Dry Eyes Part 6: Losartan, Flaxseed Oil, and Electrolytes

My eyes continued to be a problem, despite all of my futile efforts.  I also had a very annoying new symptom.  

In April, my eyes began burning, and I didn't know why.  Obviously, it was part of the problem, but why had they started burning after the punctal plugs were removed?

In May, the burning got worse.  I have been on thyroid medication since July 2014.  In May, my thyroid medication began making my eyes burn.  The burning would commence in the one to two hours after I took the thyroid medication and continued for at least a couple hours.  It was awful.

I knew that the problem wasn't the thyroid medication.  To clarify... the thyroid medication was undoubtedly causing the burning, but something else in my body had changed and was thereby causing the thyroid medication to do that.  I was pretty sure that the sodium in the thyroid medication was the problem.  It was like the sodium was hitting my eyes and making them burn.  My eyes had also started burning after I ate salty food.  That had never happened before.  

I had wondered about losartan because my eyes began burning within a couple weeks of starting losartan.  I finally realized that I needed to quit taking losartan to see if that was the problem.  I quit taking losartan on May 30.  I felt like my eyes improved some, but I wasn't sure if the losartan was the problem or not.

My appointment with my primary care physician was on June 5.  I told him that I had quit the losartan, that my eyes might or might not be better, and that I wanted to stay off of it for at least another couple weeks.  Additionally, my blood pressure wasn't spiking yet, and I would continue to monitor it.  He agreed.

My lab tests showed that my blood sodium had gone down some, and my blood potassium was on the high side.  Both were due to the losartan.

The eye burning caused by my thyroid medication gradually lessened.  Overall, my eyes began burning less.

By the middle of June, I thought I was improving, then I got worse again.  Why.....?

It was right at the end of June when I realized that I had run out of flaxseed oil around June 10.  I want to quit taking unnecessary supplements, so I chose not to continue.  I didn't think it was helping.

Since my eyes had worsened again, I concluded that it probably had helped.  I purchased more flaxseed oil and resumed taking it.  My eyes improved somewhat.  I concluded that I should continue flaxseed oil.

My eye appointment was on July 2.  I told my ophthalmologist that I was still worse than before I got punctal plugs, although I had improved somewhat since the plugs were removed.  

Back on February 26, my doctor said that my eyes had "some dryness."  This time, he said that they weren't that dry.  

I had been thinking for around a month that my eyes were inflamed from my December 16 Covid infection, and that the punctal plugs greatly aggravated the eye inflammation.  It didn't surprise me that my eyes weren't that dry overall.  But they sure have bothered me!

I was prescribed Restasis eye drops to use in addition to the serum tears.

Dry Eyes Part 2: Blood Pressure Medications

In late March, I began considering that blood pressure medications could be part of the problem.

I will start with the backstory, since it is relevant. 

I was on lisinopril paired with hydrochlorothiazide for around 8 years from around 2006 to July 2014.  I was fine on it at first, but towards the end, I coughed constantly.  The coughing impacted my quality of life, and I was switched to Bystolic.  Over the years, my blood pressure gradually increased, so I needed to be put on a secondary medication.

In November, it was suggested that we try chlorthalidone, which is a diuretic.  I was hesitant, because of my problem with coughing before and how excessively dry I am.  I agreed to try it, and I didn't cough, so I thought I was okay.  Unexpectedly, routine labs in early February showed that my electrolytes were dangerously low.  I was pulled off the diuretic.

Lisinopril without a diuretic was suggested.  I agreed, since the medication would not be paired with a diuretic.  At first, I thought I was fine, and I didn't realize anything was amiss.  In fact, I ignored the obvious due to my preoccupation with my eye trouble.

I detailed in my previous post my attempt to fix my eye trouble that began in late February.  I thought I had figured it out on March 23, but I worsened again.  It was on the morning of March 26—and not in relation to anything with my eye trouble—that I suddenly thought about how much I had been coughing.

I realized that I was taking lisinopril and that I was coughing uncontrollably.  The coughing was violent and caused loss of bodily functions.  Really awful coughing.  I was sure that it was worse than the coughing that I had previously while on lisinopril paired with hydrochlorothiazide.  I couldn't believe that I hadn't made the connection.  I had been so distracted by my eye condition that I hadn't realized that lisinopril was making me cough.

I now know that I cannot take lisinopril with or without a diuretic because of the coughing caused by it.  And to think it took me over a month to figure it out.

As soon as I realized that I was coughing too much, I typed up a message to my doctor explaining and requesting a change.  After I did that, I considered my eye situation.  Hmm...

I thought through the sequence of events.  I figured out that I took my first dose of lisinopril on February 17.  The coughing began around February 23, nearly one week later.  I believe the coughing worsened on February 24 and 25.  I know that the coughing became a problem early that week.

Once I worked that out, I came to a huge realization.  My eye appointment was on February 26, three days after I started coughing from the lisinopril.  I also recalled vaguely but without specifics that my eyes had worsened a little in the few days before my eye appointment.  They became dramatically worse immediately after my appointment.

It seemed that lisinopril could be what caused my eye trouble.  I would never have suspected that, since I previously took lisinopril for eight years with no eye trouble.

I quit taking the lisinopril as soon as I realized that it was the cause of my terrible cough.  I noticed that my eyes were immediately less dry.  I thought maybe I had figured it out, but no.  Once I started on losartan, my eyes became more dry again.

I did believe that the blood pressure medications were a part of the problem with my eyes, but I knew that something else was at play.  After all, I've been on blood pressure medication since around 2006 without the eye pain that just developed this year.