I'm A Mess (very High Blood Pressure, Mostly)

[milk]

(To sum it up: a lot of bad decisions, very high blood pressure, high anxiety, liver and thyroid don't seem to be in good shape.)

I'm 30 years old. I've been sort of following the Peat thing for a couple of years now. Not very rigorously, I admit. I got into it because I'm trying to save my hair. I wasn't measuring my pulse or my temps throughout. And I was drinking a lot of alcohol.

To top it off, I dabbled in Cynomel and Cynoplus now and then. I shouldn't have. It's a long story. I took Cynomel on impulse one day when I was feeling very depressed, basically. I was meaning to get bloodwork first, don't get me wrong. It was an impulsive thing. Obviously a serious mistake, as the exams below probably indicate.

Everytime I take thyroid I feel pretty good, but my anxiety worsened after that first time I took it. It has been more of an intense, almost cold sweat anxiety ever since. Things that made me nervous before now make me dizzyingly nervous.

Anyway. I wasn't feeling very well one month ago, so I went to the hospital. Turns out I have very high blood pressure. I went to a heart doctor and she had me take a bunch of exams.

Some of the names below are in Portuguese. I'm Brazilian. I have no time to meticulously translate everything. I hope a glance at those numbers and facts may indicate something significant. I wasn't taking thyroid when I took them. (They're the usual exams mainstream doctors ask for apparently. No T3, T4 and other things Ray Peat recommends checking out, I know. I took them all in the same week.)

(I'm a noob about all of this stuff, as you might have noticed. But I'm willing to learn, ok?)

Blood test 20/03/15

Uric acid - 6,78 mg/dL
Calcium 9,8 mg/dL
Creatinine 0,96 mg/dL
Gama GT 40,5 U/L
Glicose 77,65 mg/dL
Total cholesterol 233,0 mg/DL
HDL cholesterol 57,6 mg/dL
LDL cholesterol 154,6 mg/dL
Non-HDL Cholesterol 175,40 mg/dL
Triglicerides - 102,3 mg/dL
TGP Alanina aminotransferase - 28,3 U/L
Antiestreptolisina O - Aslo -- 100 U/Todd
Rheumatoid factor – Latex – 8,0 UI/mL
Urine – Volume 10 mL – pH -6,0 Density 1.005 Clear Yellow / Limpid Aspect
Vitamin B12 – 622 pg/mL
Serotonin – 23,3 ng/mL
Cortisol 24,0 ug/dL
Ferro 97,00 ug/dL
Ferritina 120,70 ng/mL
Insulin 10,5 mU/L
Potassium 4,50 mEq/L
Total testosterone - 598,27 ng/dL
TSH – 2,620 mUI/mL
Vitamin D 25 Hidroxi - 13,46 ng/mL

VHS Blood hemossedimentation velocity – 3mm


Hemogram / CBC

Eritograma

Hemácias / red blood cells – 5,26 milh/mm3
Hemoglobin – 15,40 g/dL
Hematocrit – 47,10%
V.C.M. – 89,71 fL
H.C.M. – 29,33 pg
C.H.C.M. 32,70 g/dL
RDW 13,40%

Leucogram (I don't know if this is readable outside of my language but here goes)

Leucóticos – 6.310,00/mm3
Eosinófilos – 3%
Basófilos – 0%
Bastonetes – 3%
Linfócitos típicos – 31%
Segmentados – 55%
Monócitos – 8%
Neutrófilos – 58%
Plaquetas 185.000,00/mm3


Blood pressure map (25/03/15) (I wore a blood pressure pump around my arm throughout the day):

Basically during the day it starts at 12/9 but soon goes way high, gradually going from 14/9 to 15/10 to 17/11. During sleep it stays around 14/9 or 14/10.

I’m on Benicar for three days now and measured my blood pressure at the drugstore around 17:30 pm today, and it was 16/9, so no results so far, it seems.



Abdominal ultrassound (25/03/15)

Liver

"discreetly hyperechoic parenchyma", "ecographic signs of slight fatty infiltration in liver", so "slight fatty liver" I guess?

Thyroid:

"Discreet enlargemente of the dimensions of the right lobe."

Right lobe: 4,3 x 2,0 x 2,0 cm Volume: 8,9 cm3
Left lobe 4,5 x 1,7 x 1,7 Volume 6,7 cm3
Isthmus: 0,3 cm (espessura média) Volume 0,7 cm3
Total volume 16,3 cm3


Heart ultrasound: everything seems normal.

