Low BP and Blood Sugar with High Cortisol

[chompie]

Hi All,

I'm stumped. My BP recently dropped dramatically and coincided with a big drop in blood sugar. Diet was unchanged. Supplements unchanged (been on Thyroid for about 1 year). I was using about 0.5mg Cyproheptadine alongside the thyroid but came off. I've since reintroduced and dropped cypro with all dizziness unchanged no matter whether on or off. I was pretty sure that the cortisol lowering effect of cypro had tanked my cortisol, so I ran a 4pt salivary cortisol test. High cortisol confirmed at each point and I'm at or above the top end of the range on each of the 4 points.

My BP is something like 81/55 down from my normal of 115/75 and my blood sugar comes in at 55-60. I'm terribly dizzy and feel sick. Bizarrely, the only thing that seems to improve my dizziness is a hefty dose of adrenal cortex which is likely increasing cortisol further....

I've run so many labs and I look like I'm in good health. Everything "in range". Any ideas, history, or suggestions appreciated.

 

[ThinPicking]

Hi All,

I'm stumped. My BP recently dropped dramatically and coincided with a big drop in blood sugar. Diet was unchanged. Supplements unchanged (been on Thyroid for about 1 year). I was using about 0.5mg Cyproheptadine alongside the thyroid but came off. I've since reintroduced and dropped cypro with all dizziness unchanged no matter whether on or off. I was pretty sure that the cortisol lowering effect of cypro had tanked my cortisol, so I ran a 4pt salivary cortisol test. High cortisol confirmed at each point and I'm at or above the top end of the range on each of the 4 points.

My BP is something like 81/55 down from my normal of 115/75 and my blood sugar comes in at 55-60. I'm terribly dizzy and feel sick. Bizarrely, the only thing that seems to improve my dizziness is a hefty dose of adrenal cortex which is likely increasing cortisol further....

I've run so many labs and I look like I'm in good health. Everything "in range". Any ideas, history, or suggestions appreciated.

Where are you in the world?

 

[chompie]

Where are you in the world?

Everywhere

 

[Peatness]

Everywhere

Great reply!

 

[haidut]

Hi All,

I'm stumped. My BP recently dropped dramatically and coincided with a big drop in blood sugar. Diet was unchanged. Supplements unchanged (been on Thyroid for about 1 year). I was using about 0.5mg Cyproheptadine alongside the thyroid but came off. I've since reintroduced and dropped cypro with all dizziness unchanged no matter whether on or off. I was pretty sure that the cortisol lowering effect of cypro had tanked my cortisol, so I ran a 4pt salivary cortisol test. High cortisol confirmed at each point and I'm at or above the top end of the range on each of the 4 points.

My BP is something like 81/55 down from my normal of 115/75 and my blood sugar comes in at 55-60. I'm terribly dizzy and feel sick. Bizarrely, the only thing that seems to improve my dizziness is a hefty dose of adrenal cortex which is likely increasing cortisol further....

I've run so many labs and I look like I'm in good health. Everything "in range". Any ideas, history, or suggestions appreciated.

Salivary cortisol is very unreliable and mostly demonstrates localized production of cortisol in the salivary glands. It can be good for assessing bio-availability of an exogenously administered steroid especially if taken in high doses, but it is not a good measure of endogenous production. I would suggest checking both AM and PM cortisol in blood, preferably on the same day. If BP and glucose are indeed low then blood cortisol is almost impossible to be high.

 

[chompie]

Salivary cortisol is very unreliable and mostly demonstrates localized production of cortisol in the salivary glands. It can be good for assessing bio-availability of an exogenously administered steroid especially if taken in high doses, but it is not a good measure of endogenous production. I would suggest checking both AM and PM cortisol in blood, preferably on the same day. If BP and glucose are indeed low then blood cortisol is almost impossible to be high.

Thanks. Helpful. Do you have an opinion on 24hr urinary cortisol as a marker?

 

[ThinPicking]

Great reply!

lol

 

[chompie]

High cortisol confirmed via serum x2/day, 24 hr urine, and 4 point saliva. All confirm very high cortisol, yet my blood pressure and blood sugar are low. Stumped still.

 

[InChristAlone]

Cyproheptadine is an anticholinergic which would promote less parasympathetic dominance which lowers blood sugar and blood pressure. On the cypro you would have more normal BP and more normal blood sugar, maybe you are having trouble since using it? It would theoretically help the situation to go back on but you said it didn't help symptoms. Be sure to avoid potatoes with the peel, and other nightshades like tomatoes as those block cholinesterase making the parasympathetic more dominant.