low blood pressure due to neuropathy

Question

I have been facing many complications due to hiv related neuropathy. Sensory and motor nerve damage in most areas of my body. Now my docotr and I are looking at neuropathy as the cause of my low body temperature in my extermities (feet and hands are purple in shade for most of the year. blood pressure has dropped from the 120/80 to 90/60 over the past few years. Not on any of the "D" or other related drugs that factor into drug related neuropathy. Tried neurotin and lamitical to help with the problem but not change in condition.

taking 300mg of elavil and 120mg of morphine to help with the problem and reduce the high level of pain suffer.

is it possible that neuropathy can cause all of these problems? every neurologist said neuropathy is the root of all the problems but i do not know where to go. seen neurologist at john hopkins and geirge washington hospital and awaiting on nevre regroth factor, but do you know of any other options?

the low blood pressure is making life miserable. thank you for your time in my ramblings.

Answer

Tough situation. For treatment of autonomic neuropathy with low blood pressure I have had a few patients take Florinef (a mineralicorticoid) with replacement doses of hydrocortisone (i.e. 10-15 mg/day). I also make sure than other hormones are OK (thyroid, testosterone) and that there is no anemia. I would stick with your neurologist who seem to be doing everything that is reasonable. KH