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Low blood pressure

Pinkerbell

Well-Known Member
Messages
56
Location
Cambridge
Type of diabetes
Type 1
Treatment type
Insulin
I was wondering if anyone else with LADA suffers from low blood pressure and fainting episodes? I often partially black out on standing, particularly after food or on a hot day (gardening is a nightmare in the summer!) My BG, is variable at these times, but my blood pressure is always low. I have only suffered from these symptoms since the onset of diabetes three years ago and have had multiple tests on my heart, which was deemed healthy, as well as several tests for Addison's.
 
I'm T2 but have had problems with low BP to the point of fainting. It's better since I started on thyroid hormones but now and then I get AF and my BP falls rapidly. I got myself a BP monitor to show I wasn't making things up.

Have you had a heart monitor recorder thingy? That's how they picked up the AF in my case. There are also methods to record BP during 24 hours but I don't know much about that.

My BP rarely goes below 95/55 now.
 
Hiya, I also have a history of thyroid problems, but have been stable for about 20 years now. I had a 24 hour heart monitor, an echocardiogram, tilt table test and multiple ECGs, the consultant was brilliant and seemed confident that my heart was in good shape! He theorised that a naturally low BP was exacerbated by the 'flushing' mechanism triggered by high blood sugars. The faints reduced massively after starting on insulin, but have recently started up again with a vengeance. I seem to get problems only when it drops below 110/60. I fell and hurt my knee the other day and it feels like just a matter of time before something more serious happens
 
110/60 is normal so question is why you faint.

You mentioned adrenal checks. Any other symptoms of low cortisol?
 
I'm OK at that level, but when I drop below that I have problems standing. It usually happens after I eat...I stand up slowly, stand for a moment in my soft carpeted living room to make sure I'm OK,take a few steps into my tiled hallway and that's usually where it happens! My HR goes up to 100+ and I feel a little breathless also. I'm not sure about the low cortisol symptoms, my BG does have a tendency to return to just below 4 by the evening (I still have some insulin capability) and I do have some pigmentation on my calves and face, but three short synacthen tests have turned up nothing, although I don't think my endo has completely dismissed the idea :/
 
The synacthen test shows your adrenals work properly but doesn't say if your pituitary does. Is you cortisol generally low? Have you other signs and symptoms of low cortisol and/or low aldosterone?

Have you had FT3 tested?
 
If you had Addison's then both your bp and bs would be low very low in fact and you would not be able to raise your bs if you were an untreated addisonian. As a matter of interest how far does your BP drop when you stand up?
Found this if it's of any help http://www.bloodpressureuk.org/BloodPressureandyou/Yourbody/Lowbloodpressure
This is interesting as well http://patient.info/health/synacthen-test

PS just looked at your profile and you say you exercise 1 - 2 hours a day an undiagnosed Addison patient would not be able to exercise. Putting one foot in front of the other is like climbing Everest.
 
Last edited by a moderator:
Pinkerbell said:
Ummm in answer to all those questions, I don't know! What's FT3?
Click to expand...
The active thyroid hormone. IMO, the one that counts. Common thyroid tests are TSH and FT4. TSH is a pituitary hormone, FT4 a thyroid hormone and the synthetic version is what you get with Levothyroixine. It's FT3 that matters though. It tells you how much usable thyroid hormones you have in your blood. That's not the whole story but a good help.
 
As @Pinkerbell has had three synacthen tests with normal results I draw the conclusion she has symptoms of low cortisol but no adrenal problem as such.
 
Awesome, that's very reassuring The last thing I need are any more complicated long term conditions! I guess it might just be something I have to learn to live with. I'm just finding it a bit frustrating to not be able to find out why it keeps happening
 

Ahhh I see, I'm not sure if they test that, but I had been stable with no symptoms for 20 years after radioactive iodine treatment for graves and starting on Levo. That is, until I started to develop LADA a couple of years ago. Is there a kind of negative interaction between diabetes and medicated thyroid?
 
Not as far as I know. Long-term Levo treatment can however result in lower ability to convert the synthetic T4 to usable T3. Get FT3 checked.
 
BTW, do you eat enough salt? You could try some extra salt and see if it helps. I take half a teaspoon of sea salt in a small glass of water once or twice per day when heart/BP seems out of order and it helps surprisingly often.
 
Hi I also had / have this although it us much better recently. I have t1 but had adrenal insufficency after having my son. It's adrenal insufficiency rather than addisons as my adrenals were fine (as totto mentions) however my piturity gland wasn't sending the signal so no cortisol produced! For some reason it started to work again, however I still get spouts of this and had the symptoms you described. If it is postural hypotension and is mainly when you stand you could ask them about fludrocortisone as this really helped me anyway. For me, they now think I have it because of my autonomic neuropathy but I'm not so sure:/ I think there may still be a problem with piturity. Have you had an MRI? I've upped my salt intake and try to drink more too and this might be why it's improved. Hope you get some answers, it's horrible isn't it.
 
Not as far as I know. Long-term Levo treatment can however result in lower ability to convert the synthetic T4 to usable T3. Get FT3 checked.
Click to expand...

I didn't realise that, I will raise it with my consultant, thanks I have raised my salt intake, but not made much difference so far. Does it work straight away, or is it a cumulative effect?


Thank you, yes it's rubbish! I will question my cortisol levels as I have no idea of the actual numbers. I I've not had an MRI, but will question whether it might be useful when I next visit the hospital. I thought starting on insulin and gaining a little weight had improved the situation, but now I'm back where I was before with no idea why
 
Additional salt will show effect within half an hour, usually less. Start with half a teaspoon, if no effect in half an hour, add another half. If no effect from that I'd say it's not salt deficiency.
 
I know you already do this, but you might need to get up even more slowly than you already do. My brother has battled with low BP for years and his doctors say there is nothing they can do to help. He just gets up really slowly. I hope you find some answers soon.
 
Thank you, I've started leaning on the bookcase for a while until I'm sure it's passed!
 
I have primary Addison's disease and ran a half marathon a week before my diagnosis/ crisis. I had been ill and very tired before, but I guess it is possible to exercise and have it!

Ask for you cortisol test results Pinkerbell. Have you had a morning cortisol test?

I agree that fludrocortisone might help with your symptoms, with or without addisons.

Take care and I hope you get it sorted soon x x x
 
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