Low Blood Pressure

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Low Blood Pressure

Postby captex » Tue Jun 12, 2012 5:53 am

I'm not having a "crisis" but I get alot of low pressure events at night. Last night it dropped to 84/54. I drank water and took 2.5mg of Prednisone and it slowly started to go back up after 30 minutes and got back to normal in 2 couple of hours. My wife made me leave the cuff on and she checked it while I slept. I woke up because I have Sleep Apnea and Desaturations will normally wake me up.

How long does it take to stabilize Addison's? I also have High Blood Pressure and I am adjusting those meds too.
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Re: Low Blood Pressure

Postby gkardel » Tue Jun 12, 2012 9:15 am

Have you had your sodium, potassium, and renin levels checked? You may need to replace aldosterone which is a mineralcorticoid hormone produced by the adrenal gland and controls sodium retention and potassium excretion. Prednisone has little mineralcorticoid component. Aldosterone is replaced by fludrocortisone medication.

Two main types of adrenal insufficiency exist: primary and secondary. Main cause of primary adrenal insufficiency is immune system attacking the adrenal cortex. Secondary is usually caused by exogenous steroid therapy. In primary, usually both cortisol and aldosterone need to be replaced. In seconday usually only cortisol needs to be replaced. Here's an article on adrenal insufficiency and rheumatoid arthritis:
http://www.ncbi.nlm.nih.gov/pubmed/12114253

Your endo has some work to do.

-Glenn
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Re: Low Blood Pressure

Postby captex » Tue Jun 12, 2012 1:39 pm

I agree Glenn, I get to see him tomorrow and go over all the Labwork and the plan that he has for me. I have alot of issues and he is aware of all of them. They are all Auto-Immune with the exception of Sleep Apnea.

Last night my BP dropped as I mentioned despite me cutting my dose of Losartan in half. After reading more about Losartan, I see that it is Losartan Potassium. So adding potassium may not be smart. I also read about the side effects and that seem to indicate a contradiction with Addison's Disease.

I'll ask about it too.
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Re: Low Blood Pressure

Postby NJ » Wed Jun 13, 2012 5:24 am

ACE or Angiotensin II hibitors are not good for an Addison's patient. They do raise potassium. I took an angiotensin II for a long time before realizing it was really complicating my Addison's. I knew another Addisonian who had the same experience...
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Re: Low Blood Pressure

Postby captex » Fri Jun 15, 2012 3:48 am

NJ wrote:ACE or Angiotensin II hibitors are not good for an Addison's patient. They do raise potassium. I took an angiotensin II for a long time before realizing it was really complicating my Addison's. I knew another Addisonian who had the same experience...


I will be seeing my Cardio soon and I'll discuss it. I was switch from Prednisone to Hydrocortisone at my insistance and I've noticed that I feel much better and the side effects are less noticeable.
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Re: Low Blood Pressure

Postby Wanda » Mon Jul 16, 2012 7:28 pm

It may help your low BP if you adjust the timing/amount of the HC. How much and when do you take it?

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Re: Low Blood Pressure

Postby captex » Tue Jul 17, 2012 6:12 am

I take 20mg of HC at 6:30AM and 10mg at 5pm. Stress dosing as needed.
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Re: Low Blood Pressure

Postby Wanda » Thu Jul 19, 2012 9:56 am

Taking 20mg will really cause your BS to go way too high. It is much easier on us to take at least 3 doses daily. I don't like to take more than 10mg at a time unless sick and stress dosing. Also taking your doses so far apart leaves you with low cortisol for a good share of the day. HC does not last in the system all day. There is a chance this is causing the lower BP at night. We never know what will help until we experiment.

You could try splitting your dose differently.....

15mg 6:30am
10mg 11:00am
5mg 5:00pm

If I experienced the low BP at night I would take 5mg immediately, to bring it up. You need your electrolytes checked to see if you might need florinef even tho you are secondary.
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