It’s a diuretic and it’s taken for people who need to get rid of fluids. I’m taking it to make a different med work better. I’m not drinking more water than normal and I’m skinny. Where is the extra liquid coming from to make me pee more?
It didn’t create more urine, in my experience. It created more urgency, “you will pee right now” as long as it was on board, until it had pulled as much fluid out of circulation as the drug’s blood level and half life synergy could make happen. I choose the timing of that “right now!” to be over long before I planned to be asleep by taking it in the morning. If my schedule called for me to be somewhere without easy access to bathrooms soon after I was due to take it (like being on a plane or at a huge outdoor event), I just juggled taking it that day to a point in the day where I’d again be back in easy access to bathrooms for those several hours of urgent diuresis. YMMV.
Thanks. That makes sense. And I’m not suffering that effect thankfully.
I’ll go ahead and bump this thread rather than start a new one. We’re still trying to dial in my BP meds and it’s starting to drive me a little nuts.
Started on Losartan alone, and it didn’t bring my BP down nearly enough. Something else got added in there (I can’t remember what), and it still wasn’t working.
New doc has me trying a combination of Hydrochlorothiazide, Amlodipine, and Valsartan. Changed dosages a couple of weeks ago, because I was having a lot of light-headedness. BP was running 110 - 114/60-ish. Because the new dosages are not available in a combo pill, I’m taking each one separately, Hydrochlorothiazide in the morning, and the other two before bed. For the last couple of weeks I’ve been feeling good with hardly any light-headedness and BPs pretty consistently around 120/70. All good, right?
This morning I went to the gym for the first time in a couple of weeks for a half-hour strength training workout. Started getting ing a little dizzy about 20 minutes in, and quit early a couple of minutes later. Had to sit down for 5 minutes or so before i felt good enough to drive home. A half-hour after the end of my workout, my BP measured 82/50 (!) and I still wasn’t feeling great. My pulse was 91 (after a max of about 135 during the workout), and historically my HR recovers much faster than that.
So - I don’t know if I’m still adjusting to the new dosage or what, but if I can’t exercise that’s not going to work for me. It’s just so frustrating having to do all this trial and error.
Grrrr.
I think I posted earlier in this thread.
Blood pressure is just a range that doctors try to fit you into or prescribe drugs. You have a natural BP range of your own that may be fine.
My BP used to be about 160/80, used to be normal but now the Dr must do something about it because they consider that out of the prefered range. They will not even consider that perhaps each person may be defferent from the next one.
I have permanent, persistant atrial fibrilation, always been there since I was young, always will be. My old doctor would just ask me, “do you know that you have extra heartbeats?” I thought everone’s heart did that. He was about to put me on Metoprolol but his ekg machine was broken so he sent me to the hospilal next door to get a ekg. Holy shit! They were convinced i was in the middle of a heart attack! Spent a week in there and about $30k. Ecocardiagram, every test they could do. I still felt just fine.
Prescription:
Warfarin as a blood thinner and a rat poison. I couldn’t even shave before going anywhere, a simple nick would bleed for hours. I realised that if I fell and hit my head I was likely to die of a brain bleed, from the stuff that was saving me. I quit taking that. Oh no! your afib may cause a blood clot in your heart leading to a stroke! No, not after 50 of more years. Plus you have to go in for regular INR tests.
Losartan Potassium. I liked that, maybe just a placibo effect but it seemed to make me feel better for no reason.
Spironolactone. was interesting. My personal care dr. a young lady said she was on it for acne when she was young. I was taking it as a water pill that would not drive the magnesium out of your system, so you would not get cramps. My only side effect was that every grey hair that fell out would come back it its original color. Took years off of my apparent age. I understand that it is used to treat a hair loss condition too, which I am not going to look up now, that is probably where the side effect on hair comes from. Not really sure of the science behind how it works, but it has many talents.
Metoprolol is a beta blocker that helps a number of other things to calm your heart down. 200mg a day, you may as well go home and sit on the couch an wait to you die. I if you are a man, I hope you remember what a hard on was like. I quit taking it
There are probably other drugs I can’t remember.
I retired a few hears ago but instead of sitting around and getting fat, I actually eat a lot less and not as often. A small meal once a day in the afternoon is plenty. So I lost about 30 lbs doing nothing. I have my own BP reader but I don’t really worry about BP anymore. Lose weight is what your really need to do.
My normal BP was about 160/80 for years and told that is too high. I now take zero medications and my normal BP is about 160/80.
(referring to spironolactone) It affects the androgen levels, and helps with hair loss in some people. I’m female, and I was prescribed it because I was losing a lot of hair and needed a new BP med anyway. It didn’t help with the hair loss, sadly. Last year I switched to minoxidil, the same minoxidil that people rub all over their scalps for hair loss, but in pill form. It was originally a BP med. It not only works beautifully on my blood pressure, but also reversed the hair loss - it’s all grown back in. Same thing with my sister.
