As we age, our ability to absorb magnesium, calcium and potassium decreases. Lower levels increases blood pressure.All three should be supplemented. And if you are prescribed medications for hypertension – they actually will drop these minerals lower and partially increases blood pressure. This is an awkward medication feedback — it contributes to what it is suppose to treat!

• Not enough minerals. Too little potassium, calcium or magnesium in the diet can cause leg cramps. Medicines often prescribed for high blood pressure can cause increased urination, which may drain the body of these minerals.“
  https://www.mayoclinic.org/diseases-conditions/muscle-cramp/symptoms-causes/syc-20350820

As a result of my last post, several reader pinged my about hypertension, in some cases associated with POTS (a common morbidity with ME/CFS). This is just a quick recap of recent research.

The age-standardized prevalence of hypertension at baseline was 74.3% for men and 70.2% for women.

Prevalence and Incidence of Hypertension in the General Adult Population [2015]

• ” Obesity and weight gain also contributed to progression; a 5% weight gain on follow-up was associated with 20-30% increased odds of hypertension. ” [2001]
• “Dose-response analyses showed that all of the carotenoids[ β-cryptoxanthin, lycopene, lutein with zeaxanthin and total carotenoids ] were inversely associated with hypertension in a linear manner. Total carotenoids showed significant effect of lower risk of hypertension at 100 μg/kg per day. “[2019]
• ” It appears that the use of nutritional supplements and medical foods containing L-methylfolate and vitamin D may be effective in facilitating the improvement of diabetic and hypertensive retinopathy.”[2019] “
• ” In conclusion, higher dietary calcium intake, independent of adiposity and intake of other blood pressure-related minerals, is slightly associated with a lower risk of developing hypertension. ” [2019]
• Zinc deficiency is an independent risk factor for prehypertension in healthy subjects. [2019]
• ” When studies were categorized based on participants’ mean age, ginger dosage and duration of intervention, systolic BP and diastolic BP were significantly decreased only in the subset of studies with mean age ≤ 50 years, follow-up duration of ≤8 weeks and ginger doses ≥3 g/d.  ” [2019]
• Cross-sectional NHANES data do not support the hypothesis of a positive association between choline intake and BP. [2019]

A nice summary article

Other antihypertensives

That is, BP lowering substances, not cited above:

• Effect of hibiscus sabdariffa on blood pressure in patients with stage 1 hypertension. [2019] SBP: -7.4, DBP -6.7
• Flavonoids in hypertension: a brief review of the underlying mechanisms. [2019] ”  catechins and quercetin impart significant blood pressure lowering effects “
• Ethnobotany of Anti-hypertensive Plants Used in Northern Pakistan. [2018] ” Pharmacological studies show that Allium sativum[garlic], Lepidium sativum [Garden cress], and Ocimum basilicum [Basil], Mentha sp.[mint], Trigonella foenum-graecum [Fenugreek], Urtica dioica[common nettle], Olea species [Olive], and Eucalyptus globulus[Tasmanian Blue gum] are effective species in treating hypertension “
• Antihypertensive Effects of Corn Silk Extract and Its Novel Bioactive Constituent in Spontaneously Hypertensive Rats: The Involvement of Angiotensin-Converting Enzyme Inhibition. [2019]
• Poor sleep quality increases blood pressure [2020]
• Consumption of nattokinase is associated with reduced blood pressure and von Willebrand factor, a cardiovascular risk marker: results from a randomized, double-blind, placebo-controlled, multicenter North American clinical trial. [2016]
  • Effects of nattokinase on blood pressure: a randomized, controlled trial.[2008] SBP -5.55, DBP: -2.84

Earlier Posts

• Blood Pressure and the Microbiome
• Blood Pressure and CFS-IBS-FM
• CFS Low Blood Pressure, High Blood pressure and gut bacteria
• The Heart and Blood of the CFS Patient

Personal Observations

I have found that a combination of Piracetam with Bacopa Monnieri (and flushing niacin) dropped Systolic BP, mmHg by 40mm and Diastolic BP, mmHg by 10mm within 30 minutes. This effect lasted about 3 hrs.

