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I'm on Metoprolol 25 mg bid and losartan 25 mg daily if I go…

Customer Question
I'm on Metoprolol 25...

I'm on Metoprolol 25 mg bid and losartan 25 mg daily if I go for a walk my bp goes high to 160 to 170/90 he 100 with slight headache

Doctor's Assistant: Is the headache episodic or daily? And what about nausea?

No nausea but I have mild sleep apnea and I have mouthguard

Doctor's Assistant: Anything else in your medical history you think the doctor should know?

High chol,osteoarthritis I was in ER 3x this yr in feb my bp reach 224/113 they say it was hypertensive crisis, the 2 last visit anxiety attack I had echo done on March and it was neg.Imalways cold at night and always with fatigue

Submitted: 6 months ago.Category: Health
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Answered in 3 minutes by:
12/23/2017
Health Professional: Dr. Arun Phophalia, Doctor (MD) replied 6 months ago
Dr. Arun Phophalia
Dr. Arun Phophalia, Doctor (MD)
Category: Health
Satisfied Customers: 38,760
Experience: MBBS, MS (General Surgery), Fellowship in Sports Medicine
Verified

Welcome to Just Answer.
Answers here are for education and information.
I will respond shortly with an answer, or further information request.

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Health Professional: Dr. Arun Phophalia, Doctor (MD) replied 6 months ago

What is your age?

Were you investigated for fatigue and being cold in night?

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Health Professional: Dr. Arun Phophalia, Doctor (MD) replied 6 months ago

It seems that you are offline, so I am writing you the initial answer. Once you are online, you may ask follow up questions.

The dietary and other helpful measures for high blood pressure are;

1) weight loss,

2) sodium reduction,

3) stress management,

4) nutritional supplement interventions of calcium, magnesium, potassium and fish oil.

5) light physical exercise like walking.

6) yoga

7) meditation

8) breathing exercises

9) relaxation exercises

10) stop if you; smoke, drink only in moderation

You may try following, which lower the blood pressure (available without prescription);

1) Garlic

2) Fish oil

3) Herb Hawthorn

4) Coenzyme Q10 (CoQ10)

Following also is advised:

a) Patients with the hypertension do need to restrict table salt which is considered as a prime regulator of the blood pressure. It is advised to reduce sodium intake to no more than 2.4 g sodium or 6 g sodium chloride per day. It is also advised that adequate intake of dietary potassium (approximately 90 mmol/d), helps in reducing the blood pressure.

b) Following dietary and nutrition measure are strongly recommended to bring down the blood pressure;

A diet rich in fruits, vegetables, and low-fat dairy products may lower blood pressure by 10-16 mm Hg.
Oral potassium supplement may lower both systolic and diastolic pressure. Calcium and magnesium supplements, too, decrease the in blood pressure.
Low alcohol consumption lowers the blood pressure.
Stop smoking, if you do and reducing intake of dietary saturated fat and cholesterol benefits tremendously in overall cardiovascular health.

Following causes should be investigated for chronic fatigue and being cold at night;

Thyroid disease

Connective tissue diseases

Chronic anemia

Neoplastic disease

Chronic infections like Epstein Barr virus

Endocrine diseases (Addison disease).

Chronic fatigue syndrome

Myasthenia Gravis.

You would need following investigations:

Complete blood count (CBC)

Liver function tests

Thyroid function tests

Erythrocyte sedimentation rate (ESR)

Serum electrolyte level measurement

Immunoglobulin M (IgM)/immunoglobulin G (IgG) coxsackievirus B titer

IgM/IgG human herpesvirus 6 (HHV-6) titer

IgM/IgG C pneumoniae titer

Autoimmune panel

Anemia panel.

Other causes of fatigue may also be considered;

1) Recurring episodes of weakness should raise the question of periodic paralysis.

2) Weakness exacerbated by effort and relieved by rest is characteristic of myasthenia gravis.

3) Proximal muscle weakness suggests a myopathy, whereas distal muscle weakness is more consistent with a peripheral neuropathy or pyramidal tract disorder. Myopathy would be detected by a blood test creatinine kinase.

4) Recurring episodes of apprehension, tremulousness, and palpitations are seen with generalized anxiety.

5) Weakness or fatigue that occur only after work, fasting, or insufficient sleep are most likely explained by normal physiologic mechanisms.

6) All prescription and over-the-counter medications should be considered. Frequently used medications such as antihypertensives, sedative-hypnotics, antidepressants, tranquilizers, and antihistamines are common causes of fatigue.

Your medicine doses may also be increased for proper regulation of the blood pressure.

Please feel free for your follow up questions.

I would be happy to assist you further, if you need any more information.

Thanks for using Just Answer.

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Health Professional: Dr. Arun Phophalia, Doctor (MD) replied 6 months ago

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