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Re: CONNS AND PREGNANCY

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For Lynn and anyone else thinking about starting a family.

I hear what you say Dr Grim but here is my two pence worth for people

to think over.

Spironolactone should not be taken during pregnancy or whilst breast

feeding. This advice is from the British Pharmacy. Basically it is an

instruction of " no, no way, never " . I'm not even sure if it would be

easy to become pregnant or sustain the pregnancy if taking higher

doses of spironolactone as it mimics female hormones and can mess up

the menstral cycle. That is just my gut feeling and I've no evidence

to back it up - just seems to be common sense.

High BP during pregnancy is a risk factor. My BP was high during my

last pregancy and caused complications. First two pregnancies BP was

okay but not wonderful. I wasn't diagnosed with Conns until 15 years

after my last pregnancy and my BP had been rising all that time. The

thought is that I already had the PA when pregnant. I know Dr Grim

has said " many " patients have sucessful pregnancies but there are no

statistics here or an indication of the % of sucess / fail /

complications / unable to conceive nor are the parameters of success

given. Maybe there is no reliable statistical data on this.

My last pregnancy resulted in a live birth but my child has had

problems all her life and the medical profession are now of the

opinion that my high blood pressure, hormonal imbalance during

pregnancy etc could be a major contributing factor in her health

problems. A sucessful pregnancy may be counted as a live birth of

a " normal " baby but my child's problems did not become apparent until

3 months after the birth which was (and is) recorded as a successful

birth. This is something to think about.

High BP at any time increases the risk of stoke etc so if your BP is

high without medication before pregnancy you are running risks before

you even become pregnant.

If you have the geneticly transmitted form of PA you need to consider

if passing the disease on to your child is a risk worth taking.

Despite how this reads I am not trying to be a doom and gloom

merchant but attempting to put in words some of the concerns I would

have if I was considering another pregnancy (which I'm not!)

The urge to have a baby is very strong and not a rational thing. No

pregnancy is risk free even in a very healthy mother. All you can do

is be aware of your special case and take as much care as you can.

Best wishes to everyone,

helen in a cold and snowy Scotland

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  • 3 weeks later...

I would guess that 20 to 30 would not be a statistically significant sample.

Helen

Original Message:

-----------------

From: lowerbp2@...

Date: Fri, 09 Jan 2004 14:42:57 -0500

hyperaldosteronism

Subject: Re: Re: CONNS AND PREGNANCY

Indeed if we can get 20 or 30 women to tell us about their pregnancies

before and after the DX of PA, I think we can write a paper about it!

CE Grim MD

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thats what happened in my case. BP started out high went normal

through pregnancy and then rose up about 34 weeks bed rested for 2

weeks then induced at 36weeks. at the time did not know why bp did

this but it never went down so i have had 2 years of testing to find

out i have hyperaldosteronism? I want to get pregnant again but i

have a few more tests to do and then hopefully i will have my adrenal

gland removed. Anyone know anything about pregnancy after gland is

removed?

shelley

> Did they also find the data that BP frequently normalizes during

preg without

> meds as Progesterone is an naturally occurring anti aldo and indeed

aldo

> normally goes up remarkably during pregnancy-at least 100 fold

normally-the reason

> this does not cause HTN is though to be the placental production of

> progesterone.

>

> Clever thing the human body.

>

>

>

>

> May your pressure be low!

>

> CE Grim, BS (Chem/Math), MS (Biochem), MD.

> Professor of Medicine and Epidemiology

> Board Certified in Internal Medicine, Geriatrics and Hypertension

> Published over 230 research papers, chapters and reviews in the

area of high

> blood pressure: epidemiology, history, endocrinology, genetics and

physiology.

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In a message dated 1/17/04 1:28:19, luckx2@... writes:

thats what happened in my case.  BP started out high went normal

through pregnancy and then rose up about 34 weeks bed rested for 2

weeks then induced at 36weeks. at the time did not know why bp did

this but it never went down so i have had 2 years of testing to find

out i have hyperaldosteronism?  I want to get pregnant again but i

have a few more tests to do and then hopefully i will have my adrenal

gland removed.  Anyone know anything about pregnancy after gland is

removed?

shelley

Should not be a problem. Just be sure there is excellent evidence that only one side is involved. This will require adreanl vein blood samples for aldo and cortisol with ACTH is being infused.

