Posted by CareBear04 on March 18, 2005, at 16:13:48
Dear Dr. Steinhauer,
I was wondering whether you could comment on the connection between weight and blood pressure. I know there's a correlation at the high ends-- obesity and hypertension-- but what about at the other extreme?
I'm a 22-year old female with baseline BP between 110 and 120 systolic. I've always been a little underweight but otherwise healthy. In the fall, various circumstances caused me to lose about 15 pounds, placing me at a BMI of around 15. Since then, my BP has been no higher than 90 systolic, usually between 70-80, even though I've gained back most of the weight I lost. At first, I was always really dizzy, but I think my body has adjusted. I'm not so lightheaded, and I'm able to be pretty active. I have trouble standing still for very long, but I can walk and swim, and I drive short distances. The major concern has been passing out, which has happened several times. The last instance was about three weeks ago, but as long as I remember to get up slowly, I'm usually fine.
During this time, my pulse has, if anything, been too fast. I don't know if this is a natural compensation for the low BP or whether it's med-related (I take Adderall, Concerta, and Prozac among others). Recently, I've also started having bad tremors that are unlike the tremors I'm used to from lithium. They involve the whole body and feel like the shakiness associated with low blood sugar, but I've been eating small meals frequently.
Should I be more concerned about these problems? And is there any suitable treatment for them? I see my psychiatrist 2x a week (and am cutting back to once a week), my PCP once every two weeks, my physical therapist 2x a week, and other doctors about once a month. I also have to get labs drawn once a week. It all adds up to a lot of time, and I'm tired of all the appointments. Also, have you ever known medical supervision of weight to be detrimental? The frequent weight checks and all the outside pressure to eat more-- something I am already trying to do-- make me want to do the opposite, though I've been consistent with weight gain. I feel medically and psychologically stable, and I'd like to feel more autonomous and less supervised. What sort of monitoring and frequency of visits do you think is appropriate? I'm sure the recommendation depends on more details than I've provided, but I was hoping you could give me a general idea. Thank you so much!
poster:CareBear04
thread:472551
URL: http://www.dr-bob.org/babble/eating/20050314/msgs/472551.html