Losartan Potassium and swollen ankles

Hello Mrs O,  my husband had a chest x-ray some time ago and had ECG, both were normal.  We think his heart is OK, but you never know.  We both go to the gym 3 times a week and also hill walk.  The activities don't seem to make him out of breath or weak.  He does like a lot of salt though.  I don't use salt when I am cooking so I can't reduce his intake that way, but I shall work on him to reduce how much he puts on his meals.  He drinks enough water as I make him a drink every time I have one.

What he does have however, at least that is what we think it is, is yellow nail syndrome.  His nails are a mess.  They grow from the cuticle looking normal and then start to go green and mis-shapen and eventually drop off.  Associated with this is a lung problem, some sufferers get bronchiastosis (not sure of spelling) which could be the cause of his coughing.  The only problem is, that we can't get our doctor to investigate it.  The doctor does not believe that it is yellow nail syndrome.  I am wondering whether lung disorders can give you swollen ankles.

I think my husband is going to stop taking his BP pills for a while, but keep on eye on his blood pressure, to see if it makes any difference.  At least he can rule out if it is the BP medication causing cough or swollen ankles. 

I guess we shall see.

Hello marie86421...I fully understand what you are dealing with in regards to your husband's cough. MrsO-UK Surrey is quite correct when she says the A.C.E. Inhibitor (Rampiril Lisinopril, etc.) very commonly causes cough. 

I have been taking an A.C.E. Inhibitor (Coversyl Plus HD) for 3 1/2 years now. I developed a dry cough...but it was before I stated the A.C.E. There have been just 2 healthcare people suggest to me the cause is the A.C.E., but how could that be when the cough existed before I started the meds? THAT makes no sense to me, & I won't accept that as an excuse! I have had chest x-ray..negative...gastroscopy...negative...esophogeal mannometry...all fine. I saw the General Surgeon who had these tests performed & I was advised that she didn't think a repeat gastroscopy was necessary at this time (April/2017). My cough has been going on for a few years now. It is not productive, but hard...dry. Over the last month or so, it is worse. I can hear a wheezing in my chest at times. I do not have allergies that would cause this. Should this persist, I shall visit my GP & advise him of this. He's already aware of the cough, but not aware that it has worstened yet again. I know for sure that I cough during the night because I'm half awake. Just how much I cough, I don't know. The cough can be very annoying at times because it comes on without warning...except for a very strong tickling sensation in the centre of my chest, which very quickly hits the back of my throat, then the cough hits.

I have a mind to ask my GP for a breathing test, but I can't seem to get one done here in my city because my Dr. isn't a member of their "Family Health Team". How ridiculous is that. If I must travel to the city, then so be it, but perhaps he can make a referral to the hospital. They might have a facility there, i.e.the cardio-respiratory centre..but I'm not sure if this sort of thing would be taken care of in that area. 

I also have a friend who experiences a very hard dry cough. Yes, it hurts my ears if I'm sitting next to her. One time we went out for a meal together, & I could hear her coughing all the way across the restaurant, & I can assure you, I wasn't that close to her at that time.

Hopefully we can find an answer to this mystery. Please keep us informed.

Mike, give Manuka Honey a try - it might just help to soothe the esophagus, in the absence of any other diagnosis after all your tests.

MrsO-UK Surrey...thanks!...I'll give it a go. I'm in a quandry as to what's causing this cough, especially since I was advised that everything was ok.

Surely there must be other tests that can determine just 'why' I'm experiencing this cough. 

I don't know if Manuka Honey is available here in Canada, but it's worth the hunt to find out. Thanks again!!!!!

Ash! He definitely needs to cut the salt which will definitely help to reduce the fluid build-up around his ankles, and then put his feet up quite high every time he sits down. I know someone who was diagnosed with bronchiostasis after loads of other stuff was ruled out. Not quite sure what her treatment is though but whatever it is she is finally doing well.

I'm sure it's available almost everywhere, Mike - it comes from the Australian Manila bush. Ensure you get one with guaranteed bacterial activity though - look out for the symbol UMF on the jar. A warning though, it is very expensive! Even if the cough started before the ACE, I bet the ACE is aggravating it. Has asthma been ruled out?

Hello Mike,  just read out your post to my husband and he seems to think that his cough started before the meds.  The cough can be dry and tickly but at other times it can be phlegmy sounding but not productive.  I have noticed a wheezing sometimes with it too.  The last time we mentioned it to our doctor, she listened to his chest and told us that everything sounded fine to her.  End of story.  I am not sure what tests he needs, and the other problem I have is getting him to the doctors to get it sorted.  He does not want to be sitting for hours in hospitals waiting for tests.  It does not help that he is not the one bothered by it, but I am sure it is slowly sending me mad!

I just don't think anyone should have to cough so much and so hard.  The one thing that worries me is that he might burst a blood vessel, the coughing is so hard.  Listening to him at night, it only takes one cough and then it triggers this coughing session which lasts for ages until he can get it under control, usually by going to take some cough medicine to soothe his throat. 

Someone has suggested that it might be post nasal drip or chronic rhinitus, both of which don't seem to have a cure.

I would like it if my husband could be referred to a dermatologist to see if his nail condition is from a lung condition not yet diagnosed, but it is trying to convince him to push his GP for the referral.

I shall keep you all posted.

Hi MrsO-UK Surrey...The last time I had a test for breathing..I think it's called a spirometry..was about 3 years ago. As I mentioned in a previous statement, my Doctor wanted me to have a more up to date test, but the "Family Health Team" here in my city said it cant be done there because my Dr. is not a member, because he's not located in this city. I would have to travel 1 1/2 hrs. to Toronto to have the test. I'll be seeing my Dr. in the next month or so, then will certainly tell him the cough is worse than ever. 

To answer your question, as far as I know, I do not have asthma. At least not when I had that first breathing test. I passed that test no problem.

You also could be right...that the ACE may be aggravating things. I do hate to switch meds at this stage of the game though..I'm used to them, & if it gets closer to Jan. before I see the Dr., my travel insurance will consider the switch in meds to be that the reason for taking them is not stable. Those travel insurances are nothing but legal robberies.

Sorry - "Manila" should, of course, read "Manuka"!

Oh Mike, I so agree about travel insurance.  Having booked a special celebratory cruise and paid the deposit recently, I then found I couldn't get insurance cover from anywhere because I was waiting for an exploratory procedure.  That, and the results, took weeks and, after the cruise company put back the final payment three times for us, we finally had to take a chance and pay two-thirds of the whole holiday cost just before me getting the all-clear and being able to get insurance cover.  Cost an arm and a leg, too!

MrsO-UK Surrey...the news about that pill is GREAT news! As you might remember, I too suffer from chronic cough, which was being blamed on the ACE inhibitors that I'm taking, but I had the cough, although not as bad, before I started taking the ACEs. As of the past week or so, the cough is worse. A 37% reduction in coughing isn't a lot, but if I were to fall into that 37%, I'd be happy. Did the article state just how long a person must take the tablets? Yes, the chronic coughs can be caused by infections or asthma, the theory is that those affected have hypersensitive nerves. I don't have infection or asthma, but certainly, I'm dealing with a nerve issue. Has this pill been released to the market. 

I do wonder because what becomes available to say Britain, may not be available in Canada.

Mike. as I mentioned, although one trial has been carried out, a larger trial is planned by the drug company, Merck.  As we all know, these trials can take an eternity to get underway and even longer for the results to become available.  Still worth keeping your eye out for any mention on your Canadian health service sites though, remembering that this seems to be something taking place in America rather than here in the UK.  The best news would be that it became a multi-centre study in which case patients would be invited to take part in many different countries.  Still it's good to hear that at least they are taking notice that there is such a thing as a cough that exists in some patients without any apparent cause or therefore a cure, and especially that research is taking place.  I'm no medic but I would think that once a cough takes hold for whatever reason, then the nerves become ultra sensitive and hence the cough continues.  As I said, it might be an idea to keep your eyes and ears open,,,,,,and fingers crossed for a cure for you and people like you! 

That's interesting.  I shall have to keep an eye on that and see what happens.   Thanks for the info.

Hi MrsO-UK Surrey...well, I finally had the spirometry test at the end of January. I passed no problem, however the Respirologist wants me to have the 'golden standard' test to confirm or rule out asthma. The test itself is available within reasonable time, but the Dr. wasn't. So, from the end of January to June 25th, that's a 5 month wait to have a test where they have me use a few puffers. If I have a heavy sensation in my chest or breathing is harder, that will confirm asthma. 5 months!!! My GP didn't say anything when I told him (they're not permitted to), but he did turn his nose up which told me the 5 months was ridiculous. I still have the cough...but I also have GERD. I see a Gastroenterologist next week. I'm fed up with pills...want the problem fixed. It amazes me how doctors know which meds to ease or control problems, but they can't cure it. I had esophageal manometry 2 yrs ago..normal...endoscopy 2 1/2 yrs ago..normal. So what's going on now that's causing the cough & acid reflux? I know things can change in the lengths of times I've mentioned. I'm a layman...surely Drs. should know better! My GP has me taking prescription strength Tecta...but I have to take it EVERY day or I'll have a reflux attack like you wouldn't believe. We did try every-other-day but without success, so my GP said to stay on the pills every day because it's just next week I see the Gastroenterologist. The beat goes on!

