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orlamh 07-10-2009 01:08 PM

Low blood pressure with high cortisol?
Hi everyone, I'm just trying my luck here because I'm running out of ideas.

For the last 4-6 weeks, my BPs been really low, down to 80s/40s (my normal should be about 110/70). I get dizzy a lot, but can usually stop myself fainting. My doc initially thought vasovagal syncope, but my dizzyness gets worse in the evening, and in particular when I'm training. In fact, I haven't made it through a full (outdoor) training session in weeks, even though I've been on midodrine for almost two weeks. I should mention that training outdoors causes me the most trouble, and I'm wondering if the heat & humidity has anything to do with it, though I've also increased my salt intake massively and that hasn't seemed to help. I started P90X this week, and am just about managing to get through most sessions, though the cardio ones do make me quite dizzy. My HR doesn't get as high for P90X (150bpm in cardio) as it does for my outdoor training though (>170bpm).

My doc referred me to a cardiologist for the low BP and also really low resting pulse (>40 bpm in the morning). EKGs were normal (slightly short P-R interval that he was not concerned about), and he gave me a cardiac event monitor to see if I could record a fainting spell. Of course, the next time I trained, I fainted, and I sent in the results. He said my heart rate was surprisingly high during the syncopy (around 185bpm I think), but the EKG pattern itself looked normal. They also did an echo which was normal. He put me on midodrine to get my BP up, and it's working ok for day-to-day activities, but I still can't train through a full session.

My regular doc ran bloods for me, and I'm the picture of health in everything (renal, liver (she actually thought I was a non-drinker :D), thyroid), except my cortisol was high. Does anyone know what this might mean, or how it would relate to having low BP, because I was expecting my cortisol to be down... She has ruled out Cushings because I don't have abdominal weight gain (though my hair has been falling out wayyyy more than normal lately), and thinks the whole thing may just be stress. But should that not raise my BP rather than lower it?

If anyone has any ideas, I'd really appreciate it. I'm getting very frustrated about feeling so tired and dizzy all the time, unable to concentrate at work etc. Sometimes it's so bad, I feel like I can't drive, cos I'm afraid I'll pass out at the wheel, or at the very least I know my reactions are majorly slowed when I'm like this.


zuzu8 07-10-2009 02:52 PM

Re: Low blood pressure with high cortisol?
Hi Orlamh,

What an ordeal you are going through!
Seems like you've had an enormous amount of tests and there's still a lot of head scratching.

Having exhausted any new ideas from both cardiologist and GP, with high cortisol, I would now take myself to an endocrinologist. Even though your GP has ruled out Cushing's, it doesn't always follow that weight gain is a "must have" sign.

Not that I'm saying you have Cushing's but endos are the experts when it comes to knowledge of our hormones, cortisol of course being one of them.
Worth a shot, don't you think?


sertorius 02-15-2010 06:10 PM

Re: Low blood pressure with high cortisol?
have you solved your problem?
what was the cause?

bbiker 06-24-2011 02:52 AM

Re: Low blood pressure with high cortisol?
My husband has just found out that he has high cortisol levels and his blood pressure has been running extremely low for the last couple of months. Before that his blood pressure was perfect, even though he has had to have bypass surgery in 2002 and stents in 2003. We found out that he has kidney disease last fall and he was put on lisinipril, he was already on Norvasc, but not for blood pressure. He was on it for spasms of the coronary artery. He also was fount to have an elevated PSA (no cancer) and his doctor increased his Flomax from 0.4 to 0.8 mg. About the time the Flomax was increased was when his blood pressure went to nothing. Once, when I took his pressure it was 76/52. He is 6ft. an 69 yrs. old. We are like the other person. If anyone has any ideas, please help. He feels terrible, no energy. He can barely make it through the day.

momomroma 07-26-2011 06:11 AM

Re: Low blood pressure with high cortisol?
My daughter is a nineteen year-old very healthy fit girl. She is a college soccer player and has been experiencing many of the symptoms that you are having. We have gone through all the cardiac diagnostic testing (even the tilt table test) and she passed with flying colors. We have been seeing the endocrinologist and so far everything is good except that her cortisol levels are elevated. We are in the process of a 24 hr urine test with her to rule out cushings. She too is slender and does not have a weight problem. Unfortunately she tore her ACL about two weeks ago and is no longer working out so her episodes have not been as bad. We have an appointment with the nephrologist August 11th. I would like him to do a CAT scan of her adrenal glands to make sure there is nothing growing on them. Through my research (I am a teacher, not in the medical field so take from where it is coming from), I have found all of her symptoms keep leading me back to the adrenals. I would love to hear how you made out with your doctors.

kspseudolayman 08-04-2011 07:26 PM

Re: Low blood pressure with high cortisol?
Hi, sounds like we're in the same boat. My daughter has many of the same symptoms.She is a 19 year old ex soccer player and current college student with high cortisol (25) high aldosterone (30) Normal renin (3.90) and low blood pressure 95/57 with extreme fatigue and dizzyness upon standing. Endocrinologist doesn't know what to make of the contradictory symptoms. Have you been able to determine anything yet??

We are pursuing an integrative medicine Dr. in Los Angeles but are still waiting to get in (15 month wait list) but will post if we find anything out.

All our best!

momomroma 08-05-2011 06:21 AM

Re: Low blood pressure with high cortisol?
Please keep me posted. It does sound similar however, my daughter's adolsterone is normal (5.5) and actually after doing a 24 urine on her to re-test her cortisol, it came back within the normal range. (I haven't seen the results yet, just got a call from the doctor.) How is your daughter's ACTH level? Did they do a cat scan on her adrenals? Just through my research on the computer I found that was going to be my next step if the cortisol came back high. Benign tumors can form on the adrenal glands that cause the adrenals to over produce. They are removed and most of the time everything goes back to normal according to what I have found. My daughter tore her ACL in her left knee so she had to stop working out. Since she has stopped working out the blood pressure has increased and she is feeling a little better but we will continue to search for whatever is causing this. Please keep me posted and best of luck to finding the answer.

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