Need help to solve low blood pressure. Recommendations for private clinic?

[JonTNL]

Hi Everyone,

This is my first time posting. I’m hoping someone maybe able to recommend a private specialist or offer some advice.

My 78 year old mother has recently been diagnosed with low blood pressure. She’s had many boood tests and scans at the hospital, but no underlying condition has been diagnosed and doctors seem to have run out of tests they can carry out.

Regardless, I am convinced there must be an underlying condition as the drop off in her wellness has been quite severe. Her blood pressure can read as low as 60/X with a drop of 30 to 50 points between sitting and standing. Mentally she is all there, but struggles to talk when feeling very bad and dizzy.

It was not until very recently (8 weeks ago) we discovered the problem when she fainted and since that moment her health has never been the same. She has gone from being relatively active (able to walk the dog) to being bed bound with the odd up day where she can potter around the house but little more than that.

Results of blood tests and scans have returned no obviously cause, although an MRI scan did return evidence of chronic small vessel disease in her brain. This however does not seem to have been a concern for doctors in relation to her condition.

The medication she is on is Midodrine and Fludrocotisone. We have been varying the dose following direction from our GP, but this does not seem to help sufficiently and she continues to fluctuate between feeling reasonably OK one day to being unable to stand up or walk the next.

There seems to be no pattern to her blood pressure readings and wellness. I take readings every day and she can be feeling OK with a low reading of 70/X then the next day be very unwell with a similar reading or a much higher (normal) reading.

The NHS seem so stretched doctors don’t seem to be able to do anything further for my mum, so I am considering paying for a private assessment and treatment,

My question is whether anyone has a recommendation for a specialist clinic for low blood pressure that I could contact. London or Home Counties ideally.

I would greatly appreciate any advice?

[bridgeit]

Hi Jon. Based on my own experience (no medical training at all), I suggest you try three specialisms in no particular order, assuming they've not already been involved and functional tests carried out, to investigate your mum's situation. One, an endocrinologist to find out if there's anything amiss with your mum's adrenal glands (adrenal function test), which control blood pressure (BP), or any compromise to her immune system. Two, gastro-enterology for a colonoscopy to see if there's an upper bowel problem, particularly around the area of the caecum. This would be appropriate if your mum has seen bowel habits changed e.g. unexplained diarrhoea and has lower-right abdominal discomfort similar to but not as severe as appendicitis. Three, a cardiologist to see if there's a heart valve problem. Mitral valve issues are not uncommon given your mum's age and can result in low BP.It's also really important that your mum stays well hydrated. She would be wise in my opinion (not a medical one don't forget) to avoid foods that lower blood pressure, such as sprinkling chia/flax/pumpkin/sunflower seeds on food, taking turmeric supplements or any other kind of anti-inflammatory food/supplement, at least until you both know what's going on.

Your mum is on some powerful medication. You'll need to bring that immediately to the attention of any specialist you see as she may need to come off those meds for a few days prior to certain tests; the specialists will advise about timing.

As far as private providers go, I've used both Nuffield and Spire and found both to be good. Given your area of preference, I suggest you look for specialists that work for good London NHS hospitals in clinical lead capacities. Some London NHS hospitals offer private consultation facilities where fees feed directly back into their counterpart NHS side. Have a good dig around online to see who's available and where.

I hope you and your mum are able to obtain identification of the problem that enables treatment of the cause of her very low and fluctuating BP rather than just the symptoms.

[deniseinmilden in reply to bridgeit]

Wow, what a superb reply!

I read this with interest and I totally agree. It's good to know I'm heading in the right direction.

I'm 50 and have always had these sorts of problems although mostly less severe. I'm doing all those things and have made some progress/am managing not to decline too much.

Nutrition is always a good place to start, with full hydration being paramount.

Especially check calcium (if high this locks up other nutrients), sodium, potassium, magnesium, and iron, and vitamins B12 & folate and D.

I am not medically trained but have spent decades trying to sort out my problems, helping other people, and am qualified in animal nutrition.

[Partner20]

No relevant personal advice to offer, I'm afraid, just an observation. You stated that your GP was not concerned about the MRI finding of small vessel disease in the brain, but this is known to cause dizziness and balance issues, and perhaps should be investigated further. I am sorry your mother is experiencing such debilitating symptoms despite being on strong medications, and hope you find some answers soon.

[JonTNL in reply to Partner20]

Thanks, and yes I also feel it does deserve further investigation. When I discussed this with the doctors however, they told me there is nothing that can be done, and dismissed it as being a cause of her issues. They did make me aware it raises the chances of stroke or dementia but no sign of either being present.

[Partner20 in reply to JonTNL]

It is true that many older people have such findings on an MRI while not presenting with symptoms of the more serious conditions that can be associated with them, but I would have thought it helpful to pursue the matter. However, in the current climate doctors, both GPs and consultants, do not seem too enthusiastic about exploring anything other than the obvious or straightforward, if that! I do hope you will find a way forward with your mother soon.