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Q. You frequently write about high blood pressure, but my situation is different. My doctor wants me to increase my blood pressure, even though I feel OK with it in the high 80s to 90s. I tend to have low sodium.
I was advised to cut down from 2 liters of beverage daily to 1.5. Having done that, my systolic blood pressure is now in the upper 90s to low 100s. I wonder whether cutting back my intake of liquids is healthy. Any advice?
A. Low blood pressure (hypotension) can be problematic. Doctors may diagnose this condition when systolic blood pressure is below 90 and/or diastolic is below 60. Symptoms may include dizziness upon standing, fainting, nausea, difficulty concentrating, blurred vision or fatigue.
Low sodium levels (hyponatremia) could cause some similar symptoms (nausea, fatigue, confusion and dizziness upon standing). Doctors sometimes treat low blood pressure by recommending more salt (sodium chloride). But too much can become a problem. This requires a bit of a balancing act and frequent blood tests.
We're not sure why your physician recommended reducing your fluid intake. You may want a second opinion about that.
Another suggestion may be compression hose. These elastic stockings are supposed to improve blood flow from the legs to the heart. As long as you continue to feel well, you may not need intensive treatment.
Q. Now that it's cold, I am spending less time outside. Consequently, I have upped my vitamin D intake. I have found that doing so around this time of year seems to help me avoid respiratory infections in the winter. I have read on your website that "excess vitamin D can result in toxicity." How much is too much?
A. Getting outside for fresh air and sunshine has benefits beyond vitamin D. In moderation, sun exposure may benefit certain aspects of immune function (Photochemical & Photobiological Sciences, May 2023).
People with low levels of vitamin D appear to be more susceptible to infection (Pathogens, Aug. 25, 2026). The benefit of supplementation is less clear, though.
Ideally, the level of circulating vitamin D (measured as 25-hydroxyvitamin D) is between 20 and 50 ng/mL. But people are different, so we can't say how much vitamin D you should take to achieve that level.
You asked how much is too much. Nutrition experts usually recommend taking no more than 4,000 IU daily. If a person took excess vitamin D for an extended period, symptoms could include nausea, confusion, weakness, loss of appetite, heart rhythm disturbances or kidney stones.
You can learn more about the benefits and risks of vitamin D in our "eGuide to Vitamin D and Optimal Health." This online resource may be found under the Health eGuides tab at www.PeoplesPharmacy.com.
Q. Do you know why there has been a shortage of estradiol patches for months? Is this a nationwide problem? Are there any workarounds?
A. The Food and Drug Administration removed a scary warning about hormone replacement therapy in 2025. As a result, the FDA reports that demand for estradiol patches has nearly doubled. Drug companies have had a hard time keeping up.
Your physician and pharmacist may be able to help by locating a different formulation that would work for you.