***

(The following exam was taken one year ago. I wasn't taking thyroid at the time either. I believe my blood pressure was closer to normal then. T4 and T3 are included.)

Last year’s blood exam (13/06/14)

TSH 1,11
Total T4 6,6 ug/dL
Total T3 79 ng/dL
Glicemia while fasting 96 mg/dL
Ureia 30 mg/dL
Total cholesterol 223 mg/dL
HDL Cholesterol 62 mg/dL
LDL Cholesterol 147 mg/dL
Trigliceridios 69 mg/dL

***


When I brought the newest exams back to the doctor she prescribed me Benicar. I asked if she knew anything about taurine helping with hypertension (I've read about it on this forum) and she literally got mad at me. It wasn't pretty.

Another thing: I smoked weed about a week before going to the hospital and learning about my blood pressure, more than I usually do (which is almost never), and became very anxious afterwards. It might have contributed to the current anxiety/blood pressure situation.

(The blood pressure might have been this high for a longer while though. Months maybe, maybe a whole year. I remember getting prescribed valerian for high blood pressure at the same hospital about eight months ago. I thought it was just from the stress from that day, as did the doctor given that he just prescribed me valerian.)

Ok, this is a lot already. If anyone's willing to take a look and give some tips I appreciate it a lot. I really need to get this blood pressure down.

 

[tara]

I'm not good on reading most of the test results.
Looks as though your TSH was not too bad a year ago (1.1), and has gone up to not such a good level now (2.6). How long had you been off thyroid supps before each of these tests? How much have you been taking when you were taking it?

You could try dropping the alcohol and weed and any other such stresses for a while and see if that helps.

What is your typical days diet like? Might give some more clues, if you feel like posting.

 

[Stilgar]

Your Vitamin D level is incredibly low. This could be affecting blood pressure, blood sugar regulation, depression and anxiety for sure.

I think weed generally will exacerbate adrenaline and blood sugar regulation symptoms, at least it does for me. It is likely not causing a problem per se, but rather worsening an already disregulated system. Lowering adrenaline and keeping blood sugar higher would help tolerance. Alcohol is the same, if not worse, because of its immediate and prolonged effect on blood sugar and the liver.

 

[YuraCZ]

So do you want to drink alcohol and smoke, or do you want to be healthy?

 

[gretchen]

Get morning sun from 8-11 am. It's an anti hyper tensive.

 

[milk]

Thanks for the replies, everyone.

@tara: I took T3 and T4 intermittently throughout the last two years. About half a Cynoplus and half a Cynomel a day, or sometimes just half a Cynomel. I took them at times of great stress and anxiety, for two or three days in a row, when valerian, magnesium chloride and lemongrass tea weren't doing the job. In fact I took 10mcg of Cynomel today. I'm trying not to touch the thyroid supps but my anxiety and OCD are giving me a hard time.

Of course I should never have taken those supplements. I was doing fine anxiety-wise when I started peating, I could distinctly notice the anxiety weakening. With the thyroid supps I just messed that up. By the way, one of the exams there says my thyroid is slightly swollen, and I wonder what that means. The doctor who did the exam assured me that it's not cancerous, but that it could indicate either hypo or hyperthyroidism.

I decided to quit drinking and the intermittent tobacco smoking. The weed was a very occasional thing, I only smoked about half a dozen times. I don't intend to smoke weed again. My diet generally consists of the Peat staples: OJ, milk, guavas, well cooked potatoes, red meat, shrimp, eggs, raw carrot. But I'm undisciplined about it and cheat a great deal, not to mention the drinking.

@Stilgar: I don't intend to smoke weed again. As for drinking I'm not touching that either for the time being. The doctor prescribed me a weekly Vitamin D pill. I felt great the few times I tried sunbathing in the last two years, as if I had taken a powerful well-being supplement. I should definitely do it often.

@YuraCZ You're right.

@gretchen: I definitely mean to do that.

 

[Anonymous]

I think some sort of anti histamine/serotonin medication should be standard protocol before trying thyroid. Especially if you have anxiety,

 

[cantstoppeating]

I think some sort of anti histamine/serotonin medication should be standard protocol before trying thyroid. Especially if you have anxiety,

Yes. And to extend it I'd add anti-prolactin (like bromocriptine) and anti-estrogen (like Vitamin E and aspirin).

