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Anyone have problems with Losartan?

bjl218

Senior Member
Messages
145
Location
Chelmsford, Massachusetts
My attempts to fight high blood pressure naturally didn't work and so one of my docs suggested I take Losartan which, in addition to lowering BP, has some anti-inflammatory effects. However, I think I've had an adverse reaction. A short while after taking 50mg once per day, I developed insomnia and significant joint and muscle pain. The joint and muscle pain seems to be worst at night when I'm trying to sleep. This of course contributes to the insomnia. These are documented (although supposedly rare) side effects. I Googled around and found quite a few people who have had these reactions.

I have issues other than hypertension so I'm not sure whether the Losartan exacerbated an existing condition or whether this is just an independent adverse reaction. Or whether Losartan is really the culprit at all for that matter... I stoped the Losartan about 5 days ago and I'm still having some of these symptoms.

I'm wondering whether anyone else here has experienced this and whether it took a while for the symptoms to clear.
 

hangininthere

Senior Member
Messages
101
Location
USA
I had a bad reaction from Losartan the very first dose, so didn't take any more and the symptoms went away by the next day.

My reaction was that I felt pressure all throughout my body head to toe inside and out, kind of like I would physically explode. Like sick all over. Don't know how else to describe it.

I take Lisinopril instead, which agrees with me.

Patti
 
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uglevod

Senior Member
Messages
220
This could be an anti bacterial effect(herx) which predominates anti infl one:

In Vitro Screening of an FDA-Approved Library Against ESKAPE Pathogens
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5662795/
Antimicrobial resistance is a serious threat to global public health in every geographic region, requiring immediate global action. Bacterial resistance to antibiotics emerges rapidly and can disseminate globally following its initial recognition [1]. Infections with resistant pathogens are difficult to treat, requiring costly and sometimes toxic alternatives. Furthermore, patients with resistant infections require longer hospital stays and are often much more likely to die [2, 3]. Despite the emergence and global spread of highly resistant organisms such as Enterococcus, Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa, and Enterobacter (ESKAPE) pathogens, the discovery and development of new antibacterials has slowed to an unacceptable level. This highlights the urgent need for the identification and development of novel antibacterial agents and their expedited introduction to the clinic in order to address this public health crisis.
...
In this study, we were most interested in exploring non-antimicrobial drugs that show antimicrobial activity. Of the 1,600 drugs tested, we initially found 74 non-antimicrobial drugs with potential antimicrobial activity against at least one of the ESKAPE pathogens.

...
From their table: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5662795/table/T2/
Structure, description and MIC of Pharmakon non-antimicrobial compounds against Gram positive bacteria.

Olmesartan medoxomil:
MIC (µM) VRE = 16; MRSA > 16

Valsartan:
MIC (µM) VRE = 16; MRSA > 16

Candesartan:
MIC (µM) VRE > 16; MRSA = 16


...

Losartan is an ARB family drug very similar to above ones.
 

bjl218

Senior Member
Messages
145
Location
Chelmsford, Massachusetts
However, this paper also says:

It was also notable that the tetrazolobiphenyls angiotensin II inhibitors (Olmesartan medoxomil, valsartan, and candesartan cilexetil) had reasonable antibiotic activity (Table 2); however, other members of this class revealed no antibacterial activity under the same experimental conditions.

Although it doesn't state whether Losartan was one of the ARBs that they tried. Interesting information nonetheless.

Losartan is an ARB family drug very similar to above ones.
 

aaron_c

Senior Member
Messages
691
I had horrible muscle pain as well when starting Losartan. I wound up fixing that problem by taking more potassium. As I understand it Losartan is actually supposed to increase potassium but my take at this point is that it's based on an incomplete understanding of how Losartan works. In any case, I'd be careful adding potassium. In my experience it's usually ok to up your dose by 99 mg at a time--that's the maximum dose they'll allow in pills in the USA. So if anyone is interested in trying this I'd suggest consulting with your physician who may, at the very least, want to run some tests to make sure your blood potassium isn't high--mine has been tested multiple times and it's been fine in spite of this really high dose I'm taking). Then I'd suggest increasing your dose slowly to avoid potentially life-ending electrolyte problems. If it starts feeling uncomfortable, then that's the clue to roll the dose back down a bit.

