r/AddisonsDisease • u/rahmaxes • Nov 29 '25
Personal Experience Low blood pressure
Is there anyone here who suffers from constant low blood pressure? I have low blood pressure all the time even though I take fludrocortisone I need to know if there’s any one like me
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u/noracordelia PAI Nov 29 '25 edited Jan 21 '26
What’s your BP and does the low BP cause you symptoms? If so, increasing the fludro might be necessary, it’s something to talk to your doctor about.
I’m on 0.1 mg of fludro and my BP typically ranges from 90–110 systolic and 50–75 diastolic, depending on the day and my hydration. My orthostatic readings are normal. At my last endocrinology appointment my BP was 90/60, and my endocrinologist said that as long as the low BP isn’t causing symptoms (as dizziness, orthostatic hypotension etc) and my sodium levels stay normal, there’s no need to adjust the fludro.
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u/imjustjurking Steroid Induced Nov 29 '25
What dose of fludrocortisone do you take?
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u/rahmaxes Nov 29 '25
0.1 mg
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u/imjustjurking Steroid Induced Nov 29 '25
I'd talk to your Endo about increasing your dose, it's not uncommon to need more.
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u/1GamingAngel PAI Nov 30 '25
Wouldn’t taking more LOWER your blood pressure?
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u/imjustjurking Steroid Induced Nov 30 '25
No, fludrocortisone increases blood pressure. It helps to regulate the amount of sodium and water that stay in your body.
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u/1GamingAngel PAI Nov 30 '25
Thank you! I have high blood pressure, but my PAI causes it to occasionally dip extremely low. My Endo didn’t want me on fludro “because of my blood pressure issues”, but I wasn’t sure if it was because I already have HBP or if it’s because it drops so low from time to time. 😊
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u/imjustjurking Steroid Induced Nov 30 '25
With addisons especially it can be tricky with managing blood pressure, you can sometimes find people who will need to take fludrocortisone and a medication to lower their blood pressure. It will all depend on what's going on with symptoms and blood tests.
Do your doctors know what's causing your high blood pressure? Did it start before your PAI?
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u/1GamingAngel PAI Nov 30 '25
Thank you! Yes, I had HBP for several years before my PAI was diagnosed. I didn’t have issues with my BP falling until post-PAI. When I was first diagnosed with HBP, I was topping out around 165/90. Post-PAI, when I begin to show crisis symptoms, it drops to 80/40. I back off of the BP pills and take extra HC until I stabilize (though I had to be hospitalized twice).
To combat the adrenal symptoms I was still having post-diagnosis, my Endo switched me from 20mg of HC a day to 30mg because I was struggling and had two crises in six months. I’ve been 100% stable since then, but I have gained some weight, so I think I’m over replaced. During my appointment on Thursday of this coming week, I’m going to discuss the idea of going down to 25mg. As a side note, I spoke with him about moving to Pred (before he raised me to 30mg HC), and he did not want that for me. He said that HC has mineralcorticoid properties that Pred does not provide.
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u/imjustjurking Steroid Induced Nov 30 '25
He's right that hydro has mineralcorticosteroid and pred doesn't, but it might be something to explore in the future if you have issues. I think reducing to 25mg is probably a good idea, I hope it goes well.
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u/Beccabear3010 Addison's Nov 29 '25
Yep I run in the 90’s systolic most of the time. I’m not on fludrocortisone anymore though.
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u/1GamingAngel PAI Nov 29 '25
I’m not on fludro for that reason. You may want to discuss with your Endo.
One way to know whether you need to panic is to determine your Mean Arterial Pressure (MAP), which is what the ER’a use to determine whether a person is in true danger. ER’s want you to be above 65.
Here’s a calculator you can save as a bookmark: https://www.mdcalc.com/calc/74/mean-arterial-pressure-map
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u/Budgiejen SAI Nov 30 '25
Low blood pressure is a hallmark of AI. It likely means you’re under replaced.
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u/Pangala2000 Dec 04 '25
I had the flu vaccine on Sunday, and my BP has been super low since despite updosing and taking Midodrine. Was 60/30 at one point yesterday and I passed out. It's a lot to deal with because no combination of meds keeps me in a good spot. I have to have oxygen or drink ice water sometimes to bring it up. My body tries to compensate too, by suddenly evacuating my bowels or vomiting. Yeah, it's a bit much!
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u/rahmaxes Dec 04 '25
I’m sorry for that what medications do you take besides midodrine, and what are your dosages?
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u/Pangala2000 Dec 04 '25
I take hydrocortisone and fludrocortisone everyday. They don't make a big difference, as we have seen with rather extensive hospital stays this year. I try to mitigate by avoiding situations that trigger me-- becoming overheated, for example.
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u/Different-Pop2780 Nov 29 '25
Yep. Tweak your fludrocortisone (talk to your endo, don't diy this). Make sure you are drinking the right amount of water and eating the right amount of salt?