BP Meds and cycling
 

So about 6 weeks ago I had a little stroke. Not a TIA, an actual, lacunar stroke. Anyway, my BP was a little high, but my cholesterol was perfect and, really, they don't have a clear idea what caused it. So I'm on BP meds, and a low dose of aspirin, and a low dose of a statin, and I really just feel like crap. Tired all the time, and more depressed than I can attribute to what's going on in my life.


I'm being treated as they would treat a 70 year-old obese diabetic, basically, because that's the SOP. (They're doing the same deal with Michael Johnson!) Meanwhile, I'm a 58 year-old road biker with a resting pulse rate of 54, and quite a lot of muscle. (I bench 300.)


I did a pretty normal 20 mile ride over the weekend (1400' of climbing), and really felt crappy. No energy. had to stop a few times to rest on some big grades, which is unheard of for me, and when I got home, my feet and ankles were so swollen I didn't recognize them!


Now, I'm on a max (10 mg) dose of Norvasc, and the swollen feet seems to be a symptom of that, but I was wondering if anyone else had experienced this tiredness and lack of energy on BP meds? (I'm also on the minimum does of rosuvastatin, (5mg), maybe that could also be a factor.)


I've got a call in to my GP to discuss this all with him, but in the meantime, I thought I'd solicit thoughts from my fellow cyclists. I wanted to see if there was any collective wisdom about about BP drugs and cycling/exercise.



Any of you fellow oldies have any thoughts or experiences?


Thanks!

Yeah, it's frustrating when medical professionals don't differentiate between patients who are trying to stay healthy and those who've given up and plan to finish their lives watching TV and exercising only the Cheetos and coke lifting muscles. I've had both types of doctors.

I took amlodipine around 25 years ago for severe headaches -- for some folks with migraines, calcium channel blockers and beta blockers can help. The only side effects I remember were low energy, dizziness and depression. At the time I wasn't exercising and had gained about 50 lbs, so I probably wouldn't have noticed any minor swelling. I did later develop some swelling of my feet and ankles but if I'm recalling correctly I'd discontinued the amlodipine by then.

Since then I've lost 50 lbs, partly exercise, partly diet. Now I have a beta blocker for occasional severe headaches but don't take it daily. My BP and cholesterol seem good. I do experience some low energy from the beta blocker but it passes within a day. Supposedly we get accustomed to it with daily usage. I'd rather not find out.

Strokes are pretty terrifying no matter what the age or cause. When I was younger and worked for a tissue bank harvesting tissue and organs from donor cadavers, my first donor with the team was a woman in her early 20s who dropped dead from a massive cerebral stroke while at an air show with her family. No previous history of medical problems. It was one of those experiences that left me feeling a little less invulnerable despite my youthful arrogance. Later my mom had many TIAs and her older half-brother had major strokes and heart problems. Both ended up with dementia in their late 70s.

After a bike ride this weekend a friend and I were chattering about our encounters with mortality via cancer -- his, skin; mine, thyroid -- both relatively easily treatable. But once that C word is in mind, it's hard to shake the thought. It's made us both more determined to enjoy our time and make the most of what we have. Another friend tried to change the subject, apparently uncomfortable with it and trying to seem reassuring. But I think she misunderstood our point -- that we've found our own ways of coping, which includes acknowledging the thing rather than ignoring it or pretending it doesn't exist.

It was about two months after my MI I got back on the bike, with prescriptions for anti-platelet, beta blocker, and statin. Riding five miles back and forth on a flat, deserted street had me heading back to my recliner for the next two days.

Two years later, I'm regularly commuting by bike (10 miles each way) and doing weekend rides of 50 miles plus. Forty pounds lighter, two years older, 2,000' accumulated climbing isn't unusual, but I'm not as fast as I once fantasized I would be if I took off that weight. I'm still on the beta blocker and statin, and I enjoyed a cycling vacation of 420 miles in a week last summer. (With a couple passes.)

Your system had a heckuva shock. You've been off the bike for six weeks, deconditioning for that time. You're not the 21 year old stud kicking sand on the 97 pound weakling any more. Be kind to yourself. While I'm sure you'd rather walk out the door tomorrow morning and pick up where you were six weeks ago, you're going to have to rehab your body. Treat this as an experiment of one to see how far you can go (in a metaphorical sense) from where you are now. Six months to a year out you can look back and see how you've progressed, but right now you're too close to start those comparisons.

It's bizarre that someone your age and in your condition would have a stroke, and FWIW, I think it is odd that they would be treating you with a series of drugs as if you were that 70ish overweight, diabetic couch potato. And all those drugs look to be compromising your quality of life.

I would seek second, third, and fourth opinions from different docs and specialists and be the annoying squeaky wheel until they find out WHY you had the stroke. Simply putting you on a serious combination of meds without knowing the cause would be unacceptable to me. Once they are sure why it happened, all those drugs would be easier to swallow ... literally ... or even be shown to be unnecessary. IMHO, all drugs have side effects, and should be taken only if they show benefit for YOU, not a demographic you really don't belong in.

At the very least, if shown to need the drugs (the benefit outweighs the side effects), different doses may be in order.

I take Amlodipene 5mg and Losartan HCT 100-12.5 mg for BP. And I don’t feel tired or fatigued. My BP problems are genetic I have always been active with sports, weights and cycling. Though I haven’t weight trained since a ripped my guts out deadlifting :lol: the hernia mesh hurts sometimes but the surgeon said that is normal you would know if it is really messed up. I also take Crestor 10mg for a slightly elevated cholesterol and that knocked it down to below normal so that is great. The doc said you might get body aches from the statin but I didn’t. But yeah it makes you feel that a bloated couch potato watching Jerry Springer eating Twinkies and Ding Dongs all day :lol:

Yes, it is frustrating and anger prompting to be treated as you are. It is helpful to remember that under the law you, the patient, are ultimately in charge. With limited exceptions you have the right to see your records and to make final decisions about your treatment. You are wise not to give up that decision making authority.

