, then this could either be a symptom of your Hypothyroidism or an effect of Metoprolol or a combination of both. You need not worry about this.

5. The pressure in left hand is non specific, likely a symptom of Hypothyroidism. If it is painful or discomforting, you can use Voltaren gel for local application.

I hope this helps and wishing you good health.
Thank you.

Dr. J Muthukrishnan
Category: Diabetologist
1. 10th Asia-Pacific Pediatric Endocrine Society  Fellows meeting, Seoul, Korea, Oct 2008
2. Eighth ICMR Course on Genetics and Genetic Counseling – Jul 2008 – SGPGI, Lucknow
3. Annual Certificate Course on Endocrinological Laboratory Techniques at National Institute of Nutrition (ICMR) Hyderabad,India, ( Aug-Sep 2006) 
Fellowship: Endocrinology, Diplomate of National Board, National Academy of Medical Sciences, New Delhi, 2008, Medwin Hospital, Hyderabad
Senior Residency: Diplomate of National Board (General Medicine), National Academy of Medical Sciences, New Delhi, 2002
Residency: MD, General Medicine, 1997-2000, Armed Forces Medical College, 2nd position in University
Medical School: MBBS, Armed Forces Medical College, 1992
Dr. J Muthukrishnan and 4 other Medical Specialists are ready to help you

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