RE: Calcium??? Dave's answer

[Guest guest]

In a message dated 12/28/07 12:06:19 PM, riothamus2@... writes:

>

> Val, sorry for the delay answering. I was out of office.

>

> The effect was episodes much like the one you describe. K down in the

> 2's. My arrhythmia included PVCs and a-fibs, and twice, I had to be

> defibrillated. One of those times I got a morphine injection into the

> heart muscle.

>

Probably was an injection of norepinephrine not morphine.

> But not only was I taking calcium back then, my diet

> contained unknown, but high amounts of sodium.

>

> Third : ameloride. Whe I stopped it, the attacks stopped for a long

> while (almost a year). Later I found that it did nothing to " spare

> potassium " in a patient with advanced PA. It acted just like the other

> thiazides / diazide diuretics - a no-no for hypokalemic PA, period.

>

> Normokalemic PA - I have no idea.

>

Classically diuretics convert a normokalemic PA to a hypokalemic one

depending on where one is in the evolution.

> As Dr Grim said, Wash U (

> Jewish) had been trained, but the bigshot endocrinologist was clueless

> as a tree surgeon on bus maintenance.

>

> The HCTZ type of diuretics were so obviously toxic the doctors (despite

> repeated attempts) no longer prescribed them. Later, when I got into

> this group I found out why - they lower potassium, among other PA problems.

>

> I do know that drinking V-8 or eating mountains of bananas, etc. won't

> do it for your blood or tissue potassium, and taking supplements is

> temporary. I had to have potassium IV with close monitoring at the

> worst episodes. In many dietary attempts and worrying over what I ate

> causing this or that, only lowering my sodium worked.

>

Did the Wash U bigshots tell you to eat a low sodium diet? Prob not.

>

> Calcium was only the worst, but not the only trigger. Lots of salt did

> it. One ER doctor from Vietnam told me that in Southeast Asia people

> turn up in hospitals with heavy salt levels in their bloodwork after

> taking calcium supplements. " They retain salt, " he said. When I asked

> my PA doc he said he'd seen it - but only in a few pts myself included.

>

> I was far along into stage 4 of PA before I got help. It makes me feel

> stupid, but for 15 years I thought doctors knew what they were doing.

> Sometimes they do, sometimes they don't. On this disease, most often

> they don't.

>

> I also know that when I tried to take a magnesium supplement per my PA

> doc's recommendation (low Mg levels in bloodwork), that most of them are

> made with calcium - same problem. I had to get one without anything but

> the magnesium. The citrate tablets (by Solgar) worked very well,

> relaxing me and making bowels regular. The liquid sold by pharmacies

> did not.

>

> If you have high aldo and low renin, and most especially low potassium

> numbers, I would insist the doctor prescribing the diuretic try DASH

> diet and one of the aldo-blockers alone. That is what stopped all of my

> episodes, kept my BP low and stable, my K in the 40's

>

Trust it was in the 4s and not the 40s

> and made me able

> to tolerate other meds, and a long list of problems disappear.

>

> However, calcium still does it - even when in a food with isolated

> " added calcium. " I don't know why. Naturally occurring calcium doesn't

> affect me. Of course, I've never tried " guzzling " milk. Maybe. . .nah,

> I'll be moderate.

>

> By the way, recently my doc asked me to try Vit. D because I cannot use

> calcium, and my alkalosis is so pronounced (spinal stenosis, scoliosis

> and arthritic buildups beginning, white calcium powder in sweat, 5-6

> kidney stones forming at a time, etc,), and I did, but even it caused

> the old attacks to come back - with my DASH and spiro. He said, " well,

> Vit D makes the body use more calcium, so it may have created the low

> K. "

>

Hmmm. Never heard of this. But alkalosis is clasically associated with PA

that can be profound. The urine is also alkaline. Indeed in the early

days, before we could measure renin and aldo the finding of HTN with Low K and

alkalosis and a high blood Na was a sign of PA.

> I still don't understand it, and neither does anyone else. Not

> completely. Electrolytes and the RAAS system are one of the most

> exciting areas in new research.

>

Here is the Grim explanation:

aldo causes the kidney to reabsorb Na+ from the urine which is pumped into

the bloood. In order to keep urine neutral K+ or H+ is excreeted into the

urine. K and H come from the blood. As blood K gets low the cell moves K

out to keep the blood K up. In exchange the H moves into the cell. The

balance of H and HCO2 in the blood (pH or the negative log of the H ion

conentration) is determined by the H in the blood. When this goes into the

cell the H

ion concentration in the blood goes down and thus the pH goes up = akalosis.

Get Guyton's newest Textbook of Medical Physiology for the best reveiw of

this. (now called Hall and Guyton).

>

> Any strain on my metabolism isn't good - overeating included. An 8 oz

> glass of water after each meal stopped the kidney stones (so far, a year).

>

> That's about it.

>

> Dave

>

> [h

> >

> > Dave, could you repeat the affect calcium has on you?

> >

> > I've been going through an " episode. " Last Saturday, I went to the ER with

> > BP 190/100. It had gone as high as 210/114. I'd been guzzling low sodium

> > V-8 but my K was at the bottom of the range. It can be that high one day

> > and 137/85 the next. Go figure. At my suggestion, the doc changed my HCTZ

> > to Triam/HCTZ 37.5-25. I've had a horrible last two days - terrible

> > anxiety, night sweats and insomnia. It just dawned on me that (per the ER

> > doc's suggestion) I had restarted calcium + Vit D. I'm really wondering if

> > that is the culprit. TSH was = 2.00 so it is not thyroid OD.

> >

> > I found a new doc today and have an appointment next Friday.

> >

> > Val

> >

>

>

[Guest guest]

Dave and Dr. Grim, I appreciate all your insight. Had I not read Dave's

post from some time ago, I would have never suspected my resuming calcium in

this latest episode.

BTW, I do DASH like my life depends on it.

Val

> But not only was I taking calcium back then, my diet

> contained unknown, but high amounts of sodium.

Here is the Grim explanation:

aldo causes the kidney to reabsorb Na+ from the urine which is pumped into

the bloood. In order to keep urine neutral K+ or H+ is excreeted into the

urine. K and H come from the blood. As blood K gets low the cell moves K

out to keep the blood K up. In exchange the H moves into the cell. The

balance of H and HCO2 in the blood (pH or the negative log of the H ion

conentration) is determined by the H in the blood. When this goes into the

cell the H

ion concentration in the blood goes down and thus the pH goes up = akalosis.