The most a Provider can do is state in your chart your actions were AMA, Against Medical Advice, as though that advice were sacred. Most times the Provider will recognize you are different and treat you accordingly.

I spoke to my GP, and he said to stop taking the BP meds, keep track of my blood pressure, and call him in 2 weeks. If it goes back up, he'll put me on something different and see if it works better.

Upside, I stopped taking the norvasc Tuesday, and my energy level is coming back! Went for a ride yesterday, same basic route, did better on all segments! My ankles weren't swollen after, either.

However, my blood pressure is going back up, so I suspect I will have to be on something for it. We'll see.

Thanks for all the replies, advice, and moral support, guys!

I'm on an ACE (lisinopril) and I have never noticed any side effects at all. It is working, albeit slowly -- it took months to really kick in. That sounds like it might be an appropriate medicine for you.

I have heard of fit people that had strokes after a plane ride, does that apply?

Start taking 1g of sodium nitrate every morning. You'll need a gram scale. You can get it food grade on Amazon. There are many, many studies showing that this harmlessly decreases BP, plus it's good for your riding.
https://trainright.com/nitric-oxide-...c-performance/
I've been doing this for a couple years. It's good.

Never use a mouthwash - it kills the bacteria you need to make NO.

I wouldn't compromise oral hygiene for nitric oxide. The body makes NO on the fly while we're exercising, especially in sunlight. Nitric oxide is volatile, can't be stored or effectively supplemented (some differences of opinion there based on various studies), so all we can do is hope we're healthy enough to manufacture the stuff as needed.

There are factors than can reduce available NO -- which that article lists -- but oral hygiene is probably way down near the bottom of those factors. Being 61 with Hashimoto's (auto-immune disorder with a dysfunctional thyroid) and taking multiple meds for chronic inflammation and respiratory problems are much more significant factors for me.

If anything, omitting oral hygiene steps may result in chronic infections that can cause serious health issues. For years I've used strong mouthwash, followed by a water pick, brushing and finishing with hydrogen peroxide rinse. This routine helped relieve some chronic gum inflammation that, along with chronic sinus inflammation, was aggravating a lifelong problem with severe headaches due to trigeminal neuralgia and vagus nerve pressure and inflammation. I'm not going to risk that for a marginal gain in nitric oxide.

The body makes NO other ways. To give a little, possibly imaginary, boost I often use a creatine/BCAA powder in water before and during workouts and intervals or hard rides. Seems to help. Also tends to make me need to pee a lot more often.

For whatever reason, possibly available NO, my BP tends to be lowest immediately after exercising, especially outdoor bike rides at moderate effort. My BP will spike during interval training, as high as 160/100, but it drops again quickly. After a long moderate effort ride my BP will sometimes hover around 90 to 100 over 50-60. Oddly, my heart rate tends to stay elevated for hours after exercise, usually 90-100 bpm, before dropping back into the 60s.

Supposedly nitric oxide and Vitamin D for bone health are enhanced by exposure to sunlight. So this year I'm cutting way back on the sunscreen and UV apparel. For rides up to an hour I'm going without sunscreen. So far, so good. My doctor prescribed massive amounts of Vitamin D and calcium supplements, but there's little evidence that the body actually uses D supplements beyond a tiny amount in multivitamins or fortified milk and dairy products. It'll be interesting to see my next bone density scan in a year or so.

There's also a theory that body fat and too much sugar and junk carbs somehow contribute to the tendency to sunburn and get skin cancer. My anecdotal experience indicates a possible correlation. I used to burn easily, but back then I was 50 lbs overweight and ate a lot of sweets and junk carbs. Since I've been back down to 150 lbs, I don't seem to sunburn easily. Maybe just a coincidence.

In the developed world, overuse of antibacterials is a major problem. They depress the immune system and cause innumerable problems.

Mouthwash in particular is problematic and peculiarly damaging. It increases blood pressure and may encourage development of diabetes.
https://askthedentist.com/nitric-oxide-oral-health/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4008816/

https://watermark.silverchair.com/81...nJrBylZLwLPNlI

The watermark silverchair link doesn't work -- expired token, no way to backtrack to an index of articles.

The other two articles emphasize the importance of nitrates and nitric oxide, which I don't dispute. I've used potassium nitrate toothpaste for years. It's one of the oldest remedies for asthma, probably due to enhanced oxygen metabolism. And I try to get enough dietary nitrates to enable the body to produce adequate NO.

But I don't see any compelling evidence to support compromising oral hygiene. Certainly not enough to risk compromising proven oral health risks for the sake of a marginal gain in NO. Most of our NO needs appear to be satisfied through diet, exercise and reasonable exposure to sunlight.

10 or so years ago I was HBP meds had no issues. The high cholesterol meds caused leg pain when standing or walking. I quit the cholesterol meds and felt fine.

Meds and ills
 

I know what you guy are going through BP elevated, severe depression, things like that. Admitting to yourself that something is really, really wrong is hard. I scare the checkers at walmart. Sometimes I here what i said. It's really awful. I split my time between home and mom's home they're my baby sitters. It's just easier to keep my mouth shut and not get lost in the middle of walmart. Lots of that doesn't have a name yet. I keep trying to feel better. That's why I'm on the forum with you guys , bikes the last thing I can think of to feel better.