Morning Bp Question

[redoctober]

I'm not sure what to make of my BP changes in the morning, so I wanted to throw it out there to see if anyone has a similar experience. When checking my BP in bed immediately after waking up this morning, I noticed that it was 130/45 (HR 62). As soon as I stood up, my BP changed to 112/70 (HR 102). I just started Florinef last week, so I'm not sure if that has something to do with it.

Does anybody have a similar experience or know what this means? Any input is appreciated...

[HopeSprings]

Isn't this Orthostatic Hypotension - if BP drop more than 20 points standing? I would think Florinef is supposed to help with that - not cause it. I could be wrong? Did you have tilt testing done? This should have shown OH. I would test it out a few more times and see if it happens a lot or if this was just a rare occurence.

[potsgirl]

Yes, that's know as orthostatic intolerance or ortho. hypotension. You would need more data to firm up that diagnosis, though. As Naomi writes, a tilt table test would give you a diagnosis. With POTS, usually when you go from laying to standing your BP stays about the same and your HR goes up at least 30 points. With orthostatic intolerance (which I have), your BP will drop by a significant amount and your HR will go up at least 30 - if not 60 or more - when you stand. Be very careful when sitting up or standing from a seated or laying position.

Florinef helps your body retain salt, so it keeps your BP higher. I think you should be feeling the effects of the drug within a week or two....someone correct me if I'm wrong, because I could never tolerate Florinef.

Please feel free to personal message me if you have more questions. Have you had a work-up with a dysautonomia specialist yet?

Cheers,

Jana

[redoctober]

Thanks for the responses. I guess it's the odd supine pulse-pressure that troubles me. Florinef started to normalize things last week, but I needed to back-off my dosage due to headaches for a few days. I'm trying to titrate back up now.

Regarding a work-up, I seem to be falling between the cracks. Endocrinologist refers me to my PCP. PCP refers me to the Cardiologist...who does a full workup (all normal) and prescribes Florinef. Meanwhile, I'm very symptomatic of something and doing my best just to make it through each day.

[mwise]

Hi Redoctor,

Did the Cardiologist do a tilt table test? I am in agreement with the others-this will diagnose Orthostatic Hypotension which is a significant drop in Bp (20-30) from lying/sitting to standing for 3 minutes. I can go from 130/80 lying/sitting to 70/50 standing for 3 minutes, which I just experienced last week at my Neurologist's office. I had a positive tilt table test along with an abnormal QSART which gave me my diagnosis. I am on both Mestinon & Midodrine for it. I wasn't able to tolerate Florinef-like you I had terrible headaches along with extreme fatigue & weakness, high anxiety levels, my bp didn't go up & my heart rate was racing all the time. I would see if you can't get the Cardiologist to order a tilt table test or make a referral to a Neuorologist or someone who specializes in Dysautonomia. I live in Ohio and would recommend Dr. Shields (My Neurologist) at the Cleveland Clinic and/or Dr. Blair Grubb (Beth his NP)-Toledo Medical Center. Hope this helps.

[redoctober]

The Cardiologist performed a 30-day Holter, Echo, and stress test...all of which were normal. He did mention the tilt-test, but only if the stress test was abnormal. I'll ask him about the tilt-test...to see if I can convince him to order it.