Unlike some of my colleagues, I know that both an overactive and an underactive thyroid can cause blood pressure elevations. But the other day a patient with erratic pulse and blood pressure didn’t believe that he needed a heart monitor and a 24 hour urine for the various stress hormones that can cause his symptoms. He thought a small change in thyroid function was the only reasonable explanation and that an adjustment of his levothyroxine dose would do the trick. He was unsure about how soon this change might be effective, because the TSH blood test takes 4-6 weeks after a dose adjustment to reflect the new steady state. Of course I know that symptoms usually change much quicker than that after a dose change.
Share this post
When Patients Disagree and Don’t Believe You
Share this post
Unlike some of my colleagues, I know that both an overactive and an underactive thyroid can cause blood pressure elevations. But the other day a patient with erratic pulse and blood pressure didn’t believe that he needed a heart monitor and a 24 hour urine for the various stress hormones that can cause his symptoms. He thought a small change in thyroid function was the only reasonable explanation and that an adjustment of his levothyroxine dose would do the trick. He was unsure about how soon this change might be effective, because the TSH blood test takes 4-6 weeks after a dose adjustment to reflect the new steady state. Of course I know that symptoms usually change much quicker than that after a dose change.