Sue was getting lightheaded. Vin found lemon balm in her nightly stack.
Blood pressure at 110/55. Free T3 critically low. Levothyroxine that didn't seem to be working. On a hunch, Sue snapped a photo of the "sleep support" bottle on her nightstand and sent it to Vin. What came back reframed the whole problem.
Published July 2026 · ~7 min read · Name changed. Lab values, BP, and supplement doses real. Published with the user's consent.
Meet Sue
She's in her 50s, holds a demanding management role, and works out most days. Like most women her age, she's navigating menopause — and the shifts it brings to sleep, energy, mood, and the hormones layered on top. She's tried the food-tracking apps and the fitness wearables — cycled through a shelf's worth over the years — and came away with the same conclusion each time: none of them held the whole picture. She joined Numi as one of our earliest beta users, looking for one place where her food, her sleep, her supplement stack, her labs, and her symptoms could all live together — with something intelligent to make sense of it all.
I truly feel Numi was built just for me. It's what I needed.
— Sue
The conversation
A question. A photo. A rethink.
Sue had been lightheaded for days and had checked her BP a few times — always around 110/55. She'd been on Levothyroxine for years but her most recent labs showed Free T3 stuck at 1.37, well under optimal. She opened Vin on a Sunday morning to ask a simple question.
Vin
Numi · personal health AI
Sunday morning
I've been feeling very lightheaded, and when I checked my blood pressure it's always something like 110/55. What can I do to help the blood pressure — or is there something I'm taking that I shouldn't be?
That's worth taking seriously. A BP around 110/55 with lightheadedness points to low diastolic pressure — the bottom number is doing most of the work keeping blood flow to your brain when you stand up. Let me check your labs and recent supplement data to give you a grounded answer.
Vin · pulled labs + supplement schedule + recent vitals
Here's what I see across your labs, meds, and supplements that's relevant:
🔍 Most likely culprits
1. Levothyroxine dose may need rechecking
Your Free T3 from June is 1.37 ng/dL — significantly below the optimal range of 3.0–4.4. Low thyroid hormone output is directly associated with low blood pressure, fatigue, and dizziness. This is worth bringing to your prescribing doctor — your current dose may not be fully converting to active T3.
2. Estradiol Patch (0.06mg)
Estradiol can cause vasodilation — it relaxes blood vessel walls — which lowers diastolic pressure specifically. If the lightheadedness is worse around patch change days (Wednesdays and Sundays for you), that's a clue.
3. Magnesium Glycinate (350mg at bedtime)
Magnesium also relaxes smooth muscle in blood vessel walls, which can lower BP. It's a solid dose on its own — but not on its own, given what else you're taking at bedtime.
4. Valerian Root (300mg at bedtime)
Sedating, mildly hypotensive on its own — but you're also taking Relax All at bedtime, which many formulations layer with more valerian. Worth pulling that label to see what's actually in it.
💧 What can help right now
- · Salt + fluid — your sodium (142 mmol/L) is normal, but if you're drinking lots of water without electrolytes, that pushes BP down. A pinch of sea salt in the morning glass helps.
- · Hydration first thing — 16 oz before you stand up preloads blood volume.
- · Stand up slowly — orthostatic hypotension is the most common mechanism here, and it's worsened by every vasodilator above.
- · Electrolyte drink — low-sugar sodium + potassium + magnesium mid-morning makes a real difference.
⚠️ One thing to bring to your doctor
The Free T3 of 1.37 is the outlier and warrants a conversation. That level combined with consistently low BP and lightheadedness is worth re-evaluating your thyroid protocol. Don't adjust Levothyroxine on your own.
Want me to log this as a symptom so we can track whether it correlates with specific days or supplements?
Yes, log it. And can you show me my thyroid lab history?
Vin · queried lab_results
Logged as a symptom with the likely triggers noted. Here's your thyroid trend:
| Date | Marker | Value | Optimal | Status |
|---|---|---|---|---|
| Jun 2026 | Free T3 | 1.37 ng/dL | 3.0–4.4 | 🔴 Well below |
| Jul 2025 | Total T3 | 96 ng/dL | 80–200 | 🟢 In range |
| Jul 2023 | TSH | 2.55 µIU/mL | 0.5–2.5 | 🟡 Slightly above |
The trajectory — TSH rising → Total T3 low-normal → Free T3 now very low — paints a picture worth discussing with your doctor. The missing piece is a recent TSH and Free T4 to complete the current view of how your Levothyroxine is actually working.
Could my Relax All and Valerian dosage be affecting my thyroid?
Good question. Here's the honest breakdown:
Valerian Root — some research suggests valerian may mildly inhibit thyroid function at higher doses by interfering with thyroid hormone synthesis or uptake. Mostly animal-based evidence, but not zero. At 2 pills (450–900mg total), it's worth flagging.
