Q&A: when to worry about low blood pressure; targeting belly fat; how to heal from a stomach bug; & fighting foot fungus

Keep your questions coming!

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In this week’s reader-submitted Q&A, we’re tackling these questions:

• When should I worry about low blood pressure?

• How can I lose belly fat?

• How can I heal from the stomach bug?

• How to get rid of a foot fungal infection?

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It’s clear from last week’s poll that you much prefer my written answers over the audio version. So, this week I’ll go back to the original format.

You can now submit your questions for a future Q&A in two ways:

• Click here to write me your question.

• Click here to record your question directly from your phone or computer.

Disclaimer: The views expressed here are entirely my own. They are not a substitute for advice from your personal physician.

Photo by Immo Wegmann on Unsplash

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The following subscriber questions have been lightly edited for length and clarity.

QUESTION #1: WHEN TO WORRY ABOUT LOW BLOOD PRESSURE

I appreciate your column so much. I’m 73 and have a question about blood pressure - mine skews really low - like 100/60 and sometimes even a bit lower than that. I've wondered if my Ehlers-Danlos has anything to do with that? I'm often fatigued and I wonder if it is possible, or advisable, to raise my blood pressure somehow? And if so, how would I do that? I realize this question might be pretty unique to just me so I won't necessarily look for an answer in your column but it's just kind of nice to know that you're hearing this.

- Rebecca

Hi Rebecca,

I’m glad to hear from you! It’s certainly possible that your Ehlers-Danlos Syndrome (EDS) is playing a role here. For those who don’t know, EDS causes increased elasticity in connective tissues and can affect blood vessel integrity which might contribute to low blood pressure in some individuals. That said, EDS is rare and low blood pressure is common. Chronically low blood pressure readings can be caused by a variety of different factors. It also could be your healthy baseline. In other words, low blood pressure doesn’t always signal an underlying medical problem.

Some of the common causes of a chronically low blood pressure that are important to rule out include:

• heart problems that affect the heart's ability to pump blood effectively (such as heart failure, an extremely low heart rate, or heart valve problems)

• hormonal imbalances from conditions like thyroid disorders (hypothyroidism or hyperthyroidism), adrenal insufficiency (Addison's disease), or low blood sugar (hypoglycemia)

• certain medications, such as diuretics, alpha-blockers, beta-blockers, and antidepressants

• postural changes where sometimes standing up quickly after sitting or lying down can cause a temporary drop in blood pressure, known as orthostatic hypotension

• autonomic insufficiency which is an impairment in the part of our nervous system that is responsible for controlling the constriction and dilation of blood vessels and the rate of heartbeats and, therefore, regulating blood pressure

Some of these conditions will cause fatigue. Some will not. Whether or not your low blood pressure and fatigue are related should be discussed with your doctor. My point is that it’s important to understand the root cause of the low blood pressure (if there is one) before you assume that it is related to your fatigue and before you treat it. 

Here are a few VERY general strategies that might help manage low blood pressure if and when you have ruled out any underlying causes:

• Drinking more fluids. This can help increase blood volume and prevent dehydration (which lowers blood pressure).

• Increasing your salt intake. This should be done under the guidance of a healthcare provider. For example, increasing salt intake in a patient with heart failure can make their condition worse!

• Eating small, frequent meals: Large meals can sometimes cause a drop in blood pressure, so eating smaller, more frequent meals might help.

• Wearing compression stockings: These can help reduce blood pooling in your legs and improve circulation to help stabilize blood pressure.

• Reviewing your meds with your doctor: Make sure you aren’t experiencing low blood pressure as a side effect of one of your meds—or as a result of your medications to treat HIGH blood pressure being too strong!

• Changing positions slowly: When moving from a lying or sitting position to standing, do so slowly to avoid sudden drops in blood pressure.

Again, talk with your doc. But I hope this general gist is helpful! 

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QUESTION #2: TARGETING BELLY FAT

I am a 68-year-old woman. I have a fully postmenopausal “middle.” I am wondering what your best suggestions are for losing weight especially around the abdomen/middle. I have heard that stress can play a role?

- Ellen A.

Hi Ellen,