Low BP (70/40) in Teen - How to Raise This?

Updated on December 10, 2012
J.B. asks from Boston, MA
15 answers

Hi - my oldest son has now become super high maintenance ;-) At his physical in September his BP was 100/60. At a concussion check 3 weeks ago, it was 70/40 at the pediatrician's office. She took it again a few minutes later to make sure it wasn't from just standing up and it was the same. It was also taken by a psychiatrist last Friday and was again 70/40. His doctor wasn't concerned about it and said that it's common in tall, thin kids (he's 5'10 and 125 lbs) whose blood volume hasn't caught up with rapid growth but that symptoms could be dizziness and lightheadedness. Of course those are also symptoms of concussion, which he sustained three weeks ago, and are side effects of Concerta, which he just started to take today for ADHD. He's completed his graduated return to play plan but had a dizzy spell this morning at practice (before taking medication), so I'm looking to increase his BP and see if that prevents dizzyness vs being a sign on continued concussion symptoms.

Has anyone dealt with hypotension, either in yourself or your kids? Was there anything you did about it? From what I've been able to find, water and salt can help so I'll try to give him stuff like Gatorade but I hate how sports drinks are mostly sugar and artificial color and flavor. Thanks for any tips or stories you can share!

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M.M.

answers from Boston on

My bP tends to be on the lower side...in high school (back in the dark ages) I averaged about 92/60 and felt fine (and I'm a far cry from tall and thin)...70/40 sounds, well, ...as a mom, I might be concern particularly w/ a concussion ....good luck, hope he's OK

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G.B.

answers from Boise on

OK, first off to those like Christy lee who said "you shouldnt worry about it when your doctor isn't" doesnt have a damn clue what she is talking about and should not even be commenting on medical advice if she doesn't have medical knowlege. 70/40 is dangerously low. Coma can be obtained at 50/35 and anything under can lead to death. Low blood pressure is NEVER something to be brushed off. In fact, when your child gets dizzy and passes out, it is essentially the same thing as a stroke- a lack of blood flow to the brain.That will cause damage after a while. His first blood pressure listed- 100/60, still falls in the low category. '100' systolic is very low-normal, and 60 diastolic is right on the border of hypotention. By the way, the systolic number relfects a person's cortisol levels, and the diastolic number relfects aldosterone levels.

My 2 yr old girl had a bladder infection that was 'brushed off' as nothing by 4 doctors, they kept telling me she had the flu. By day 8 her lips were turning blue and her eyes sunk in and she was vomiting- she was going into renal shock. (It was in fact a kidney infection.) So fast forward,now- she is 15 yrs old, and she is very ill. she was DX'ed with vasovagal syncope. (that is actually a symtpom, it means low blood pressure). She has hypotention. Her hypotention is caused by damage either to her adrenal glands (addisons syndrome) or to the renal tubules of her kidneys. A direct result of docotrs brushing her off when she was sick!! If she had gone on an IV antibiotic when first taken in, she would not be sick today. I have been working on getting her DX'ed but they dont want to find the 'source' of the problem. I have been doing medical research for 12 years, with heavy endocrine studies for the last 5.I HAVE finally gotten some tests done wich proved my theory, now I cant find an endocrinologist willing to see her.

Blood pressure for the most part is controlled by adrenal hormones, aldosterone mainly. A person with normal aldosterone had normal BP. If you have high aldosterone you have high BP. If you have low aldosterone, you have low BP. Aldosterone's job is to control perfect levels of the electrolytes. The electolytes (sodium and potassium) control the water level of the body..this is how: Aldosterone triggers the body to retain sodium in the kidney, and then release some potassium.
If aldosterone is low, then it doesn't retain the sodium amount that it should, and sodium is not kept, but wasted out in urine. Sodium levels keep you hydrated, because salt/sodium attracts water like a magnet. Low sodium causes the body to NOT retain enough water, and dehydration sets in. The body NEEDS a certain amount of water to make blood. Without enough water, there is not enough blood made. With low amounts of blood circulation in the body, there is not enough pressure on the veins to get enough blood to the brain and extremities. Hypotention ensues. That is why they tell you to take more salt. Anyway, electrolytes work on a see-saw like fashion- if you are wasting sodium, then that means you are retaining too much potassium. (eventually there seems to become an adversion to high potassium foods like OJ, Bananas, potatoes...the body just seems to know what it needs.) Usually the person will also crave things high in sodium: pickles, lunchmeats, soups, chinese foods, chips, etc. They may also have blood sugar swings and crave sweets/chocolate.) If the body is indeed too high in potassium, the last thing you want to give is a sports drink which is loaded with potassium. Stick with the salt. In water, it can gag. My daughter pours some in her hand, licks it up, then drinks water down. Use a natural sea salt like Redmond.

