I wonder if anyone could give me some advice please? I don’t want to go back to my GP as, given his reaction when I told him I was doing the BSD, he’ll tell me to scrub the diet.

I am on 20mg of lisinopril daily for blood pressure. I am now into week 3 and have noticed a couple of times in the last few days that I have felt light-headed. I checked my BP and found it is lower then normal. I think I need to reduce the BP meds. As I am only taking one tablet a day I guess I should just stop taking it and monitor my BP? Has anyone any experience of this please?

Hi Steve,
Firstly, I’m no medic – but I wouldn’t recommend just stopping any meds unless your GP OK’d it. Could you see someone else at the same surgery if you think your own GP won’t be supportive???
I am on assorted meds following a heart attack years ago. A few weeks ago, I also felt rather dizzy – I got an appointment to get my BP measured (two or three days later) and it was normal. I think in the book it says that if you do experience light-headedness you could have a bit of salt. If it keeps on happening, then get back to your GP. I think this is something that is known to happen if you are on BP meds and losing weight so your meds might need adjusting. Guess it means you are successfully losing weight!
Regards, Rose

Thanks Rose for being so helpful. I had quite a salty dinner this evening deliberately and I’ve been careful to add salt to my BSD meals since I started. That was a culture shock after several years of squeezing salt out of my diet to help with high BP. And I’ve taken your advice and am speaking to my GP tomorrow. And if he’s still being Mr Unhelpful I’ll try another doctor in the practice. Oh the delicious irony of having a low blood pressure problem!!

My pleasure, Steve. A couple of times on the BSD I’ve pigged a bag of salt & vinegar crisps – I suppose I may have accidentally been doing myself some good! I too have spent years not adding salt to anything. Ironic indeed.
Hope you get on OK with your GP.

I read your post with great interest, Steve. I have a similar situation with my GP (the worst thing is to end up with ‘Non-compliant’ recorded on my e-health records, lol) but ironically he’ also says as an intelligent human being I’m in charge of my own health. When it comes to my GP, I’ll let my annual blood tests do the talking. After Week 8 (and only 12lbs lighter), I feel my BP has dropped but I need to take regular daily BP readings. I haven’t done so yet, having focused on blood glucose levels instead. I need some hard evidence like regular daily BP readings to justify to myself my coming off meds (even if it’s only 40mg pill a day). And the results have to show consistency. Keeping in mind BP is an indicator of external stress (unrelated to diet) which can obviously fluctuate, I’ll rely on two or three months of BP readings. So long as the records are consistently in the Normal range for BP, I’ll be happy. If BP starts to drop to below Normal, then I believe I can be reasonably sure the meds are pushing BP below normal. Keen to see how you go!

Can you make an appointment with a practice nurse instead of your GP just to get a blood pressure check?
If it is quite low, you can then see the GP if needed to review meds, and avoid seeing them at all if it is not.

I guess like a lot of people who have a BP problem, I’m “lucky” enough to have a BP monitor and have been taking regular readings – so there’s no need for me to see a practice nurse as I can see exactly what is happening. The lightheaded episodes prompted me to wonder what was going on during them so I tested blood sugar (which came up 5 or 6) and then blood pressure. Those readings came up 120/76, 128/69 and 127/79. The diastolic (second) element of these readings is I think the problem – they are below the Normal range.

I am approaching the end of Week 3 and have lost 18lbs. I feel that this weight reduction has definitely reduced my BP as my readings have reduced steadily since I started. I will be asking my GP later whether my lisinopril dose might be dropped from 20mg/day to 10mg/day. I hope he’ll be helpful.

By the way Rod, I love it that somebody who is trying to take charge of their own health is marked “non-compliant’ in their health records! That seems to me such a grotesque thing to do.

Hi SteveT, like you I have a blood pressure monitor, I have low blood pressure so am always under your ‘normal range’ but when I was light headed at the beginning of the BSD and checked with my monitor my BP was at the lowest possible end of acceptable. So I think this is a natural occurrence while our bodies adjust to low calories and low carbs. I keep saying I’m in week 13 but having just checked the calendar it is week 15 and my BP is still lower than at the beginning, but the same as it was 10 years ago so I am very happy with that. My 90 year old dad is still about 120/70 (without meds) so hopefully you can lower your lisinoprol dose and hopefully by the end of 8 weeks come off it!!! 🙂

PS I should add that my friend who is on medication for high blood pressure has been advised to add salt to her food when her BP crashes – despite being on renal dialysis. So it can’t hurt the rest of us to follow that advice! 🙂

Interesting thread!

I’ve been on a cocktail of anti-hypertension meds for over 2 decades, and now my blood sugar is creeping into the red zone. Moving home and changing doctor has brought things into focus, so time to do something.

I had been monitoring my BP for the last week or so, at my GP’s request, as I seem to get “white coat syndrome”. We’ve had an Omron blood pressure gauge for years – get one, they cost so little!

The first day, I took my blood pressure first thing in the morning (before I had taken my meds) and got a reading of around 167/103. Since then, I’ve taken a reading mid-afternoon after taking meds first thing. Readings last week were 145/96 149/93 134/89 126/89 139/91 133/89 137/86

Then I started the 800-cal diet. The following day my BP was 120/84. Today it was 113/79. “Can’t be true”. Checked again later – 107/72. Changed the batteries in the BP gauge – 113/76! Have only lost a couple of pounds at most, so that’s not the reason – it must just be the low-carb diet I guess.

