Sign-in to Ask A Doctor - 24x7
OR
Sign in with Google
Suggest Treatment For Severe Coldness And Extreme Tiredness
Question: Hi,
My mother is 92 and in relatively good health except for severe coldness and bouts of extreme tiredness. She takes a blood pressure pill called nifedipine --once a day plus some vitamins. The coldness has been ongoing for several years but is worse this year - the same with the fatigue. This condition is causing her to stay in bed for most of the day because she is too cold to get out. We have seen many specialists and had virtually every test done. We have basically ruled out everything that could be a possible reason - eg. Thyroid problem, heart problem, circulation.
A hematologist said that nothing showed in the tests (blood/urine) but that she could possibly have a blood cancer. The only way to confirm would be a bone marrow test and we thought that would be too difficult on her. She is frail.
Nothing is obvious in terms of what is wrong....but over the past few days a friend asked me if my mom's blood pressure was dropping and perhaps that was causing the tiredness. Interestingly enough I was with my mom tonight and she went into a major fatigue spell. She couldn't walk and was barely functioning. Half an hour prior she was fine. The tiredness is sudden. We managed to put her in a wheelchair and get her in bed where she fell asleep. I took her bp before she fell asleep and it was low low low. I continued to take it and it did slowly come back to normal. At 1:50 pm it was 83/30 p. 51, then 2:05 74/49 p. 51, 3:15 86/52 p. 57, 3:30 86/52 p. 57, 4:00 94/54 p. 57, 5:10 70/53 p. 59, 5:40 98/62 p. 50, 5:50 103/ 61 p. 59, 6:30 94/58 p. 60, 8:10 109/67 p. 64, 9:30 pm 101/61 p. 65, 12:10 am (while sleeping) 95/52 p. 56.
5 years ago she had a fainting episode where she almost died ..pulse went low etc...almost like today. She was hospitalized and the docs said she would not make it. They gave her aptrapine to increase her pulse but the dosage was too strong and she went into shock. The next day she was fine. The cardiologist thought that she needed a pace maker and installed an external one. Over the next day he indicated that she didn't need it. We are wondering now if her coldness and tiredness are indicators that she does need a pace maker and probably has needed one for quite some time. Advice would be appreciated.
My mother is 92 and in relatively good health except for severe coldness and bouts of extreme tiredness. She takes a blood pressure pill called nifedipine --once a day plus some vitamins. The coldness has been ongoing for several years but is worse this year - the same with the fatigue. This condition is causing her to stay in bed for most of the day because she is too cold to get out. We have seen many specialists and had virtually every test done. We have basically ruled out everything that could be a possible reason - eg. Thyroid problem, heart problem, circulation.
A hematologist said that nothing showed in the tests (blood/urine) but that she could possibly have a blood cancer. The only way to confirm would be a bone marrow test and we thought that would be too difficult on her. She is frail.
Nothing is obvious in terms of what is wrong....but over the past few days a friend asked me if my mom's blood pressure was dropping and perhaps that was causing the tiredness. Interestingly enough I was with my mom tonight and she went into a major fatigue spell. She couldn't walk and was barely functioning. Half an hour prior she was fine. The tiredness is sudden. We managed to put her in a wheelchair and get her in bed where she fell asleep. I took her bp before she fell asleep and it was low low low. I continued to take it and it did slowly come back to normal. At 1:50 pm it was 83/30 p. 51, then 2:05 74/49 p. 51, 3:15 86/52 p. 57, 3:30 86/52 p. 57, 4:00 94/54 p. 57, 5:10 70/53 p. 59, 5:40 98/62 p. 50, 5:50 103/ 61 p. 59, 6:30 94/58 p. 60, 8:10 109/67 p. 64, 9:30 pm 101/61 p. 65, 12:10 am (while sleeping) 95/52 p. 56.
5 years ago she had a fainting episode where she almost died ..pulse went low etc...almost like today. She was hospitalized and the docs said she would not make it. They gave her aptrapine to increase her pulse but the dosage was too strong and she went into shock. The next day she was fine. The cardiologist thought that she needed a pace maker and installed an external one. Over the next day he indicated that she didn't need it. We are wondering now if her coldness and tiredness are indicators that she does need a pace maker and probably has needed one for quite some time. Advice would be appreciated.
Brief Answer:
Anemia, heart failure and rhythm disorders may be the cause, upload test...
Detailed Answer:
Hi XXXXXXX
I read your query very carefully and try to understand your mother problem.
Your mother is experiencing low BP, cold and extreme fatigue, which are both sign of low blood per fusion of the tissue. This may be due to a combination of factors, such as, anemia, heart failure and rhythm disorders.
This is why if your mother was my patient i would recommend to stop immediately Nifedipine (blood pill) and to do the following examinations:
- Cardiac echo
- Holter (ECG) monitoring
- Blood count
You are saying that you have done virtually all the test. Can you specify what kind of cardiac test you have done recently (within last 2 months)? If you have done cardiac Echo and Holter (ECG) 24 hour monitoring, can you upload the test result for me? This way I would give an evidence based opinion about the cause of extreme weakness and the necessity of the pacemaker.
