Hypertension – Can’t quite figure it out

[NightOwl]

Hello Dr. Mariano (and everyone on this forum) Thought I’d sign up and post my question since this seems to be a really helpful place. I’m a 32 year old male, excercise regularly and eat a high protein, moderate carb and low fat diet. (250 gm, 120 gm, 45 gm)

Since the last year or so I started noticing a fullness in my ears, or my head. This would shift to headaches at times – having never had headaches before my entire life, I thought it had to do with my sleep schedule (I stay up till 5 am or so – sleep till 2 pm) and didn’t think much about it.

This wouldn’t go away, so I measured my BP – turned out to be 160/110.. so I had a whole barrage of tests done. Btw, before this hypertensive problem I had extremely low libido, which I attributed to a possibly low testosterone level. I am also normally a stressed out individual (type A) – but have calmed down recently. My BP fluctuates – some days it’s a textbook 120/80 – sometimes it’s in the 140+ range.

I noticed that with melatonin supplementation – it drops 20 points (not always, but most of the time) Taking lisinopril helps, but some days it doesn’t do anything. I went to the ER once because it was 194/110 – they gave me hydrochlorthiazide.. but that did nothing really.

My free test came to 241, T3 is 2.9 and Cortisol (AM) was 13.9.

I had a 24 hour urine test carried out (I noticed that when I carried out the 24 hour collection, my BP was normal) since my physician wanted to check for pheochromocytoma –

Epinephrine – 4 ug/L… 24 hour Epinephrine – 10
Norepinephrine – 19 ug/L and 24 h Norepinephrine – 48

Dopamine – 138 and 24 hour dopamine – 345

Homovanillic avid 24 hour – 9.0

Everything else (cholesterol, blood profile, metabolic, renal panel, etc) is normal. I have an appointment with my physician this week – but do the urine tests look normal? My libido is absolutely ZERO – I have no ED problems related physically (the rare times my libido gets back, I can perform very well, so no vascular issues)

I’ve been trying to scratch my head over what could be causing my hypertension – I’ve even been looking at not eating chicken, lol (that’s what I eat most of the time) because of tyrosine levels. Any suggestions would be appreciated – btw my physician thinks my test levels are normal!

[DrMariano2]

@NightOwl 1105 wrote:

32 year old male, excercise regularly and eat a high protein, moderate carb and low fat diet. (250 gm, 120 gm, 45 gm)

Since the last year or so I started noticing a fullness in my ears, or my head. This would shift to headaches at times – having never had headaches before my entire life, I thought it had to do with my sleep schedule (I stay up till 5 am or so – sleep till 2 pm) and didn’t think much about it.

This wouldn’t go away, so I measured my BP – turned out to be 160/110.. so I had a whole barrage of tests done. Btw, before this hypertensive problem I had extremely low libido, which I attributed to a possibly low testosterone level. I am also normally a stressed out individual (type A) – but have calmed down recently. My BP fluctuates – some days it’s a textbook 120/80 – sometimes it’s in the 140+ range.

I noticed that with melatonin supplementation – it drops 20 points (not always, but most of the time) Taking lisinopril helps, but some days it doesn’t do anything. I went to the ER once because it was 194/110 – they gave me hydrochlorthiazide.. but that did nothing really.

My free test came to 241, T3 is 2.9 and Cortisol (AM) was 13.9.

I had a 24 hour urine test carried out (I noticed that when I carried out the 24 hour collection, my BP was normal) since my physician wanted to check for pheochromocytoma –

Epinephrine – 4 ug/L… 24 hour Epinephrine – 10
Norepinephrine – 19 ug/L and 24 h Norepinephrine – 48

Dopamine – 138 and 24 hour dopamine – 345

Homovanillic avid 24 hour – 9.0

Everything else (cholesterol, blood profile, metabolic, renal panel, etc) is normal. I have an appointment with my physician this week – but do the urine tests look normal? My libido is absolutely ZERO – I have no ED problems related physically (the rare times my libido gets back, I can perform very well, so no vascular issues)

I’ve been trying to scratch my head over what could be causing my hypertension – I’ve even been looking at not eating chicken, lol (that’s what I eat most of the time) because of tyrosine levels. Any suggestions would be appreciated – btw my physician thinks my test levels are normal!

A low animal fat diet will generally be a nutrient deficient diet. Protein absorption would be impaired. Fat soluble vitamin deficiencies would be suspected. Mineral deficiencies would be suspected. Fats are necessary to form cellular membranes and other metabolic components. An unbalanced, high protein diet may also be stressful to the kidneys.

A shifted sleep schedule may indicate excessive stress-system activation. At times this is in compensation for impaired energy production in conditions including suboptimal thyroid hormone signaling, hypothalamic-pituitary-adrenal axis dysregulation, and metabolic-nutrient problems.

The Endocrine Society’s guidelines on Hypogonadism is here: http://www.endo-society.org/guidelines/final/upload/AndrogensMenGuideline053006.pdf

The loss of libido may have multiple causes. This includes excessive stress system activity (which may result in a loss in dopamine production), hypothyroidism, nutritional deficiencies, hypogonadism, and hypothalamic-pituitary-adrenal dysregulation, etc.

Here is Quest Diagnostics monograph on the 24-hour Urine Fractionated Catecholamine test: http://questdiagnostics.com/hcp/intguide/EndoMetab/EndoManual_AtoZ_PDFs/Catecholamines_24Hour_Urine.pdf

There are many causes for hypertension. Multiple causes may also exist, each contributing its part to hypertension. Common contributing factors include excessive stress-system activation, excessive activity along the stress-system-renin-angiotensin-aldosterone system, hypothyroidism, hypogonadism, nutritional deficiencies, etc.

Frequently, to control hypertension, three anti-hypertensive medications are necessary. Antihypertensives may contribute to loss of libido. ACE-inhibitors, angiotensin II receptor blockers, alpha-blockers may do the least to reduce libido. Calcium Channel Blockers may act like male contraceptives since they impair the sperm-to-egg acrosomal reaction that would allow fertilization.

Low testosterone predicts a shortened life-span in men. http://health.ucsd.edu/news/2007/6-5-Testosterone.htm

Excessive stress-system activity, low thyroid hormone, and/or low testosterone may lead to an increase in pro-inflammatory signaling. This may lead to migraine headaches.

Hypertension may lead to heart attacks, strokes, renal failure, blindness, dementia, etc.

[Author]

Posts