Re: Re: HA suspected and testing

November 16, 2009

Hypertension is a relative thing. For example if your normal BP had been 100 and it went up to 120 we would call it personal HTN like personal PA up to 138 you dont yet have "group" HTN till you cross 140. Great play on words conning your Dr. I will remember that. On Nov 16, 2009, at 11:38 PM, tbarcellona@... wrote:I can only tell you my diagnosis. For one, my potassium levels dropped long before I had any high blood pressure. I was hospitalized twice in about a 14 month period because of irregular heartbeat due to low blood potassium. My BP was about 140/90 but had been that for a couple of years so it didn't appear to be Primary Aldosteronism. Once I conned the doctor into testing for conn's, my tests consisted of aldosterone and renin within a full CBC panel. Aldo was a high-normal and renin was undetectable. The Renin was indicator for me. Then I had a 24 hour urine sample /test which proved I was dumping potassium. In the 2-3 weeks that I was doing all these tests, my BP suddenly jumped up to about 170/110 on average. Once I started taking Spironolactone, It dropped like a rock. Within 3 weeks I was 120/80 and within a couple of months I was 110/65. Now I am about 108/60. That big of difference with a single 25mg Spironolactone pill a day. Unfortunately, the low potassium problem keeps coming back but now I am on both spironolactone and 1,500 mg of Potassium and it seems to be working. > >> > 20 + years of hypertension and taking as many as 11 pills aday to try to control without much success. New cardiologist suggested seeing endo who suspected HA and is now testing. Spirinolactone started and pressure dropped greatly to current average of 130/74. Potassium went from marginally low to marginally high. Old CT showed growth which no one mentioned or took notice of till now. Scheduled for saline suppression testing next week after being off BP meds for 7 days--just taking Coreg and Norvasc twice a day now. Is this a proper course of events for positively identifying HA and it cause ?> >>

November 17, 2009

The low K continues to be a problem because you are likely eating too much sodium. Keep track of all sodium intake for a few days. (See Loseit the iPhone app online to track Na) The ap is free.It should be below 1500 mg a day. On Nov 16, 2009, at 11:38 PM, tbarcellona@... wrote:I can only tell you my diagnosis. For one, my potassium levels dropped long before I had any high blood pressure. I was hospitalized twice in about a 14 month period because of irregular heartbeat due to low blood potassium. My BP was about 140/90 but had been that for a couple of years so it didn't appear to be Primary Aldosteronism. Once I conned the doctor into testing for conn's, my tests consisted of aldosterone and renin within a full CBC panel. Aldo was a high-normal and renin was undetectable. The Renin was indicator for me. Then I had a 24 hour urine sample /test which proved I was dumping potassium. In the 2-3 weeks that I was doing all these tests, my BP suddenly jumped up to about 170/110 on average. Once I started taking Spironolactone, It dropped like a rock. Within 3 weeks I was 120/80 and within a couple of months I was 110/65. Now I am about 108/60. That big of difference with a single 25mg Spironolactone pill a day. Unfortunately, the low potassium problem keeps coming back but now I am on both spironolactone and 1,500 mg of Potassium and it seems to be working. > >> > 20 + years of hypertension and taking as many as 11 pills aday to try to control without much success. New cardiologist suggested seeing endo who suspected HA and is now testing. Spirinolactone started and pressure dropped greatly to current average of 130/74. Potassium went from marginally low to marginally high. Old CT showed growth which no one mentioned or took notice of till now. Scheduled for saline suppression testing next week after being off BP meds for 7 days--just taking Coreg and Norvasc twice a day now. Is this a proper course of events for positively identifying HA and it cause ?> >>

November 19, 2009

Thanks for the information. My BP has been consistently "building" over the years, with readings as high as 200/110 at times. Doctor's response has always been to add additional BP meds and increase strenght/frequency. No mention was made of potassium levels over all that time, yet the blood tests taken in the past year have always shown marginally low levels. 3.0 or so. When cardiologist sent me to Endo and we started Spiro, BP dropped to average of 130/74 and Potassium elevated to current levels of about 5.4. Rarely had any episodes of irregular heart beat, except once when I was hospitalized. Given Potassium IV (which burned like crazy !!!).

24 hour urine sample taken 8 months ago was inconclusive. Hence the upcoming saline suppression test this Friday. Also note that I'm taking 125mg. Spiro a day as compared to your much smaller dose of 25mg. Not sure what that means.

Glad to hear you are doing better on your journey and thanks for your input.