If these examinations aren't done recently than I suggest to do them again.
Wish you and your mother health?
Anemia, heart failure and rhythm disorders may be the cause, upload test...
Detailed Answer:
Hi XXXXXXX
I read your query very carefully and try to understand your mother problem.
Your mother is experiencing low BP, cold and extreme fatigue, which are both sign of low blood per fusion of the tissue. This may be due to a combination of factors, such as, anemia, heart failure and rhythm disorders.
This is why if your mother was my patient i would recommend to stop immediately Nifedipine (blood pill) and to do the following examinations:
- Cardiac echo
- Holter (ECG) monitoring
- Blood count
You are saying that you have done virtually all the test. Can you specify what kind of cardiac test you have done recently (within last 2 months)? If you have done cardiac Echo and Holter (ECG) 24 hour monitoring, can you upload the test result for me? This way I would give an evidence based opinion about the cause of extreme weakness and the necessity of the pacemaker.
If these examinations aren't done recently than I suggest to do them again.
Wish you and your mother health?
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thank you Dr. Shehu,
This is very helpful information. We will be seeing a cardiologist on Thursday..they are trying to fit us in. My mom has been fine since that episode. I had indicated that she is taking one blood pressure pill - nifedipine XP - 1 30 mg daily.
In addition, she takes 1/2 15 mg tablet - mirtazapine at bedtime to help her sleep. A couple of years ago she went through a difficult time whereby she couldn't sleep.
She takes omeprazole 20 mg twice a day.
Other than the three drugs she takes ASA EC 325 mg tab, Calcium carbonate 1500 mg tab, and vitamin D drops.
The coldness did increase after she was given the nifedipine XL. Prior to that drug she was taking micardizine and cardizine together to control blood pressure.
My mom has been on bp pills for over 30 years and was never diagnosed with bp as such because she opted not to do the XXXXXXX test.
We will get more answers - hopefully this week but a quick look at side effects of both nifedipine and mirtazapine - indicates chills are rare but can happen. Mom describes her coldness and chills down her back and all over her body. She said it feels like cold wet clothes have been placed on her body.
Once again - thank you.
XXXX - for my mom XXXXXXX
I think I can ask two follow-up questions. I did not ask a question in my last post. I wondered if you have any information on the side effects or combination side effects of these drugs?
I had meant to add that she also takes Tylenol - 650mg - 2 tabs - 3 times a day.
This is very helpful information. We will be seeing a cardiologist on Thursday..they are trying to fit us in. My mom has been fine since that episode. I had indicated that she is taking one blood pressure pill - nifedipine XP - 1 30 mg daily.
In addition, she takes 1/2 15 mg tablet - mirtazapine at bedtime to help her sleep. A couple of years ago she went through a difficult time whereby she couldn't sleep.
She takes omeprazole 20 mg twice a day.
Other than the three drugs she takes ASA EC 325 mg tab, Calcium carbonate 1500 mg tab, and vitamin D drops.
The coldness did increase after she was given the nifedipine XL. Prior to that drug she was taking micardizine and cardizine together to control blood pressure.
My mom has been on bp pills for over 30 years and was never diagnosed with bp as such because she opted not to do the XXXXXXX test.
We will get more answers - hopefully this week but a quick look at side effects of both nifedipine and mirtazapine - indicates chills are rare but can happen. Mom describes her coldness and chills down her back and all over her body. She said it feels like cold wet clothes have been placed on her body.
Once again - thank you.
XXXX - for my mom XXXXXXX
I think I can ask two follow-up questions. I did not ask a question in my last post. I wondered if you have any information on the side effects or combination side effects of these drugs?
I had meant to add that she also takes Tylenol - 650mg - 2 tabs - 3 times a day.
Brief Answer:
Her problems may be from interaction between...
Detailed Answer:
Hi back,
Thank you for following up.
The hypotension problems that your mother is facing might be due to aggravation of heart failure.
That's why further evaluation is needed.
Another cause could be interaction between nifedipine and mirtazipine due to alpha blocker effect of mirtazipine. This can lead to hypotension and heart failure. You can discuss about that with her doctor.
All the best!
Dr.Benard
Her problems may be from interaction between...
Detailed Answer:
Hi back,
Thank you for following up.
The hypotension problems that your mother is facing might be due to aggravation of heart failure.
That's why further evaluation is needed.
Another cause could be interaction between nifedipine and mirtazipine due to alpha blocker effect of mirtazipine. This can lead to hypotension and heart failure. You can discuss about that with her doctor.
All the best!
Dr.Benard
Note: click here to Consult a cardiac surgeon online. to know the best treatment option for your heart-related issues
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
Get personalised answers from verified doctor in minutes across 80+ specialties
