High Blood Pressure (Hypertension) is a symptom of both Hypothyroidism and Hyperthyroidism

High blood pressure is a problem for hyperthyroid and hypothyroid patients. In hypothyroidism, noradrenaline is secreted to compensate for the lack of thyroid hormone, and this causes not only high blood pressure, but a fast heart rate, anxiety, and other symptoms.  The diastolic (lower) number is often higher than 90 mm Hg.[1] Bringing thyroid levels up will often normalize blood pressure. I profiled my experience with the condition here:  Hyperthyroid Symptoms (Anxiety, Tachycardia); Hypothyroid Labs

In hyperthyroidism, T3 reduces systemic vascular resistance (resistance to blood flow), heart rate elevates, and cardiac output increases; these all raise blood pressure. The systolic (upper) number is often higher than 140 mm Hg. Pulse pressure refers to the difference between the systolic (upper) and diastolic (lower) numbers. A widened pulse pressure is a common feature in hyperthyroidism.[2] Long-term negative effects on the cardiovascular system include arterial stiffness and left ventricular hypertrophy (thickening of the heart muscle).

If you are taking T3 in any form (desiccated thyroid or liothyronine like Cytomel), and your systolic BP is over 140 mm Hg while your diastolic number is less than 90 mm Hg, you may need to adjust/reduce your dose. A resting heart rate over 85 beats per minute also suggests overmedication, as does any form of arrhythmia (irregular heartbeat, especially atrial fibrillation).

If your diastolic BP is over 90 mm Hg and you have a high heart rate and anxiety, along with other symptoms of hypothyroidism like dry skin, brain fog, and a body temperature that never reaches 98 oF, then your dose may be too low, and you should certainly get more complete testing that includes a Free T3. http://tiredthyroid.com/what-labs.html

[1] Streeten, D. H., et al. “Effects of thyroid function on blood pressure. Recognition of hypothyroid hypertension.” Hypertension 11.1 (1988): 78-83.

[2] Prisant, L. Michael, Jaspal S. Gujral, and Anthony L. Mulloy. “Hyperthyroidism: a secondary cause of isolated systolic hypertension.” The Journal of Clinical Hypertension 8.8 (2006): 596-599.


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  1. I realize that these “rules” don’t apply to everyone, but I find it very confusing and, to say the least, frustrating when it seems that others find answers in these clues to the thyroid dosing puzzle. I never had a systolic number greater than 138, always had a diastolic around 80 to 84 but my pulse rate was rarely over 60. I felt horribly hypo and was on just T4 at the time. Now I take dessicated, and while my BP is good at about 128/74, my pulse rate is still low and so is my temp. If I raise dose even a tiny bit, I get heart flutters, but BP rarely changes. It does seem to stay high on the systolic side, though, but that heart rate will not come up. In your research, have you found BP to be more of an indicator of hyper or hypo than heart rate? Or do they, in most people, seem to correlate together better than they do with me? By the way, love the book. Lots of good stuff in there, but I can’t ask you questions while I am reading it :)

  2. Blood pressure is confusing, because thyroid isn’t the only hormone affecting it. There’s noradrenaline, cortisol, aldosterone, and probably others. My point was that thyroid plays a huge role, and I did not realize I was overmedicated on desiccated thyroid, except that my BP was always high (heart rate normal). I had high BP on “only” 2 grains, so the thought that it could be from my thyroid dose escaped me. Bringing the desiccated dose down to 1 grain and adding T4 finally normalized it.

    I know a man who increased his desiccated dose, which raised his BP, but his heart rate remained low too. So maybe heart rate is less responsive to desiccated than BP. Hopefully others will chime in with their experience!

  3. hi, barb
    I had hypothyroidism symptoms with high blood pressure. After treatment and diet adjustment, I have a little recovery. I hope I have an opportunity to share with you :). But sometime I feel some physical fatigue as your article mentioned. What is a better solution for high blood pressure for thyroid patients?

    • Obviously, thyroid isn’t the only hormone involved with BP, but for some people, just getting both T3 and T4 at the right levels will normalize BP. This may mean taking both types of hormones or combining different thyroid medications.

  4. Very interesting reading about high bloodpressure and thyroid conditions! Thank you for this blog and the excellent Tired Thyroid site with all information! I have always before had a low BP 115/70, but suddenly this autumn I started to feel bad, headaches, extra heartbeats, anxiety and high BP 160/100. I have used NDT for three years without any problems, felt better in fact, than before, when I was taking the synthetic T4/T3 combo. But my labtests on NDT always no matter if I increased the dose or lowered it, showed a T4 in the lowest range and T3 in optimal range. I will now after reading and giving the matter some thoughts, try to lower my NDT dose and instead add some extra T4 to see if that will in time help to make my BP normal again. My doctor put me on metropolol (betablockers) and I would like to try to come off the betablockers.

  5. Hi,
    I am hypothyroid and had high blood pressure but didn’t know there could be a link. However I was self-treating for candidiasis and came across coconut oil which is claimed to lower blood pressure (among many other benefits). Sure enough the quantity I was consuming did lower my blood pressure and the doctor allowed me come off the beta blockers.
    By the way my kidney function has also returned to normal. Now I want to know if the coconut oil can assist my thyroid function!!

    • Hi Lesley,
      I have been using synthroid replacement since 2006, recently found that my morning diastolic blood pressure is above 90. I suspect this is due to hypothyroid. I wonder what quantity of coconut oil did you use to lower your blood pressure. Did you have isolated diastolic blood pressure too?


  6. Hi Barb , you are so very right when you say that high blood pressure does not only come from thyroid medications . You are right when you said it could come from adrenals . I don’t think we are aware how much adrenals play a role in our well being and the connections between thyroids and adrenals . Thank you Barb for educating me and many many other thyroid patients . YOU ARE HEAVEN SENT !!!!!!!!! THANK YOU !!!!! THANK YOU!!!!!! THANK YOU!!!!!!!!!!

  7. I have had RAI and I am taking natural desiccated thyroid. I have been hypothyroid for well over 25 years. My blood pressure has been pretty high. If I don’t take blood pressure meds it goes to around 165/100. I have pretty dry skin on my body and heels. My liver enzymes are also elevating, and having signs of insulin resistance. I literally have to watch my food to keep from gaining weight, and find it EXTREMELY hard to lose weight. I am thinking of trying adding the T4 to my NDT to see if I get better results. I have tried so many things and still searching for answers for weight loss.