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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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What Causes Difficulty In Balancing?

Hi, I am on Simvastatin 40mg but lately I am feeling unbalanced on my feet, like a drunk, first thing in the morning but it cleared up during the day. I tak e 40mg at night. my other medication iscandesartan 32mg a day pradxa 110MG 2X a day Metoprolol 95mg once a day. please advice. my e-mail address is YYYY@YYYY Thank you
Mon, 31 Aug 2015
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Cardiologist 's  Response
Hello!

Welcome and thank you for asking on HCM!

Regarding your concern, I would explain that your symptoms may be related to Candesartan treatment.

In some studies, Candesartan treatment has been associated to coordination problems and gait difficulty (called ataxia).

Neither simvastatin, nor metoprolol have any similar side effects.

I recommend consulting with the GP for a careful physical examination and perform some lab tests :
- a complete blood count
- thyroid hormone levels
- fasting glucose
- kidney and liver function tests
- blood electrolytes
- Vitamin B12 plasma levels,

to exclude other metabolic disorders related to this symptomatology.

I would also recommend performing a nerve conduction study to rule in/out possible peripheral neuropathy.

A brain CT scan may be needed if suspicions for a cerebellar disorder are raised during physical examination.

If all the above tests result normal, I recommend consulting with your cardiologist to consider the possibility to switch into another ARB, different from candesartan.

Hope to have been of help!

Best wishes,

Dr. Iliri
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What Causes Difficulty In Balancing?

Hello! Welcome and thank you for asking on HCM! Regarding your concern, I would explain that your symptoms may be related to Candesartan treatment. In some studies, Candesartan treatment has been associated to coordination problems and gait difficulty (called ataxia). Neither simvastatin, nor metoprolol have any similar side effects. I recommend consulting with the GP for a careful physical examination and perform some lab tests : - a complete blood count - thyroid hormone levels - fasting glucose - kidney and liver function tests - blood electrolytes - Vitamin B12 plasma levels, to exclude other metabolic disorders related to this symptomatology. I would also recommend performing a nerve conduction study to rule in/out possible peripheral neuropathy. A brain CT scan may be needed if suspicions for a cerebellar disorder are raised during physical examination. If all the above tests result normal, I recommend consulting with your cardiologist to consider the possibility to switch into another ARB, different from candesartan. Hope to have been of help! Best wishes, Dr. Iliri