From: "tbarcellona@..." <tbarcellona@...>hyperaldosteronism Sent: Mon, November 16, 2009 11:38:48 PMSubject: Re: HA suspected and testing

I can only tell you my diagnosis. For one, my potassium levels dropped long before I had any high blood pressure. I was hospitalized twice in about a 14 month period because of irregular heartbeat due to low blood potassium. My BP was about 140/90 but had been that for a couple of years so it didn't appear to be Primary Aldosteronism. Once I conned the doctor into testing for conn's, my tests consisted of aldosterone and renin within a full CBC panel. Aldo was a high-normal and renin was undetectable. The Renin was indicator for me. Then I had a 24 hour urine sample /test which proved I was dumping potassium. In the 2-3 weeks that I was doing all these tests, my BP suddenly jumped up to about 170/110 on average. Once I started taking Spironolactone, It dropped like a rock. Within 3 weeks I was 120/80 and within a couple of months I was 110/65. Now I am about 108/60. That big of difference with a single 25mg Spironolactone pill a day.

Unfortunately, the low potassium problem keeps coming back but now I am on both spironolactone and 1,500 mg of Potassium and it seems to be working. > >> > 20 + years of hypertension and taking as many as 11 pills aday to try to control without much success. New cardiologist suggested seeing endo who suspected HA and is now testing. Spirinolactone started and pressure dropped greatly to

current average of 130/74. Potassium went from marginally low to marginally high. Old CT showed growth which no one mentioned or took notice of till now. Scheduled for saline suppression testing next week after being off BP meds for 7 days--just taking Coreg and Norvasc twice a day now. Is this a proper course of events for positively identifying HA and it cause ?> >>

November 19, 2009

K of 3 is never marginally low. You have PA and if doing well would continue on spiro. DASHing will very likely lower your need for Spiro.Keep us posted. Be sure you take my article to your Drs so they dont miss anymore people for 20 years.CE Grim MDOn Nov 19, 2009, at 3:37 AM, Darwin Bonogofsky wrote:Thanks for the information. My BP has been consistently "building" over the years, with readings as high as 200/110 at times. Doctor's response has always been to add additional BP meds and increase strenght/frequency. No mention was made of potassium levels over all that time, yet the blood tests taken in the past year have always shown marginally low levels. 3.0 or so. When cardiologist sent me to Endo and we started Spiro, BP dropped to average of 130/74 and Potassium elevated to current levels of about 5.4. Rarely had any episodes of irregular heart beat, except once when I was hospitalized. Given Potassium IV (which burned like crazy !!!). 24 hour urine sample taken 8 months ago was inconclusive. Hence the upcoming saline suppression test this Friday. Also note that I'm taking 125mg. Spiro a day as compared to your much smaller dose of 25mg. Not sure what that means. Glad to hear you are doing better on your journey and thanks for your input.From: "tbarcellonaymail" <tbarcellonaymail>hyperaldosteronism Sent: Mon, November 16, 2009 11:38:48 PMSubject: Re: HA suspected and testing I can only tell you my diagnosis. For one, my potassium levels dropped long before I had any high blood pressure. I was hospitalized twice in about a 14 month period because of irregular heartbeat due to low blood potassium. My BP was about 140/90 but had been that for a couple of years so it didn't appear to be Primary Aldosteronism. Once I conned the doctor into testing for conn's, my tests consisted of aldosterone and renin within a full CBC panel. Aldo was a high-normal and renin was undetectable. The Renin was indicator for me. Then I had a 24 hour urine sample /test which proved I was dumping potassium. In the 2-3 weeks that I was doing all these tests, my BP suddenly jumped up to about 170/110 on average. Once I started taking Spironolactone, It dropped like a rock. Within 3 weeks I was 120/80 and within a couple of months I was 110/65. Now I am about 108/60. That big of difference with a single 25mg Spironolactone pill a day. Unfortunately, the low potassium problem keeps coming back but now I am on both spironolactone and 1,500 mg of Potassium and it seems to be working. > >> > 20 + years of hypertension and taking as many as 11 pills aday to try to control without much success. New cardiologist suggested seeing endo who suspected HA and is now testing. Spirinolactone started and pressure dropped greatly to current average of 130/74. Potassium went from marginally low to marginally high. Old CT showed growth which no one mentioned or took notice of till now. Scheduled for saline suppression testing next week after being off BP meds for 7 days--just taking Coreg and Norvasc twice a day now. Is this a proper course of events for positively identifying HA and it cause ?> >>

