HBP Taking Hyzaar

[qbican]

I am taking the blood pressure med HYZAAR does any one know if it interferes with the Diet Iam currently on induction I have notice that i will be in deep ketosis on the sticks showing purple and about an hour later it is light pink ketosis on the sticks

[nonstickpam107]

Sticks, schmicks! The true test of lowcarbing is if you are losing weight. I've taken BP pills the whole way through and maintenance and had no trouble..as long as I do NOT cheat...and I go EXACTLY according to my plan (I lost the majority of my weight using Protein Power book and then incorporating Atkins...but reading the plan/book is ESSENTIAL).

Pam

[qbican]

thank you

[dbaldes]

Hyzaar is a blood pressure pill that contains 2 medications: Losartan and hydrochlorothiazide (HCTZ).

HCTZ works as a diuretic (water pill) to decrease your circulating blood volume and subsequently lower your blood pressure.

You are seeing a change in your sticks from darker to lighter because the HCTZ is causing your kidneys to remove more free water from your blood stream and put it in the urine, thus diluting the ketones. This results in a lower concentration of ketones in the urine which, in turn, results in a lighter color on the stick, as the sticks measure ketone concentration, and not absolute levels of ketones in the urine.

This has happened to me as well, and I've continued to lose weight.

(as a side note, I'm graduating with my M.D. in May. I hope it's okay that I gave this medical explanation, so long as it's not medical "advice")

[nonstickpam107]

And I congratulate you on your upcoming M.D...and sincerely hope you give thought to treating your hypothyroid patients using FT's and not just TSH, and medicating with Armour, or a combo of synthetic T4/T3.

Dr. Atkins said that those on a diuretic may have to have their doctor adjust their meds as their weight falls...I know I had to have my doc adjust during the 3rd week, the 12th week (reading from my journal...long time ago! and I'm still on ONE BP med). The WOE is diuretic itself.

Pam

[dbaldes]

@nonstickpam - I definitely am "thyroid patient friendly". I am hypothyroid myself. Although I actually will be specializing in psychiatry and won't deal with primary thyroid issues too much, thyroid screening will definitely be a part of the initial workup of all of my depression, chronic fatigue, etc, patients, and I will treat aggressively. I think we'll see in the next 10 years a big spread in the use of Armour thyroid.

[nonstickpam107]

Oh, do I love YOU!!! LOL My 'story' began with a Mother who had Hashimoto's Encephalopathy, yet was in and out of mental institutions during my teen years. She died at 49 yrs. old....was Dx'd as schizoid (amongst other things). For want of medical treatment with hormone.

Anyway, most patients think the thyroid just 'controls metabolism' and have no idea or concept of the emotional/mental side of the disease and many patients go undiagnosed and instead are just given antidepressants and so on. Can't blame a lot of the docs either...they are busy, too busy to research, and haven't been taught proper and correct testing and interpretation unless endocrinology is the field they are in.

So VERY pleased you will be doing thyroid screening!! (sorry, hard to type jumping up and down, lol).

Pam

[Doggygirl]

dbaldes, this is indeed good news from you! Out of curiosity, do you feel you got a good foundation in thyroid care from your schooling, or did you have to learn by the school of hard knocks where you were your own first patient? Given the vast number of people that seem to suffer from some form of thyroid malfunction, I'm hoping it is becoming a higher profile topic in medical school.

Best wishes to you!

DG

[dbaldes]

@Doggygirl - I do feel like my schooling has prepared me well for dealing with basic thyroid problems, and given me the judgment to know when to refer to an endocrinologist. No doubt, my experience with hypothyroidism has made me very sympathetic to patients with thyroid problems.

Remember that the new American College of Endocrinology guidelines for treatment of hypothyroid and what TSH levels should be only came out in the last few years. I'm not surprised that these new standards have not yet trickled throughout the bulk of the medical community yet. I'd expect that there will be a more substantial sea change in the next 10 years or so.

[nonstickpam107]

If they keep doing ONLY TSH, we'll all be doomed anyway, lol. I was referred to five endo's, each one did a TSH, and told me I was normal (ok...that's not quite right..one told me to come back when my TSH was over a 10 and I'd gained 100 pounds). It wasn't until I was taken to the hospital ICU with myxedema (TSH a nice .30 or so, lol, NOTHING registered on the FT4, FT3's at all...whoops..surprise!!!!).

Pam

[dbaldes]

@nonstickpam- I've always wondered why at least FT4 isn't included with TSH on a first thyroid screening. We were taught in the classroom to order both, but I don't see it in clinical practice too frequently.

Based on only TSH, a diagnosis is only a reasonable guess. TSH and FT4 in conjunction can give definitive information about a number of conditions. So, we are in agreement on that.

I think some clinicians use just TSH because in the majority of cases, it is a good surrogate marker for actual thyroid function. However, it's clear that hypothyroid simply cannot be ruled out with just a TSH, and if a patient is showing classic symptoms, it's important to follow clinical judgment and order further testing.

[Doggygirl]

My TSH was just tested last week at .21 (.4 - 4.5 range). What do you think? Just curious. My doctor does not approach thyroid at all like you discuss, unless I misunderstood something.

DG

[dbaldes]

@Doggygirl - I'll try this delicately as I really absolutely should not, cannot, and will not dispense any kind of medical advice online.

So, with that, at face value, your test shows that you have a level of TSH that is just below normal. Without making a recommendation on what to do, I can tell you that this may mean a couple of things. One, it may mean that your thyroid is completely normal, two it may mean that your thyroid is overactive. Based on that number, it is very unlikely that your thyroid is underactive at this time.

Your physician's decision as to whether to pursue this further would be based on your clinical presentation. There are certainly people with your TSH level walking around who have no thyroid problem, and others that do have an overactive thyroid.

So, I would talk to your physician and ask him/her for their interpretation of the results based on your clinical presentation.

[nonstickpam107]

Three, it may mean that you are well medicated (But, then again, I've seen the FT's that go with that TSH...once again proving that TSH doesn't really mean a whole lot in the face of actual thyroid hormone measurements).

Thank goodness more and more doctors are 'getting it' that TSH means..um...not a whole lot....and should never be looked at without an entire thyroid panel (T4, T3, FT4, FT3 where needed, and everyone should be aware of WHY a doctor would do Free's and not Totals, there's a huge difference).

Now I'm wondering how many patients are depressed (resultant from thyroid disease) and get treated mentally (and not treated for thyroid) after ONLY doing a TSH....No, forget it, I don't want to know, I've seen plenty.

Pam