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  #1   ^
Old Wed, Feb-15-17, 21:21
Whited Whited is offline
Senior Member
Posts: 299
 
Plan: Very Low Carb
Stats: 312/235/185 Male 66 inches
BF:
Progress: 61%
Location: Missouri
Default Hctz and Diabetes

Hi. Dennis here -- I'm 59 (youngster) and I've been on a low card diet since Nov. 2014. I initially lost about 100 pounds and have since gained some back but not all. I'm still about 70 pounds lighter than I was. I am diabetic but I manage it with a HF/LC diet although I have cheated some lately so my A1C is now up to a 5.5

Anyway I have high blood pressure and it got up to 150s over 100 in the fall for a time then at around mid140s over mid 90s so I went on valsartan (80mg). Doctor pushed it pretty aggressively and said I could get kidney problems even if controling BG. Also both Grandmothers had strokes so something of a history. That dosage didn't seem to do anything and he upped it to 160mg a month ago which also didn't have an effect. Then he put me on the 160mg plus Hctz (a hydrochlorothiazide water pill) I've been on that for a couple of weeks and it did lower BP BUT in looking it up there are some sites that claim that this drug can lead to diabetes and insulin resistance. Some claim it can actually cause diabetes in people that didn't have it before. I assume this is because you lose so much potassium and mess up your electrolytes.

Some sites claim its bad combined with a high fat diet (which of course I'm on) and can increase lipids and raise LDL significantly (by 50%)

So do any of you have any insight or experience with this drug -- kind of a hard decision for me -- go off the drug and risk stroke and kidney disease OR stay on the drug and risk a reversal of my decent health strides with LDL and runaway blood sugars and increased insulin resistance -- great choices.

Do you think I'm overreacting? I left a note for the doctor (It takes a couple months to get an appointment unless its an emergency) and cited a couple of concerns in the note about what I'd read and he had the receptionist call and say "stay on it." end of story.

Any thoughts?

Thanks

Last edited by Whited : Wed, Feb-15-17 at 21:43.
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  #2   ^
Old Thu, Feb-16-17, 04:50
JEY100's Avatar
JEY100 JEY100 is online now
Posts: 13,368
 
Plan: P:E/DDF
Stats: 225/150/169 Female 5' 9"
BF:45%/28%/25%
Progress: 134%
Location: NC
Default

Hi Dennis,
I don't know anything about this medication and not a doctor, but my question would be ..do you really have high BP that needs treatment with medication? Were those numbers taken one off at a doctor's office, or do you take them at home multiple times and average? Consistent readings of 140/90 to 160/100 is only considered "slightly elevated" and lifestyle changes could lower those without the risk of side effects. Specifically a LC diet without cheating. you know that by eating high carb your BG, insulin, glycogen stores and the water that comes along with the glycogen all rise, contributing to higher BP.

Guide to Blood Pressure: https://www.dietdoctor.com/blood-pressure

(Important...read all of the guide but especially how to take BP correctly! Yesterday my Y was having a wellness day...I sat down for a BP after rushing around from home to car to gym. Nurse took measure immediately...so I said to her you are suppose to wait five minutes, no surprise, my BP was 158/82. Told her to do it again after maybe two minutes sitting there, then it was 138/70. If she would have waited the correct amount of time of 5-10 minutes, it would have been nearer my usual 110/70. KNOW How BP should be taken, don't let a rushed doctor's office create a problem that might not exist.)

