Dr. Anshul Varshney
Internal Medicine
The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.
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Patient's Query
Hello doctor,
I have been using medicines for high blood pressure for two years. The medicines are:
1. Olmezest 10 mg tablet in the morning.
2. Prolomet XL 50 mg in the evening.
My blood pressure is under control with these medicines. It is below 130/80 mmHg. Today I got tested for sugar levels which are as follows:
1) Fasting blood sugar= 141 mg/dl
2) Post prandial blood sugar= 236 mg/dl
3) Urine sugar fasting= Nil
4) Urine sugar post prandial= 2+
Please tell me if I am diabetic with these readings and whether I can control this with any lifestyle changes, food, exercise, etc. Please suggest to me what is the course of action for me. Do you suggest any medicines for this? Is it safe to use the same high blood pressure medicines continuously, or is any change required?
Hello,
Welcome to icliniq.com.
You are already on very low-dose medicines for hypertension. So, you may skip Prolomet XL (Metoprolol Succinate) and see how it works. As far as your diabetes is concerned, these readings suggest that you have diabetes. So to be sure, I would advise you to get glycosylated hemoglobin (HbA1c) test which would give an average reading of your blood sugar for the last three months irrespective of your meals. With that report, we will discuss the possible treatment options for you.
I hope it helps you. If you have any further queries, please ask me.
Thank you.
Patient's Query
Hello doctor,
Our physician has prescribed the following medicines:
1) Gemer 1- 1 tablet twice a day.
2)Tazloc-H 40 mg 1 tablet in the morning.
3) Eltroxin 75 mg for hypothyroidism.
In my previous query, I forgot to mention that I also suffer from hypothyroidism, and my TSH value is 5.9 mIU/L. When I use this thyroid tablet, I feel tachycardia, so I am not using that. Are my above medicines fine, or do I need to add or remove anything from them? Please advise. Now Prolomet XL is replaced by Tazloc. Is that fine?
Hello,
Welcome back to icliniq.com.
The medicines are fine, but I am concerned about such a high dose of Eltroxin (Levothyroxine) as this range of thyroid level does not require such a high dose. I need to know what was your initial TSH (thyroid stimulating hormone) level when you were started on Eltroxin. What was the dose at that time? Have you got your TSH test repeated? Revert with the asked details for better help.
Patient's Query
Hello doctor,
The first time I got tested for thyroid was eight years back, and my report values are:
T3= 85 ng/dl
T4= 6.4 mcg/dl
TSH= 7.05 mIU/L
For this, our physician gave Eltroxin 50 mcg. But as I did not have any symptoms like weight gain, and I even lost some weight at that time, so I started with only 25 mcg. I used it for one month. Somehow I did not feel good about it, my blood pressure elevated, and my heart rate also increased, so I stopped taking that medicine completely.
Again after a few months, I got tested for thyroid; readings were:
T3= 92 ng/dl
T4= 6.4 mcg/dl
TSH= 5.91 mIU/L
I am not using Eltroxin for one year. Please advise me in this regard whether there will be any problems if I do not use this medicine. If I use it, I experience more blood pressure and increased heart rate.
Hello,
Welcome back to icliniq.com.
You have subclinical hypothyroidism, and this does not require any treatment because you do not have any symptoms. You just need to keep regularly monitoring your thyroid functions. Get them repeated quarterly. In case the value rises to more than 10, then only we would start the treatment that too with just 25 microgram dosage. 75 micrograms are definitely not required for you.
I hope it helps you.
If you have any further queries, please ask me.
Patient's Query
Hello doctor,
Thank you for answering regarding the thyroid problem. I have one more doubt to clarify. I was using Prolomet XL 50 for hypertension and a slightly higher heart beat of 90 to 100 beats per minute. With this, my blood pressure and heart rate are under control. Now, this is replaced by Tazloc H 40 mg. Is it fine to take it? I am concerned about the sudden change in the medication. Will my heart rate also be under control with this? Kindly help.
Hello,
Welcome back to icliniq.com.
Yes, your heart rate may go up but if it goes beyond 90 beats per minute then you would need to take a Metoprolol for high blood pressure .
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Internal Medicine
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