November 19, 2009

You want to be sure they do AVS (if PA is Dxed) before deciding on surgery. Let us seen actual number and the normal values in that lab for all renin and aldo tests. Keep us posted. On Nov 19, 2009, at 9:00 PM, dbonogofsky wrote:Thank you. Appreciate your advice. Blood work from 2 days ago now shows K at 4.0; down from 5.7. However, I'm thinking this may be due to discontinuation of Spiro recently in prep for tomorrows saline suppression test, although its only been 5 days since such discontinuance. Not sure if K level would drop that quickly in this short of a time frame. Received prescription for K supplement 20MEQ ER twice a day. ENDO is reasonably confident that test will confirm PA and surgery will likely be highly beneficial in reducing BP to near normal levels, with at most a minimum of medications. I suspect that shortly after testing I will again go back on spiro at prior doseage of 125 and Chlorthalidone at 50mg until decision on surgery is made. I'll start working on DASHing to see if it will lower needed doseage of the spiro as you suggest. Side note that creatinine results are also changing---dropped from high of 2.22 in Sept. (after BP decreased on spiro) to 1.88 in Oct. and now 1.58. ENDO believes these changes are directly tied to blood pressure fluctuations. Increase being caused by drop in pressure when kidneys were used to years of the high pressure. And current decrease due to stabilization at lower pressure. Hopefully this is the case as ther was concern from PCP that we were seeing some signs of renal failure.

November 20, 2009

How much did you pee during the saline. The Grim quick aldo test is that if you pee out the 2 liters during the 4 hrs. Then you have PA. I should have asked them to measure how much you pee.Spiro was not out of system by 7 days. Takes at least 2-4 weeks. But going back on is fine. Send us the numbers.In over 1000 saline infusions I have never seen much of a BP increase. CE Grim MDOn Nov 20, 2009, at 10:53 PM, dbonogofsky wrote:had saline suppression test today. Drew blood before during and after being infused with 2 bags of Sodium Chloride solution. ENDO expected and warned nurse to expect increase in BP during test. Surprise !! Pressure stayed low throughout the test. Highest reading was second one taken between bags and was 133/74. Last pressure taken prior to leaving hospital was 113/71. Was lying flat during test, except for 2 trips to restroom over the 4 hour period. ENOD called later this evening and was also surprised at BP readings but is holding judgement until test results are available. Believes he should have info by Wednesday. Believes sprioshould have been out of system after being off for 7 days, Ordered me back onto spiro and chlorthalidone. BP numbers this evening are 138/84. Confusing. I'll post numbers from lab once received.> > > Thank you. Appreciate your advice. Blood work from 2 days ago now > > shows K at 4.0; down from 5.7. However, I'm thinking this may be due > > to discontinuation of Spiro recently in prep for tomorrows saline > > suppression test, although its only been 5 days since such > > discontinuance. Not sure if K level would drop that quickly in this > > short of a time frame. Received prescription for K supplement 20MEQ > > ER twice a day. ENDO is reasonably confident that test will confirm > > PA and surgery will likely be highly beneficial in reducing BP to > > near normal levels, with at most a minimum of medications. I suspect > > that shortly after testing I will again go back on spiro at prior > > doseage of 125 and Chlorthalidone at 50mg until decision on surgery > > is made. I'll start working on DASHing to see if it will lower > > needed doseage of the spiro as you suggest.> >> > Side note that creatinine results are also changing---dropped from > > high of 2.22 in Sept. (after BP decreased on spiro) to 1.88 in Oct. > > and now 1.58. ENDO believes these changes are directly tied to blood > > pressure fluctuations. Increase being caused by drop in pressure > > when kidneys were used to years of the high pressure. And current > > decrease due to stabilization at lower pressure. Hopefully this is > > the case as ther was concern from PCP that we were seeing some signs > > of renal failure.>

November 21, 2009

mine went up because I had to pee

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had saline suppression test today. Drew blood before during and after being infused with 2 bags of Sodium Chloride solution. ENDO expected and warned nurse to expect increase in BP during test. Surprise !! Pressure stayed low throughout the test. Highest reading was second one taken between bags and was 133/74. Last pressure taken prior to leaving hospital was 113/71. Was lying flat during test, except for 2 trips to restroom over the 4 hour period. ENOD called later this evening and was also surprised at BP readings but is holding judgement until test results are available. Believes he should have info by Wednesday. Believes sprioshould have been out of system after being off for 7 days, Ordered me back onto spiro and chlorthalidone. BP numbers this evening are 138/84. Confusing. I'll post numbers from lab once received.> > > Thank you. Appreciate your advice. Blood work from 2 days ago now > > shows K at 4.0; down from 5.7. However, I'm thinking this may be due > > to discontinuation of Spiro recently in prep for tomorrows saline > > suppression test, although its only been 5 days since such > > discontinuance. Not sure if K level would drop that quickly in this > > short of a time frame. Received prescription for K supplement 20MEQ > > ER twice a day. ENDO is reasonably confident that test will confirm > > PA and surgery will likely

