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Karin & David Henderson

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Low Blood Pressure and Meniere's Disease Symptoms

The information and the questions I am going to pose, and the thoughts I am going to share, are meant to make you think, not just about low blood pressure and Meniere's disease, but of other concerns as well. My purpose is to create an awareness of the actions of drugs that are chemicals going into your body.

This is a plea for common sense. And this plea is directed at you, the reader, who may have Meniere's disease symptoms that are “inconvenient” and you want relief, but at what price. It is perfectly understandable to want relief. When you make the appointment with your doctor you expect that they will provide you with a prescription for a drug to take away those symptoms. You know you will get it. You expect it. You feel it is the right answer. My concern arises from many emails and phone calls that originate from our Meniere’s disease website.

Some of the main Meniere's disease symptoms we discuss on this website are dizziness, vertigo and tinnitus: symptoms that create a lot of misery and chaos in people’s lives.

But I want to carry this a bit further than just the Meniere's disease symptoms. I want to expand on my concerns: my observations on what seems to be a trend of drugs (any kind) and the lack of support or willingness to look at interactions or simply side effects. Frankly I am very concerned about the lack of interest about side effects by the medical community. So many times I see hypotension and no one is willing to explore this seriously. Hypotension, or low blood pressure, can create some real problems.

Most doctors are focused on lowering your blood pressure readings. I fully agree with the idea, but let’s look at this a little differently. In this article, you will see a thread of problems associated with low blood pressure, plus the discussion of possible chemical results. I find it impossible to separate these to make a point by point paragraph. It would appear that some places I am repeating myself, but if you look closely, I refer to hypertensive drugs and other treatments as well. Included are several ways that you can be in control of your own health decisions.

Let’s get the definitions, signs and symptoms, and the links out of the way, BUT you need to keep these links handy as you read the rest of the article. You may need to refresh your memory and these sites will give you professionally-correct information. Before you do anything, even if you suspect your own situation might be causing problems, read the article to its conclusion and completion. Do NOT run to make any changes without medical support. Arm yourself with questions, possible answers, and research to back your thoughts.

Definitions, signs, and symptoms of low blood pressure or Hypotension.  Mosby describes “hypotension” as a condition without actual numbers and that makes so much more sense to me. It states: ”an abnormal condition in which blood pressure is not adequate for normal perfusion and oxygenation of the tissue.”

http://www.nlm.nih.gov/medlineplus/ency/article/003398.htm “Hypotension (blood pressure below normal): may be indicated by a systolic pressure lower than 90, or a pressure 25 mmHg lower than usual“ (paraphrased) Low blood pressure is an abnormal condition where the pressure of the blood against the walls of the blood vessels during and after each beat of the heart is much lower than usual. This can cause low blood pressure symptoms such as dizziness or lightheadedness. When the blood pressure is too low, there is inadequate blood flow to all parts of your body, including the heart, brain, and other vital organs. A blood pressure level that is borderline low for one person may be normal for another. The most important factor is how the blood pressure changes from the normal condition. Most normal blood pressures fall in the range of 90/60 mm Hg to 130/80 mm Hg, but a significant change, even as little as 20 mm Hg, can cause problems for some people.

http://www.noah-health.org/en/blood/types/hypotension.html “Within limits, the lower your blood pressure reading is, the better. In most people blood pressure isn't too low until it causes symptoms such as lightheadedness or fainting. In certain conditions or disease states, blood pressure can become too low, as in these examples: certain nervous system disorders (orthostatic hypotension, autonomic failure), endocrine disorders (parathyroid disease), heart attack and heart failure, prolonged bed rest, fainting (syncope) (SIN'ko-pe), decreases in blood volume due to severe bleeding (hemorrhage), or dehydration, effects of certain drugs, severe infections (sepsis), shock .”

http://www.mayoclinic.com/health/low-blood-pressure/DS00590 “Some people with low blood pressure are in peak physical condition with strong cardiovascular systems and a reduced risk of heart attack and stroke. For these people, low blood pressure, rather than being a cause for concern, is a cause for celebration. But low blood pressure can also signal an underlying problem, especially when it drops suddenly or is accompanied by signs and symptoms such as: dizziness or lightheadedness, fainting (syncope), lack of concentration, blurred vision, nausea, cold, clammy, pale skin, rapid, thirst, shallow breathing, fatigue, depression, etc. “

http://www.lowbloodpressure.wisepages.com/hypotension.html “Low blood pressure, otherwise known as hypotension, is a condition characterized by abnormally low pressure in blood vessels. When blood pressure is too low, the supply of oxygen that is carried in the blood cannot be effectively distributed throughout the body.”

