Blood pressure medication can cause loss of crucial electrolytes.
Q: My elderly mother has been very conscientious about a low-salt diet. She never salts her food and is careful not to eat processed foods high in sodium.
Despite this, her doctor diagnosed her with mild high blood pressure and put her on a diuretic called hydrochlorothiazide. Last week she got up in the middle of the night to go to the bathroom; she suddenly felt weak and collapsed. When the paramedics came in response to her call button, she was confused.
They took her to the hospital and discovered that her sodium and potassium levels were perilously low. Could her medicine be responsible for this scary episode?
A: Hydrochlorothiazide (HCTZ, HCT) is one of the most commonly prescribed blood pressure drugs in the world. It is considered safe and costeffective.
Nonetheless, HCTZ could have led to your mother’s low sodium and potassium levels. This medication can cause loss of these crucial electrolytes (Journal of Emergency Medicine, March 2015).
One population-based study found that those taking this diuretic were five times more likely to develop hyponatremia (low sodium) than those not on it (American Journal of Kidney Diseases, July 2013).
Weakness and confusion are common symptoms of low sodium. Others include loss of appetite, muscle cramps, headache and nausea. If the sodium depletion is severe, seizures or coma may result.
Q: I have been taking zolpidem for insomnia for 10 years. When I was laid off, I needed to take more and more to get to sleep.
Without insurance, I can no longer afford this drug. I have found that I can’t go cold turkey. Heart palpitations kept me awake all night. I would appreciate your advice on how I can get off zolpidem.
A: There is considerable controversy surrounding the question of zolpidem (Ambien) dependence and withdrawal symptoms. Researchers have reported no rebound insomnia, even after a year of nightly use (Journal of Psychopharmacology, August 2012). The official prescribing information warns, though, that “There have been reports of withdrawal signs and symptoms following the rapid dose decrease or abrupt discontinuation of zolpidem.”
Gradually tapering the dose with your doctor’s assistance may reduce symptoms.
Q: I have been reading articles on saturated fats versus unsaturated fats. Guess what? I quit using vegetable and canola oil, and started using butter, lard and coconut oil in my cooking.
After about six months of this, my bloodwork showed total cholesterol at 150. My LDL and HDL cholesterol were in good order, and my triglycerides were better than they’ve ever been at 130. I’ve had high triglycerides since I was a small child (due to a thyroid disorder).
I’ve never had numbers so good. My HbA1c also was better at 6.2! Other than olive oil, I doubt I’ll be using unsaturated vegetable oils again.
A: You probably realize that you are challenging 50 years of conventional medical advice to avoid saturated fat. You aren’t the only one who has started questioning traditional dietary recommendations, however.
Three prominent cardiologists authored an article titled “Saturated fat does not clog the arteries” (British Journal of Sports Medicine, online, April 25, 2017). They state, “Despite popular belief among doctors and the public, the conceptual model of dietary saturated fat clogging a pipe is just plain wrong.”
Instead, these heart doctors point to inflammation and insulin resistance as the bad actors in heart disease. Their recommendation: Coronary artery disease can be reduced by “walking 22 minutes a day and eating real food.”
Your improved HbA1c, a measure of blood sugar over several weeks, also might indicate reduced insulin resistance. Resistance to insulin is a hallmark of prediabetes or Type 2 diabetes.
Q: My ice addiction has been driving my family and co-workers crazy. I’m 47 and have craved chewing ice since I was a teenager. It gets worse when I’m stressed.
I’ve always had heavy periods and low energy. A Red Cross nurse told me I was too anemic to give blood, but I never made the connection between iron deficiency and craving ice.
Recently I decided to try consuming blackstrap molasses (as a home remedy for a different ailment), and overnight the ice cravings disappeared.
I don’t have to consume molasses every day; I take it maybe three times a week. Rather than eat it straight from the jar, I put a tablespoonful in my almond milk, stir it and drink it like chocolate milk. It’s very tasty and an excellent source of iron.
A: Blackstrap molasses is indeed a good source of iron. A tablespoon contains 3.5 mg of iron.
The recommended dietary allowance for an adult woman is 18 mg, though, so you probably need to get some iron from other sources as well.
Lean meat, seafood, nuts, beans and fortified grain products are good food sources.
Taking vitamin C with your iron can help absorption, but red grape juice and prune juice can inhibit iron uptake (Journal of Agricultural and Food Chemistry, Nov. 6, 2002).