Taking T3 and/or T4 while the above is high (and if one of them is high, it means almost certainly that the others are high too) can be somewhat helpful but more often than not can cause more harm by forcing the metabolism to increase without the fuel available -- and what stops it from being available are things like estrogen, prolactin and serotonin (and things further down the pathways like free fatty acids).

I didn't realise this until I got back more bloodwork and tried cyproheptadine. With cyproheptadine I instantly noticed clear vision, higher temps and pulse, better sleep etc. I didn't know what to look for to identify high serotonin, but the bloodwork showed high prolactin and with such an obvious positive impact from cyproheptadine it confirmed for me that both serotonin and prolactin (and tissue estrogen) are positively linked. Now when I take T3 I notice a much more positive pronounced effect.

So try cyproheptadine, Vitamin E, aspirin and if needed bromocriptine. Make sure you do all the relevant research and speak to your doc.

 

[tara]

It's hard to assess what the TSH results mean (not that I'm an expert anyway) without knowing how much supplemental thyroid you'd taken in the week or month before before tests, since T4 has a long half life, and the thyroid adjusts its own production when supplements are added and removed.
My guess is that if you are going to use them, you might be better off with a tiny bit regularly everyday, than larger reactive doses when you feel like it.
I think a slightly swollen thyroid is what they mean by a small goiter. If I've understood it right, that can indicate that the thyroid gland is producing thyroid hormone, but keeping it building up in storage form - increasing the size of the thyroid - rather than releasing it as fast as it's produced. High estrogen is one of the things Peat has said can hinder the release of thyroid hormones from the gland.

One of the things Peat talks about as important for good blood pressure is getting enough calcium. He's suggested 1200-2000mg/day, and a calcium:phosphorus of at least 1:1, preferably 1.5:1. There's an interview where he talks about an example of increasing calcium and decreasing blood pressure from 150/100 down to normal over a few months. If you can't get enough calcium from milk, he's suggested clean eggshell powder as next best, and after than oystershell powder.

 

[milk]

I know. I definitely shouldn't have messed around with thyroid without knowing exactly what I was doing. Anyway: I tried two different BP meds so far and the results have been ... very bad.

Let me warn you, the side effects I'm experiencing are of a "graphic" nature.

I took Benicar for a week, and it made my limbs ache after a little walking or typing. Worst of all, it made me lose my libido and gave me erectile dysfunction. This situation now seems even worse than when I briefly took finasteride three years ago. The Benicar may have worsened the lingering post-finasteride syndrome symptoms, which were mild in my case.

So I went to the hospital and a doctor prescribed me amlodipine besylite instead (it is a "long-acting dihydropyridine-type calcium channel blocker"), to be taken every 12 hours. He informed me that is an older, more traditional medication, not a modern one like Benicar. Which probably doesn't mean much, right?

I took one amlodipine pill eight hours ago. I felt drowsy one hour after taking it, and two hours later the back of my head and neck felt stiff, like when you have serotonin syndrome. Mentally I felt strange for a while, kind of hyper, unable to focus. More importantly, my libido hasn't come back and my genitals don't seem to have recovered much. In fact my penis looks weirdly retracted, more than the slight retraction I could notice before. Not cool at all.

Mind you, my libido and sexual function were great before taking these HBP meds. My genitals when soft still showed some lingering finasteride effects, but otherwise everything was remarkably ok. I had a high libido which felt healthy and normal.

I did some googling and it seems that losartan has a smaller chance of causing sexual side effects. On the other hand, "blindness" is reported as one of its rare side effects. That doesn't strike me as very auspicious.

Basically, I don't know about all these prescription HBP meds. They are certainly having a horrible effect on my libido and genitals. It seems like anything else -- vitamins, supplements -- that would effectively lower BP would be a way, way better idea. I think the BP meds have lowered my BP a bit, yes, but these side-effects are definitely not worth it.

On that note, this thread viewtopic.php?t=5087, among others, recommends vitamin D for for lowering HBP. This one viewtopic.php?t=5584 recommends vitamin K2. A few other threads also recommend taurine. (By "recommend" I mean it's pointed out that studies indicate it might work, or that people have had good experiences with those approaches.)

In fact, the doctor who prescribed me Benicar also prescribed me Vitamin D3, 7.000 UI, prescription only, to be taken once a week. As has been observed in this thread, my vitamin D levels are low. The box only contains four pills and there are only two left. I wonder if I can get vitamin D without a prescription here. Brazilian regulations are tight.

I'm honestly worried. Should I give the vitamins a try? What about the taurine? I figure it couldn't hurt.