There are advantages and disadvantages to higher blood pressure. My mom fainted when she stood up (or even sat up quickly) when her BP was “normal”. So she maintained it at high enough levels that every time she was admitted to a new hospital (for things unrelated to BP) i had to talk down the hospitalist, and explain that was normal for her. I think her high BP contributed to her dementia; she probably had a series of micro-strokes, and had lost a huge fraction of her brain volume before her death (which was not related to her blood pressure issues.) On the other hand, falling is very dangerous for the elderly. In fact, a fall indirectly did lead to her death (very indirectly) and significantly reduced her quality of life (very directly). So keeping her blood pressure lower would likely have caused more serious problems than keeping it high.
I take Amlodipine and Losartan for high blood pressure (also Rosuvastatin for cholesterol) I think the only actual side effect was low potassium , which I take another pill for.
But as for any noticeable side effects, I haven’t noticed any.
Yeah that happened to me! The stupid PA bumped the machine or it had a power surge or some shit so she thought I was having a stroke or something and sent me to NYU Langone Hospital.
Spironolactone has a mild testosterone-blocking effect, which is one reason why it can be used for acne when lesser treatments fail, if the person (usually a girl) has a hormone imbalance.
You know you have the legal right to refuse medical care, right? I checked myself out when the hospital wanted me to stay overnight for observation. Then i drove to a square dance. Because it was clear to me before i left that i wasn’t having a heart attack, and hadn’t had a heart attack. I eventually got around to doing the stress test they recommended (it was normal) but not until after a vacation where i was at least 45 minutes from an emergency department, probably more like 2 hours, depending on exactly where on the island i was.
Spironolactone also, oh joy, oh bliss, promotes gynocomastia in men.
Metoprolol caused me to gain 50 lbs. and when I asked the Dr about it, he said he’d never heard that. Plus, my feet really swelled up.
All they did was an ekg and some tests to figure out what was going on. I didn’t have to stay overnight or anything.
I haven’t read this entire thread, but coughing is a side effect of ACE inhibitors. You can take an ARB instead that basically does the same thing, and this will not cause the coughing.
I’m on an ARB and a CCB and I have zero side effects from them. Having said that, I had severe side effects from metoprolol and chlorthalidone. But I quit taking them.
You can take eplerenone instead of spironolactone instead if you need an aldosterone antagonist. Eplerenone doesn’t cause the sexual hormonal effects of spirononlactone.
Am taking that to heart; I can’t thank you enough for the info! I don’t like having bigger &$+=#%s than my wife.
My understanding is that the lifetime NNT (number needed to treat) for hypertension is around 5-10.
What that means is if you take a group of 1000 people who are in their 30s or 40s who have hypertension and put them on meds, then about 100-200 would’ve had a heart attack or stroke, or another complication of hypertension over the course of their lives, but didn’t due to the meds.
The rest either never would’ve had complications from hypertension, or they would’ve had strokes or heart attacks anyway irrelevant of if they took the meds.
on a society wide level those numbers are impressive. But as an individual, that means there is about an 80-90% chance you won’t benefit from taking the meds over the course of your life. If the meds cause chronic side effects, its something people need to consider.
Having said that, the more risk factors you have the higher your chances of benefitting. If you’ve had a heart attack or stroke in the past, or if your hypertension is extremely high, or if you have various other risk factors, etc your chances of benefitting go up.
I had a PCP put me on lipitor, and it caused such severe muscle pain I could barely walk. I would rather take the risk of a higher rate of a a heart attack or stroke than suffer from crippling muscle pain the rest of my life. My understanding is statins have a lifetime NNT of about 10, so even if I had taken the lipitor my entire life, there is a 90% chance I wouldn’t benefit. If the drug caused no side effects, that would be fine. But crippling muscle pain is a serious side effect.
one issue is that the medical profession is full of practitioners who gaslight their patients. It happens all the time. If a patient says a med causes a side effect, the practitioner may gaslight the patient to make them believe they are wrong. Its a very serious issue and happens all the time. That’s not to say that all practitioners do it, I’ve had practitioners believe my input and had others gaslight me. But its very common and very frustrating. Also the more social stigmas you carry as a patient (female, black, obese, mental health history, etc) the more practitioners will gaslight you.
