RE: Anyone know about a Salt-Loading Defect?

February 6, 2004

You are in the right place to ask these things. I don't know but someone on

this list will.

It is very important that your sone gets checked for PA as well as you. How

are your potassium levels?

Helen in Scotland

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February 6, 2004

--

CE Grim MD

Hydralazine induced hepatitis is a very rare problem. What else were you on?

Tylenol would be much more likely to cause a liver problem of you were taking

lots of it.

The most common BP drug to do this would be alpha-mehtyl-dopa or Aldomet.

When hydralazine was used in very high doses in the old days it einuced a Lupus

like syndrome-joint pains etc but those on H lived longer than those who stopped

it as it was about the BP control drug at that time-so those who could not take

it died of high blood pressure complications.

February 6, 2004

--

CE Grim MD

Your heart failure should become much better as the BP is controlled on Spiro.

Indeed it may disappear.

Is there any family Hx of low K and /or HTN?

Some forms of PA are inherited.

February 6, 2004

In a message dated 2/6/04 16:39:58, spirlhelix@... writes:

Hi, Dr. Grim

We do have hypertension and heart problems in the

family, but sometimes they only occur at later ages.

For instance, my maternal grandmother had a pacemaker,

but she was in her eighties at the time!

She did have short stature and carried her weight

around the waist.

My father has had hypertension for many years, but his

is controllable with medication.

I don't know of a history of low potassium, but these

are details that may not be acessible to me, as some

of my relatives prefer to present themselves or their

parents as ideal specimens!

Warmly,

Pam

Dont be afraid to ask your Dad if his potassium has ever been low or if he has had to take potassium. GRA can occur even if the K is normal. We reported the first family.

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.

February 6, 2004

In a message dated 2/6/04 16:39:58, spirlhelix@... writes:

Hi, Dr. Grim

We do have hypertension and heart problems in the

family, but sometimes they only occur at later ages.

For instance, my maternal grandmother had a pacemaker,

but she was in her eighties at the time!

She did have short stature and carried her weight

around the waist.

My father has had hypertension for many years, but his

is controllable with medication.

I don't know of a history of low potassium, but these

are details that may not be acessible to me, as some

of my relatives prefer to present themselves or their

parents as ideal specimens!

Warmly,

Pam

Dont be afraid to ask your Dad if his potassium has ever been low or if he has had to take potassium. GRA can occur even if the K is normal. We reported the first family.

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.

February 6, 2004

In a message dated 2/6/04 16:39:58, spirlhelix@... writes:

Hi, Dr. Grim

We do have hypertension and heart problems in the

family, but sometimes they only occur at later ages.

For instance, my maternal grandmother had a pacemaker,

but she was in her eighties at the time!

She did have short stature and carried her weight

around the waist.

My father has had hypertension for many years, but his

is controllable with medication.

I don't know of a history of low potassium, but these

are details that may not be acessible to me, as some

of my relatives prefer to present themselves or their

parents as ideal specimens!

Warmly,

Pam

If he does not konw ask him to get his K from his Dr as far back as possible.

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.

February 6, 2004

In a message dated 2/6/04 16:39:58, spirlhelix@... writes:

Hi, Dr. Grim

We do have hypertension and heart problems in the

family, but sometimes they only occur at later ages.

For instance, my maternal grandmother had a pacemaker,

but she was in her eighties at the time!

She did have short stature and carried her weight

around the waist.

My father has had hypertension for many years, but his

is controllable with medication.

I don't know of a history of low potassium, but these

are details that may not be acessible to me, as some

of my relatives prefer to present themselves or their

parents as ideal specimens!

Warmly,

Pam

If he does not konw ask him to get his K from his Dr as far back as possible.

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.

February 6, 2004

In a message dated 2/6/04 16:38:05, spirlhelix@... writes:

The side effects from the hydralazine were pain and

stiffness in the muscles and joints, headache, fever,

and dark urine. This was after only two doses.

Hepatitis from hydralazine is considered a

hypersensitivity reaction. I won't be going back on

it.

These are the calssic symptoms of Lupus. The Hepatitis

A is the most likely culprit though. I would not go back on Apresonine either.

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.

February 6, 2004

In a message dated 2/6/04 16:38:05, spirlhelix@... writes:

The side effects from the hydralazine were pain and

stiffness in the muscles and joints, headache, fever,

and dark urine. This was after only two doses.