I haven't heard anything about the pill you mentioned several months ago. There are days when I cough more than others. Some days I hardly cough at all..other days it's very frequent. Some days it's very dry, while there seems like there's liquid at other days.I also have a wheeze at times. I'm truly fed up with it all. 

I'm not at all surprised you are "fed up with it all", Mike.  Five months wait for an appointment after all this time is excessive especially when it involves something as simple as puffers, and even more especially as this appointment is, hopefully, to either confirm or rule out asthma.  If confirmed, then there is appropriate treatment to get you out of misery.  I suppose the medication you take for the GERD has been ruled out as a possible reason for the cough?  I'm not familiar with Tecta - Ranitidine is supposed to be one of the more harmless reflux treatments. Stick with it, Mike, but if it gets worse then do ring and make sure they know you are happy to take any last-minute cancelled appointment.

Hello Mike and Mrs O

Since my first post my husband stopped taking the Losartan tablets and monitored his blood pressure for several weeks.  His blood pressure remained normal and when he went to have his review for blood pressure with the doctor, it was agreed that he did not need to take them anymore.  It has been several months now and probably enough time to see if his cough and swollen ankles would have shown any improvement.  He still has the cough, although it is not as bad, and his ankles are still very swollen.  The doctor tells us that the swollen ankles is due to valves in his leg veins being weak which is causing blood to pool around the ankles.

As far as the cough is concerned, my husband has been referred to an ear, nose and throat specialist and the appointment is this month.  On the appointment letter it states that he might have to have a small camera inserted into his nose to view his nasal passages and sinuses.  He has had nasal polyps in the past, so wondering if he could have that problem again, although his cough was still there when he was treated for it.

I shall let you know how he gets on and what the consultant suggests.

Marie

Hi marie86421. Thanks for the info! It hasn't been suggested to me that I have a scope where a camera is inserted into my nose. My problem at the moment is GERD & I'm told that GERD can cause a nagging cough...but also, a Respirologist is having me tested for Asthma. I have passed the spirometry testing, but now must go through something that's called the 'golden' test to confirm or rule out Asthma. Go figure..I had the spirometry test at the end of Jan. but can't have the other test 'til June 13..because the same Dr. is not available 'til that time. So, I would have a total of 5 months wait where if I do have asthma, it has had the chance to worsen now that the damp weather is upon us.

I also have a Gastroenterologist appt. next week because of the GERD. I'm sure he'll want to do an endoscopy to find out wha'ts going on. 2 1/2 yrs ago I had endoscopy..normal results. Then in July/2016 I had esophageal manometry...normal results..but this time has gone by & in my mind, just because those tests were normal, doesn't mean that something hasn't changed since then. I'm at wit's end with it all. Meds are all fine & good, but it reaches a point where one wants to say..."enough meds...just fix it". Yes, I'd go through surgery if necessary rather than taking more pills. Hell, I take 4 meds for bp., 2 tabs/daily of potassium chloride, 3,000 I/U vitamin D...3,000 I/U/week of B12, & 1 Tecta pill. My wife has said...'you take enough meds...no more".

Sorry to rant...but one does reach the end of the perverbial rope. Hope things continue to improve for you!!!

Hi Mike

I know exactly what you mean with regards to getting the problems fixed instead of just giving you something to alieviate the symptoms.  Had a similar problem with getting things sorted for my own health problems.  What is the point of keep medicating?  Why not find out what is causing the problem and fix it? 

I had acid reflux for a while and had the endoscopy procedure.  Nothing sinister was going on and all was normal but I took Ranitidine for a while.  That medication did not work for me and I was given Omeprazole which worked a treat.   The only problem with that one is that it makes your bones weak and I had to take a calcium supplement to counteract the side effect.  My acid reflux did go away eventually but it took a while.  Do you think it could be something that you are eating or drinking irritating your stomach?

Good luck with your appointment next week.  Let us know how you get on.

Marie

marie86421...Hello again.

