I recently saw a very interesting patient.
20 year old male college student (whom I will call Mr. X) with no known past medical history was referred to the medical clinic by his dentist for high blood pressure. During the office visit, Mr. X did not complain of any symptoms and said that he felt fine. On pressing a little further he said that at times he had headaches for which he takes over the counter painkillers.
Past medical history, family history and social history were unremarkable.
On examination his blood pressure was 180/116 in right arm and 175/110 in left arm. Heart rate was about 80. Rest of the physical exam was normal.
I tried to ask Mr. X if he was taking any drugs especially cocaine, marijuana or over the counter medications (besides painkillers – NSAIDS), but he denied.
Unable to explain the high blood pressure, I asked Mr. X to get some blood work done and asked him to come back in a week.
Next week Mr. X is back, asymptomatic with a high BP similar to the previous visit. His blood work is normal. Now I decide to start a million dollar work up to get to the root of his mysterious hypertension.
But then he tells me something interesting – cramps. He has been having mild cramps from weight lifting and exercising in the gym for about 3-4 weeks.
With a rush of adrenaline surging in me, I ask Mr. X “how many times do you work out in a week”
Mr. X – “Daily, I am trying to build some serious muscles”
Me – “I hope you are not taking steroids for body building”
Mr. X – “No, no, not at all. I know they are bad. I actually use this wonderful pre-workout supplement which I purchased from the internet. It does not have any steroids in it and works great”
Me – “And what is the supplement”
Mr X – “NO-xplode”
Case solved. Next week Mr. X’s blood pressure is 120/80.
(This is one of the many patients which I have seen and heard from colleagues, in which people get duped by fraudulent internet companies that sell FDA unapproved, non-tested diet supplements, body building supplements, herbal medicines and a whole lot of other stuff which can be extremely harmful. If you are taking any such supplement please consult your doctor).
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