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Suggest Treatment For High BP, Nausea And Diabetes
Question: Neuropathy not associated with diabetes, increased thirst, slight nausea,high blood pressure controlled by amlodipine and triamterene HCTZ
Brief Answer:
More info on neuropathy might be useful.
Detailed Answer:
I read your question carefully and I understand your concern.
While neuropathy is commonly due to diabetes, there can be many other causes to it. I wonder what type of neuropathy you have, tests have you had to determine the cause, some more information would be appreciated. That is as the first rule in treating neuropathy is identifying the cause and addressing it when possible. Causes can be many such as nutritional deficiencies, hormonal alterations, nerve compression, infections, inflammation etc.
If you have had testing and no cause has been found (may happen in 25% of cases) then according to the symptoms medication with gabapentin, pregabalin or duloxetine may be considered.
As for the symptoms of thirst and nausea, I wonder if you have considered them being side effects of medication. You take two diuretics in triamterene HCTZ which may cause dehydration and thirst as a side effect. So you should discuss with your doctor the possibility of trying another blood pressure medication instead.
I remain at your disposal for other questions.
More info on neuropathy might be useful.
Detailed Answer:
I read your question carefully and I understand your concern.
While neuropathy is commonly due to diabetes, there can be many other causes to it. I wonder what type of neuropathy you have, tests have you had to determine the cause, some more information would be appreciated. That is as the first rule in treating neuropathy is identifying the cause and addressing it when possible. Causes can be many such as nutritional deficiencies, hormonal alterations, nerve compression, infections, inflammation etc.
If you have had testing and no cause has been found (may happen in 25% of cases) then according to the symptoms medication with gabapentin, pregabalin or duloxetine may be considered.
As for the symptoms of thirst and nausea, I wonder if you have considered them being side effects of medication. You take two diuretics in triamterene HCTZ which may cause dehydration and thirst as a side effect. So you should discuss with your doctor the possibility of trying another blood pressure medication instead.
I remain at your disposal for other questions.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Please provide examples or suggestions for tests that can be used to identify the underlying cause of the neuropathy. Specifically, suggestions for viral infections that could cause nerve damage or lead to hormonal alterations. Suggestions for specific nutritional deficiencies and identifying those nerves in the leg below the knee that may be inflamed or subjected to compression. The neuropathy is a constant condition.
Occasional episodes of the list of symptoms provided in the first communication apparently have a "trigger" which I cannot identify.
Sorry Dr. Taka. Thank you for your initial helpful response.
Occasional episodes of the list of symptoms provided in the first communication apparently have a "trigger" which I cannot identify.
Sorry Dr. Taka. Thank you for your initial helpful response.
Brief Answer:
Read below
Detailed Answer:
Hello again! Thank you for the follow up.
Again it would have been helpful if you had provided some more details on symptoms, time and manner of onset. The causes and as a results the tests for neuropathy is really extensive, one does not have them all, judging by manifestations it is decided on possible alternatives, or ones to rule out and which tests are needed.
Anyway tests to be considered include electromyography and nerve conduction studies (EMG/NCS), electrolyte panel (KCl/Ca/Mg/Phos), CPK, vitamin B12 levels, full blood count, erythrocyte sedimentation rate, TSH, hemoglobin A1c, Lyme titer, syphilis, liver and kidney function tests, serum and urine protein electrophoresis, antinuclear antibodies, XXXXXXX antibodies, ALA, ACE level, chest c-ray, heavy metals, fat pad biopsy for amyloid, Hep C virus, Hep B virus, HIV, cryoglobulins, MRI imaging.
The first test in identifying responsible nerves would be EMG/NCS studies
Viral infections which could cause nerve damage may include Lyme, hepatitis B anc C, Epstein Barr virus, HIV.
Most common hormonal cause is thyroid dysfunction.
Most common nutritional deficiency is vitamin B12 deficiency.
Let me know if I can further assist you.
