OT: BP meds and low carb diet...

[YeOldeCup]

I was on Lisinopril for many years and did low carb off and on with no negative effects.

A little over a year ago, I had an out-of-the-blue allergic reaction to the Lisinopril (angioedema) that resulted in a high speed trip to the ER before my throat swelled shut. As it turns out, this is a known, but unpredictable side effect. Oddly enough, my father-in-law suffered the exact same thing only a few months later, and he had been on Lisinopril far longer than I. Consequently, no ACE inhibitors or ARBs for me.

My doc and I experimented with several replacements and settled on Losartan, which has been effective in achieving the same BP range as the Lisinopril. However, I have twice now started on a low carb diet (which works really well for me), and find my BP crashes to as low as 85/55 under moderate exertion, which means I have to stop immediately. I have cut the dosage in half, but am still experiencing this -- I will reduce further to see if that works.

Have any of you experienced this (side) effect of Losartan and low carb?

 

[ThePennsyOracle]

Do you have a medical need for a low-carb diet?

 

[Delco Lion]

I am allergic to Lisinopril too. Had ER vist and that was the end of Alpha blockers. I dont think its the low carb diet. Have you spoken with your doc?

 

[YeOldeCup]

Do you have a medical need for a low-carb diet?

No -- I just kinda let myself go at times and leverage low-carb to cut the weight. I drop 10-20, then return to a more balanced diet with exercise.

 

[YeOldeCup]

I am allergic to Lisinopril too. Had ER vist and that was the end of Alpha blockers. I dont think its the low carb diet. Have you spoken with your doc?

I check in every six months for blood work, which will be due in a month or so, so we will discuss then. I'm cutting my dosage (literally cutting tablets) to see if I can discover equilibrium.

 

[Jack Hammer]

I was on Lisinopril for many years and did low carb off and on with no negative effects.

A little over a year ago, I had an out-of-the-blue allergic reaction to the Lisinopril (angioedema) that resulted in a high speed trip to the ER before my throat swelled shut. As it turns out, this is a known, but unpredictable side effect. Oddly enough, my father-in-law suffered the exact same thing only a few months later, and he had been on Lisinopril far longer than I. Consequently, no ACE inhibitors or ARBs for me.

My doc and I experimented with several replacements and settled on Losartan, which has been effective in achieving the same BP range as the Lisinopril. However, I have twice now started on a low carb diet (which works really well for me), and find my BP crashes to as low as 85/55 under moderate exertion, which means I have to stop immediately. I have cut the dosage in half, but am still experiencing this -- I will reduce further to see if that works.

Have any of you experienced this (side) effect of Losartan and low carb?

Losartan functions by softening the elasticity of the arterial walls - no reason that'd be affected by carbs in diet.
Often Losartan given in combination with a diuretic - Losartan HCTZ - which reduces blood volume.

 

[john4psu]

I never knew that could happen. I was on Lisinopril without any success and thankfully never had a reaction. I was on a diuretic for a while but too inconvenienced by it. I now take diovan (valsartan) and nifedipine, a calcium channel blocker, with success. Talk to your doctor.

 

[Delco Lion]

My allergic reaction to lisinopril was pretty bad. My lips and tongue swelled up, and my throat started closing up. I knew what was happening after a very quick Google search and went to the ER. YeOldeCup, I would not wait for your next appt. Ask for your docs asst-nurse, leave a VM and tell her what is happening. Adjusting your meds without the docs advice is probably not a good thing, and the significant drop in BP is certainly not a good thing.

 

[GTACSA]

I check in every six months for blood work, which will be due in a month or so, so we will discuss then. I'm cutting my dosage (literally cutting tablets) to see if I can discover equilibrium.

Don't you think 85/55 deserves a phone call to you doctor?

 

[not so fast my friend]

Very low carb can cause dehydration which can lower BP. Lower BP can be from weight loss. In worst case, if always drops during exertion, you may need a cardiac workup.

 

[YeOldeCup]

Don't you think 85/55 deserves a phone call to you doctor?

My mom and my wife have much lower BP than me and 85/55 is not out of range for them. I'm usually around 120/80 on Losartan -- it only gets quirky when I go low carb. The crash has never happened on a regular (or even unhealthy) diet.

Now that I recognize the symptoms - always due to exertion - I moderate my activity and stop if necessary to recover. When I'm done with low carb in a few weeks, it shouldn't be a problem. I was just curious about any similar experiences from the all-knowing board.

 

[YeOldeCup]

Very low carb can cause dehydration which can lower BP. Lower BP can be from weight loss. In worst case, if always drops during exertion, you may need a cardiac workup.

I had one of those "speedy" annual physicals earlier this year, but at 59, you're right -- I should get a closer look.

 

[tboyer]

I take lisinopril and have been low-carb on and off for quite a few years so I do have some thoughts for you.

BTW, read the "New Atkins" diet book (the one put out by Dr. Eric Westman at Duke). The Atkins Foundation has clinical experience with low-carb that goes back 50 years now so they have a lot of good advice and resources, and some pretty good explanation of the science behind it. Another great book if you are just curious about the science is "Why we get fat" by Gary Taubes which is a brilliant explanation of how human metabolism probably works.