Just as you need to know the definitions of “hypotension”, you also need to know the definition of “hypertension”. Then you can understand the difference. The medical term or prefix, “hyper”, means “over”. And the prefix “hypo” means “under”. The “over” and “under” values or numbers have already been decided by the medical community. It is not my purpose to question them. Here we simply want to see if the “under” reading might need to be looked at a bit more closely as having such a low reading might not be in your best interest.

http://www.noah-health.org/en/blood/hypertension/index.html “Hypertension exists if the systolic pressure (top number) is 140 or higher or the diastolic pressure (bottom number) is 90 or higher. Optimal blood pressure is less than 120 systolic and less than 80 diastolic.” You have already read that the readings vary, so you know there is a lot of discussion underway by the medical community.

http://www.medem.com/medlb/article_detaillb.cfm?article_ID=ZZZQ3C905YC&sub_cat=74

Here is some information that should be of great interest to you if you suffer from high blood pressure.

In my work with many people with Meniere’s disease and I always ask what sorts of drugs they are talking. Then I have to pry out of them if they are taking any prescription drugs. It seems that these don’t seem to count. Yet they are often the underlying cause for their symptoms. Not so much as the direct cause, but that the effect of low blood pressure could be the cause of so many other problems. I point out that any chemicals coming into the body is seen by the body as a foreigner: unwanted. Thus they could be subjected to the protective mechanism you have at all times, your immune system.

The medical world is always looking for signs (visible to others) and symptoms (your description of your Meniere's disease symptoms), but if you are dizzy, no one else would know. You don’t show any signs. The same thing happens with low blood pressure. You feel awful: completely drained, weak, and have no energy, but you look very normal. Some people are pale and feel cool. Little else “shows”. The only “sign” you can show is a blood pressure reading. And my present very real concern involves hypotension: low blood pressure.

Many people question their medications but are assured that there couldn’t possibly be a problem. This sense of security lasts for a short while: until the Meniere's disease symptoms show up again. But common sense is imbedded somewhere deep in all of us. When something is not right (we all understand our bodies better than anyone else.), we know it.

Now you go to a different source as the first one has already told you there could be no problem. Most people know when they feel differently, know it hasn’t always been like that and know they don’t want to continue in the same way. The Internet has changed many things. Amongst them how people get medical information. It is why I include so many links to reliable sites.

Most medical facilities have their own sites, and most provide information that the lay person can understand. It is in any doctor’s best interest, (use of their time and expertise), to appreciate the clarity you have about your needs. It helps immensely if you have a good understanding of what you need and what possibilities are available. And the same applies to knowing about low blood pressure.

Obviously the medical community wants you to understand conditions. It even creates web sites around these terms. http://www.lowbloodpressure.wisepages.com/hypotension.html

Just go to the main Medline site and you will be amazed at what resources are available. I assure you that you will understand and appreciate most of the information. http://www.nlm.nih.gov/medlineplus/

As many doctors prescribe drugs or combinations of drugs, I want encourage you to read another perspective by Dr. Mercola. I like his work as he delves into background causes that few other people do. http://www.mercola.com/2000/mar/12/fda_recommends_bp_drug_stop.htm

Here is the study he refers to. It describes the different drug combinations available to treat hypertension. It is called the “Landmark Hypertension Treatment Study Launches Extensive Physician and Patient Education Program to Improve Public Health Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial (ALLHAT)”
http://www.nih.gov/news/pr/feb2006/nhlbi-01.htm

As you can see from the date imbedded in the web address, it was published in February 2006. If you are on blood pressure medications, keep an eye out for what you are prescribed. And keep yourself updated by visiting these sites regularly. You can easily print off their information by using the “print” button.

