Sign-in to Ask A Doctor - 24x7
OR
Sign in with Google
Hi, I Am Concerned About A Recent Drop In Blood
Question: Hi,
I am concerned about a recent drop in blood pressure (namely diastolic) and systematic pains.
Taking readings at home, my average pressure is 110/65. At night it can fall as low as 97/45...usually 99/57’ish. I am getting some neuropathic pains in my feet/legs at night with muscle cramps/tinges in my calves. Also getting daytime arthritis/stiffness in joints (bilateral tendinitis in elbows/knuckle pain fingers/wrists) and daytime /skeleton/muscular pain/twitching/shock sensations in my shoulders/ribs/arms and legs.
After exercising I am getting nerve pain in my leg (previous surgery but no prior nerve pain) and get more than usual fatigue after doing cardio (blood pressure seems to drop with symptoms (I feel bad) that evening.
I used to have normal BP (sometimes prehypertensive) and this all came about after taking medication with many known toxicities including mitochondrial toxicoties albeit rare.
Had an stress echo, chest X-ray and abdominal MRI (all normal) and my comprehensive panel was all moral (WBC/Comp14 as well as ESR and creatine protein and ANA).
Any thoughts on what could be going on? Next steps? Testing I should consider?
Do you think these BP readings (given symptoms) sound dangerous?
Thank you.
I am concerned about a recent drop in blood pressure (namely diastolic) and systematic pains.
Taking readings at home, my average pressure is 110/65. At night it can fall as low as 97/45...usually 99/57’ish. I am getting some neuropathic pains in my feet/legs at night with muscle cramps/tinges in my calves. Also getting daytime arthritis/stiffness in joints (bilateral tendinitis in elbows/knuckle pain fingers/wrists) and daytime /skeleton/muscular pain/twitching/shock sensations in my shoulders/ribs/arms and legs.
After exercising I am getting nerve pain in my leg (previous surgery but no prior nerve pain) and get more than usual fatigue after doing cardio (blood pressure seems to drop with symptoms (I feel bad) that evening.
I used to have normal BP (sometimes prehypertensive) and this all came about after taking medication with many known toxicities including mitochondrial toxicoties albeit rare.
Had an stress echo, chest X-ray and abdominal MRI (all normal) and my comprehensive panel was all moral (WBC/Comp14 as well as ESR and creatine protein and ANA).
Any thoughts on what could be going on? Next steps? Testing I should consider?
Do you think these BP readings (given symptoms) sound dangerous?
Thank you.
Brief Answer:
Peripheral neuropathy and Multiple Sclerosis to be investigated further.
Detailed Answer:
Hello,
I have read your question and here is my advice.
First of all these blood pressure readings are not dangerous and are in the lower extremity of the normal ranges.
It is true that certain drugs may cause peripheral neuropathy as adverse effects,so, I think you should get evaluated further in this direction.
Other causes of peripheral neuropathy include alcohol use, diabetes, viral infections, diabetes, chemicals poisoning, low vitamin B12, etc. and these should be investigated as well with appropriate blood tests.
Nerve conduction study and EMG are also necessary examinations in order to achieve a correct diagnosis.
It is possible that peripheral neuropathy may include damage of the small autonomic nerves that may explain this lowering of the blood pressure.
Another neurological condition to consider even to exclude is multiple sclerosis that may mimic a number of conditions including peripheral neuropathy like symptoms.
Getting evaluated by your Neurologist is necessary besides the diagnostic tests and before them.
This way you can get a correct answer to your concerns and a correct treatment.
Hope you found the answer helpful.
Let me know if I can assist you further.
Thanks.
Peripheral neuropathy and Multiple Sclerosis to be investigated further.
Detailed Answer:
Hello,
I have read your question and here is my advice.
First of all these blood pressure readings are not dangerous and are in the lower extremity of the normal ranges.
It is true that certain drugs may cause peripheral neuropathy as adverse effects,so, I think you should get evaluated further in this direction.
Other causes of peripheral neuropathy include alcohol use, diabetes, viral infections, diabetes, chemicals poisoning, low vitamin B12, etc. and these should be investigated as well with appropriate blood tests.
Nerve conduction study and EMG are also necessary examinations in order to achieve a correct diagnosis.
It is possible that peripheral neuropathy may include damage of the small autonomic nerves that may explain this lowering of the blood pressure.
Another neurological condition to consider even to exclude is multiple sclerosis that may mimic a number of conditions including peripheral neuropathy like symptoms.
Getting evaluated by your Neurologist is necessary besides the diagnostic tests and before them.
This way you can get a correct answer to your concerns and a correct treatment.
Hope you found the answer helpful.
Let me know if I can assist you further.
Thanks.
Above answer was peer-reviewed by :
Dr. Vaishalee Punj
Thank you- will make an appointment. I’ve got a few f/u questions.
I noticed that some of my readings have an arrhythmia/irregular symbol by them- including one I took this morning upon waking (could acutually feel the arrhythmia). I visited a cardiologist about a year ago (echo/stress).
Are arrhythmias realted to autonomic NP imminently dangerous? Prompt cardio follow up needed or discuss with neuro?
Is there any sense in making an appointment with a rhemetologist as well? (Fingers can feel broken sprained when pressure if put against them and knuckle swelling...and elbow pain also seem to have arthritic features).
Thanks.
I noticed that some of my readings have an arrhythmia/irregular symbol by them- including one I took this morning upon waking (could acutually feel the arrhythmia). I visited a cardiologist about a year ago (echo/stress).
Are arrhythmias realted to autonomic NP imminently dangerous? Prompt cardio follow up needed or discuss with neuro?
Is there any sense in making an appointment with a rhemetologist as well? (Fingers can feel broken sprained when pressure if put against them and knuckle swelling...and elbow pain also seem to have arthritic features).
Thanks.
Brief Answer:
Get evaluated first by your Neurologist.
Detailed Answer:
Welcome back.
If confirmed, neuropathy may cause arrhythmia if the autonomic system is affected.
I don't think it is necessary right now to see a Rheumatologist, you can do so if your Neurologist will think if it is necessary.
Hope this helps.
Take care.
Get evaluated first by your Neurologist.
Detailed Answer:
Welcome back.
If confirmed, neuropathy may cause arrhythmia if the autonomic system is affected.
I don't think it is necessary right now to see a Rheumatologist, you can do so if your Neurologist will think if it is necessary.
Hope this helps.
Take care.
Above answer was peer-reviewed by :
Dr. Kampana
Answered by
Get personalised answers from verified doctor in minutes across 80+ specialties
