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A daily multivitamin is advised because metformin can lead to vitamin B12 deficiency, Dr.

Mago discussed starting with basic approaches to managing the effect before opting for more intensive strategies.

To manage nausea, the most common cause of treatment discontinuation in antidepressant trials, he suggested first titrating an antidepressant up over one week, or using sustained-release formulations or split dosing.

Ginger root also is effective for combating nausea — “this is not an old wives' tale,” he said.

If these approaches do not produce results, Level 2 strategies such as prescription anti-nausea medications may be needed.

Ondansetron has been widely used, but mirtazapine works on the same serotonin receptors and may be worth keeping in the menu of options, Dr.

The goal always should remain to “have many options in your back pocket,” he said.

“Systematic Strategies for Managing Common Side Effects (Instead of Stopping or Switching the Medication).” Presented at Psych Congress 2020 : Virtual; September 12, 2020.

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Within certain limits, the lower your blood pressure reading is, the better.

There is also no specific number at which day-to-day blood pressure is considered too low, as long as none of the symptoms of trouble are present. Most doctors will only consider chronically low blood pressure as dangerous if it causes noticeable signs and symptoms, such as: Dizziness or lightheadedness Nausea Fainting (syncope) Dehydration and unusual thirst Dehydration can sometimes cause blood pressure to drop.

However, dehydration does not always cause low blood pressure. Fever, vomiting, severe diarrhea, overuse of diuretics and strenuous exercise can all lead to dehydration, a potentially serious condition in which your body loses more water than you take in.

Even mild dehydration (a loss of as little as 1 percent to 2 percent of body weight) can cause weakness, dizziness and fatigue. Lack of concentration Blurred vision Cold, clammy, pale skin Rapid, shallow breathing Fatigue Depression. Low blood pressure can occur with: Prolonged bed rest Pregnancy: During the first 24 weeks of pregnancy, it’s common for blood pressure to drop.

Decreases in blood volume: A decrease in blood volume can also cause blood pressure to drop.

A significant loss of blood from major trauma, dehydration or severe internal bleeding reduces blood volume, leading to a severe drop in blood pressure. Certain medications: A number of drugs can cause low blood pressure, including diuretics and other drugs that treat hypertension; heart medications such as beta blockers; drugs for Parkinson’s disease; tricyclic antidepressants; erectile dysfunction drugs, particularly in combination with nitroglycerine; narcotics and alcohol.

Other prescription and over-the-counter drugs may cause low blood pressure when taken in combination with high blood pressure medications. Heart problems: Among the heart conditions that can lead to low blood pressure are an abnormally low heart rate (bradycardia), problems with heart valves, heart attack and heart failure.

Your heart may not be able to circulate enough blood to meet your body’s needs.

Endocrine problems: Such problems include complications with hormone-producing glands in the body’s endocrine systems; specifically, an underactive thyroid (hypothyroidism), parathyroid disease, adrenal insufficiency (Addison’s disease), low blood sugar and, in some cases, diabetes.

Severe infection (septic shock): Septic shock can occur when bacteria leave the original site of an infection (most often in the lungs, abdomen or urinary tract) and enter the bloodstream.

The bacteria then produce toxins that affect blood vessels, leading to a profound and life-threatening decline in blood pressure. Allergic reaction (anaphylaxis): Anaphylactic shock is a sometimes-fatal allergic reaction that can occur in people who are highly sensitive to drugs such as penicillin, to certain foods such as peanuts or to bee or wasp stings.

This type of shock is characterized by breathing problems, hives, itching, a swollen throat and a sudden, dramatic fall in blood pressure. Neurally mediated hypotension: Unlike orthostatic hypotension, this disorder causes blood pressure to drop after standing for long periods, leading to symptoms such as dizziness, nausea and fainting.

This condition primarily affects young people and occurs because of a miscommunication between the heart and the brain.

Nutritional deficiencies: A lack of the essential vitamins B-12 and folic acid can cause anemia, which in turn can lead to low blood pressure.

A single lower-than-normal reading is not cause for alarm, unless you are experiencing any other symptoms or problems.

If you experience any dizziness, lightheadedness, nausea or other symptoms, it’s a good idea to consult with your healthcare provider. To help with your diagnosis, keep a record of your symptoms and activities at the time they occurred. Your donation helps empower people everywhere to learn the facts and take action to lower their risk of heart problems.

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Goals Center for Sexual Medicine Faculty and Staff Make an Appointment For Health Care Professionals Training Opportunities. The most common sexual dysfunctions in men include lack of interest, premature ejaculation and erectile dysfunction. The latter affects 52% of men between the ages of 40 and 70, including mild, moderate and complete forms of ED.

Organic or physical causes for sexual dysfunction in men include vascular, hormonal and neurologic factors. Concerning vascular causes, the risk factors for atherosclerosis (including smoking, high blood pressure, diabetes (diabetics do not respond well to pills like sildenafil (Viagra)) and high cholesterol are ALSO risk factors for erectile dysfunction.

Since a straddle injury or use of a narrow saddle can obstruct and impair arteries to the penis, bicycle riding is also considered a risk factor for erectile dysfunction. Little attention has been paid to endocrine factors.

Testosterone modulates desire, arousal and orgasmic function.

Concerning the orgasmic response, testosterone modulates the integrity of genital sensory receptors. Concerning the arousal response, decreased testosterone blood levels can influence the efficacy of sildenafil (Viagra).

If the sildenafil response is not reliably improving erection, the physician should first check if the patient is taking the pill correctly. The physician should also check the patient’s testosterone level. One investigator in Italy gave testosterone to patients with low testosterone who did not respond to sildenafil (Viagra). When daily testosterone was given, subsequent sildenafil (Viagra) use resulted in IIEF (the International Index of Erectile Function questionnaire used to determine erectile function) scores improving significantly.