Unfortunately, from what I hear a lot, not all medical practitioners welcome this enlightened state of their patients. I could tell you story after story of doctors who dismiss their Meniere's disease patients. So as always, I urge you to be most diplomatic when you present any Internet information to your doctor. But please don’t let it stop you from researching worthy help for your body. Before I go any further, I want to be clear about the terms “health” and “wellness”. In our North American culture, we tend to see our health needing to be repaired. And we see wellness as something holistic, suspicious, and to be avoided at all costs. So traditional drugs win out, time and time again. Health should be health and illness should be illness.

Please recognize that drugs are always chemicals. Your purpose for going to seek medical help is to change the state of your being. And that is what doctors are trained to do. They offer or prescribe drugs and offer and perform surgery. And that is all about repair and chemicals to create a change: the one you are seeking. But please understand that what you might be seeking in help for your headache can also have a overall body affect. When you take something like a headache pill, you will be changing the entire make up of your body. Those are called ”side effects”. And we see them as maybe not happening at all, or having negligible effects. But that is often not the case.

I sit in a very interesting and privileged position as people contact us. I hear about all the drugs they are on. I can see the overall results and ask about these side effects. (And now that I am bringing this to your attention, I hope you will do the same.) What is most interesting is the use of drugs. Having been a nurse for many years, I can see how doctors use the recognized side effects of one drug as the primary reason for using it in another situation.

Blood pressure medications are a good example. I’ll use “our” Meniere’s disease friends. The main course of treatment includes a diuretic, something to quell the dizziness and vertigo, and often an antihistamine. A low salt diet is also prescribed. The purpose of the diuretic is to draw off fluid. But it is also used in the treatment of high blood pressure. If you follow this, you will soon see that taking this “antihypertensive drug” and NOT having high blood pressure, could now lead to possible problems, like a (unwanted) reduced blood pressure? But let’s look at the blood pressure. In the “ALLHAT” study: http://www.nih.gov/news/pr/feb2006/nhlbi-01.htm ) they mention multiple drug groups. These are all vying for space and actions in your body. Could these drugs be not as effective as hoped, all the while be causing their own problems?

By law, negative side effects must be listed and available to the consumer. So when you have a prescription filled, you must read any listed side effects (aka an adverse reactions). But if you don’t like those, or if you feel you already have some of those from maybe something else, it is too late to return the product. So do your research for side effects before you buy it. What is not so easily figured out is the interrelation of the drugs you are on. They would be called interactions. http://www.rxlist.com/ 
http://search.familydoctor.org/htdigsearch/htsearch?config=familydoctor_kidshealth&words=interactions

What is a drug interaction? Here is one excellent site. http://familydoctor.org/802.xml#6

“If you use 2 or more drugs at the same time, the way your body processes each drug can change. When this happens, the risk of side effects from each drug increases and each drug may not work the way it should. This is called a "drug-drug interaction." Vitamins and herbal supplements can affect the way your body processes drugs too. Certain foods or drinks can also prevent your medicine from working the way it should or make side effects worse.

This is called a "drug-food interaction." For example, if you're taking a traditional NSAID, drinking alcohol can increase your risk of liver disease or stomach bleeding. Drug-drug interactions and drug-food interactions can be dangerous. Be certain that your doctor knows all of the over-the-counter and prescription medicines, vitamins and herbal supplements that you are taking. Also, talk to your doctor before you take any new over-the-counter or prescription medicine or use a vitamin or herbal supplement.”

If your body is relatively healthy, and you are taking one or two drugs, this may not present a problem. But as we are speaking of low blood pressure, and most healthy people do have good (adequate), relatively low blood pressure, a listed side effect of low blood pressure should make you stop and think. That is what I am trying to help you do here.

Although my discussions are around Meniere’s disease treatment, you should be very concerned if you are taking more than one drug: over the counter “OTC”, or prescription, or recreational. And please do not forget all the nasal sprays, drops and ointments! As I have mentioned several times, now, these are simply chemicals of some sort: where they come from is not that important. What is important is how these chemicals act in your body.

