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What Do Fluctuating Blood Pressure Readings Indicate?
Question: My husband has been having fluctuating blood pressure for about 3 weeks going as high as 170/122 to as low as 87/53. High at night and low in the mornings. He had bloodwork done and his testosterone level was over 3000 and his TSH was high as well. They are doing an MRI of the pituitary gland tomorrow. I'm a nervous wreck. Any suggestions on what else we can do if the MRI is negative?
Brief Answer:
Hormone tests
Detailed Answer:
Sorry to learn about your husband's oscillating blood pressure.
His testosterone levels seem considerably elevated but this is best interpreted in light of the normal range provided on the laboratory report. The TSH will need further investigation as outlined below too.
The Blood pressure swings merit a different evaluation. Some preliminary tests are warranted as mentioned below.
MRI is not typically the best first step in general.
When I see someone like him in my practice, I typically order the following blood tests in addition to a detailed physical examination:
CBC (Complete Blood Count, also known as Hemogram; includes Hemoglobin, WBC and Platelet counts)
Electrolytes (Sodium and Potassium in particular)
HbA1c (Glycosylated Hemoglobin = your last 3 months' glucose average). Also known by other names such as GlycoHemoglobin or Glycated Hemoglobin or A1c
Liver function tests (SGOT , SGPT, Albumin, Bilirubin, Alkaline Phosphatase)
Kidney function tests (BUN, Creatinine)
TSH (checks your thyroid)
Free T4 (this too checks your thyroid) 12 hour Fasting Lipid profile
IGF1
Midnight Salivary Cortisol
ARR (Aldosterone Renin Ratio)
Serum calcium
FSH
LH
Total Testosterone (repeat at 9 am)
25 hydroxy Vitamin D levels (ideal range 40 to 60 ng/ml = 100 to 150 nmol/liter)
Correct diagnosis and treatment requires the opportunity to examine the patient so you must see an endocrinologist in-person.
Hormone tests
Detailed Answer:
Sorry to learn about your husband's oscillating blood pressure.
His testosterone levels seem considerably elevated but this is best interpreted in light of the normal range provided on the laboratory report. The TSH will need further investigation as outlined below too.
The Blood pressure swings merit a different evaluation. Some preliminary tests are warranted as mentioned below.
MRI is not typically the best first step in general.
When I see someone like him in my practice, I typically order the following blood tests in addition to a detailed physical examination:
CBC (Complete Blood Count, also known as Hemogram; includes Hemoglobin, WBC and Platelet counts)
Electrolytes (Sodium and Potassium in particular)
HbA1c (Glycosylated Hemoglobin = your last 3 months' glucose average). Also known by other names such as GlycoHemoglobin or Glycated Hemoglobin or A1c
Liver function tests (SGOT , SGPT, Albumin, Bilirubin, Alkaline Phosphatase)
Kidney function tests (BUN, Creatinine)
TSH (checks your thyroid)
Free T4 (this too checks your thyroid) 12 hour Fasting Lipid profile
IGF1
Midnight Salivary Cortisol
ARR (Aldosterone Renin Ratio)
Serum calcium
FSH
LH
Total Testosterone (repeat at 9 am)
25 hydroxy Vitamin D levels (ideal range 40 to 60 ng/ml = 100 to 150 nmol/liter)
Correct diagnosis and treatment requires the opportunity to examine the patient so you must see an endocrinologist in-person.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
He had several blood tests done first. They did some tests for tumor markers. I have all of those i just dont know exactly what they mean. All i understand this far is that after running alot of bloodwork and his primary doctor consulting with the endocrinologist here in our town the mri is the next step they have chosen. Is this fluctuating blood preasure causing permanent damage to hos heart?
Brief Answer:
Follow up
Detailed Answer:
Potentially , fluctuations in blood pressure can cause heart problems but the degree and extent to which this may occur is best assessed by running heart related tests such as 2 dimensional Echocardiograms.
Follow up
Detailed Answer:
Potentially , fluctuations in blood pressure can cause heart problems but the degree and extent to which this may occur is best assessed by running heart related tests such as 2 dimensional Echocardiograms.
Note: For more information on hormonal imbalance symptoms or unmanaged diabetes with other comorbid conditions, get back to us & Consult with an Endocrinologist. Click here to book an appointment.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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