1) If you have really bad BP or some conditions you're seeing a doctor for, you should consult your doctor about diet changes just in case you're missing something.

2) Low carb (or keto, or Atkins or South Beach or Paleo whatever label someone puts on it) is a great idea for almost anybody who wants to lose weight. It almost always works and it has the additional benefits of lowering blood pressure, lowering blood sugar/insulin, reducing (sometimes curing) insulin resistence. And usually it will dramatically improve your cholesterol ratio by raising HDL.

3) When you start a low-carb diet, over the first week or two you will lose a lot of water weight (because a carb-based diet causes you to retain water). That can TEMPORARILY drop your blood pressure quite a bit, plus you have lower blood sugar, so some people can feel faint. This will pass, but in the meantime drink a lot of fluids and maybe eat some salty things to help prop up your blood pressure during the transition.

When you begin to lose weight, after as little as 10-30 pounds, your base BP can drop quite a bit and you might even be able to discontinue your meds -- monitor closely. My weight fluctuates +-15 pounds depending on whether I'm eating carbs or not, and when I'm at the bottom of the range, my BP is normal without medication.

If you're consistently seeing BP that low, you might ask your doctor if you can reduce your Losartan during the transition. And drink fluids, maybe some salty broth if you're feeling faint. Generally in a few days your body will adjust and your BP will be back up to more normal. But when you lose the weight, remember, a lot of us only need BP medicine in the first place is because we're carrying a spare tire. Lose the weight you may be able to lose the meds.

I was on Lisinopril for many years and did low carb off and on with no negative effects.

A little over a year ago, I had an out-of-the-blue allergic reaction to the Lisinopril (angioedema) that resulted in a high speed trip to the ER before my throat swelled shut. As it turns out, this is a known, but unpredictable side effect. Oddly enough, my father-in-law suffered the exact same thing only a few months later, and he had been on Lisinopril far longer than I. Consequently, no ACE inhibitors or ARBs for me.

My doc and I experimented with several replacements and settled on Losartan, which has been effective in achieving the same BP range as the Lisinopril. However, I have twice now started on a low carb diet (which works really well for me), and find my BP crashes to as low as 85/55 under moderate exertion, which means I have to stop immediately. I have cut the dosage in half, but am still experiencing this -- I will reduce further to see if that works.

Have any of you experienced this (side) effect of Losartan and low carb?

 

[tboyer]

Now that I recognize the symptoms - always due to exertion - I moderate my activity and stop if necessary to recover. When I'm done with low carb in a few weeks, it shouldn't be a problem. I was just curious about any similar experiences from the all-knowing board.

It may be simply that you're not replentishing fluids when you exercise. Low carb means your body is carrying around less water, which is a good thing, but it means it's easier to get dehydrated when you exercise. Important for a lot of reasons (especially, be kind to your kidneys) to drink an extra 30-40 ounces of water each day.

 

[YeOldeCup]

It may be simply that you're not replentishing fluids when you exercise. Low carb means your body is carrying around less water, which is a good thing, but it means it's easier to get dehydrated when you exercise. Important for a lot of reasons (especially, be kind to your kidneys) to drink an extra 30-40 ounces of water each day.

Thanks very much for the info in both of your posts.

 

[pointingdogsrule]

On Lisinopril.... thanks for the heads up.

 

[Ct. Lion]

I have been on both Lisinopril and Losartan. Lisinopril gave me a persistent tickle in my throat and a cough so I switched to Losartan which seems to be ok.
The Tboyer post and others in the same vein are key. When exercising you need to have a balance in your immediate food intake and water intake to compensate for the exercise. I had an example yesterday working in my garden. I did not eat correctly and was short on water intake and at one point felt faint. I sat for 15 minutes, took in a lot of water and had a snack and felt much better. I am not on a weight loss diet.
All of my doctors, and I have too many to list, insist on taking in lots of water and eating a stable and reasonable balanced diet spread over the course of the day to keep blood sugar, etc. in balance.

 

[MJG-90]

but in the meantime drink a lot of fluids and maybe eat some salty things to help prop up your blood pressure during the transition.

Typically a low carb diet means not eating any processed foods. Could very well be that you aren't getting enough salt. I don't have high blood pressure and stay lower carb (not always keto) most of the time. On occasion I'll feel a little dizzy when I stand up quickly. I usually load my veggies with salted butter and top with some sea salt. That usually helps.

 

[mOOse_44]

Typically a low carb diet means not eating any processed foods. Could very well be that you aren't getting enough salt. I don't have high blood pressure and stay lower carb (not always keto) most of the time. On occasion I'll feel a little dizzy when I stand up quickly. I usually load my veggies with salted butter and top with some sea salt. That usually helps.

I've been keto for almost a year, and I get this same sensation. I stand up too quickly and get dizzy. I'll have to get back on the salty broth. Thanks for the info.

 

[Thorndike2012]

I was on Lisinopril for about 20 hours. Then my feet blew up like balloons! That was strange and scary as hell.

I do low carb due to Type 2 and to lose weight. And MJG is right...you must increase your salt intake. And I'll add, drink a ton of fluids also. Less dizzy spells.

 

[YeOldeCup]

Many thanks for all the advice and war stories gents.