For our discussion in this article, I want to draw your attention the fact your blood pressure could be a little too low for you to function effectively for your lifestyle. I admire the athletic community. They are very aware of how a low blood pressure and low pulse are affecting their overall capabilities. I learned this early on in my operating room career. We didn’t get many sick athletes, but we did get many broken limbs. Their heart beats (pulse) and blood pressure were usually low enough to make us become very aware of possible problems. Hypotensive problems didn’t happen because their bodies are used to this. And I believe they don’t put many chemicals into their bodies. At least they didn’t then.

Another situation that concerns me a lot is the “isolated” use of these drugs. By that I mean that one doctor prescribes a drug, for one condition, and pays no attention to other drugs prescribed by any other doctors. I would imagine that a pharmacist would check for and question interactions and usage, but that is no longer the case. I wish it were! I believe that would save a lot for heartache and problems.

Let me share what I see happening. I’ll use the Meniere’s disease condition as an example. The traditional treatment for Meniere's disease includes a low salt diet, diuretics, SERC (betahistine), often an anti-depressant and a drug to stabilize the dizziness. Sometimes, nasal sprays. Then along comes another practioner. You are now encouraged to do some “preventative medication” for cholesterol, hypertension, (high blood pressure), and diabetes. Those are the common ones right now. Can you already see what happening here is? I see this time and time again, but no one seems to see anything wrong with this! That is why I am getting very concerned. If you looked closely at some of the links I gave you, did you see who sponsored the sites? Am I cynical? Just a touch!

I have to assume you are reading this article because you have an interest in health, not illness. Yours and maybe others close to you. It also means you have access to the Internet to research your own condition, whether it is Meniere's disease, or some other health question you may have. This is a resource that is part of globalization. You now have access to knowledge, definitions, and explanations that in the past, you got from your doctor. They could control what you learned.

Not any longer. Now you can look up hypotension or Meniere's disease for yourself. You can explore thousands of pages or sites on diabetes. You can study all about cholesterol. When you go back to your doctor for the actual prescription to “prevent” a condition, I ask you to become aware of possible drug interactions: of chemicals interaction with other chemicals prescribed. These could be causing possible side effects such as hypotension.

Many, many people I speak with are on preventative medications. And we discuss drugs they are could be on, they never mention these. It is almost as though they appear to be harmless and not to be considered. But they are used to create a certain chemical change in your body. And as drugs, they will also interact with other chemicals to create another result. Hypotension?

Let me give you a common scenario. You are on these “preventative drugs” but because of your Meniere’s disease symptoms you now get added the “traditional” diuretic (which acts as a blood pressure lowering drug). Seldom do I hear of any pharmacist doing any cross checking of drugs. Can you see the potential problem here? I am going to be a bit facetious here. What good is a drug that takes a relatively long term to make a difference (on your cholesterol rating) when your blood pressure is so low that you can’t function today? Someone needs to exercise some common sense! What I can’t understand is why no one takes the time to look at the whole person in front of them who is “complaining” of dizziness, fatigue, vertigo, and tinnitus, and are known to be on multiple drugs. Would it not make sense to look for possible drug side effects or interactions?

And in many, many cases, these are three of the most common side effects of drugs! You, as the patient in front of the doctor, are mentioning that you have this problem. Ironically or maybe naturally, you are now prescribed a drug to help you deal with that effect! I have a huge list of drugs that list tinnitus or noise in the ear, as a side effect: not a possible one, but the actual known side effect. And what do Meniere’s disease symptoms include? Tinnitus, vertigo, dizziness, hearing loss or fluctuation, and inner ear pressure! And then the traditional treatment for Meniere's disease (which it really isn’t) they prescribe more drugs such as diuretics and antihistamines that have these listed as side effects! Round and round we go!

Now let me throw this at you. Supposing you already have a reading of 140/80 (seen as hypertension) and your body adjusted to it. Now you are given medication in the hopes of lowering that reading and most often for good reason. But the side effects are dizziness and a few other things. So you go back to your doctor. Tests are done to rule out the possibility of any abnormality in the balance part of your ear (inner ear). To stop the vertigo, a diuretic is given (traditional treatment). And you already know that a diuretic will drop your blood pressure. And no one checks to see what you other drugs you are on. Now you are on TWO drugs (and maybe even more) that lower your blood pressure! Can you see any possible problems? It happens all the time! Whose responsibility is it to check? I think it is yours. No one checked before prescribing the drug(s) and no one took the time as the prescription was filled. You are the person walking around with these effects. Does anyone other than you care much? I doubt it. So make it your responsibility. Question all your drugs if you suspect this could be the case with you.