Starting LC when on BP meds: https://www.dietdoctor.com/low-carb...-blood-pressure

New study that aggressive lowering of BP has benefits, but the side effects can increase risks too. https://www.dietdoctor.com/major-ne...increases-risks

Last edited by JEY100 : Thu, Feb-16-17 at 05:08.
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  #3   ^
Old Thu, Feb-16-17, 08:46
Whited Whited is offline
Senior Member
Posts: 299
 
Plan: Very Low Carb
Stats: 312/235/185 Male 66 inches
BF:
Progress: 61%
Location: Missouri
Default

Thanks for the response Jen -- I do take it at home 3 times daily -- it is elevated. Of course the doctors want it at 120/ 75 for diabetics but I don't think mine will ever get that low. I get a little freaky when it gets up to mid 90s and 100 on the bottom. Still looking at the articles on HTCV -- they do look bad for insulin resistance but we'll see
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  #4   ^
Old Thu, Feb-16-17, 09:11
JEY100's Avatar
JEY100 JEY100 is online now
Posts: 13,368
 
Plan: P:E/DDF
Stats: 225/150/169 Female 5' 9"
BF:45%/28%/25%
Progress: 134%
Location: NC
Default

OK, then you have sound BP readings...so next step is stay lower carb than you have been, and then sorry, but give it time.
It took Ken a while to get his BP readings down, about a year? Not sure where he addressed BP but check his Milestone reports on what he did to correct it.
http://forum.lowcarber.org/showthread.php?t=472345

I did find a Numbers Needed to Treat analysis of anti-hypertensive drugs for mild hypertension (your numbers are same range in these studies)
http://www.thennt.com/nnt/anti-hype...d-hypertension/

But if your diabetes and family history concerns you, Keep researching your options, there are different medications that work by different means. If the side effects of this one bothers you, you should ask again for another type. "Stay on it", especially if the dose had to be raised significantly, didn't really address your concerns. Though Hctz has been around for half a century, generic, and is commonly considered safe? There are other classes of diuretics; potassium-sparing and calcium-sparing.

Quote:
At levels of blood pressure which are at least moderately elevated (>160/100), such as those induced by heart disease, medication may be appropriate. Keeping in line with the lifestyle suggestions above is still a good idea, though – they may help ensure that you don’t need to take more medication than necessary for your treatment.

Blood pressure-lowering medication tends to primarily reduce the risk of the having a stroke, heart failure or damage to the kidneys caused by elevated blood pressure.

There are many good options when it comes to such medication. Examples are ACE (angiotensin-converting-enzyme) inhibitors or AII-blockers (angiotensin II receptor blockers) such as Enalapril or Losartan. If this kind of medication doesn’t give the desired effect, you might have to add other medication such as so-called calcium antagonists (e.g. Felodipin) or a mild diuretic (can be found as a combined pill with Enalapril and Losartan).

If possible, avoid using beta blockers to treat blood pressure (this means pills like Atenolol, Metoprolol or Seloken). They are less effective and cause more side effects (such as decreased potency, fatigue and weight gain). These medicines can, however, be of use in cases of heart disease (such as angina).

Last edited by JEY100 : Thu, Feb-16-17 at 12:46.
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  #5   ^
Old Thu, Feb-16-17, 12:53
Whited Whited is offline
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Posts: 299
 
Plan: Very Low Carb
Stats: 312/235/185 Male 66 inches
BF:
Progress: 61%
Location: Missouri
Default

Thanks Janet -- I called you Jen before (sorry). Yeah I think I'm going to give it a good shot natuarally for at least 6 months. Even when I was at my most sussessful with this diet I still had somewhat high blood pressure though. Many of those other drugs just didn't work at all. The only think that seems to work is adding the HTCZ. But like i said some atricles I read (a summary of course) said this drug is not good with a high fat diet and messes with BG. One article was no less than the New England Journal of Medicine

Last edited by Whited : Thu, Feb-16-17 at 13:05.
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  #6   ^
Old Thu, Feb-16-17, 17:18
WereBear's Avatar
WereBear WereBear is online now
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Posts: 14,602
 
Plan: EpiPaleo/Primal/LowOx
Stats: 220/125/150 Female 67
BF:
Progress: 136%
Location: USA
Default

These drugs lower your blood pressure; but you haven't addressed the core issue; which can still be running around causing trouble.

Here's a good site that might offer some help:

Lower Blood Pressure Naturally

Proper choices of nutrition and supplements could do wonders if you haven't tried that yet. The fact that the medication is known to create the very conditions you are trying to avoid suggests, at the least, that it is the wrong medication for you.

