Kindly let me know what should be my next action to reduce BP & TSH level based on the following observations. My blood report is as under: T3: 1.06 nmol/l T4: 39.51 nmol/l TSH: 60 microlu/ml HbA1C: 5.6 %Anti-Thyroid PAS: > 1300 Hemoglobin Variant Analysis, Blood: within range USG report of thyroid gland: Multi-nodular Goiter right Thyroid. Both thyroid shows slightly increase in vascularity. After investigation, I am taking medicine: Thyrox 100 for thyroid control Olmezest 40for BP control. Solution sought for the following: My blood pressure always remains around 150--160/ 95-105 Feeling depression due to weakness and high BP.

Dr. Prabhakar Laxman JatharEndocrinologist46yrs exp

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Mr. lybrate-user, Thanks for the query. Please tell whether TSH 60 mU/L value shown is with thyronorm 100 mcg or is it before beginning of the treatment? Because when on treatment with adequate dosage of Levothyroxine, TSH should be maintained around 3 to 4 mU/L. Your TSh value is too high, suggesting uncontrolled hypothyroidism. Plus your USG report talks of multinodular goiter. That needs to be observed periodically. Plus the antibody titre is also very high, suggesting an autoimmune problem. As regards BP, when on appropriate treatment it should be maintained around 120 to 130 /70 to 80 mm Hg. That also needs to be properly treated. If hypothyroidism is not well controlled it does cause depressive tenancy in some persons. If you have any further doubts please come back in a private conversation (paid consultation), where I will be able to give specific guidelines plus prescriptions if needed. As in this communication we are supposed to give only general guide lines, no prescriptions are allowed. Or please consult a local endocrinologist / physician. Do not neglect. Thanks. 

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