You can have his aldosterone checked by blood in the morning. Also you must have renin performed at the same time. It is always good to test the sodium, potassium, calcium, etc....but these can look normal in blood panels even in someone who has low levels. that is because it is what's happening inside tissue cells that counts.

Now, because his systolic is on the low side also, he might have low cortisol too. Also a hormone pumped out by the adrenals, it controls sleep/wake cycle, blood sugar levels, stomach acid levels, immune response, body tissue PH, and more. If your son has any other issues in these areas, you can consider him possibly and probably in some sort of adrenal fatigue state. Cortisol should be tested by SALIVA method. If the doctor isnt willing, there is a lab oneline that can do it for you. Cortisol controls your weight via glucose/metabolism. High cortisol= excess fat. Low cortisol = very thin people

Any kind of blunt trauma to the head can cause tumors, which can and will cause adrenal issues and hormone imbalance. Id like to give you more info, and get some ideas of his symptoms, symptoms can give you good ideas as to what is going on.... ...you can email me at ____@____.com

You need to get educated in this area so they CAN'T brush him off anymore. I can help.
By the way, one last thing, hormone issues isually 'pop' when the child enters puberty/ teen years, when hormones are raging and suddenly the body has a greater need for more. ADD is a 'false' diagnosis, it is a catch all diagnotic term for a cluster of metabolic/endocrine symptoms, not the cause. ADD is actuallyadrenal fatgue; a lack of adrenal hormones. ADD meds partially work only because they increase certain hormones (perhaps like serotonin and minute amounts of cortisol, and some others) but the child will get progressively sicker on them eventually until the root cause is addressed.

Kind regards,

Gail

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L.O.

answers from Chicago on

My answer? Why do you want to?
Mine has been mostly 80/50 most of my life. It got to the "normal standard" when I was pregnant, and went up slightly(85/55-90-60) after I gave birth, but stays relatively low.

The adding salt to the diet is a double edged sword, as it can permanently raise BP, and if after he tapers off his medication(only by a doctor, as incorrect weaning will also mess it up), will raise it to too high.

Natural "sports" drink.
One lemon wedge(squeezed slightly into the glass),
one teaspoon of blue agave nectar or a packet of stevia powder(I use truvia),
one pinch of salt
Place into a 32 oz container of water. Mix well.

Lemon balances out the super sweet of stevia(a little goes a long way, and you may find he needs or wants less), and also balances out the slight maple-like taste of agave nectar(a better and sometimes cheaper alternative to pancake syrups, as a little goes a long way), and both sweeteners are natural, and if they are diabetic friendly, not harsh on a growing body, so yeah, no artificial sweets or colours or flavours.

He's going to need to learn how to GET UP SLOWLY. My one issue was if I sat down for a while, then got up quickly, I'd get dizzy.
When working out, your BP will elevate, but when I was younger, my body would quickly try to return to low. I had to learn to cool down and stretch a bit longer than most(hence my taking yoga) after running to prevent after workout dizzy spells. He will need to learn how his body reacts, and cool down longer than most.

Caloric intake. Healthy foods--fresh veggies and fruits(or flash frozen prepared properly), Whole Milk, Whole grain breads and cereals, sensible , lean meats and fish.
Teenagers and young adults, especially an athlete like your son, needs a slightly higher caloric intake to "feed" his muscles, as they are taking the most of his food intake for conversion. BTW, unless his metabolism is Superman awesome, weight gain will occur as muscle weighs more than fat. If you don't feed the muscles, yup, you guessed it, dizzy from lack of calories.

When I ran a lot, My intake went from the standard 2,000 calorie intake to 2,800 calories. I was sensible, and ate healthy fats(as you need about 600 calories a day from fat to feed your body). I also had healthy snacks. I drank smoothies with whole milk, tofu, and used frozen fruits instead of ice. I ate home made "trail" mix made from things like cheerios, unsalted nuts, dried grapes and cranberries and other fruits we dehydrated ourselves. I drank lots of water and barley tea(handful of roasted barley boiled in a pot of water).

One thing to remember about medication...it takes about a month for your body to adjust to it, and your body to discover how to metabolize it. It's not until then that you can decide if the pros and cons balance each other out.

Looking at the doctor's comment on blood volume...