It took a surprising amount of potassium for me to prevent the pain from 50 mg of Losartan. And I have no idea what the effect of the potassium would be on blood pressure, so that's something else to consider. But I couldn't take Losartan without the potassium, the pain was just too debilitating.
 
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aaron_c

Senior Member
Messages
691
While we're on the subject I'll also mention that Losartan seemed to cause weight gain for me, but only when I was taking malic acid too. Once I stopped the malic acid--which had never caused weight gain before--the weight gain faded away rather quickly.
 

uglevod

Senior Member
Messages
220
I had horrible muscle pain as well when starting Losartan. I wound up fixing that problem by taking more potassium.

There is a blood test for potassium - you can try it just to be sure...
But science tells that all ARBs have potassium-sparing effect.
 

bjl218

Senior Member
Messages
145
Location
Chelmsford, Massachusetts
My doctor ordered some tests including electrolytes and kidney function so we'll see. Unfortunately, I had already been off the Losartan for a few days prior to these tests so they might not give an accurate picture of what was going on with me at that time. Also, as I recall, I was eating some fairly high-potassium foods (nuts, nut butters, etc) so I guess that could have contributed to the problem. That's assuming the problem was hyperkalemia of course.
 

aaron_c

Senior Member
Messages
691
There is a blood test for potassium - you can try it just to be sure...
But science tells that all ARBs have potassium-sparing effect.

Like I said, I've done those blood tests a few times(my ND insisted, for exactly the reason you point out). In spite of my 2.7 grams of daily supplemental potassium that I take to eliminate the muscle-aches, blood potassium has always tested as normal.

So my understanding is that science tells us that ARBs *should* have a potassium-sparing effect if they work how we think they do (by blocking angiotensin receptors, thus lowering aldosterone secretion in response to high blood potassium, increasing potassum excretion). It seems like they must have found this to be the case in some of the trial patients, so I'm not doubting it exactly. But I do doubt that it's the case for everyone, as it seems clear that it's done the opposite for me, and those muscle cramps are a really common side effect so I suspect I'm not the only one.

My suspicion is that what's happening is that since the renin-angiotensin system operate in a loop, blocking one part of it just amplifies the signal until the system corrects itself--or at least brings a few critical inputs (like the sodium density in the distal tubule or the perfusion pressure) back where it thinks they should be. For instance I found an old paper that states "Antagonists of the type 1 (AT1) angiotensin II (Ang II) receptor increase renin secretion and plasma Ang II levels, and the increased Ang II levels may counteract the effects of the antagonist" [1]. For at least some people I suspect this kind of attempt to find a new equilibrium results in potassium wasting. So I truly think that if you have muscle cramps as a result of Losartan that potassium is worth checking out.

[1] Effects of losartan on angiotensin and bradykinin peptides and angiotensin-converting enzyme. Campbell DJ,
Kladis A, & Valentijn AJ. Journal of Cardiovascular Pharmacology 1 Aug 1995, 26(2):233-240.
[https://europepmc.org/abstract/med/7475048]
 
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bjl218

Senior Member
Messages
145
Location
Chelmsford, Massachusetts
All very interesting. I've been off of Losartan for a while now and on Lisinopril 10mg for about a week and a half. I haven't had the nerve to check my BP yet. The muscle/joint pain has completely resolved. My lab results came back and my K was 4.3 (3.5-4.3). This is in the middle of the range and a few days after I stopped taking Losartan so I'm not sure I can deduce anything from this. All other tests including Na, kidney and liver function were fine.

So I guess my Losartan adventure will go down as yet another adverse reaction of unknown cause to a pharmaceutical.
 