And don't go off it without medical supervision. You might have to taper, or something... to do otherwise could be dangerous.
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  #7   ^
Old Fri, Feb-17-17, 08:27
Whited Whited is offline
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Posts: 299
 
Plan: Very Low Carb
Stats: 312/235/185 Male 66 inches
BF:
Progress: 61%
Location: Missouri
Default

Hi Thanks for the response -- I already take Vit. D and Co Q 10 and Magnesium as well as eat healty oils. The blood pressure is still high.
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  #8   ^
Old Fri, Feb-17-17, 08:49
WereBear's Avatar
WereBear WereBear is online now
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Plan: EpiPaleo/Primal/LowOx
Stats: 220/125/150 Female 67
BF:
Progress: 136%
Location: USA
Default

That's great, actually; might be why it's NOT sky high.

Quote:
Nicotinic acid (niacin) is a well-established treatment for dyslipidaemia – an important cardiovascular disease (CVD) risk factor. However, niacin may also reduce blood pressure (BP), which is another important CVD risk factor.


Does nicotinic acid (niacin) lower blood pressure?
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  #9   ^
Old Sat, Feb-25-17, 04:32
JEY100's Avatar
JEY100 JEY100 is online now
Posts: 13,368
 
Plan: P:E/DDF
Stats: 225/150/169 Female 5' 9"
BF:45%/28%/25%
Progress: 134%
Location: NC
Default

Remembered this thread yesterday. Terry Graedon of People's Pharmacy resent her Jan article in the newsletter about Hctz because she got reamed by a doctor for suggesting some meds may cause higher blood sugars. He seems to think if a patient needs BP diuretics, it would be better to risk diabetes and then treat that too.
Whatever, the article with all the comments is helpful on this topic.

https://www.peoplespharmacy.com/201...rigger-diabetes

Last edited by JEY100 : Sat, Feb-25-17 at 05:11.
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  #10   ^
Old Sat, Feb-25-17, 11:23
WereBear's Avatar
WereBear WereBear is online now
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Posts: 14,602
 
Plan: EpiPaleo/Primal/LowOx
Stats: 220/125/150 Female 67
BF:
Progress: 136%
Location: USA
Default

Some very stark comments at that link, Janet. I love the seniors crying out against "all these pills!"

They are often not the solution at all, and in fact can make things so much worse. I feel blessed by the long term decisions I have made that are keeping me still pill-free when all about me are on at least three.
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  #11   ^
Old Sun, Feb-26-17, 21:22
Whited Whited is offline
Senior Member
Posts: 299
 
Plan: Very Low Carb
Stats: 312/235/185 Male 66 inches
BF:
Progress: 61%
Location: Missouri
Default

Good points. I did find a doctor that looks at nutrition first then only if neccesary prescribes drugs. Actually for diabetes the receptionist said they recommend a totally paleo low carb diet with no extra carbs except from vegatables. While that might be a little strict for me (I like Bernstein's 30 carb a day plan) that shows me they are my kind of doctor. Unfortunatley the doctor isn't taking new patients and I could only get in to see the nurse pratitioner. However, I've heard real good things about her. But the first opening is the middle of May. That means I'd have to put up with 160/100 BP for three months unitl I could get in just to start treatment (or discovery of the problem). My regular doctor would freak out if I told him I wanted to wait. The other option is go back on the BP drugs until then but the doctor I have will insist on the diuretics (the same in the article). Then I would potentially screw up my blood sugars and cholesteral and insulin resistance. I now have excellent HDL and LDL and controlled BG. I'd sure hate to reverse that after two years of work. Of course my doctor would suggest metfomin to deal with the rising BG, you get the picture. I know he thinks I'm totally overreacting and perhaps I am but there are a LOT of articles implicating these type of diuretics with blood sugar problems and also weight gain. Also for the three or four weeks I took the diuretic I had real loopy episodes. Almost as if my BG was super low. I even had to concentrate to drive right after I took it. And it wasn't that my BP or BG was too low. It wasn't. When I left a note for the doctor he said the side effects weren't casued by the drug -- just a coincedence. Funny though when I stopped the drug the loopy weird symptoms stopped immediatly.