Here are things you can do right now to give yourself some control over your fears. First I would discuss it with your pharmacist. They are trained in drugs and chemical interactions. Read the inserts in all the drugs you get. Believe them. By law, any negative effects have to be listed. These happen all the time. When you choose to take these chemicals, there will be affects: good and bad. Bring in all your drug slips and any OTC products. Herbal products are the basis of many drugs. So bring that information if you are on any.

Normal vitamin and mineral supplements are mentioned often as being a problem, but I believe true supplements are food and you wouldn’t mention foods normally. But don’t confuse herbals and vitamins. They are not the same. One very important action you need to do is to take your blood pressure for a few days or even two weeks. Follow the directions on the machine you choose. Stick with that one machine: you can be confident with the results. Read the directions for clothing. If you push up your shirt, you could well change the reading, but it should tell you not to do that on the instructions. Next you want to get accurate and consistent readings. Do NOT compare a morning reading with an afternoon one. They will not be the same! And if you go to your doctor’s office, ask them to tell you the reading. Don’t accept the “it’s a bit on the high side” or it’s OK”. Get the numbers so you can compare them yourself. Normal readings are listed on the machine. Believe them.

When you spot a potential problem, take them to your primary care physician. They should have your best interest at heart. They should be seeing your entire body: not just one segments of it. If you are still reluctant to ask your doctor, and that happens often, ask yourself why you went in the first place. Were the symptoms bad enough for you to seek help? Has anything changed so you can now cope? If not, have some courage and seek other help. But in the meantime, you might also find other possible ways of coping with your original symptoms.

There is a lot of research and many books that can help with non-drug or chemical treatments. It might mean a change in diet, a bit more exercise, an avoidance of sugars, diet products, plus other things. You don’t need to join a gym if you can walk a round your house, walk the stairs a bit more, or simply park further from the shopping center entrances. If you have low blood pressure, mild exercise is great to help you bring extra oxygen to your body! Wash your car (and mine) a bit oftener. Walk two floors. It might take a bit extra time, but it feels good.

Just by reading to this point, you can’t help but have learned a lot about drug interactions and possible low blood pressure and dizziness. A few lifestyle changes, including finding courage to make some enquiries, could make an amazing change in your health!

I am reluctant to add something of serious importance to an already overloaded health article, but you might also start looking at your environment. Often it gives a hint of things you are exposed to “generally”. Many respiratory problems start here. Then you get drugs, and it adds to your body’ workload of trying to get them out. Your body is always trying to protect you from anything that is not “natural” to it. You might want to read this article on the Inflammatory Process.  But that so-called allergy can also cause your blood pressure to increase and now you are given a drug for that. Get the picture? Incidentally, for many of the conditions where drugs are prescribed, often a very effective “non-chemical” treatment is available. Water is the very best natural diuretic. Your body craves it and it doesn’t cause hypotension or hypertension.

My personal thought always is” “if I mixed all these chemicals in a laboratory, what could happen?” Might your body be a living laboratory? I am going to conclude by restating the signs of low blood pressure and the effects they could have on you. Hypotension, or low blood pressure, means that the pressure of blood circulating around the body is lower than normal, or lower than expected. You may have low blood pressure compared to others of similar physical characteristics, but be perfectly healthy.

Low blood pressure is only a problem if you experience negative symptoms. For example, vital organs (particularly the brain) may be starved of oxygen and nutrients if your blood pressure is too low. Your symptoms could include lightheadedness, when standing from a sitting or lying position, unsteadiness, dizziness, weakness, blurred vision, fatigue, and fainting. Usually, low blood pressure develops over time.

Realize that you are in control, of your health, your decisions, your symptoms, and any actions you are prepared to take to deal with them. Does this sound like any experiences you might have had? Please learn from this, but do NOT make ANY changes without a medical practioner supervising your actions. Doctors assume that you will follow their instructions. They base their future advice and decisions on this knowledge.

By Karin Henderson - Nurse, Retired.

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