 

[milk]

I did look up "cyproheptadine, Vitamin E, aspirin and if needed bromocriptine", seriously. Thanks for the tips. I think cyproheptadine would tackle my anxiety most of all, no? Which is probably related to my HBP. Though at this point I hesitate to mention non-mainstream meds to physicians and I don't know if I'd be able to get it without a prescription.

I'm kind of at wit's end here. Without HBP meds I feel tense, heavy, out of breath, and there's the risks involded in HBP. With the meds I tried so far I get horrible side effects. I took amlodipine today and my face today is red and bloated and there's a weird sickly feeling throughout my body, not to mention the sexual side effects.

So obviously one wonders if there's a "peaty", non-aggressive approach that could efficaciously lower HBP. I mean there's a thread titled "Vitamin D 'as good as drugs' at reducing high blood pressure" in this very forum. I know it seems like I'm looking for a quick fix. I certainly should read up on Ray Peat more thoroughly and be more disciplined about it. Underlying issues and all that.

I have an appointment with another physician today. Let's see how it goes.

 

[tara]

Drs getting mad when we ask well-meaning questions seems to be common.
Here's a search in the Interview Transcripts subforum for 'blood pressure'. May not all be relevant, but some of them may be. I'd suggest taking a look. If you don't want to read, you can listen to the original audio versions .

 

[milk]

I don't see a link in your post, but I get the idea, thanks. I'd rather read than listen to audio, I'm just too undisciplined to study things rigorously.

I was basically just following the Hair like a fox dietary guidelines without looking up what it all means.

My last doctor prescribed me losartan for HBP, along with a bunch of other things like goji berry, all in a one-pill combo. I was wary of taking it but it seems to be doing the trick. No nasty side-effects so far.

He also prescribed me escitalopram, an SSRI, and I know SSRI's are frowned upon here. I took one 15 mg pill last night. Truth be told, I feel way less depressed, my anxiety has subsided to a noticeable degree. I don't feel at wit's end anymore. I'm afraid I'll have to stick to this med for a while.

 

[milk]

I know there's a lot of things I could try for anxiety instead of an SSRI. Things like tianeptine. But tianeptine is prescription-only in Brazil; so is cyproheptadine, it turns out. It seems like you need a prescription for everything, and doctors are never willing (or able) to stray from the things they're used to prescribe.

So yeah, I'm sorry for taking a SSRI, I know that's a no-no in this circle. But I definitely need something to handle my anxiety right now, and that's all I've got.

 

[Anonymous]

I've had a lot of success using amitriptyline you may be able to get that more easily. It is structurally very similar to cyproheptadine and it is prescribed for depression and anxiety.

 

[tara]

Having trouble getting prescription medicines seems like another good reason to try seeing what you can do with food, minerals, and vitamins etc first. Peat suggests getting as much of your nutrition as you can from food, and if you need to supplement, pay attention to the excipients, and avoid dodgy ones. (Dan Wich's Toxinless.com website may help with this.)
Have you taken a look at something like cronometer to see how you are doing with nutrition? Sometimes extra of particular vitamins and/or minerals can help when things have got out of balance.

I have not solved my key issues yet since implementing more Peat-inspired diet ideas, but I can say that I spend a lot less time feeling acutely anxious, and that my blood pressure was down from slightly high to 120/80 at my last drs visit.
I put the reduction in acute anxiety down to a combination of changed life circumstances + more and better timed food esp sugar and protein, daily small amounts of chicken neck stock (hopefully giving me a little natural T3 and T4), progest-e (I wouldn't put this at the top of your list since you are male, though some men have found it helpful), and maybe B - vitamins (the first one Peat usually suggests for many people is niacinamide).
I find I do best if I eat breakfast early, eat a lot morning till middayish, then lighter in the afternoon and evening, and definitely need some supper most nights. This varies a bit from person to person. Where I am, it clashes a little with local culture, because the usual habit is small breakfasts and lunches and larger evening dinners, so it took a while to work out that this is what I need.
Not from Peat, but I also found it useful to learn that standard public calorie recommendations are typically too low for most people. So I started eating more, and that definitely helped against anxiety.
I also s

When blood sugar drops, adrenaline and cortisol tend to rise. It is hard to feel relaxed with high levels of stress hormones running. Salt can sometimes help reduce adrenaline, and sugar can help reduce both. Hunger makes people feel stressed, and this can feel like anger/anxiety, etc. Sugar, salt, niacinamide, chicken neck soup, magnesium etc are all safer anxiolytics than any medicine you are likely to be prescribed, so worth seeing if you can use these in ways to help yourself.