Hepatitis from hydralazine is considered a

hypersensitivity reaction. I won't be going back on

it.

These are the calssic symptoms of Lupus. The Hepatitis

A is the most likely culprit though. I would not go back on Apresonine either.

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.

February 6, 2004

In a message dated 2/5/04 19:56:13, spirlhelix@... writes:

Hi

I remember last week when I went to my nephrologist, he mentioned a

possible salt-loading defect. He also said something about hydroxy-

17 DOC. Anyone know anything about that? Is it genetic? Would it

explain my wild weight fluctuations (9 lbs in one week, normal for

me)?

Thanks in advance for your help.

Warmly,

Pam

Get your renin and aldo and K numbers for us to look at.

He also said something about hydroxy-

17 DOC. Pts with this syndrome are of several different kinds and would not look for it until I had all of the renin aldo numbers.

Many are in women who have no secondary sex characteristics and it is due to a genetic mutation causing a deficiency in the DOC pathway.

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.

February 6, 2004

In a message dated 2/5/04 19:56:13, spirlhelix@... writes:

Hi

I remember last week when I went to my nephrologist, he mentioned a

possible salt-loading defect. He also said something about hydroxy-

17 DOC. Anyone know anything about that? Is it genetic? Would it

explain my wild weight fluctuations (9 lbs in one week, normal for

me)?

Thanks in advance for your help.

Warmly,

Pam

Get your renin and aldo and K numbers for us to look at.

He also said something about hydroxy-

17 DOC. Pts with this syndrome are of several different kinds and would not look for it until I had all of the renin aldo numbers.

Many are in women who have no secondary sex characteristics and it is due to a genetic mutation causing a deficiency in the DOC pathway.

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.

February 7, 2004

In a message dated 2/7/04 5:27:06, spirlhelix@... writes:

I have a serum aldosterone reading of 31.0 and a serum

renin of 3.1.

I can't find my urine results, but they are apparently

in the normal range. I do remember my nephrologist

saying "urine aldosterone 15" last time I saw him. He

has also mentioned a "low renin condition".

Need to know what is the normal values for this lab and what meds your were on when they were done.

A 24 urine aldo of 15 is not very high but could be high for youu. Will also depend on how low your K was when the urine was tested.

Has your BP and K normalized on sprionolactdone?

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.

February 7, 2004

In a message dated 2/7/04 5:27:06, spirlhelix@... writes:

I have a serum aldosterone reading of 31.0 and a serum

renin of 3.1.

I can't find my urine results, but they are apparently

in the normal range. I do remember my nephrologist

saying "urine aldosterone 15" last time I saw him. He

has also mentioned a "low renin condition".

Need to know what is the normal values for this lab and what meds your were on when they were done.

A 24 urine aldo of 15 is not very high but could be high for youu. Will also depend on how low your K was when the urine was tested.

Has your BP and K normalized on sprionolactdone?

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.

February 7, 2004

In a message dated 2/7/04 5:24:54, spirlhelix@... writes:

Hi, Dr. Grim

I'll ask him why he eats half a banana everyday

religiously. You may be onto something there.

Smile.

Warmly,

Pam

Pt with PA may need to eat 20 bananas a day to get K up. Hands also tend to drag on the ground after eating this many ;-)

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.

February 7, 2004

In a message dated 2/7/04 5:24:54, spirlhelix@... writes:

Hi, Dr. Grim

I'll ask him why he eats half a banana everyday

religiously. You may be onto something there.

Smile.

Warmly,

Pam

Pt with PA may need to eat 20 bananas a day to get K up. Hands also tend to drag on the ground after eating this many ;-)

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.

February 9, 2004

That assumes you have access to medical records - fine in the US but not so

good for the ish patients who have no access to their records (after

all Doctor knows best!)

>>>>>>>>>>>>>

Dont be afraid to ask your Dad if his potassium has ever been low or if he

has had to take potassium. GRA can occur even if the K is normal. We

reported the first family.

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/ .

February 9, 2004

That assumes you have access to medical records - fine in the US but not so

good for the ish patients who have no access to their records (after

all Doctor knows best!)

>>>>>>>>>>>>>

Dont be afraid to ask your Dad if his potassium has ever been low or if he

has had to take potassium. GRA can occur even if the K is normal. We

reported the first family.

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/ .

February 9, 2004

And even when you like bananas and chocolate it isn't any fun having to eat

them in supervised conditions in front of a witness......

Helen

Original Message: