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Should I Get Myself Checked For Diabetes When I Have Slight Headaches And Occasional Lightheadedness While On Lisinopril And Metoprolol?
Question: Sometimes I have slight headaches when I wake up in the morning that go away after I have breakfast. I have occasional lightheadedness that seems to happen at odd times, sometimes to the point that I feel too dizzy to walk or move. I get very tired and sleepy even if I have not really done anything to make me tired and the heat and humidity seems to drain me more than it ever did before. I am female, 65 yo and have HBP that is controlled by Lisinopril and Metoprolol, 5'6" and 170 lbs. My last physical was in December of 2017 and my doctor said that I was not diabetic at that time. But both of my older sisters are being treated for diabetes. I wonder if I should be checked for this again?
Brief Answer:
If symptoms are recent another check-up is needed
Detailed Answer:
I read your question carefully and I understand your concern.
If these symptoms have appeared after your last check-up then I do believe they should be evaluated. They are not very specific symptoms, meaning they could be present in many different conditions, it's hard to pinpoint a cause by that alone. So a general physical examination as well as some blood tests would recommended.
Among some possible common cause to be mentioned would be anemia or chronic infections. Liver or kidney dysfunction would be another possible cause (one to be considered in particular given the many medications you are under). Thyroid dysfunction would be another possible cause. Excessive drop of blood pressure or heart rate in the setting of the medication would be another cause to be considered, but probably you already monitor those at home.
For that reason as I said some screening blood tests like complete blood count, erythrocyte sedimentation rate, liver and kidney function tests, electrolyte panel, thyroid function tests and vitamin B12 levels would be recommended.
If at the end everything results normal, then mood disorders may also be considered. I see you are under escitalopram already, perhaps its dosage may be reseen. I would also reconsider the regular use of diclofenac, it is not that suitable for long term use, perhaps if really necessary another medication of the same class but with less side effects like Ibuprofen or Naproxen may be considered.
I remain at your disposal for other questions.
If symptoms are recent another check-up is needed
Detailed Answer:
I read your question carefully and I understand your concern.
If these symptoms have appeared after your last check-up then I do believe they should be evaluated. They are not very specific symptoms, meaning they could be present in many different conditions, it's hard to pinpoint a cause by that alone. So a general physical examination as well as some blood tests would recommended.
Among some possible common cause to be mentioned would be anemia or chronic infections. Liver or kidney dysfunction would be another possible cause (one to be considered in particular given the many medications you are under). Thyroid dysfunction would be another possible cause. Excessive drop of blood pressure or heart rate in the setting of the medication would be another cause to be considered, but probably you already monitor those at home.
For that reason as I said some screening blood tests like complete blood count, erythrocyte sedimentation rate, liver and kidney function tests, electrolyte panel, thyroid function tests and vitamin B12 levels would be recommended.
If at the end everything results normal, then mood disorders may also be considered. I see you are under escitalopram already, perhaps its dosage may be reseen. I would also reconsider the regular use of diclofenac, it is not that suitable for long term use, perhaps if really necessary another medication of the same class but with less side effects like Ibuprofen or Naproxen may be considered.
I remain at your disposal for other questions.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
I had been taking Naproxen for my osteoarthritis but it was no longer effective at relieving my pain. My PCP prescribed the Diclofenac for twice daily and it has been relieving my pain. I had been thinking that maybe the Escitalopram should be increased. I will set an appointment with my PCP for review. I notice that you didn't say anything specific about diabetes, per se. Should I review that with him also?
Brief Answer:
Read below
Detailed Answer:
Hello again and thank you for your feedback.
I didn't mention diabetes because none of the symptoms you mention indicate diabetes. Yes tiredness is often present but as I said it's a very non-specific symptoms found in most conditions. There aren't any typical diabetes signs like weight loss, increased thirst, frequent urination. At times symptoms are not that prominent, but I am sure anyway that diabetes testing will be part of screening blood tests ordered alongside the tests I mentioned as it is part of any routine metabolic test.
As for Diclofenac it is true that its more potent than Naproxen, but at the same time has a higher potential for side effects. So I would be cautious about continuing it indefinitely.
Read below
Detailed Answer:
Hello again and thank you for your feedback.
I didn't mention diabetes because none of the symptoms you mention indicate diabetes. Yes tiredness is often present but as I said it's a very non-specific symptoms found in most conditions. There aren't any typical diabetes signs like weight loss, increased thirst, frequent urination. At times symptoms are not that prominent, but I am sure anyway that diabetes testing will be part of screening blood tests ordered alongside the tests I mentioned as it is part of any routine metabolic test.
As for Diclofenac it is true that its more potent than Naproxen, but at the same time has a higher potential for side effects. So I would be cautious about continuing it indefinitely.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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