• Bacopa Monnieri and Its Constituents Is Hypotensive in Anaesthetized Rats and Vasodilator in Various Artery Types [2011]
• Does nicotinic acid (niacin) lower blood pressure? [2009]
• [Effects of Piracetam on Occupationally Significant Functions of Patients With Arterial Hypertension Working Under Conditions of Psychoemotional Stress] [1995]
  • [The Treatment With Antihypertensive and Nootropic Preparations of Hypertension Patients Working Under Neuroemotional Stress] [1996]

It is important to note that is may be just a transitory effect (i.e. a single daily dosage may not reveal significant changes in a study), that can occur on each dosing.

What is Piracetam?

Piracetam (2-oxo-1-pyrrolidine-acetamide), the most common of the nootropic drugs, is a cyclic derivative of gamma-aminobutyric acid [GABA]. The treatment with piracetam improves learning, memory, brain metabolism, and capacity. Piracetam has been shown to alter the physical properties of the plasma membrane by increasing its fluidity and by protecting the cell against hypoxia. It increases red cell deformability and normalizes aggregation of hyperactive platelets. Piracetam is an agent with antithrombotic, neuroprotective and rheological properties. The interaction of this molecule with the membrane phospholipids restores membrane fluidity and could explain the efficacy of piracetam in various disorders ranging from dementia and vertigo to myoclonus and stroke.

Piracetam–an Old Drug With Novel Properties? [2005]

Monitoring Blood Pressure

An upper arm pressure cup gives the most accurate results. I have also used a cheap chinese watch ($20) that records O2 saturation, Pulse and Blood Pressure every hour. The first two use the same technology used in clinics to get those two measurements. The Blood Pressure uses a different technology (more below).

Not all watches advertising Blood Pressure measurement support automatic hourly reading. Below is a screen shoot a few days after being released from hospital where an infection had pushed this to 160/110 for a while.

It is interesting that the mid-night spike at 4am appears to match with night sweats when I suspect that my body was fighting the residue infection. My pulse also went up to 159 (with 79 an hour before, and 85, then 64 after). O2 saturation also went up to 99% during this period. To me, not something of concern, just interesting.

UPDATE After a few months on the above

The watch is reasonable for general pattern only

” The accuracy guidelines were only met for the HR measurements in both devices. SBP measurements deviated 16.9 (SD 13.5) mm Hg and 5.3 (SD 4.7) mm Hg from the reference values for the Everlast and BodiMetrics devices, respectively. The mean absolute difference in DBP measurements for the Everlast smartwatch was 8.3 (SD 6.1) mm Hg. The mean absolute difference between BodiMetrics and reference SpO₂ measurements was 3.02%.”

Accuracy of Vital Signs Measurements by a Smartwatch and a Portable Health Device: Validation Study [2020]

The high end Samsung watch has the same challenges. The technology, is described in this article The use of photoplethysmography for assessing hypertension [2019]. The measurements are still not up to par with upper arm cuffed blood pressure measure, with hopes for improvement over the next 5 years.

The human microbiome changes easily even when there is an illness. The bacteria associated with an illness are often from a collection of compatible bacteria — so you may have subset A this week and subset B next week.

To illustrate this, prior to the ME/CFS relapse, my blood pressure tended to be around 120/80. Having ME/CFS with all of the associated issues, makes BP a measure prone to wild fluctuations at time. See these earlier posts:

• The Heart and Blood of the CFS Patient You may have a small heart
• The Heart and Blood of CFS
• Blood Pressure and CFS-IBS-FM

My recent visit to an urgent care has the physician concerned about high blood pressure. Usually, I have not been concerned about that because I have had a history of low BP with POTS. With the recent work on symptom templates (see this post), I wrote a time plot page to plot the pearson chi-square probability over time of each one of our many disease profiles.

I then looked at the blood pressure one for myself:

There is definitely some art in using this. The Criteria takes some playing with to see patterns (remember the studies indicate a change of average values, not extreme values … so 24% may be better than 6% for some conditions).

For those who missed the prior post that explains how these numbers are calculated, see this post with video.

What are we looking for?