Relax All — depends entirely on what's in it. Many formulas layer valerian, passionflower, GABA, L-theanine, or magnesium. If yours also contains valerian you're double-dosing at bedtime. And some formulations include lemon balm, which has documented mild thyroid-suppressing properties — it can block TSH from binding to thyroid receptors.
You're on Levothyroxine for low thyroid, your Free T3 is well below optimal, and you're taking two sedative/adaptogenic supplements at bedtime — one of which may compound thyroid suppression. That's worth surfacing with your prescriber.
Can you send me a photo of the Relax All label? I can tell you exactly what's overlapping.
Here's the label for Relax All.
Vin · extracted ingredients from photo
This is really helpful — and honestly, this label explains a lot.
🔴 Thyroid-relevant ingredients
- · Lemon Balm (100mg) — this is the big one. Melissa officinalis is well-documented to block TSH receptor binding and inhibit thyroid peroxidase. At 100mg per serving taken nightly, it could meaningfully suppress thyroid activity — especially problematic when your Free T3 is already at 1.37.
- · Valerian Root (300mg) — you're also taking this separately. Your total valerian at bedtime is 300mg here + your standalone 300mg = 600mg nightly.
- · Ashwagandha (150mg) — this one actually stimulates thyroid hormone production in some studies, so it's a mixed signal. But combined with the other adaptogens, the net effect is unpredictable.
🔴 BP / dizziness-relevant ingredients
- · GABA (450mg) — vasodilatory at higher doses, can lower BP.
- · Magnesium aspartate (200mg) — you're already taking 350mg Magnesium Glycinate at bedtime separately. That puts your total bedtime magnesium at ~550mg, and both forms are known contributors to low BP and dizziness.
- · L-Tryptophan (600mg) — sedating; compounds the hypotensive effect of everything else here.
The bottom line: you have two thyroid-suppressing compounds (lemon balm + valerian) hitting nightly, on top of Levothyroxine that's already not converting adequately to Free T3. And your bedtime magnesium stack is a plausible direct contributor to the 110/55 readings and lightheadedness you logged this morning.
This is a conversation worth having with your prescriber before your next thyroid panel — ideally bringing this label with you. The lemon balm especially is worth flagging explicitly.
Should I stop taking Relax All given the thyroid concerns?
Genuinely a judgment call that belongs with your doctor, but here's how I'd frame it so you can make an informed decision together:
The case for pausing it
- · Lemon balm nightly is likely working against your Levothyroxine — you're medicating to raise thyroid hormone while taking something that blunts thyroid receptor signaling.
- · Your Free T3 is already critically low at 1.37; any suppressive effect matters more than it would with normal thyroid function.
- · The high bedtime magnesium total (~550mg) is a plausible direct cause of your 110/55 and dizziness.
- · You have multiple sedating compounds stacked (valerian, GABA, L-tryptophan, magnesium, progesterone) — the combined hypotensive load is real.
The case for not abruptly stopping
- · If you've been taking it for a while, valerian and ashwagandha can have a mild discontinuation effect (poorer sleep for a few nights).
- · Sleep is critical for thyroid function too, so tanking your sleep to protect your thyroid is a trade-off worth considering.
A practical middle path to suggest to your doctor
- Drop Relax All and the standalone Valerian for 4–6 weeks.
- Retest Free T3 (with TSH and Free T4) at the end of that window.
- If sleep suffers, lean on L-theanine + magnesium alone at bedtime — without the lemon balm and valerian.
That way you isolate the variable and have data to show whether removing these actually moves your Free T3. Your next thyroid panel becomes the proof point.
Can you write up a summary of all this that I can share with my doctor?
Here's a clean summary you can copy and share ↓
The artifact
One request. Doctor-ready in seconds.
Sue asked for a summary. This is what came back — structured, dated, and framed as a professional handoff. Vin generated it verbatim from the same conversation you just read.
Patient Summary
Supplement Review for Low Blood Pressure & Dizziness
Prepared for physician review
July 2026
Presenting concern
Recurring lightheadedness with consistently low blood pressure readings (~110/55). Symptom onset correlates with current supplement and hormone regimen.
