electrolyte question - High & Low Blood Pressure Message Board

ramonamom · 06-22-2007, 03:07 PM

This is kind of a long question - sorry! I have hard-to-control HTN and, until last week, was on all classifications of BP meds except diuretic. I had been taken off of diuretics a couple of years ago when I ended up in the hospital with very low electrolytes. Since my bp was out of control again, they changed my Cozaar to Hyzaar, which contains HCTZ. I am only on 12.5 of the HCTZ, but am having what I believe may be electrolyte problems already (started taking it on the 20th - only three doses so far). I have a real hard time believing it could be that so quickly, though.

My symptoms are weakness, fatigue, nausea. After lunch today my legs would hardly move because they were weak. This is not due to low bp, as my readings are still in the 130's/90's mostly (down from 140's-160's/90's-100's). These symptoms do seem to come and go in severity.

I also take potassium supplements, prescription strength (30 meq) and OTC magnesium supplements (never got that back up after the stay in the hospital, so they sent me home on supplements). I am diabetic and have a neurological disorder called dystonia. I had three surgeries for the dystonia in late April/early May but have fully recovered from those.

On my last lab reports, my sodium level was at the low end of normal - 136. Is it possible for me to be having electrolyte problems this quickly on such a low dose of HCTZ?!

Thanks!
Ramona

bethsheba · 06-22-2007, 05:06 PM

ramonamom,

I'm no expert on electrolyte problems, but I can say that the year I was on hydrochlorothiazide, I experienced every side effect in the book...fatigue was a biggee. No matter what the reason, I would suggest you contact your pharmacist and your doctor regarding these changes immediately, because although they come and go as side effects often do, they may also get worse.

Bsheba

Lenin · 06-23-2007, 06:52 AM

Ramona,
If you started with a sodium level of 136 (lowish normal) I imagine it is CONCEIVABLE that 3 x 12.5 mg. of HCTZ could cause you to drop into the abnormal range...After YEARS of 50mg./day, I got well into the 120's on a regular basis. BUT, I think it's highly unlikely.

WHY are you taking 30 Meq. of potassium along with a potassium sparing diuretic (the ARB class?) How long have you been taking that high dose K+ supplement <about 1200 mg.>?
What drugs are you taking for the dystonia? Klonopin?
Do you exhibit edema?

(I'm thrashing about here trying to get a handle on your situation.

)

IF HCTZ is not a good option for whatever reason, you could try Lasix, anther diuretic with a COMPLETELY diifferent method of operation. That's what I did so that I could get my perenniallly low sodium in line...it's fine now!

ramonamom · 06-26-2007, 03:15 PM

Lenin - some good questions there. I have been on potassium supplements for years, since I was found to have low levels on a blood test. I think they assumed it was from taking so much blood pressure medication. And, as we all seem to find out, once you get on a medication it is hard to get off of it! I have asked a number of times, but my GP is very hesitant to lower the potassium doses. My last lab level was 4.5, which is smack dab in the middle of the range. I think they just don't want to mess with what they consider "success".

My dystonia is dopamine responsive, so I take Stalevo and Sinemet for it. The surgery has helped tremendously, so I may eventually begin to come off of those.

There is something really strange going on, though. I doubt that any doctor would actually believe me about it, as matter of fact. The surgery I had was Deep Brain Stimulation surgery. They placed electrodes in my brain and neurostimulators in my chest and there is an electrical current that goes through wires that lead up my neck. I have problems with electromagnetic interference with this system, however. Oddly, when I take the diuretic, I am much more susceptible to that interference. I noticed this when I first took the Hyzaar, so I went off of it for a few days. The interference settled down, so today I tried the Hyzaar today and it has flared up. I can go back and forth like this a few times to make sure I am not imagining things or to help rule out other coincidental issues, but that appears to be what is happening. I guess it makes sense that my electrolyte balance would affect how my body reacts to electromagnetic sources, though.

Anyway, thanks for the input. I will just have to work through this and check back with my doctor. Maybe they will try the Lasix instead of the HCTZ, to see if that works.

Blessings
Ramona

famnd · 06-26-2007, 09:57 PM

Hi Ramona,

Regarding your potassium intake: are you eating a well balanced diet with enough potassium? I am wondering if you have too much potassium at the moment? Are you able to urine a normal amount of urine (urinating a normal amount seems to be one of the symptoms of hyperkalemia (too much potassium) that isn't the same for hypokalemia. It's confusing. I'm on HCTZ (25mg). I've only gotten into electrolyte problems twice because I was sick & didn't eat enough. Do you eat enough sodium? I drink 16 oz of water before meals twice a day plus juice, milk & tea. I have resistent HBP too & have taken Cozaar (severe reaction). If you ever get pain with no apparent cause in your wrist, see the Dr. immediately. This was the beginning of my drug induced Lupus reaction to Cozaar which damaged my knees & hands permanantly. Many people take cozaar without problems. I'm currently on Lebetalol 1800mg daily & HCTZ 25mg daily. Fam