May your pressure be low!

CE Grim, BS (Chem/Math), MS (Biochem), MD.

Professor of Medicine and Epidemiology

Board Certified in Internal Medicine, Geriatrics and Hypertension

Published over 230 research papers, chapters and reviews in the area of high blood pressure: epidemiology, history, endocrinology, genetics and physiology.

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In a message dated 1/19/04 3:09:22, Helen@... writes:

I didn't have adrenal vein sampling - the scan showed up the tumour on the

lh gland and the right looked normal.

Arrenal vein sampling is not done in the UK unless very necessary because

of the risk. Another difference in health care practise between countries.

There is a real risk in relying only on the scan-I assume you mean the CT scan and not an nuclear scan.

Lost so things can cause bumps on the ddrenal glands-cancers, fat tumors clots etc. I have personally been involved with pts who have had bumps found nad the gland removed only to find that the bump was not the Conn's tumor which was on the other side. The pt needed to have both adrenals removed. I never want to have that happen again.

May your pressure be low!

CE Grim, BS (Chem/Math), MS (Biochem), MD.

Professor of Medicine and Epidemiology

Board Certified in Internal Medicine, Geriatrics and Hypertension

Published over 230 research papers, chapters and reviews in the area of high blood pressure: epidemiology, history, endocrinology, genetics and physiology.

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I didn't have adrenal vein sampling - the scan showed up the tumour on the

lh gland and the right looked normal.

Arrenal vein sampling is not done in the UK unless very necessary because

of the risk. Another difference in health care practise between countries.

Helen

Original Message:

-----------------

From: lowerbp2@...

Date: Sun, 18 Jan 2004 21:36:13 EST

hyperaldosteronism

Subject: Re: Re: CONNS AND PREGNANCY

In a message dated 1/17/04 1:28:19, luckx2@... writes:

> thats what happened in my case.  BP started out high went normal

> through pregnancy and then rose up about 34 weeks bed rested for 2

> weeks then induced at 36weeks. at the time did not know why bp did

> this but it never went down so i have had 2 years of testing to find

> out i have hyperaldosteronism?  I want to get pregnant again but i

> have a few more tests to do and then hopefully i will have my adrenal

> gland removed.  Anyone know anything about pregnancy after gland is

> removed?

> shelley

>

Should not be a problem. Just be sure there is excellent evidence that

only

one side is involved. This will require adreanl vein blood samples for

aldo

and cortisol with ACTH is being infused.

May your pressure be low!

CE Grim, BS (Chem/Math), MS (Biochem), MD.

Professor of Medicine and Epidemiology

Board Certified in Internal Medicine, Geriatrics and Hypertension

Published over 230 research papers, chapters and reviews in the area of

high

blood pressure: epidemiology, history, endocrinology, genetics and

physiology.

--------------------------------------------------------------------

mail2web - Check your email from the web at

http://mail2web.com/ .

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I do understand what you are saying but the adrenal vein sampling is just

not done as a matter of routine here. There aren't the funds in tje NHS for

it to start with. Private clinics are far beyond my means and the nearest

is a long way from here.

The centres that would be able to do it are few and far between and in my

case it was decided I was not well enough to travel any further. The

journey to and from Newcastle was bad enough but had I to go to Leeds or

Aberdeen it would have been a very serious undertaking. As it was the

transport arrangements were pretty awful (only one bus a week from the

nearest town - no train services here at all) and although the hospital

were very good at arranging inpatient facilities to fit in, on the days I

was very ill the journey was almost more than I could bear.

At the end of the day I was so ill that something had to be done and very

quickly. Sending me elsewhere for more tests was considered even more risky

than having to take out both glands.

Now I just have to find out about my BP. Next appt. is late tomorrow.

Helen

Original Message:

-----------------

From: lowerbp2@...

