[38F] Experiencing high blood pressure and headaches

Patient Description

A 38-year-old female has been experiencing high blood pressure for the past two weeks, with readings around 155/96, measured four times a day. She started a new blood pressure medication recently but has not noticed any improvement in her symptoms. Additionally, she began taking Duloxetine four weeks ago, which coincided with the onset of her high blood pressure. The patient reports fatigue affecting daily activities, sharp and throbbing headaches located at the right temple and behind the eyes, with an intensity of 5 out of 10, nasal congestion, and mild nausea. She also experiences tension in the chest, occasional dizziness, and changes in stress levels and sleep patterns due to sick family members and restless sleep. Her medical history includes Lyme disease, Mast Cell Activation Syndrome (MCAS), and Alpha-Gal Syndrome, diagnosed a year ago. Current medications include Duloxetine, low dose naltrexone, NP thyroid, melatonin, a multivitamin, Nasacort, and Flonase, along with supplements like magnesium, a B complex, and probiotics. There are no known allergies to medications.

Arora's Assessment

What might be happening

Based on the information you've provided, here are some possible explanations for your symptoms:

Hypertension (High Blood Pressure): Your blood pressure readings are consistently high, which can lead to headaches, fatigue, and other symptoms. It's important to monitor this closely, especially since you recently started a new medication for it. Sometimes, medications like Duloxetine can contribute to increased blood pressure as a side effect.
- Treatment: Your doctor has already started you on a blood pressure medication. It may take some time to notice improvements, so continue monitoring your blood pressure and follow up with your healthcare provider.
Medication Side Effects: Duloxetine, which you started 4 weeks ago, can cause side effects such as headaches, fatigue, and increased blood pressure. It's possible that your symptoms are related to this medication.
- Treatment: Discuss with your doctor whether Duloxetine might be contributing to your symptoms and if any adjustments to your medication regimen are needed.
Sinus Congestion: Your nasal congestion and headache, particularly around the eyes and temple, could be related to sinus issues, which can also cause fatigue.
- Treatment: Over-the-counter decongestants or nasal sprays like Nasacort and Flonase, which you're already using, can help alleviate these symptoms. Ensure you're using them as directed.

What you can do

Monitor Your Blood Pressure: Continue to check your blood pressure regularly and keep a log of your readings. This information will be helpful for your healthcare provider to assess the effectiveness of your treatment.
Manage Stress and Sleep: Try to find ways to manage stress and improve your sleep quality, as these can impact both your blood pressure and overall well-being. Techniques such as deep breathing, meditation, or gentle exercise might be beneficial.
Stay Hydrated and Eat a Balanced Diet: Ensure you're drinking enough water and eating a diet rich in fruits, vegetables, and whole grains, which can support overall health and help manage blood pressure.
Use MDandMe: Consider using the MDandMe app to journal your symptoms, track your progress, and share this information with your healthcare provider. This can provide valuable insights into how your symptoms are evolving over time.

What you should look out for

Seek Medical Attention If:
- Your blood pressure remains high despite medication.
- You experience severe headaches, chest pain, or shortness of breath.
- You notice any new or worsening symptoms.

Remember, it's important to follow up with your healthcare provider to discuss your symptoms and any concerns you have. They can provide a formal diagnosis and adjust your treatment plan as needed.

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2 mo ago

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