Read below
Detailed Answer:
Hello again! Thank you for the follow up.
Again it would have been helpful if you had provided some more details on symptoms, time and manner of onset. The causes and as a results the tests for neuropathy is really extensive, one does not have them all, judging by manifestations it is decided on possible alternatives, or ones to rule out and which tests are needed.
Anyway tests to be considered include electromyography and nerve conduction studies (EMG/NCS), electrolyte panel (KCl/Ca/Mg/Phos), CPK, vitamin B12 levels, full blood count, erythrocyte sedimentation rate, TSH, hemoglobin A1c, Lyme titer, syphilis, liver and kidney function tests, serum and urine protein electrophoresis, antinuclear antibodies, XXXXXXX antibodies, ALA, ACE level, chest c-ray, heavy metals, fat pad biopsy for amyloid, Hep C virus, Hep B virus, HIV, cryoglobulins, MRI imaging.
The first test in identifying responsible nerves would be EMG/NCS studies
Viral infections which could cause nerve damage may include Lyme, hepatitis B anc C, Epstein Barr virus, HIV.
Most common hormonal cause is thyroid dysfunction.
Most common nutritional deficiency is vitamin B12 deficiency.
Let me know if I can further assist you.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thank you for the additional information on potential tests.
The onset of the episodes includes the symptoms given in the initial inquiry and an enhanced level of neuropathy. An episode usually starts with a restless night's sleep accompanied by an intestinal upset and other symptoms. The episodes tend to subside over time.
I intend to pursue the search for answers with my family doctor. Thanks again for the suggested approaches.
The onset of the episodes includes the symptoms given in the initial inquiry and an enhanced level of neuropathy. An episode usually starts with a restless night's sleep accompanied by an intestinal upset and other symptoms. The episodes tend to subside over time.
I intend to pursue the search for answers with my family doctor. Thanks again for the suggested approaches.
Brief Answer:
Read below.
Detailed Answer:
Thank you for the additional information. I am not sure you understood me completely as you still do not mention what you mean by neuropathy. In the initial inquiry you mention only thirst , nausea, increased blood pressure. None of those are neuropathy symptoms. I meant symptoms like tingling, numbness, painful or unpleasant sensations muscle weakness, balance issues etc as well as the areas involved over time, manifestations of neuropathy can be very different. The restless sleep and the intestinal upset may be due to other causes like anxiety.
Anyway it is good that you will discuss the issue with your family doctor, so that the appropriate tests will be chosen.
Wishing you good health.
Read below.
Detailed Answer:
Thank you for the additional information. I am not sure you understood me completely as you still do not mention what you mean by neuropathy. In the initial inquiry you mention only thirst , nausea, increased blood pressure. None of those are neuropathy symptoms. I meant symptoms like tingling, numbness, painful or unpleasant sensations muscle weakness, balance issues etc as well as the areas involved over time, manifestations of neuropathy can be very different. The restless sleep and the intestinal upset may be due to other causes like anxiety.
Anyway it is good that you will discuss the issue with your family doctor, so that the appropriate tests will be chosen.
Wishing you good health.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Brief Answer:
Read below.
Detailed Answer:
Yes, those complaints sound much more like neuropathy and they do deserve testing at least the nerve conduction studies and some of the most routine blood tests (vitamin B12 level, blood count, liver and kidney function, electrolyte panel and thyroid function). Whether more elaborate tests will be necessary will be decided depending on findings.
In the meanwhile gabapentin or pregabalin should help in alleviating those symptoms.
I hope to have been of help.
Read below.
Detailed Answer:
Yes, those complaints sound much more like neuropathy and they do deserve testing at least the nerve conduction studies and some of the most routine blood tests (vitamin B12 level, blood count, liver and kidney function, electrolyte panel and thyroid function). Whether more elaborate tests will be necessary will be decided depending on findings.
In the meanwhile gabapentin or pregabalin should help in alleviating those symptoms.
I hope to have been of help.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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