Suggest Treatment For Hyperthyroidism And Anxiety

Posted on Sat, 18 Feb 2017

Medically reviewed by Ask A Doctor - 24x7 Medical Review Team

Sat, 18 Feb 2017 Answered on

Sun, 12 Mar 2017 Last reviewed on

Question : I am 39 yr lady with chronic stress systems for last 14-15 years. Had pcod, had hyperthyroidism that got over corrected after 2 yrs and i discontinued electroxin. Then started having migraines and was put on prothiaden 50 mg . Also had intermittent High bp. Am on prothiaden 50 mg at bedtime and Aten 25 for bp in the morning last 3 yrs. nov 2016 had thicked uterus lining for which i had a dnc done. Again hormonal imbalance was the likely cause. My period cycles are regular last 3 times post dnc. However the bp fluctuates drastically.

Had an ambulator put for 24 hrs . Results are as follows:

Avg daytime 138.3/85.4
Avg nighttime 100/22.2
Diff in day/ night avg. -17.1/-22.6

Sys bp min 101, XXXXXXX 252!!
Dia bp min 53 XXXXXXX 196!!
Heart rate 50 XXXXXXX 98

These readings look alarming to me.

Also got an mri brain done 3 yrs ago and it said acute is hemiec foci on the left side. Im wondering if this has a connevtion.

All night readings are very low , while the day readings are alarmingly high.

Can u pls advice if i am sustebile to a stroke and what really is happening

Answered by Dr. Geeta Sundar (8 hours later)

Brief Answer:
Blood pressure is normally lower at night. This is called nocturnal dipping

Detailed Answer:
Hi XXXXXXX welcome back. I reviewed you previously.
Blood pressure is normally lower at night. This is called nocturnal dipping. Yes your fluctuations are more.
I will suggest you switch to metoprolol XL 25 at night and Amlodipine 2.5 in the morning. Metoprolol is more safe for the heart, sugar and lipids than Atenolol. By adding a small dose of Amlodipine your fluctuations in blood pressure and pulse can be controlled.
Can you tell me your latest TSH, B 12, Vitamin-D and lipid values?
Prothiaden should definitely be withdrawn although very gradually.
You are young and should get into a vigorous exercise program to combat your anxiety.
I think there is still a minor hormonal imbalance, fluctuating Blood pressure and anxiety.
If you take care of your lipids and blood pressure, your chances of stroke are low.
Please revert back.
Regards

Above answer was peer-reviewed by : Dr. Raju A.T