When at the doctor's, have your son's hemoglobin count looked at. Liquid Chlorophyll(commonly recommended to boost pregnant women's blood volume) might assist in increasing blood volume if he is slightly anemic(also a dizzy spell trigger). It's a natural plant iron supplement available at most health food stores. Pricey, but a bottle typically lasts me four to five months, so spending $20 on a bottle is not bank-breaking. Two tablespoons in his morning OJ. It has no negative issues if you opt not to use it later, as it's just a green supplement.

Hope these help.

Agree or disagree, as always, it's...

Just my 2cp.

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L.L.

answers from Rochester on

My regular BP, even these days with being overweight (sigh) is still 90/60. When I was a fit, thin teenager (and I was NOT tall) my BP was about 80/50. 70/40 does seem really low, but not dangerously low...if the doctor isn't having you try measures to raise it, I certainly wouldn't worry. If you are worrying, get a second opinion. But definitely don't give him extra salt!

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K.P.

answers from New York on

It is pretty common and will adjust as his body adjusts. In the meantime if he's experiencing the symptoms then add some salt to his diet and see if it helps. A good friend of mine has hypotension (not blood volume related) and she addds salt where she can and "sugar free" sports drinks throughout her day!

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B.F.

answers from Dallas on

I usually run on 110/70 and I am 50 and "plump" : ) I only have a bit of trouble sometimes upon standing, I feel dizzy.

His blood pressure reading is not troubling. It's working for him and he has likely been running low for a long time now. Apparently, he has not been complaining.

The thing that has changed now is the concussion and the meds.
He had his dizzy spell before he took his meds.

I think you know where I am going with this but either you or your son don't want to face it could be the hit that sent him for a concussion check.
I am telling you now that is playing with fire. if he gets another hit on the head while recovering from one, the results will be far worse than living his whole life with low BP.

Get a more extensive concussion check and don't let them pressure him into playing.

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K.F.

answers from Dallas on

Hi,

I have recently seen a cardiologist and electrophysiologist for low blood pressure and an ejection fracture. The electrophysiologist told me to eat salt consistently throughout the day. Pretzels/goldfish/misc I don't really want to eat junk food all day so I started eating salted sunflower seeds and salted nuts. She also said to drink sugar free gatorade. I don't like sports drinks either if I'm sitting at my desk all day! You can make your own by adding salt to water and sweeten with a little lemon or honey. I don't like salt, but have been salting everything I eat now. I've only been doing it about a week and some of the symptoms have subsided. I also have a high heart rate, not sure if that's the case with your son, but that is why I need to raise my blood pressure - to lower my heart rate. Increasing salt is the only thing I have found online to raise your bp. It is difficult to live with and you may find other problems he's having are related. My eye sight got bad a while back and that is a side effect. I never knew! My heart rate is highest early morning before I have ate so if he is worse in the mornings it might help to have a salty snack by his bed before he gets up. That is the worst time for me and the only time I feel I may pass out. He does need to be careful because standing/sitting can be issues. Good luck!

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D.D.

answers from New York on

I have to agree with Christy. If the doctor says it's common and isn't concerned then I'd let it go. As long as he's hydrated and eating good quality food his blood volume will catch up soon. You might want to pick up a blood pressure cuff for the house if it would make you feel better (pretty inexpensive. we have one for my high blood pressure hubby).

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S.E.

answers from New York on

if its about blood volume, can you give him an iron pill.. my mom took then while she was undergoing chemo and it worked wonders on her blood counts

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C.V.

answers from Columbia on

Okay, his doctor is not concerned about it and has not stated that any action needs to be taken to increase his BP, So why are you?

I advise that you ensure that he is consistently hydrated and eating properly. Since he is an athlete, he does need more calories in his diet than the average Joe. He needs more salts and potassium. He needs more protiens.

Read up on sports nutrition. Add a few things to his diet to ensure he is getting the nutrients he needs, and make sure he's staying hydrated (which means he's replenishing those salts and potassium along with water). But don't worry so much about his BP. As long as he's getting the hydration and nutrients he needs, his BP will level out to where it needs to be for his age and activity level.

Here's a great book to read on sports nutrition: http://www.amazon.com/Nancy-Clarks-Sports-Nutrition-Guide...

ETA: Gailski: I'm an Army combat medic and nationally registered EMT. The fact that you "love to do medical research" and cut and paste from Web MD and the Mayo Clinic sites doesn't make YOU a medical professional any more than my husband watching the Bears makes him a football player. The problem with you "laptop doctors" is that you immediately assume the worst possible diagnoses and run around like Chicken Little screaming about it and scaring people away from the most logical explanations.

Let's see: Did the boy have a CT scan to ensure he doesn't have a hematoma along with that concussion? I'll bet he did, which is why the doc didn't immediately refer him for one.

