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Suggest Treatment For Severe Fatigue And Depression In A Hypertensive Person
Question: I am suffering from extreme weakness,Orthostatic blood pressure, fatigue, sleeping to much, can barely put one foot in front of the other. I normally have high blood pressure, I've had to quit my blood pressure meds. My dystolic is dropping 20 points from lying to sitting, sitting to standing. My thought process is being effected. I suffer from depression since I was a teenager and take med for it. I have had to take FMLA from work. This ame on suddenly. My chest feels So heavy. I know this is vague. My family doctor is not taking me serious. I need help.
Brief Answer:
Please provide relevant drug history
Detailed Answer:
Hello, Madam.
I can certainly understand your concerns.
I can guide you better, if you disclose your medication history with regards to the depression and high blood pressure.
Thank you
Please provide relevant drug history
Detailed Answer:
Hello, Madam.
I can certainly understand your concerns.
I can guide you better, if you disclose your medication history with regards to the depression and high blood pressure.
Thank you
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
I take panel 60mg daily and have for 3yrs. Inderal 40mg I have been on for about 20yrs. I ve quit the Inderal for now under direction of my PCP. But, he's not running any test. I did get him to do a Cortisol level (fasting) but he won't order a non fasting to compare. I'm feeling weaker and I can not keep going. I'm a Registered Nurse and I need to go back to work. I'm suffering from this. And my depression is starting to creap back up. I'm feeling deeper depressed. It effecting everything in my life. To add something, my hair has began to fall out. As I wash my hair I get a handful each time. As I brush my hair I get another handful. This could be related.
Brief Answer:
Possible Orthostatic hypotension.Need further evaluation.
Detailed Answer:
Hello, Mam.
I can certainly understand your concerns.
I have worked through query in detail.
Stopping Inderal is not the solution here.
You need a thorough evaluation to assess the cause for Orthostatic hypotension and suitable medications have to be instituted. You should find another primary physician who accepts same insurance. You can ask for the following testing:
1. Serum Cortisol at 7 am and 7 pm.
2. Complete thyroid profile.
3. Quantitative Sudomotor Axon Reflex Testing (QSART) and Tilt table testing.
4. Serum electrolytes.
5. Blood Glucose estimation ,fasting and Postprandial values.
Further management if any is largely based on test results.
Antidepressant medications have to be continued meanwhile.
Update me with test results to guide you further on therapeutic grounds.
Please check with your physician if he can offer you these tests.
Post your further queries if any.
Thank you.
Possible Orthostatic hypotension.Need further evaluation.
Detailed Answer:
Hello, Mam.
I can certainly understand your concerns.
I have worked through query in detail.
Stopping Inderal is not the solution here.
You need a thorough evaluation to assess the cause for Orthostatic hypotension and suitable medications have to be instituted. You should find another primary physician who accepts same insurance. You can ask for the following testing:
1. Serum Cortisol at 7 am and 7 pm.
2. Complete thyroid profile.
3. Quantitative Sudomotor Axon Reflex Testing (QSART) and Tilt table testing.
4. Serum electrolytes.
5. Blood Glucose estimation ,fasting and Postprandial values.
Further management if any is largely based on test results.
Antidepressant medications have to be continued meanwhile.
Update me with test results to guide you further on therapeutic grounds.
Please check with your physician if he can offer you these tests.
Post your further queries if any.
Thank you.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Some of these test have been done. I don't have values, I only know that my PCP said all was in normal range. This is what has been done, fasting Cortosol, normal, complete Thyroid Panal, normal, CMP, normal ranges, fasting sugar was included on CMP and was normal. I am looking for a new PCP, have seen two other family doctors and they blew me off. Said it was stress and anxiety.
I do appreciate the help and ideas of what to have done. And I especially appreciate your time.
I will see if my PCP will do these other test.
I do appreciate the help and ideas of what to have done. And I especially appreciate your time.
I will see if my PCP will do these other test.
Brief Answer:
keep me updated
Detailed Answer:
Hello, Madam.
I can certainly understand your concerns.
Thanks for your appreciation.
Stress and Anxiety alone do not contribute to your symptoms.
Autonomic dysfunction could be a major possibility, which need confirmation or a rule out.Test No 3 can help you in this regard.
I advise you stay courageous and do not get depressed.Things will soon fall in their place for you.
Keep me updated about your health status.
Take Care.
Thank you.
keep me updated
Detailed Answer:
Hello, Madam.
I can certainly understand your concerns.
Thanks for your appreciation.
Stress and Anxiety alone do not contribute to your symptoms.
Autonomic dysfunction could be a major possibility, which need confirmation or a rule out.Test No 3 can help you in this regard.
I advise you stay courageous and do not get depressed.Things will soon fall in their place for you.
Keep me updated about your health status.
Take Care.
Thank you.
Note: For further queries related to coronary artery disease and prevention, click here.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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