Relevant lab context (June 2026)
- · Free T3: 1.37 ng/dL (low; optimal 3.0–4.4)
- · Ferritin: 88 ng/mL (within optimal range)
- · TSH: 2.55 µIU/mL (last tested July 2023 — due for retest)
Current medications
- · Levothyroxine (as prescribed) — Free T3 conversion appears inadequate
- · Estradiol patch 0.06mg — known vasodilating effect that can lower blood pressure
Supplements under review
| Supplement | Mechanism of concern |
|---|---|
| Relax All (bedtime, 2 pills) | Contains lemon balm 100mg (blocks TSH receptor binding + inhibits thyroid peroxidase), valerian 300mg, GABA 450mg, magnesium aspartate 200mg, L-tryptophan 600mg, ashwagandha 150mg. Two thyroid-suppressing compounds + sedative/hypotensive load compounding nightly. |
| Valerian Root 300mg (bedtime, standalone) | Layered on top of the 300mg valerian in Relax All. Total nightly valerian: 600mg. |
| Magnesium Glycinate 350mg (bedtime) | Vasodilating, mild diuretic. Cumulative bedtime magnesium with Relax All's aspartate: ~550mg. |
| Triphala (bedtime, 2 capsules) | Amla content has ACE-inhibitor-like vasodilating properties; mild diuretic. |
| Spirulina 3000mg (afternoon) | Not a direct BP concern; iodine content may interfere with thyroid signaling given low Free T3. |
Cumulative concern
Two mechanisms are running in parallel and both matter. On the thyroid side: lemon balm (in Relax All) + doubled valerian (Relax All + standalone) may be actively blunting the effect of Levothyroxine while Free T3 is already well below optimal. On the BP side: Estradiol (vasodilating) + cumulative bedtime magnesium (~550mg from two sources) + GABA + L-tryptophan + Triphala + low Free T3 create a stacked hypotensive load. No single item is the sole cause — the concern is additive.
Questions for physician
- Is Levothyroxine dose optimized given Free T3 of 1.37 ng/dL? T3 conversion may be poor.
- Should TSH be retested alongside Free T3 and Free T4 for a current full picture?
- Is nightly lemon balm 100mg an active headwind on Levothyroxine — and if so, does pausing Relax All for 4–6 weeks then retesting make sense as a controlled experiment?
- Which supplements are safe to resume once BP stabilizes, and at what doses?
- Is the Estradiol patch dose contributing meaningfully to BP symptoms?
From chat to action
What Sue walked away with.
A conversation is only as useful as what happens next. Vin gave Sue an experiment she could start today, and a matching set of questions for her physician, because interventions at this scale deserve a professional's eyes.
Recommended actions now
A four-to-six week clean experiment.
-
Pause Relax All and standalone Valerian.
Removes both thyroid-suppressing compounds (lemon balm + doubled valerian) at once. The single biggest lever from the whole conversation.
-
Keep Magnesium Glycinate 350mg on its own.
Dropping Relax All removes the extra magnesium aspartate, bringing total bedtime magnesium down to a single 350mg source. Also removes GABA + L-tryptophan from the hypotensive stack.
-
Log BP twice daily for the whole window.
Morning and evening, same posture. Numi handles the trend line. Without the data, "did anything change?" is guesswork.
-
Retest Free T3, Free T4, and TSH at week 4–6.
The proof point. If Free T3 moves without any Levothyroxine dose change, the Relax All hypothesis just got real evidence behind it.
Discuss with your doctor
Five things to bring to the visit.
-
The Relax All label itself.
Lemon balm 100mg nightly on someone medicating for low thyroid is the specific thing worth flagging.
-
Is Levothyroxine optimized for Free T3 at 1.37?
T4-to-T3 conversion may be poor. TSH alone doesn't tell the full story at this T3 level.
-
Retest TSH + Free T3 + Free T4 together.
The last TSH is from 2023. A current full panel would anchor any dose decisions.
-
Is the Estradiol patch dose contributing?
The vasodilating effect is real, and worth confirming at this combination of hormones + supplements.
-
The four-to-six week experiment plan.
Pause Relax All + Valerian, retest thyroid. Get physician sign-off before starting, and a plan for what to do with the results.
What Vin actually used
Five data sources. One thread.
Full lab panel history
Free T3 (June 2026), Total T3 (July 2025), TSH (July 2023) — Vin surfaced the trajectory across three years, not just the latest number.
Recent BP + vitals
110/55 wasn't a one-off — it was a consistent baseline. Resting HR of 56 bpm and three wake-ups the prior night fit the low-perfusion picture.
Full active supplement stack
All 14 items on her daily schedule, grouped by time of day. Vin knew Valerian Root was on her list separately from Relax All — the doubled-dose insight came from that.
Photo of a supplement label
The pivotal turn. Vin read the ingredient panel from a photo, matched each compound against her thyroid + BP situation, and surfaced the one thing her prescriber probably didn't know was in the bottle.
The lemon balm insight would not have existed without the photo. The doubled-valerian insight would not have existed without the full schedule. The thyroid-trajectory insight would not have existed without three years of lab history. Any two of those sources on their own would have missed the pattern. This is the difference between a fitness app that shows you rings and a health app that reads your labs, your stack, and your bottles.
Your labs and your stack, in one conversation.
Numi holds your daily logs, your Apple Health data, your supplement schedule, and your lab work — then hands the whole picture to Vin. Free to try.
Not medical advice. Numi is a personal health-tracking app. Vin is an AI assistant that helps you make sense of your own data. Nothing in this case study is a diagnosis or a treatment plan — every recommendation in the physician summary was framed as a discussion point for the user's own doctor. Values shown are her real lab and vital readings, published with her explicit consent; her name has been shortened for privacy.