His BP was low at his last physical and now it's even lower...because he's taking Concerta today FOR THE VERY FIRST TIME. His BP will adjust as his body adjusts to the new medication. It's only a concern when it doesn't show a trend of adjusting over the next few weeks.

Had he eaten that morning prior to his appointment? Did he have a full meal with his meds? Taking a stimulant medication on an empty stomach can make you feel pretty messed up and shaky.

When you hear hoofbeats, think HORSES, not zebras. Diagnosticians don't consider the rarest possibility first, because...it's rare.

If you want to be a medical professional, go to school and learn to be one. Don't assume your Google-Fu makes you one.

To JB: After some thought about your son's medication, I suggest that talk to the doc again to ensure that your son's medication dosage is correct for his weight. And also know that it will take his body some time to adjust to the new meds.

Since a side effect of Concerta is a drop in BP, he might need a dosage adjustment. Yes, he is hypotensive to the point of dizziness and it is affecting his daily activities, but don't jump right to stopping the meds completely, since he does need a few days to adjust to the medication. It's like having 3 cups of coffee when you've never had coffee before...you're REALLY going to feel that caffeine and notice every little affect it has on you. Once you've drank 3 cups of coffee a day for a week or two, you won't notice it.

Best of luck to you!

To Gamma: I recommend asking the nurse or medical assistant to take your BP manually, and let them know that they only need to inflate the cuff to 120mmHg since you have low BP. They should accommodate you. ♥

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D.B.

answers from Boston on

Don't give him Gatorade or Powerade or Vitamin Water - you are right that they are all sugar, salt and dyes. There is something you can give him that has a lot less sugar, sodium, and uses beta carotene which is natural and safe. You can buy it on line. It also has chrome-mate (niacin-bound chromium) which will help level off his blood sugar, and it increases absorption right into the cells so he's not just peeing it out. You want to look for US government patents which prove safety, efficacy and uniqueness. You can also supplement for him to help his ADHD - you need to talk to a friend of mine, a teacher, who did this for her son, and he didn't need the medication and has great focus. My son did the same regimen as an athlete and did great - no injuries, no issues, and improved performance (started breaking records, etc.). I'm talking about all food and no meds - happy to give you more info.

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B.B.

answers from New York on

I can't speak about his concussion but I had low blood pressure as a teen and young adult. It runs in my family and now in my 30's my blood pressure usually runs 110/70. As for now, yes, putting on weight will definetely help your son. He also can not skip any meals either as that was often a trigger for me. This is especially important when he goes out to party with his friends. He should also pay attention to the signs of passing out (flashing lights, blurry darkened vision) and sit down with his head down between his legs as if he ignores the signs, he will pass out.

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S.T.

answers from New York on

Kids with low blood pressure are generally kids who are super healthy. the only downside is that when they stand up suddenly everything can go black - he jsut needs to be cautious when standing up suddenly. I had it for many many years when I was young, healthy and always riding my bike, swimming, running, etc. There's nothing to treat him with - it's not a bad thing. Elite runners and triathon atheletes usually have low blood pressure.

But as it relates to the concussion there is very, very new research - just published in the last few weeks that's very concerning about concussions. Do your research quickly. They're saying even a few concussions over a life time can cause damage that's irreparable. neurologists now have new guidelines about how long after a concussion kids should be sidelined from sports. My son's had a few concussions over the years playing sports and it's sobering to read this new study.

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G.B.

answers from Oklahoma City on

I would talk to the doc. I would not accept they are not worried about this. Go to a different kind of doc. One that deals with blood pressure issues. Not a cardiac one but the other kids.

I have low bp too, it's often 80 over 50-60 and the docs just take it over and over and over then call the nurse in to do it and they get the same thing. By that time I am nearly in tears because those silly automated ones go up to 200 each and every time. That is painful on my arm and it's totally unneeded since my bp is never over 100 on top.

There are many things you can do. The salt is one for sure but it that healthy for his body over all? Not really. He may need to see a doc that will specifically address this issue. A cardiologist would address high blood pressure so I don't know who would address the extreme opposite but I would call my insurance and find out. He's having injuries that "might" be from this and that tells us he's not getting enough blood and oxygen to his brain. So it is an issue now.

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K.S.

answers from Denver on

I like the idea of not worrying if the doctor is not. But it may be worth asking docs what you might do to keep it up safely. My BP is 90/60. Not a problem, but if I get up too fast, especially in the morning, I do get quite dizzy. But I've had this all my life and never had any problems. His is lower than mine though, so again, ask about ways to keep it at a healthy level and to ensure that there is no problem, and then try not to worry (easier said than done, I'm sure!). Good luck.

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