Q: What is the effect of hypothyroidism on cardiac health? Is low blood pressure (90/60) common in hypothyroidism and does it in any way indicate cardiac risk? The patient is a 65 years old man and is hypertensive since 1998. But now all his hypertensive medicines have been stopped. Is serum TSH level of 22 uIU/ml, T4-3.1 ug/dl, T3-0.45 ng/ml a serious threat? Medicine prescribed is eltroxin 100 mcg/day. Can a person having this much level of thyroid hormone have complete loss of appetite and weakness to the extent of being bedridden?

A:The effect of thyroid hormone is to provide energy to every system in the body. The effect of prolonged poor control of thyroid status is usually higher BP due to thickening of blood vessels, but if BP is low, then it is serious matter and it is due to weakening of heart muscles. This patient needs urgent attention. The dose of eltroxin needs to be very gradually stepped up so that thyroid status is normalised slowly. Extreme muscular weakness is very likely and so is loss of appetite.