Headaches, Possibly Polycythemia?


So, not sure where to go from here.

I’m a 24 year old male, 5’9" 180lbs…

About 4 years ago I had some pretty high blood pressure. Adjusted my diet and started some cardio and that killed it off for a long time. I haven’t thought about it since.

Anyway, I work at a coffee shop and drink a lot of it (normally) but not to excess. Maybe 800mg max, but that was about a year ago. I usually cap it around 400mg in the last year just so im not a zombie without it.

2 months ago I started feeling ‘off’. Hard time focusing mentally and visually (small letters), tinnitus pretty bad, and just felt nausea like the flu or something. After a few weeks of it (bc of daily coffee drinking) I suspected it was blood pressure, and it was. Hit about 150/95, the lowest getting to about 135/90. I tried coffee again after not having it in a while and that lead to issues, which lasts several hours. It’s 90-100% gone when I don’t have caffeine, more often towards 100% gone, but not always.

I’ve been without caffeine for a month now and nothing works, was at 148 last i checked. I’m a pretty calm guy, so I doubt it’s white coat hypertension.

The biggest concern is that I start getting these symptoms with just 4oz of coffee.

Just got this from my blood test a few days ago…

Anyone got any ideas?

So you said it was because of coffee (the headaches) but the blood pressure is high even when you stop. Right?

How heavy are you?

I have suspected from time to time that I might be allergic to coffee. But is your problem the headaches with coffee or the high blood pressure? If te BP is high now its not the coffee right? If coffee gives you headaches for sure then stop drinking it. You might try tea to see if its the caffeine or an allergic reaction.

[quote]mertdawg wrote:
So you said it was because of coffee (the headaches) but the blood pressure is high even when you stop. Right?

How heavy are you?

I have suspected from time to time that I might be allergic to coffee. But is your problem the headaches with coffee or the high blood pressure? If te BP is high now its not the coffee right? If coffee gives you headaches for sure then stop drinking it. You might try tea to see if its the caffeine or an allergic reaction. [/quote]

Yes, the blood pressure doesn’t seem to drop regardless.

Forgot some details, im 5’9" 180 and 24.

Too much tea gives me the same issues.

Anyway, I would conclude that the blood pressure is not related. Did you say that your blood pressure had been normal in tests in past years?

If you actually have high blood pressure it can lead to other issues that may present as head aches.

It sounds like you have already high blood pressure and so the caffeine is pushing it to the danger zone. I don’t see any reason to believe that your higher than normal blood pressure was caused by caffeine because you stopped? Did you go through withdrawal?

I don’t think the caffeine is the cause, it’s the underlying cause I’m worried about, since the little bit of blood work I did do showed I should be fine. Are there any more tests I can request that might help?

Where are the headaches? Temples? Behind the eyes? Forehead? Top of head?

<-------------- Not an MD

I guess behind the eyes, it’s a pretty large disbursement of the ache I suppose

You may be suffering from migraines and caffeine is just one of a number of triggers.

Looking at some other tests my blood numbers for rbc and hematocrit are just outside normal levels. Looking into my symptoms, I think it could be polycythemia?

Did your doc see your RBC numbers? Hematocrit looks to be in range on the labs you show above.

If you’re on TRT or taking AAS, you may want to share that with your doc. Or you may not. Your call.

What has your history of BP readings been like?

White coat syndrome is a thing, calm or not, and there are different diagnostic cut-offs for in-office vs in-home measurements.

Keep in mind that BP readings are notoriously inaccurate. One issue that lifters might face is improper cuff sizing. I measured 180/110 (really bad - consider hospitalization) once due to using a too small cuff, which can erroneously elevate readings. The equipment is almost always improperly calibrated. There are many other factors that can affect readings too.

Don’t see any significant cause for concern in the labs. Keep in mind that reference ranges typically represent a span of 2 standard deviations of the healthy population mean, so there are outliers. You are not significantly out of range, either. Diagnosing without repeat testing is generally a bad idea unless you have crazy numbers.

The symptoms you’ve listed could be attributed to side effects of caffeine, especially since it sounds like your caffeine intake lately is all over the place. These are also rather vague symptoms that could be attributed to a lot of other things. There are also a lot of factors we don’t know about.

Bottom line: There are a lot of things we don’t know about. I wouldn’t worry by trying to self-diagnose, and PLEASE don’t try and seek medical advice over the internet, no matter how qualified the poster. If your symptoms are cause for concern, you should bring it to your doctor. It doesn’t seem that your doctor is worried, so that’s a good sign.

[quote]Apoklyps wrote:
One issue that lifters might face is improper cuff sizing. I measured 180/110 (really bad - consider hospitalization) once due to using a too small cuff, which can erroneously elevate readings.
[/quote]

This is an excellent point. One’s arm doesn’t have to be huge to be too big for a standard-sized cuff. I would say anyone with an arm 16" or larger should always ask for the larger (ie, obese individual) cuff. You will be doing yourself and your doc a favor by doing so.