So you see my dilema. I just wish I could talk to someone (not my drug happy doctor) who could tell me if that's (the high BP) is really going to mess with my kidneys in that timespan.

I have gone back to a strict low carb plan (no occasional cheating, take decent supplements, drink hibiscus tea 3 X daily etc. but I don't even know if that will take effect or how long. Maybe there's a hidden reason my BP is high.

I tell you what -- I get why people just say screw it and eat what they want and just take a fistful of drugs, forget it and hope for the best -- I really do. It makes life easier, I know its not so healthy, but easier.

Last edited by Whited : Mon, Feb-27-17 at 08:15.
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  #12   ^
Old Mon, Feb-27-17, 04:05
JEY100's Avatar
JEY100 JEY100 is online now
Posts: 13,368
 
Plan: P:E/DDF
Stats: 225/150/169 Female 5' 9"
BF:45%/28%/25%
Progress: 134%
Location: NC
Default

Dennis, you seem set that you are changing to the new doctor practice, and both doctor and NP do seem supportive of controlling BG through diet. So on the nothing ventured method... call the office to see if you could 1. speak to the NP on only your one specific question (would Kidney damage occur at x average BP for 3 months..is it safe to wait?), 2. could you complete their new patient /med history forms now to get a file (including your home BP readings) in place, and finally, get on their wait list for last minute or any earlier openings. They will likely say can't advise over phone until have seen you and you are their patient, but be clear you will accept it as general advice while waiting.
You may find their practice does not prescribe diuretics or not until BP is consistently over 160/100.
You know your body better than a doctor, if you felt "loopy" on the med..it was not a coincidence. (See Dr Davis new book excerpt post in Media forum) Diuretics mess with electrolytes, low potassium is a known issue, and maybe combined with your lower carb diet, you felt side effects someone on a HC diet wouldn't.

Last edited by JEY100 : Mon, Feb-27-17 at 04:31.
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  #13   ^
Old Mon, Feb-27-17, 07:44
WereBear's Avatar
WereBear WereBear is online now
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Posts: 14,602
 
Plan: EpiPaleo/Primal/LowOx
Stats: 220/125/150 Female 67
BF:
Progress: 136%
Location: USA
Default

Quote:
Originally Posted by Whited
I tell you what -- I get why people just say screw it and eat what they want and just take a fistful of drugs, forget it and hope for the best -- I really do. It makes life easier, I know its not so healthy, but easier. So what that I have 78 fasting blood sugars now if my blood pressure is high and all this work doesn't help.


Yes, because we are constantly fighting with the people who ignore what we tell them!

I think JEY100 is giving excellent advice and I support your attempts to "do it right" because there is a lot at stake. These are some serious side effects your doctor is dismissing.
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  #14   ^
Old Mon, Feb-27-17, 08:17
Whited Whited is offline
Senior Member
Posts: 299
 
Plan: Very Low Carb
Stats: 312/235/185 Male 66 inches
BF:
Progress: 61%
Location: Missouri
Default

Thanks ladies -- hope I didn't sound too whiney. Another thing I thought was refreshing was that the receptionist said their philosophy was that that it was the patient's body and they had the final say, not the doctor.
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  #15   ^
Old Mon, Feb-27-17, 08:39
WereBear's Avatar
WereBear WereBear is online now
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Posts: 14,602
 
Plan: EpiPaleo/Primal/LowOx
Stats: 220/125/150 Female 67
BF:
Progress: 136%
Location: USA
Default

My gosh, you are down almost a hundred pounds, I would think that is a big adjustment for your body to make: almost like it is still thinking that it has to push blood through all those extra pounds!

Blood pressure can be the last thing to come down: and there are studies out now that indicate drugs don't solve the problem: they just stress other systems while trying to make the BP read lower. As in your case, screwing up the electrolytes that make the whole thing work.
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