<s>[INST] I am 50 years old, I am diabetic and taking Levemir insulin 12 unit at night, Novonorm 2mg three times with main meals. I am taking Glucophage 1 g two times. I Have hypothyroidism I am taking eltroxin 150 microgram. Recently I noticed my pulse rate is around 135-140. I have started Novonorm two weeks back. I have hysterectomy five years back. Can you tell me what could be the reason of my high pulse rate, while my blood pressure shoots to 150/100 at times. My thyroid levels are normal with medication. Thanks [/INST] A normal heart rate is 60-100 beats/minute. It is less if you exercise and more if you don’t. Episodic rise has multiple possible causes, particularly with underlying medical problems. You have enough that the question that you ask cannot be answered quickly or easily in this forum. You should discuss these episodes with your doctor and consider having a monitor done to catch the heart rhythm. </s>