Hip

Senior Member
Messages
17,824
My attempts to fight high blood pressure naturally didn't work and so one of my docs suggested I take Losartan which, in addition to lowering BP, has some anti-inflammatory effects. However, I think I've had an adverse reaction. A short while after taking 50mg once per day, I developed insomnia and significant joint and muscle pain. The joint and muscle pain seems to be worst at night when I'm trying to sleep. This of course contributes to the insomnia. These are documented (although supposedly rare) side effects. I Googled around and found quite a few people who have had these reactions.

Losartan is an angiotensin II receptor blocker (ARB) drug, and in patients with chronic diseases (such as ME/CFS and sarcoidosis), ARBs are known to cause the symptoms you experienced.

But these symptoms do not occur in people who are generally healthy. In fact ARBs are used by millions of people daily for blood pressure management without any such symptoms.

Prof Trevor Marshall became aware of this phenomenon, and he called the symptoms experienced from ABBs an immunopathology reaction, and theorized that the reaction occurred because ARBs activate the vitamin D receptor (VDR) in cells, and this in turn switches on an immune response which destroys infectious pathogens inside the cell. Thus Marshall believed the immunopathology was a sort of Herx reaction as pathogens in the cells are killed.

He then employed this immunopathology reaction — which he says kills intracellular pathogens inside cells — as the basis of his Marshall Protocol for treating chronic illnesses such as ME/CFS. The MP involves taking the ARB drug Benicar.

More info in this post.
 

bjl218

Senior Member
Messages
145
Location
Chelmsford, Massachusetts
Interesting theory @Hip . If this is true, I'm not sure why I wouldn't have gotten a similar reaction from taking a 6-week course of Doxycycline after a suspected tick bite or from the high-dose vitamin C and glutathione IVs I periodically do.

You could of course make the case that anyone with high BP is not "generally healthy." I found plenty of postings online from people having the identical reaction I had. They didn't mention any other medical condition. Although they may have been harboring some pathogen that they weren't aware of.

Losartan was suggested to me specifically because it is also known to have anti-inflammatory properties. One of the reasons Shoemaker uses it in his mold protocol. But I suppose that immune-boosting properties could also come along with this.

When I had my severe reaction to Cipro, it was suggested by some that this was actually a severe herx because of some pathogen I didn't even know I had.
 
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Hip

Senior Member
Messages
17,824
If this is true, I'm not sure why I wouldn't have gotten a similar reaction from taking a 6-week course of Doxycycline after a suspected tick bite or from the high-dose vitamin C and glutathione IVs I periodically do.

In the case of doxycycline, I guess that might also be a Herx reaction. Not sure about the glutathione.



You could of course make the case that anyone with high BP is not "generally healthy." I found plenty of postings online from people having the identical reaction I had. They didn't mention any other medical condition. Although they may have been harboring some pathogen that they weren't aware of.

That's true, and not all chronic illnesses cause this immunopathology side effect when ARBs are taken; it's only certain chronic illnesses. It may be that it's only chronic illnesses which are associated with a widespread intracellular infection (which includes ME/CFS and sarcoidosis) that you get immunopathology.



Losartan was suggested to me specifically because it is also known to have anti-inflammatory properties. One of the reasons Shoemaker uses it in his mold protocol. But I suppose that immune-boosting properties could also come along with this.

Yes, Marshall also talks about the anti-inflammatory effects of ARBs such as Benicar. This is something which actually makes the Marshall Protocol more tolerable. But on the other hand, as Benicar switches on the VDR (which is located actually on the nucleus of a cell), this causes the secretion of anti-microbial peptides which have antibacterial and antiviral effects, and hence a Herx. That at least is Marshall's theory as to what's going on.

I briefly tried the MP for around 2 months (this was years ago), and developed the light sensitivity that is very common when patients with certain chronic illnesses take ARBs. But I found the immunopathology side effects quite minimal, at least at the 2 month stage.
 

bjl218

Senior Member
Messages
145
Location
Chelmsford, Massachusetts
Thanks again @Hip. I couldn't have tolerated the level of pain I experienced long-term. I was very happy when it finally receded a while after I stopped the Losartan.

