Question for Dr. Chung

Brian Mink said:

Hi Dr. Chung,

I have been using Nifedical XL 30mg QDay to treat systolic
hypertension. It certainly lowers my BP to the target
range however, I'm a serious road cyclist and one of it's
side effects is it lowers my lactate threshold
significantly. I'm begining to have muscle cramps at about
35 miles of riding. Generally, I am not bothered by cramps
until about mile 80 - 100 miles. If I stop taking
Nifedical, my lactate threshold returns to normal and
muscle cramps go away.

Nifedical generally works well and has no noticeable side
effects in the normal course of ADL. Is there anyway to
mediate the lactate threshold effects of nifedipine? I'd
like to continue taking a CCB as this class of drugs works
better for me than HCTZ, ACE inhibitors, AII inhibitors or
Beta Blockers. I've tried many antihypertensives during
the last 12 months CCB's work well except they
significantly effect my ability to bicycle.

PS: I pay very close attention to hydration, nutrition,
electrolyte issues. My cramps and decreased lactate
threshold are most assuredly related to Nifedical.

I would be concerned that you might be having claudication.
Have you been evaluated for peripheral vascular disease?

Quoted message said:

Thanks for your assistance.

You are welcome.

Servant to the humblest person in the universe,

Andrew

--
Dr. Andrew B. Chung, MD/PhD
Board-Certified Cardiologist
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No, I'll pass this recommendation on to my internist.

On Tue, 01 Jun 2004 03:51:07 GMT, Dr. Andrew B. Chung,

MD/PhD said:

Brian Mink said:

Hi Dr. Chung,

I have been using Nifedical XL 30mg QDay to treat
systolic hypertension. It certainly lowers my BP to the
target range however, I'm a serious road cyclist and one
of it's side effects is it lowers my lactate threshold
significantly. I'm begining to have muscle cramps at
about 35 miles of riding. Generally, I am not bothered by
cramps until about mile 80 - 100 miles. If I stop taking
Nifedical, my lactate threshold returns to normal and
muscle cramps go away.

Nifedical generally works well and has no noticeable side
effects in the normal course of ADL. Is there anyway to
mediate the lactate threshold effects of nifedipine? I'd
like to continue taking a CCB as this class of drugs
works better for me than HCTZ, ACE inhibitors, AII
inhibitors or Beta Blockers. I've tried many
antihypertensives during the last 12 months CCB's work
well except they significantly effect my ability to
bicycle.

PS: I pay very close attention to hydration, nutrition,
electrolyte issues. My cramps and decreased lactate
threshold are most assuredly related to Nifedical.

I would be concerned that you might be having
claudication. Have you been evaluated for peripheral
vascular disease?

Quoted message said:

Thanks for your assistance.

You are welcome.

Servant to the humblest person in the universe,

Andrew

--
Dr. Andrew B. Chung, MD/PhD Board-Certified Cardiologist
heartmdphd.comheartmdphd.comOpen ↗

** Who is the humblest person in the universe?
makeashorterlink.commakeashorterlink.comOpen ↗

What is all this about?
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I just spent a minute thinking about your response and it
doesn't make sense. Claudication typically effects GNS
muscles. I can ride my bike at 20 miles per hour for 80 to
100 miles when not taking nifedipine and not get cramps.
The cramps occur (effecting GNS + Hamstrings + quardriceps)
only when taking a CCB which is know and reported to cause
muscle cramping as one of its published side effects. I
doubt your suspicion of peripehral athlerosclerosis has
much basis in my case.

So, back to my original question: Is there any way to
mediate the lactate threshold lowering properties of
nifedipine?

On Tue, 01 Jun 2004 03:51:07 GMT, Dr. Andrew B. Chung,

MD/PhD said:

Brian Mink said:

Hi Dr. Chung,

I have been using Nifedical XL 30mg QDay to treat
systolic hypertension. It certainly lowers my BP to the
target range however, I'm a serious road cyclist and one
of it's side effects is it lowers my lactate threshold
significantly. I'm begining to have muscle cramps at
about 35 miles of riding. Generally, I am not bothered by
cramps until about mile 80 - 100 miles. If I stop taking
Nifedical, my lactate threshold returns to normal and
muscle cramps go away.

Nifedical generally works well and has no noticeable side
effects in the normal course of ADL. Is there anyway to
mediate the lactate threshold effects of nifedipine? I'd
like to continue taking a CCB as this class of drugs
works better for me than HCTZ, ACE inhibitors, AII
inhibitors or Beta Blockers. I've tried many
antihypertensives during the last 12 months CCB's work
well except they significantly effect my ability to
bicycle.

PS: I pay very close attention to hydration, nutrition,
electrolyte issues. My cramps and decreased lactate
threshold are most assuredly related to Nifedical.

I would be concerned that you might be having
claudication. Have you been evaluated for peripheral
vascular disease?

Quoted message said:

Thanks for your assistance.

You are welcome.

Servant to the humblest person in the universe,

Andrew

--
Dr. Andrew B. Chung, MD/PhD Board-Certified Cardiologist
heartmdphd.comheartmdphd.comOpen ↗

** Who is the humblest person in the universe?
makeashorterlink.commakeashorterlink.comOpen ↗

What is all this about?
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Is this spam? makeashorterlink.commakeashorterlink.comOpen ↗

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Brian Mink said:

I just spent a minute thinking about your response and it
doesn't make sense. Claudication typically effects GNS
muscles. I can ride my bike at 20 miles per hour for 80 to
100 miles when not taking nifedipine and not get cramps.
The cramps occur (effecting GNS + Hamstrings +
quardriceps) only when taking a CCB which is know and
reported to cause muscle cramping as one of its published
side effects. I doubt your suspicion of peripehral
athlerosclerosis has much basis in my case.

The only way to know for certain would be to examine you.
Claudication can be worsened by lowering blood pressure.

Quoted message said:

So, back to my original question: Is there any way to
mediate the lactate threshold lowering properties of
nifedipine?

It is not clear that your lactate threshold is even lowered
by nifedipine. For all we know, nifidipine is altering your
serum lactate level rather than your threshold for
tolerating the serum lactate.

Servant to the humblest person in the universe,

Andrew

--
Dr. Andrew B. Chung, MD/PhD
Board-Certified Cardiologist
heartmdphd.comheartmdphd.comOpen ↗

**
Who is the humblest person in the universe?
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What is all this about?
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Is this spam?
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