In the last couple of months I increased fat soluble vitamins - I used daily estroban + 3mg K2 + 2000iu D3 + occasional extra E. I wonder if this improved my blood pressure. (I've been eating a little liver a few times a week for more than a year.)

No guarantees that you solve your issues quickly or fully with food and nutritional supplements, but there may be more here you can try.

 

[milk]

I've had a lot of success using amitriptyline you may be able to get that more easily. It is structurally very similar to cyproheptadine and it is prescribed for depression and anxiety.

Thanks.

 

[milk]

Tara, thanks for the tips. I basically eat when I'm hungry, while attempting to stick to Peat foods. I guess I should start paying attention to ratios and schedule. I feel best physically and mentally when I eat guavas, OJ, milk and carrot. As in right after I eat these foods in combination.

I never really tried all the Peat supplements except for thyroid, but I intend to start implementing them. I've been taking vitamin b3 for almost a week now with good results.

Long story short,

My anxiety was really bad when I made the last posts, so I caved in and took the escitalopram (lexapro). For better or worse, it worked very well for the anxiety. I took it for a week, until I managed to get a bottle of niacinamide.

Escitalopram side effects: I lost weight fast, to the point that my sister remarked on it. Hazy feeling. Dry mouth. Hair and beard look thinner. It made me crave bread. I ate a lot of bread. It helps with anxiety, but at a cost. I guess Peat is right about SSRIs.

I got the vitamin b3 at a local drugstore and ditched the escitalopram. I think it's niacinamide and not niacin, but I'm not sure, I asked for niacinamide specifically but the bottle just says "vitamin b3". They're 100 mg capsules, I'm taking five capsules throughout the day. I'm just ingesting the capsules, but I think I should dissolve them in water, right? I took two capsules for the first dose. I immediately lost the craving for bread and started craving guavas and milk again. And it certainly helps with mood and anxiety, thank God.

As far as I know (from reading this forum and googling): niacinamide is favored among Peat followers; both niacin and niacinamide help with anxiety and depression; niacin helps with fatty liver while niacinamide is bad for it.

I don't know what to make of it. I'm having good results with (probably) niacinamide for anxiety. And I certainly don't want to get back on escitalopram.

 

[tara]

I feel best physically and mentally when I eat guavas, OJ, milk and carrot.

Great. :)

Peat recommends niacinamide rather than niacin. I think he has said that small doses (50-100mg) should be helpful rather than unhelpful for fatty liver, but I don't think he has recommended large doses for most people.
With tablets, he tends to warn against some excipients. I don't know if it matters if you dissolve in water or swallow. I guess you could try it. Niacinamide should be water soluble, so if there is sediment after breaking up and stirring well, maybe you could just drink the liquid and ditch the solids at the bottom and get most of the B3 without so much of the extras.
If you are taking 5 doses a day, you could probably split them and just take 1/2 a tablet (50mg) each time.

I'm glad you are finding the B3 better than the escitalopram.

 

[tomisonbottom]

Yes. And to extend it I'd add anti-prolactin (like bromocriptine) and anti-estrogen (like Vitamin E and aspirin).

Taking T3 and/or T4 while the above is high (and if one of them is high, it means almost certainly that the others are high too) can be somewhat helpful but more often than not can cause more harm by forcing the metabolism to increase without the fuel available -- and what stops it from being available are things like estrogen, prolactin and serotonin (and things further down the pathways like free fatty acids).

I didn't realise this until I got back more bloodwork and tried cyproheptadine. With cyproheptadine I instantly noticed clear vision, higher temps and pulse, better sleep etc. I didn't know what to look for to identify high serotonin, but the bloodwork showed high prolactin and with such an obvious positive impact from cyproheptadine it confirmed for me that both serotonin and prolactin (and tissue estrogen) are positively linked. Now when I take T3 I notice a much more positive pronounced effect.

So try cyproheptadine, Vitamin E, aspirin and if needed bromocriptine. Make sure you do all the relevant research and speak to your doc.

This makes a lot of sense to me. I've been messing around with t3 for quite some time without long standing success. I have high prolactin, and just started cypro, and noticed higher temps with cypro right away, so hopefully I'll have better results with t3 after this. How much cypro did you take and for how long did you have to take it to be able to use T3 again?