Just to clarify, I haven't had any herx-like reactions to Doxy, IV-C, or glutathione
 

Hip

Senior Member
Messages
17,824
Just to clarify, I haven't had any herx-like reactions to Doxy, IV-C, or glutathione

Sorry, I misread and thought that you did.

I guess if it is a viral intracellular infection that you might have (the enteroviruses linked to ME/CFS are known to cause long-term intracellular infections called non-cytolytic infections), then perhaps the ARB drug will cause a Herx-like reaction against the virus, but doxycycline would not touch the virus.

Of course I guess your symptoms might also be due to some other unknown side effect of ARBs. I am not sure how quickly the immunopathology symptoms appear in the MP, and whether they can appear within days as you experienced with the symptom symptoms.
 

uglevod

Senior Member
Messages
220
I am not sure how quickly the immunopathology symptoms appear in the MP, and whether they can appear within days as you experienced with the symptom symptoms.

Commonly from the first doses. That was my case. I became terrible light sensitive among another things. Even mild morning lights through closed eyelids bothered me greatly and sometimes I've found myself with a blanket over my head(eyes) upon waking up(before I've made the bedroom completely zero-lux one).
 

uglevod

Senior Member
Messages
220
Interesting. It took a while for me to experience side-effects. Light sensitivity wasn't one of them thank goodness...

Light sensitivity was from Olmesartan. It's interesting to compare "side-effects" from different ARBs. Maybe Losartan and Olmesartan have the same direct anti bacterial potential as other ARBs from the paper above.

I believe light sensitivity = brain inflammation, since it was coupled with terrible anxiety, etc

Sometimes people become light sensitive from antibiotics(like minocycline):
https://www.theraspecs.com/blog/medications-side-effect-light-sensitivity/
 
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frozenborderline

Senior Member
Messages
4,405
Losartan is an angiotensin II receptor blocker (ARB) drug, and in patients with chronic diseases (such as ME/CFS and sarcoidosis), ARBs are known to cause the symptoms you experienced.

But these symptoms do not occur in people who are generally healthy. In fact ARBs are used by millions of people daily for blood pressure management without any such symptoms.

Prof Trevor Marshall became aware of this phenomenon, and he called the symptoms experienced from ABBs an immunopathology reaction, and theorized that the reaction occurred because ARBs activate the vitamin D receptor (VDR) in cells, and this in turn switches on an immune response which destroys infectious pathogens inside the cell. Thus Marshall believed the immunopathology was a sort of Herx reaction as pathogens in the cells are killed.

He then employed this immunopathology reaction — which he says kills intracellular pathogens inside cells — as the basis of his Marshall Protocol for treating chronic illnesses such as ME/CFS. The MP involves taking the ARB drug Benicar.

More info in this post.
This is all odd bc people with me/cfs have high tgf beta as well as patients with connective tissue disorders and mold I'llness patie ts and losartan has been suggested as a possible treatment for that. Do you think it's common to not tolerate arbs in Peoppe with me/cfs or just slightly more common than the general population?
 

Hip

Senior Member
Messages
17,824
Do you think it's common to not tolerate arbs in Peoppe with me/cfs or just slightly more common than the general population?

I've never been able to find any further details of this intolerance to ARBs that some patients with chronic diseases have. And I don't remember where I read about it, as I read it over 10 years ago, when I was first investigating the Marshall Protocol. Possibly I may have read it in the Mark London critique of the Marshall Protocol.

If I remember rightly, I think this intolerance was a phenomenon that was observed by the pharmaceutical companies selling these ARBs. They noted that certain patients with chronic diseases react badly to their drugs.

Trevor Marshall heard about this intolerance phenomenon, and started putting two and two together.

I am not even sure if this phenomenon occurs with all ARBs, or just with olmesartan. And I don't know which specific chronic diseases this phenomenon appears in; but it seems to be many, as people with various chronic diseases experience the immunopathology, if you read the MP forum.