Guest guest Posted February 8, 2006 Report Share Posted February 8, 2006 By looking at these numbers it appears to me that the doctor did not go in the left gland. The cortisol level should have been 20-30 times higher than the IVC. Cortisol on the left side and the IVC are practically the same. As you can see the cortisol on the right side shot up so much higher. Dr.Grim what is your view on looking at this report? Or is this how its supposed to look since there is an adenoma that is so large in size? mancoff <mancoff@...> wrote: Aldosterone CortisolLeft IVC 31 27 Left AV 4 26Right IVC 22 9Right AV 1385 1467 Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 8, 2006 Report Share Posted February 8, 2006 In a message dated 2/8/06 2:16:11 AM, farahbar@... writes: Aldosterone Cortisol Left IVC 31 27 Left AV 4 26 Right IVC 22 9 Right AV 1385 1467 It appears that the left "adrenal" vein sample is not an adrenal vein as the cortisol should be much higher. There are several reasons for this. The left ovarian or testicular vein can drain directly into the left adrenal vein and if one is not careful the left "adrenal" sample will really be coming from the ovarian or testicular vein. I dont know what the right and left IVC sample means. Usually it is the IVC below and above the adrenal veins that is sampled. This way of labeling makes me nervous that the samples could have been mixed up and this is the reason I try to have someone from my own lab (or me) in the xray room to assure that they are labeled correctly. Was ACTH given before and during the study (and dex the night before)? If not then it is possible that the left was sampled first as it is usually the easiest to get into and it took some time and pain to get the right sample-the ususal story as the right is much harder to find and the stresses of doing that kicked up the endogenous ACTH so that the right appears to now be stimulated. In this case (if ACTH was not given) then I reoommend that the left be sampled again. In the old days we would put a cath in each AV to sample at the same time to minimize this. So if the tumor is on the right side we still dont know what is going on on the left side. My advice would be to keep on meds if they are doing a good job of controlling K and BP and not side effects. May your pressure be low! Dr. Clarence E. Grim, BS (Chem/Math), MS (Biochem), MD Board Certified in Internal Medicine, Geriatrics and Hypertension High Blood Pressure Consulting Milwaukee, WI Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 8, 2006 Report Share Posted February 8, 2006 My endo doctor wrote " right " and " left " on the data sheet. However, the data sheet identified the samples by the clock time the samples were taken. I heard the conversation during the procedure which identified the first samples taken as from the right side. The doctor told ma after the procedure that he did the right side first (no problems) and the left side next (some difficulty). I was told before the procedure that ACTH would be administered. I don't know the exact time(s). My endo doctor decided that dex not be given based on info he had read from the Mayo clinic. Do I understand correctly that the data from the left side is worthless and that you recommend the procedure be repeated?? > > In a message dated 2/8/06 2:16:11 AM, farahbar@... writes: > > > > Aldosterone Cortisol > > > > Left IVC 31 27 > > Left AV 4 26 > > Right IVC 22 9 > > Right AV 1385 1467 > > > > It appears that the left " adrenal " vein sample is not an adrenal vein as the > cortisol should be much higher. There are several reasons for this. The > left ovarian or testicular vein can drain directly into the left adrenal vein > and if one is not careful the left " adrenal " sample will really be coming from > the ovarian or testicular vein. > > I dont know what the right and left IVC sample means. Usually it is the IVC > below and above the adrenal veins that is sampled. This way of labeling > makes me nervous that the samples could have been mixed up and this is the reason > I try to have someone from my own lab (or me) in the xray room to assure that > they are labeled correctly. > > Was ACTH given before and during the study (and dex the night before)? If > not then it is possible that the left was sampled first as it is usually the > easiest to get into and it took some time and pain to get the right sample-the > ususal story as the right is much harder to find and the stresses of doing that > kicked up the endogenous ACTH so that the right appears to now be stimulated. > In this case (if ACTH was not given) then I reoommend that the left be > sampled again. In the old days we would put a cath in each AV to sample at the > same time to minimize this. > > So if the tumor is on the right side we still dont know what is going on on > the left side. > > My advice would be to keep on meds if they are doing a good job of > controlling K and BP and not side effects. > > > > > > May your pressure be low! > > Dr. Clarence E. Grim, BS (Chem/Math), MS (Biochem), MD > Board Certified in Internal Medicine, Geriatrics and Hypertension > High Blood Pressure Consulting > Milwaukee, WI > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 9, 2006 Report Share Posted February 9, 2006 How many is too many? If a percentage were known it would make the decision easier. The Spiro has totally knocked out my sexual desire (not good for the marriage), and the lack of testerone has a lot of long term effects, ref. " The Testosterone Syndrome " by Eugene Shippen, M.D. My GP told me Spiro studies have been done with people who had other problems and it was difficult to predict what would happen with " normal " people. > > I almost always recommend PA pts stay on meds as long as they control the BP > and the K and you feel OK. > > Esp Spiro or Inspra. > > I have had too many who developed HTN again after an adenoma is removed. > Indeed the original Conn's pt did this many years later. > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 9, 2006 Report Share Posted February 9, 2006 I'm taking 50mg twice per day of Spiro, 1%Androgel, claritin, saw palmetto, singulair, multivitamin > > > > > > I almost always recommend PA pts stay on meds as long as they control > > the BP > > > and the K and you feel OK. > > > > > > Esp Spiro or Inspra. > > > > > > I have had too many who developed HTN again after an adenoma is > > removed. > > > Indeed the original Conn's pt did this many years later. > > > > > > > With good AVS studies then 75% are cured. > > I would try Inspra, but how much spiro were you on and what else. > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 10, 2006 Report Share Posted February 10, 2006 The Saw was started after I began experiencing problems with frequency and urgency of urination. The Saw proved to be effective. I know that most sources can not be trusted, so I keep to the same brand (Nutrilite) instead of shopping for the lowest price. Shouldn't Saw cause a mild increase in testosterone? The androgel is applied to my belly. I haven't used the Dash book, but I add no salt to my food, eat lots of fruits & veggies and am very careful about the salt content on foods I buy. Eating out occasionally may up the salt, but I work to order only foods I think have little salt. - In hyperaldosteronism , lowerbp2@... wrote: > > > In a message dated 2/9/06 6:34:11 PM, mancoff@... writes: > > > > I'm taking 50mg twice per day of Spiro, 1%Androgel, claritin, saw > > palmetto, singulair, multivitamin > > > > Have you tried backing down on Spiro and DASHing? Worth a try, but in my > exper once gynecomastia develops in men on spiro it has to be stopped to get rid > of the problem. > > Dont know the effects of Saw on sexual function but would not take it you > can never tell what is in it. > > How do you take the Androgel? > Quote Link to comment Share on other sites More sharing options...
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