Tomorrow I am going to have to miss out my meds or my BP will plummet – after 2 days! Today I did a “pre-medication” BP check as well, reading was 134/85 which is in the acceptable range anyway.

I wouldn’t recommend this to anyone, but I’ve forgotten my meds a few times and not had a problem with missing a day. The key seems to be that you need to keep a daily eye on your blood pressure when you do the 800-cal “full on”. I will be doing that a few times a day for the next few days so that I can come back on the meds as required.

Hello there! I would say that everyone is going to be different in the way their BP responds so it’s hard to offer any sound advice other than if you feel a change whilst still taking meds see the doctor but don’t stop taking them. You know your body best and you should be guided by that. I am on 2 drugs daily and have been since my late twenties ( I am 43 now) but have not really noticed any physiological change that I could say is BP related despite losing 16 lbs… But then I don’t monitor my BP regularly except when I visit the nurse!

Update: I missed out my BP med yesterday and BP remained Normal – but I guess missing one day wouldn’t make a vast difference. Spoke to my GP who blamed the diet for the light-headed feelings and then (rather reluctantly I thought) said he’d reduce my lisinopril to 10mg – half what I have been taking. So I’m rather pleased with that! I wonder whether, by the end, I’ll be able to get off the pills altogether?

I laughed at your post DocPWK as I’ve done the same thing when my monitor started showing low readings after being so long in the Level 1 zone. Battery change. Check all fixtures and fittings. Double takes rule!

I think the advice on this thread about watching salt intake and increasing it while on the BSD is really good advice – it just comes hard after years of avoiding salt like the plague.

Hi Steve no wonder your dr sounded a bit reluctant, he was probably feeling a wee bit stupid!

So glad you have been able to reduce your meds! 🙂

I think that this really reinforces the guidance in the book that you need to check with your GP if you are on meds for high blood pressure before starting the diet. If you are, check your blood pressure at least daily when you start the diet. I was completely stunned by the fall in my readings after just 1 or 2 days.

I am due to see the GP again early next week (follow up call which means blood sugar was causing concern) so decided to do a pre-emptive strike and go on the diet for a week before going back, based on reports that some people reported almost immediate benefits. Didn’t expect this though! It’s just a shame that Lloyds pharmacy let me down completely and never sent the blood glucose monitor I ordered a week ago, so I have no idea what my blood sugar is doing. On the upside, Boots gave me the customer services number for Roche and when I phoned them to ask where I could get a meter (Accu-chek Aviva) they said they would send me one free of charge. Result!

As a doctor myself (of IT not medicine though) I’m fairly happy to self-administer for a few days, but I’m only doing it as an emergency measure before my BP drops through the floor.

Bottom line – every home should have a blood pressure monitor (and use it)!

I’ve seen my BP fall into the 130/80 to 125/75 range since starting on the BSD. I take Exforge for my high BP and will be asking to move to a lower dosage on my next check-up as I do sometimes feel light-headed and tired. I monitor my BP morning and evenings with an Omron wrist monitor and take an average of 3 readings. The mornings are always higher – my specialist told me this is because of our inbuilt “flight or fight” response – when we wake up we don’t know what to expect and are physically ready to swing a few punches or run away! Apparently this takes an hour or so to dissipate.
Hopefully after a few more BSD 8 week blocks I can come off the Exforge completely – another great side-effect!

I’m non compliant as I don’t ever want to start taking tablets if i don’t have to… really your GP should be pleased as it means the cost of meds are not then paid for by the practise? I’m in Wales so prescriptions are free but I don’t know how it works elsewhere.

I mostly started the fast version as I have had recent high blood pressure readings over the last 4 months or so. I should invest in a monitor really.

Yesterday I was told I’m probably type 2 diabetic so I definitely want to nip it in the bud before it blooms and I get other problems. Good luck with coming off or reducing meds 😀

Off to see the GP tomorrow – blood glucose now 4.6 when it was 7.2 when tested 10 days ago, today is day 7 of the 800-cal regime.

Quick comment about wrist monitors for blood pressure (just my 2p worth) – my GP advises strongly against them and I have to say that mirrors my personal experience.

After using an Omron blood pressure gauge for years, I always hated the tightening cuff on the upper arm and the ensuing thudding pulse down the arm as it took its reading – so I bought a wrist monitor, admittedly one from Lidl!

The day after I took the first reading (hadn’t done one for months with any gauge) I was breaking down the GP’s door to get an appointment – the reading was way in the danger zone (maybe pushing 200 systolic).

Turned out the meter was wildly inaccurate – your mileage may vary as they say 🙂

My BP readings are staying startlingly (for me) low and halving my lisinopril dose 2 weeks ago has made no difference. I’m going to see what happens without the other 10mg daily. Having a good arm-band BP monitor gives confidence that monitoring will be accurate. I always thought wrist monitors were dodgy on accuracy and a waste of money.

I’m also noting that my blood glucose readings are now mostly in the fives. That’s on a DIY halving of my metformin dose two weeks ago. I’m going to stop taking the other half at the end of this week – by then I’ll have completed Week 6. HBa1c is now 37 (It was apparently 87 when I was first diagnosed with Type 2 last year!).

This is so empowering. At this rate the only tablet I’ll be taking each day is a multi-vitamin pill! Thank you Michael Mosley.