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Mayo Clinic Q&A: combating excessive sweating, high blood pressure

Published Oct. 1, 2015

EXPLORE CAUSE OF EXCESSIVE SWEATING

I'm a 57-year-old woman and am so warm all the time that I don't even wear a coat in the winter. I sweat so much that it drips off my nose sometimes, and if I do any kind of physical activity I start sweating. It is uncomfortable and embarrassing. Is there anything that can be done for this?

The excessive sweating you describe is called hyperhidrosis. Rest assured, effective treatment is available. To decide on the best treatment options, you will need a thorough evaluation with your doctor to review your symptoms and check for an underlying medical condition that could be contributing to the problem.

Sweating is your body's way of cooling itself. Your nervous system automatically triggers your sweat glands when your body temperature rises. Sweating also normally happens when you're nervous or under stress. Other factors that have an impact on when and how much you sweat include your age, sex, posture and diet, as well as the climate where you live. Your body's circadian rhythm, the 24-hour internal clock that helps regulate your sleep and wake patterns, can affect sweating, too.

The most common form of hyperhidrosis is called primary focal (or essential) hyperhidrosis. It happens when excess sweating is not triggered by a rise in temperature or physical activity. There is no medical cause for it and it tends to mainly affect the palms, face and soles of the feet, although in some cases it can involve the entire body.

Secondary hyperhidrosis is less common. It happens when sweating is due to a medical condition. Disorders that may lead to excessive sweating include diabetes, nervous system disorders, some infectious diseases, thyroid problems and some types of cancer. Of particular note for your situation is a condition called paroxysmal localized hyperhidrosis. It primarily affects women after menopause and is caused by a nervous system disorder. Certain medications also can lead to excessive sweating.

To evaluate your condition, your doctor will likely talk with you about your symptoms and your medical history. He or she may recommend blood, urine or other lab tests to see if your sweating is the result of another medical condition. If it is, then treatment for that disorder may help decrease or eliminate the sweating.

If no clear cause can be found, treatment focuses on controlling excessive sweating. Prescription antiperspirant is often used first. Certain nerve-blocking medications and antidepressants can also reduce sweating. Injections of botulinum toxin (Botox or Myobloc) may help.

A procedure called iontophoresis, mainly used for excessive hand or foot sweating, may also be an option. Iontophoresis uses a device to deliver a low level of electrical current to the areas of your body prone to excessive sweating. This treatment typically is given daily for several weeks and must be repeated on a regular basis to continue being effective.

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If hyperhidrosis doesn't respond to other treatment, surgery could be another choice. It may include removing sweat glands, or it could involve surgery to impair the nerves that control sweating. Surgery is generally not an option for isolated head and neck sweating.

Make an appointment to see your doctor to have your condition evaluated. Even if a specific cause of your sweating cannot be identified, it's still likely that hyperhidrosis can be effectively managed in a way that will decrease your discomfort and embarrassment.

Robert Fealey, M.D., Neurology, Mayo Clinic, Rochester, Minn.

EXTRA POUNDS WEIGH ON BLOOD PRESSURE

I've been on blood pressure medication for nine months. It has lowered my blood pressure, but I'm having trouble with side effects like dizziness. I eat a healthy diet and walk every day, but want to know if there are other ways to lower my blood pressure so that hopefully I can stop taking this medicine.

You're on the right track. Eating well and staying active are two good ways to help control blood pressure. But there are more steps you can take that can make a difference and could eliminate your need for blood pressure medication.

Blood pressure is a measure of how much resistance there is to blood flow through your arteries. It's recorded as two numbers: a top number and a bottom number. The top is called systolic pressure, the pressure in your arteries when your heart beats. The bottom number is diastolic pressure, the pressure in your arteries when your heart is at rest between beats.

Blood pressure generally is considered too high when the top number is more than 140 or the bottom number is more than 85. High blood pressure can lead to serious medical problems, including kidney disorders, heart attack, stroke and heart failure.

Medication often is used to help keep blood pressure under control, but it may not be necessary for everyone who has high blood pressure. Estimates are that at least 25 percent of people in the United States currently taking blood pressure medicine might not need it if they made certain lifestyle changes.

One of the best things you can do for your blood pressure is to get to and stay at a healthy weight. Weight makes a significant difference in blood pressure because every pound you put on equals about five additional miles of blood vessels through which your heart has to pump blood. To meet the extra demand, your heart works harder. As it does, blood pressure goes up. Losing even a small amount of weight can lower blood pressure.

A healthy diet is key to healthy weight, and it benefits blood pressure, too. In particular, eat at least five servings of fruits and vegetables a day, and lower the amount of salt in your diet. Salt makes your body retain fluid, and the more fluid in your body, the higher your blood pressure. Processed, packaged and fast foods contain high amounts of salt. As much as possible, eat foods prepared from fresh ingredients, without added salt.

Weight loss can also combat another contributing factor to high blood pressure: sleep apnea. About half of all people with high blood pressure have this sleep disorder. When sleep apnea is left untreated, it can be difficult to get blood pressure under control. If you snore loudly, briefly stop breathing during sleep, wake feeling unrested or have significant bouts of daytime sleepiness, consider being evaluated for sleep apnea.

Daily physical activity can also help lower blood pressure. As you move, your blood vessels open to allow for more blood flow, and they remain open for a time after you are done. As part of your activity, consider engaging in interval training, alternating bursts of intense activity with lighter activity. This type of exercise has been shown to be more effective in opening arteries than steady, continuous activity alone.

Also, limit the amount of caffeine and alcohol you have each day, and don't smoke. Over time, caffeine, alcohol and tobacco can narrow and stiffen blood vessels, raising your blood pressure.

Finally, keep track of your blood pressure at home. A number of devices are available you can use to measure blood pressure. When you see those numbers on a regular basis, you become more familiar with what has an impact on your blood pressure and you gain a better understanding of how you can control it.

Stephen Kopecky, M.D., Cardiovascular Diseases, Mayo Clinic, Rochester, Minn.

Mayo Clinic Q & A is an educational resource and doesn't replace regular medical care. Email a question to MayoClinicQ&A@mayo.edu. For more information, visit mayoclinic.org. © 2015 Mayo Foundation for Medical Education and Research. All rights reserved distributed by Tribune Content Agency, LLC.