I am taking Omeprazole, & it's also known as Tecta. I've been on it several months now. I honestly don't know if there's anything I'm eating or drinking that could be irritating my stomach. I don't eat fried foods, very rarely eat red meat.,don't eat onions, rarely have anything with tomatoes in it., etc.etc. I do drink a lot of water. Just 1 cup of coffee (12oz) black no milk or sugar per day.Tea?  I'll have 1 cup, same measurement, but with a little skim milk..no sugar. I will not give up my morning coffee!!! lol

I carry Gaviscon tablets wherever I go, along with water. I do find that cool water will ease the pain of the heartburn. As soon as I feel it happening, I'll go get a bottle of water, & take a few big gulps. I get almost instant relief. If I feel it starting right after I have a drink of water, I'll drink more, & that kills it.

Originally, if I were to chew on 1 Gaviscon...I got relief. Now I find that 1 isn't good enough...I need 2.

I really do need for the medical profession to get to the bottom of my problem. I'm fed up with it all.

Thanks for your note.I do appreciate the support.

Hi marie im with losartan almost 2 weeks from now i experience swollen ankles and joint and leg cramps to and anxiety i tried not taking the meds for 2 days i felt great no side effects.. just want to ask did you wean off the meds or just stop taking losartan that day.

Hi Anthony

My husband stopped taking them straight away and did not wean himself off of them.  Interestingly, the swelling in his ankles and lower legs remained until just recently, when he had to take some prednisolone for an unrelated disorder and this seemed to reduce the ankle and leg swelling. 

Hi Mike

My husband has now seen the ENT specialist who put a camera scope up his nose and diagnosed nasal polyps.  He also checked the back of his throat as sometimes they can appear there!  He prescribed NeilMed (a saline solution) to flush the nasal passages before using Flixonase to eradicate the polyps.  Well, I can tell you that the Flixonase has escalated my husband's cough to a new dimension.  It is now much much worse and we thought we were going to have to take him to the Accident and Emergency to get him to stop coughing.  On the leaflet that comes with the medication it does say that there could be an allergic reaction, coughing, shortness of breath and wheezing.  We contacted the hospital and the consultant actually denied that it could cause coughing and told us to go back to our doctor as something else must be going on.  Needless to say, he has stopped using the Flixonase for the time being.

Returned to the doctor and told her what we had been told by the hospital and she said that coughs can be notoriously difficult to resolve.  Not what we wanted to hear.  My husband is now on the to and fro wheel trying out different things to see what works to resolve the cough.  She has given him a nasal spray and lo and behold it makes him cough.  She has also given him Lansoprozole similar to Omeprazole just in case it is a silent acid reflux.  We don't think it is that but we are going with the flow.  She did suggest taking a codeine based syrup which we can purchase over the counter and not have a prescription for.  It is called Phalcodeine.  She said that this would sooth the throat and stop the need to cough.  Once the course of Lansoprozole has finished my husband will try it.

We think that there is something going on with his chest and shall return to the doctor to ask for a referral to a chest specialist.  We live in hope that we can eventually kill this cough.

I hope you are getting better results than we are.

Thanks for the info marie. Nice to know that your husband ankle swelling is gone.. by the way is he raking any bp meds now or you choose to have it natural way

By making some lifestyle changes he has managed to keep his blood pressure at a level that does not need medication anymore.  He has reduced salt intake, lost weight and goes to the gym at least three times a week.

Wow great nice to here that it went well. This boost my self confidence about my case just have my complete lab test a while ago its all normal and i think its the anxiety is the one that causing my bp to rise up. I will talk to my dr tom and will show her my result and ask for a natural remedies hope it will all went well and all of us will be cured.

I hope you manage to find something that works for you.  I think anxiety can cause all sorts of problems.

 

hi marie ..its my 7th day without bp med i remove them and i feel much better my bp will range 110-125/70-85. i do dash diet and exercise i eat lots of veggies and fish and fruit and drinking water with lemon. but i still feel some side effect but not as bad when im taking the meds. still wondering how long will this side effect will be out of my system.. hope we all get better soon.

Hi Anthony

I don't know how long it takes for blood pressure medication to leave your body once you have stopped taking it.  My sister had the same problem and she said that it took at least 7 days for her to stop coughing.

I too hope that we all get better soon.

Best wishes

its may 9th day without bp meds still feel fine except for a little dizziness after meal.. im still on dash diet low sodium and sugar more fruits and water. a little exercise brisk walking and i can do 20 push up but i feel dizzy after hehehe.