I'm taking hydrocholorothiazide as a diuretic, to prevent migraines. Before I started taking it, I had constant migraines for about two weeks out of every month. They were shutting me down completely. Now I have about two a year, which I treat successfully with sumatriptan. What a relief!

My potassium levels used to test borderline, so I typically eat a banana or a potato, or winter squash with lunch, and I take a potassium supplement. These measures put my potassium levels in the right range.

None of my doctors has suggested that HCTZ could be causing my symptoms. But I know it messes with potassium and magnesium, and I wonder if there could be some connection here--either that it's making my MG worse, even when my potassium tests normal, or I don't have MG at all, and the HCTZ is giving me these symptoms of fluctuating weakness--or making some other condition worse.

I am taking myself off the drug for a while to see what happens. I'm being careful to eat less salt, in the hopes of preventing migraines. So I skipped my pill yesterday, and I feel awful. I have intense pressure in my arms, and a sense of tension and nervousness--like a mounting panic attack. This is what happens every time I miss my pill. I don't know what it is. I assumed once that it was the feeling of high blood pressure, but I went to the hospital to have my bp taken, and it was normal. I don't have a headache.

Any ideas? Why does missing the HCTZ make me feel this way? And, any ideas about a connection between HCTZ and fluctuating muscle weakness--in light of HKPP channelopathies, or other ones?

I know I'm breaking rules here. I usually follow them. I will confess all to my neuro when I see him on Monday. In an ideal world, I would doctor-shop until I found one who was interested enough in my condition to take the lead in pursuing these things, but in this imperfect world I inhabit--well, the neuro I have now is the best I could find. And frankly, I'm so grateful to find a doctor who takes me seriously at all, that I don't want to risk losing him. I'm seronegative. He read my SFEMG's as almost normal. He often sees me with no discernible symptoms, and takes me word for it when I describe how I feel in the evenings. I don't respond to Mestinon, and I have no ptosis. I know that a patient in my situation could easily be dismissed as a hypochondriac, or diagnosed with conversion disorder.

Abby