At the end of follow-up, 2,851 of the 4,736 randomized patients (60.2 percent) had died, with 1,416 deaths (59.9 percent) in the active treatment group and 1,435 deaths (60.5 percent) in the placebo group. The researchers found that both life expectancy and time to the 70th percentile survival at the end of follow-up were longer for the SHEP participants who were randomized to the active group compared with those randomized to the placebo group. Life expectancy gain at 22 years was 158 days for cardiovascular death and 105 days for death from all causes. The gain in life expectancy free from cardiovascular death corresponds with 1 day (0.89 days) gained per month of treatment. For all-cause mortality, the gain in life expectancy from 1 month of antihypertensive drug treatment was estimated at a half day (0.59 days).
The authors also found that the active treatment group was associated with higher survival free from cardiovascular death compared with the placebo group (669 deaths [28.3 percent] vs. 735 deaths [31 percent], respectively).
“Reporting that each month of antihypertensive therapy was associated with 1 day prolongation of life expectancy free from cardiovascular death is a strong message that may result in increased patient adherence to drug therapy and decrease the degree of therapeutic inertia by health care providers,” the authors write.
That article is meant to make anti-hypertensive therapy sound more appealing, but when you do the math it’s really not that impressive. An extra 0.59 days of life expectancy for every month of anti-hypertensive therapy works out to about a week of life expectancy after a year of therapy. That’s about 9 months of life expectancy after using the medications for 40 years. If the meds cause severe side effects, that’s not a good deal.
But its really not like everyone gets an extra 9 months. Its more like ~10% of people get an extra 5-10 years of life expectancy, and the rest don’t gain any increase in lifespan.
The point is that, its complex. The mentality that the meds only do good and never do bad, and that everyone who takes them benefits and benefits in a meaningful way, it deeply woven into our culture but its more complex than that. Numbers on a lab test are just one part in the risk factor of disease.
Several years ago, I got fed up with the meds and was going to stop taking them. I asked a pharmacist and the office manager at the Dr.’s office what might I expect and was told Rebound Heart Attack. No further explanation, but I did respect the pharmacist’s opinion more than the Dr.’s office.
After a heart attack some years ago, I was hospitalized with a recommendation for triple bypass surgery. This is a story I’ve told before, but when I pushed back on that, it was agreed that stenting (PCI) would be adequate, but then I’d have to take blood thinners and blood pressure medications for the rest of my life.
I’ve more or less been on them, but not regularly at all, and with no ill effects. When I recently pushed back on my cardiologist about all these drugs, we agreed on a regimen of just a single blood pressure medication, and the anti-coagulants/anti-platelets, orginally Brilinta and then Plavix, being replaced by simple baby aspirin (well, enteric coated 81 mg ASA, which isn’t quite the same).
The medical profession and their motivations are interesting. When it comes to mood-altering drugs, especially opiates, they won’t prescribe shit. But when it comes to infesting your body with drugs that affect your heart function, they churn out prescriptions like snowflakes in a blizzard in January!
I’ve been on Warfarin due to AFib for about 20 years, with nary a problem. I do have to go take INR tests every six weeks or so, but I’m always right in the middle of the acceptable range.
My BP bounces around a lot, and I recently started Prinivil, with the dose increasing from 10 mg to 40 to get it down. It still bounces, but is lower in general. No side effects I’ve noticed.
Also I know this thread is about blood pressure medication, but a few people mentioned statins and the side effect profiles from those.
Here is some info that may be helpful to anyone who reads this thread to runs into that issue.
Some statins are fat soluble, and some are water soluble. The water soluble ones cause less muscle pain than the fat soluble ones since they don’t dissolve into muscles as well. Ones like crestor and Rosuvastatin cause less muscle pain than ones like lipitor that are more fat soluble.
Another thing to keep in mind is the ‘rule of 6’. The minimum dose of statins will lower your LDL about 30-50%, but each time you double the dose after that it only lowers your LDL by another 6%. Like the minimum dosage of lipitor is 10mg a day and will reduce your LDLs by 30-40%. But the maximum dose is 80mg and that lowers your LDLs by maybe 50-55%.
10mg will cut your LDL by maybe 36%
20mg will cut your LDL by maybe 42%
40mg will cut your LDL by maybe 48%
80mg will cut your LDL by maybe 54%
So if you can’t tolerate a high dose, maybe you can tolerate a lower dose.
Basically, an 80mg dose of lipitor will be far far more likely to cause muscle pain than 5mg of crestor. But the 80mg lipitor may lower your LDLs by 55%, while the 5mg crestor may still lower your LDLs by 35-40%.
Another thing to keep in mind is that PCSK9 inhibitors can lower LDLs dramatically and do not cause muscle pain. However they are injections and they cost more than generic statins.
Stuff to discuss with your medical team if you run into side effects from statins.
12.5 mg HCTZ (lowest dose). I get my potassium checked twice a year and salt my food since my sodium runs at the lower end of the normal range. No side effects.