Date: Mon, 19 Jan 2004 04:31:20 EST

hyperaldosteronism

Subject: Re: Re: CONNS AND PREGNANCY

In a message dated 1/19/04 3:09:22, Helen@...

writes:

> I didn't have adrenal vein sampling - the scan showed up the tumour on the

> lh gland and the right looked normal.

>

> Arrenal vein sampling is not done in the UK unless very necessary because

> of the risk. Another difference in health care practise between countries.

>

There is a real risk in relying only on the scan-I assume you mean the CT

scan and not an nuclear scan.

Lost so things can cause bumps on the ddrenal glands-cancers, fat tumors

clots etc. I have personally been involved with pts who have had bumps

found

nad the gland removed only to find that the bump was not the Conn's tumor

which

was on the other side. The pt needed to have both adrenals removed. I

never want to have that happen again.

May your pressure be low!

CE Grim, BS (Chem/Math), MS (Biochem), MD.

Professor of Medicine and Epidemiology

Board Certified in Internal Medicine, Geriatrics and Hypertension

Published over 230 research papers, chapters and reviews in the area of

high

blood pressure: epidemiology, history, endocrinology, genetics and

physiology.

--------------------------------------------------------------------

mail2web - Check your email from the web at

http://mail2web.com/ .

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, What do you want to know about lack of adrenals and

pregnancy. I am pregnant right now with # 2 and I have no adrenals.

I am considered to have s disease at this point. As long as

you have at least one functioning gland then there will be no

difference between a normal pregnancy and you. They will or at least

should monitor the remaining function of the last adrenal so that you

don't get into trouble. As long as the cortisol is able to adjust

and meet the stress of the pregnancy then you will be fine. If not

then they can give you additional meds to help. W

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In a message dated 1/19/04 5:40:27 AM, Helen@... writes:

I do understand what you are saying but the adrenal vein sampling is just

not done as a matter of routine here. There aren't the funds in tje NHS for

it to start with. Private clinics are far beyond my means and the nearest

is a long way from here.

The centres that would be able to do it are few and far between and in my

case it was decided I was not well enough to travel any further. The

journey to and from Newcastle was bad enough but had I to go to Leeds or

Aberdeen it would have been a very serious undertaking. As it was the

transport arrangements were pretty awful (only one bus a week from the

nearest town - no train services here at all) and although the hospital

were very good at arranging inpatient facilities to fit in, on the days I

was very ill the journey was almost more than I could bear.

At the end of the day I was so ill that something had to be done and very

quickly. Sending me elsewhere for more tests was considered even more risky

than having to take out both glands.

Now I just have to find out about my BP. Next appt. is late tomorrow.

I appreciate the circumstances you are operating under. Wish it were better allo over the world for the care of Conn's. It is even not ideal in many areas of the US because of the fact that 40 million folks have NO health insurance at all. And we call ourselves a civilized nation!

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  • 2 months later...
Guest guest

In a message dated 3/30/2004 3:49:29 AM Eastern Standard Time,

klingrahoull@... writes:

> can anyone tell me if i'm likely to experience any unexpected symptoms

> when/if i become pregnant - i'm really concerned about this

> but i cant

> get any answers - will the baby get PA?

Unless you have a rare genetic form of PA the baby will not get it.

How rare is rare-I have only seen two families in 40 years and most have never

seen one.

Be sure to monitor your BP now and tru pregnancy so you can pick up early

increases in BP. In classical PA the BP goes down with preg as the progesterone

is a natural antialdo hormone.

May your pressure be low!

CE Grim MD

Clinical Professor of Internal Medicine

Professor of Epidemiology

Board Certified in Internal Medicine, Geriatrics and Hypertenision

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Guest guest

My BP was high during pregnancy, but my PA wasn't diagnosed yet. Since then, I've read that pregnancy can actually improve your PA. One thing you do want to avoid is spiro when you're pregnant... I've read it can make little boys present as little girls.

conns and pregnancy

Hi Allcan anyone tell me if i'm likely to experience any unexpected symptomswhen/if i become pregnant - i'm really concerned about this but i cantget any answers - will the baby get PA?LYNN - SHETLAND

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