We are looking a pattern that repeats pretty constantly over several samples taken a few weeks or months apart.

I have done a video rambling on this new feature.

A few more examples:

Bottom Line

This tool may be useful as you build up samples over time. Often one sample gets odd numbers and we have a spike with before and after samples showing a constant pattern.

If you are interested, consider investing in multiple samples. I usually use a discount code and get uBiome’s 3-pack for around $150 … that’s $50 per result (which is often what a good bottle of probiotics cost).

Condition Template pages are based on bacteria shifts reported as significant in studies published on PubMed. These studies usually use the non-quantified expression “higher” or “lower”, often on the averages for a group. This makes application to individual microbiome samples a challenge — especially when averages very rarely are normal distributions.

With the improved quantiles (bins of samples) enhancement, we have a way to likely use these vague study results in a robustness safe way.

Consider a condition with 16 bacteria. If we select the 6% level, we would expect around 1 (16 x 6% =0.96) matches. With expected numbers and actual numbers, we can use a method called Pearson’s chi-squared test. Using expected numbers and actual numbers from a sample, we can compute chi-square probability of the matches being random.

For the example below, we pretend we have 16 bacteria. We expect 1 to be found(matches) and 15 not to be found. If we find 6 matches and thus 16-6 -= 10 non-matches, we can compute the odds of this happening at random. Around 0.032, 3.2% or 1/0.032 => 1 in 32 times.

• With 0 matches on 16 items we have 0.309
• With 1 matches on 16 items, we have 1.00
• With 2 matches on 16 items, we have 0.54
• With 3 matches on 16 items, we have 0.285
• With 4 matches on 16 items, we have 0.144
• With 5 matches on 16 items, we have 0.070
• With 6 matches on 16 items, we have 0.032

Traditionally, a value is 0.05 (5%) or less is needed to be significant (or, of concern). There is one change in 20 or this being random. If you check 20 conditions – you would expect one to be at 0.05 or below ( 5% x 20 = 1). So you need to use a bit of common (statistical) sense if some odd condition appears. On the other hand, if a suspect condition shows up very strong then you may wish to get definitive testing (if it is available). Not responsible for MD’s confused faces when you ask for testing because you microbiome results suggest it may be wise.

Bottom Line

Using these studies results have been an ongoing challenge for me. There is elegance in the approach implemented given that we are dealing with fuzzy data from studies that are all over the place in approach, default regional diets etc.

Again, this is not intended to predict, rather just inform people when their microbiome appears to be shifting to reported disease patterns.

Suggestions:

• The smaller the probability and the smaller the percentile (i.e. 6%), the more likely that these is a real association.
• The association should persist across multiple samples.
• The all in one is likely the best measure of microbiome dysfunction

I will see about adding a timeline to these measures for those with multiple samples.

This was released on Sept 8th, 2019. The old Symptom Bacteria Explorer is still up. It weaknesses are:

• Does not show where your values are on the table
• Uses 4-buckets analysis only
• Does not allow you to exclude symptoms during the exploration.

These two pages have been updated to use the new Plus version also:

• Very Strong Symptoms Bacteria Findings
• Strong Symptoms Bacteria Findings

Updated Version

This is available from the Select Samples Screen as a new Button.

Bottom Line

This is not prescriptive, i.e. directly suggesting actions. It is informative as to the cause. If you have not entered symptoms yet, consider doing so.

If you click on the bacteria button, you will be taken to the bacteria summary pages which may suggest changes desired. As always, changes of diet, supplements etc should always be reviewed with a knowledgeable medical professional before implementing.

With the long weekend, I bite off some of the nastier refactoring. In the late spring, I did a trial run of quantiles non-parametric statistics with awesome results. I had arbitrarily picked 4. I have now implemented the data infrastructure to support 8 and 16 quantiles. To this, I added the site source so that mouth bacteria analysis will be automatically supported with more data uploaded.

Update of Taxonomy Data

This allows you to see how your numbers compare to others in terms of percentile buckets (3% of the population in each)

Updated My Biome View

The original version used canned images. This uses scaling and appropriate placement.

Custom Suggestions