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What causes unintentional weight loss and dizziness while having hypertension?

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General & Family Physician
Practicing since : 1991
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yes my husband is on three blood pressure medicines and his dr. refuses to know that he is losing weight and feels dizzy and light headness should I get another dr. to do a work up on him.

I am losing faith in this dr. and want a second opinion so my husband gets well what do you think.
Wed, 25 Apr 2018 in Hypertension and Heart Disease
 
 
Answered by Dr. Bonnie Berger-Durnbaugh 42 minutes later
Brief Answer:
Questions so that I can help

Detailed Answer:
Hello and welcome,

I'm sorry to hear that your husband is having problems. Can you please tell me:

How many pounds has he lost and over what length of time?

Was the weight loss intentional?

Is his light headedness when he stands up quickly or all of the time (even when seated or in bed)?

Did his light headedness start after starting one of his medications?

Does he have a heart condition in addition to the high blood pressure?

When you wrote "dizzy", do you mean light headed, or that the room spins. And if the room spins, how long has this been going on?

I'll provide my thoughts after I hear back. Thanks.
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Follow-up: What causes unintentional weight loss and dizziness while having hypertension? 49 minutes later
sometimes he is light headed and sometimes dizzy, his weight loss is not due to him trying, he used to pant size 40 and is now about a 34 pants about 6 or8 mos.duration. He has a stent in but not heart problems that we know. He is being real forgetful also. I would like him to get a complete blood workup with another dr. when I told him how my husband has been he po po me , I told him my husband planted 1000 garlic a year he has not planted any this year something is wrong and I don't know how to fix it. I think its too much blood pressure medicine to start. I want to know what you think??
 
 
Answered by Dr. Bonnie Berger-Durnbaugh 15 minutes later
Brief Answer:
Information

Detailed Answer:
Some of the blood pressure medications he is on can cause orthostatic hypotension, which is when the blood pressure does not rise adequately in response to standing up or being upright. This causes there to an inadequate amount of blood going to the brain temporarily.

The dizziness can be from the blood pressure medications (usually this is perceived as light headedness) but it can also be from a heart arrhythmia.

Other types of dizziness can be from a problem with the inner ear, the eyes (nystagmus) or the part of the brain that controls balance.

His weight loss is concerning.

So I do think it would be a good idea to get a second opinion with another doctor if his current doctor does not seem interested in pursuing his new symptoms.

His evaluation should include a physical exam, including a neuro exam for balance and nystagmus, and then there should be an EKG and a rhythm strip (to look for arrhthmia), a complete blood count (CBC with differential), a complete metabolic panel (a blood test which should include a fasting blood sugar, liver enzymes, BUN, creatinine, and electrolytes), and a thyroid blood test (TSH and either T4 or T3).

In addition, the doctor should check his blood pressure and pulse in a systematic way when lying down, then seated, then standing up. This is called an orthostatic blood pressure and pulse test.

Depending on these tests, the doctor may also want to order imaging studies.

Be sure to see a real physician and refuse a physician's assistant or nurse practitioner. The latter two are now often presented as though they are physicians, but they are not - don't have much training.

I hope this information gives you a place to start.
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