Pmr and low diastolic blood pressure?
Posted , 8 users are following.
saw gp today who treats my pmr. my blood pressure was 120/60. usually its around 120/70ish or so. nurse said no problem with diastolic reading of 60 if im not having symptoms, like fatigue, she said. well...yes, im having fatigue, lots of it, from the pmr/pred. (im at 5 1/2 mg pred, got pmr 09/16).
so here is my question: anybody have low diastolic bp along the pmr/pred/fatigue journey or is this something else for me to worry about? also, 10 years ago a doctor noticed that my diastolic blood pressure was lower as soon as i SAT DOWN--she had a name for it, which ive forgotten. "wait 5 minutes, have the nurse take your bp again, it should come back up," she said. i always used to do that and sure enough, it came right back up. then the whole issue seemed to disappear altogether and my readings were normal. until today but i forgot all about asking the nurse to retake my bp.
would like to know whether anyone else has experienced low diastolic bp along with their fatigue. thanks,
0 likes, 6 replies
ptolemy Twopies
Posted
I have had grinding fatigue at 5mg. My blood pressure has been quite low, I think the lowest diastolic was 48. The fatigue seems to be improving, so I put it down to the adrenal glands not liking the idea of working again after their holiday. I have my own BP monitor so I can check my BP when I like. My diastolic is now normally in the 60s although it does occasionally drop down into the 50s. I have actually had low blood pressure most of my life on the other hand.
Twopies ptolemy
Posted
thank you, that helps ALOT! i dont feel so alone. (i too have grinding fatigue at 5 1/2, some days worse than others but always there.) i always had bp of 90/60, now that you mention it--up until last few years when its been more "normal" 120/70ish. forgot all about lifelong history of 90/60. im feeling a whole bunch better, i think.
ptolemy Twopies
Posted
It is nice to know I am not the only one too.
EileenH Twopies
Posted
One consequence of poor adrenal function is low BP. And fatigue at lower doses of pred is a sign that your adrenal function is still dodgy. The slower you reduce from this point the better chance your adrenal function has of keeping up. It will come right for most people but you need patience and not to panic and go back up the dose if you can possibly help. One lady says she was desperately fatigued from about 6.5 to 3.5 and then suddenly the fatigue cleared and she was fine. Everyone is different though - your figures may be very different.
BettyE EileenH
Posted
"One consequence of poor adrenal function is low BP."
Does the opposite apply, Eileen?
While on pred my BP was always high and I often felt hyper at the higher doses. I remember remarking to my GP that I felt as though I had too much adrenalin but he mad no comment.
Recent BP tests show 135/78 which doesn't seem to bother anyone. No medication ever suggested, thank goodness.
EileenH BettyE
Posted
Pred does commonly increase BP yes. Part of the reason is that corticosteroids cause fluid retention which in itself leads to an increase in BP. It is due to sodium retention - one of the general causes of high BP is too much salt in the diet. Mescape says:
"All corticosteroid drugs, including prednisone, can cause sodium retention, resulting in dose-related fluid retention.[19] Corticosteroids with strong mineralocorticoid effects, such as fludrocortisone and hydrocortisone, produce the greatest amount of fluid retention. However, some corticosteroids that lack significant mineralocorticoid activity (e.g., dexamethasone, triamcinolone, betamethasone) may produce minor fluid retention.[20] Corticosteroid-induced fluid retention can be severe enough to cause hypertension, and patients with preexisting hypertension may develop a worsening of blood pressure control when these drugs are initiated. The principal mechanism of corticosteroid- induced hypertension is the overstimula- tion of the mineralocorticoid receptor, resulting in sodium retention in the kidney. This results in volume expansion and a subsequent increase in blood pressure. Corticosteroid-induced hypertension may respond to diuretic therapy.[21] The smallest effective dose and shortest duration of steroid therapy should be used in order to decrease the development of this adverse effect."
We know it does it, we don't really know HOW it does it though other than the sodium-induced fluid-retention aspect. There are several factors involved - we do know that!
https://www.ncbi.nlm.nih.gov/pubmed/8829818