be highly beneficial in reducing BP to > > near normal levels, with at most a minimum of medications. I suspect > > that shortly after testing I will again go back on spiro at prior > > doseage of 125 and Chlorthalidone at 50mg until decision on surgery > > is made. I'll start working on DASHing to see if it will lower > > needed doseage of the spiro as you suggest.> >> > Side note that creatinine results are also changing---dropped from > > high of 2.22 in Sept. (after BP decreased on spiro) to 1.88 in Oct. > > and now 1.58. ENDO believes these

changes are directly tied to blood > > pressure fluctuations. Increase being caused by drop in pressure > > when kidneys were used to years of the high pressure. And current > > decrease due to stabilization at lower pressure. Hopefully this is > > the case as ther was concern from PCP that we were seeing some signs > > of renal failure.>

November 21, 2009

Yes that is a very good BP increaser and the reason you should always be asked do you need to pee before the BP is taken.How much did you pee in volume?On Nov 21, 2009, at 5:03 AM, Bindner wrote:mine went up because I had to pee Bindner Web Directory (links to my sites and blogs):http://www.geocities.com/mikeybdc/index.htmlhttp://mikeybdc.blogspot.com --- On Sat, 11/21/09, Clarence Grim <lowerbp2mac> wrote:From: Clarence Grim <lowerbp2mac>Subject: Re: Re: HA suspected and testinghyperaldosteronism Date: Saturday, November 21, 2009, 1:00 AM How much did you pee during the saline. The Grim quick aldo test is that if you pee out the 2 liters during the 4 hrs. Then you have PA. I should have asked them to measure how much you pee.Spiro was not out of system by 7 days. Takes at least 2-4 weeks. But going back on is fine. Send us the numbers.In over 1000 saline infusions I have never seen much of a BP increase. CE Grim MDOn Nov 20, 2009, at 10:53 PM, dbonogofsky wrote:had saline suppression test today. Drew blood before during and after being infused with 2 bags of Sodium Chloride solution. ENDO expected and warned nurse to expect increase in BP during test. Surprise !! Pressure stayed low throughout the test. Highest reading was second one taken between bags and was 133/74. Last pressure taken prior to leaving hospital was 113/71. Was lying flat during test, except for 2 trips to restroom over the 4 hour period. ENOD called later this evening and was also surprised at BP readings but is holding judgement until test results are available. Believes he should have info by Wednesday. Believes sprioshould have been out of system after being off for 7 days, Ordered me back onto spiro and chlorthalidone. BP numbers this evening are 138/84. Confusing. I'll post numbers from lab once received.> > > Thank you. Appreciate your advice. Blood work from 2 days ago now > > shows K at 4.0; down from 5.7. However, I'm thinking this may be due > > to discontinuation of Spiro recently in prep for tomorrows saline > > suppression test, although its only been 5 days since such > > discontinuance. Not sure if K level would drop that quickly in this > > short of a time frame. Received prescription for K supplement 20MEQ > > ER twice a day. ENDO is reasonably confident that test will confirm > > PA and surgery will likely be highly beneficial in reducing BP to > > near normal levels, with at most a minimum of medications. I suspect > > that shortly after testing I will again go back on spiro at prior > > doseage of 125 and Chlorthalidone at 50mg until decision on surgery > > is made. I'll start working on DASHing to see if it will lower > > needed doseage of the spiro as you suggest.> >> > Side note that creatinine results are also changing---dropped from > > high of 2.22 in Sept. (after BP decreased on spiro) to 1.88 in Oct. > > and now 1.58. ENDO believes these changes are directly tied to blood > > pressure fluctuations. Increase being caused by drop in pressure > > when kidneys were used to years of the high pressure. And current > > decrease due to stabilization at lower pressure. Hopefully this is > > the case as ther was concern from PCP that we were seeing some signs > > of renal failure.>

November 21, 2009

Sorry, should have told you to measure the volume. Guess your Drs don't know the Grim pee test. It sounds like you have PA based on the Grim pee volume test.CE Grim MDOn Nov 21, 2009, at 11:02 PM, dbonogofsky wrote:Can't accurately tell you how much urine I produced during the 4 hours. Went to the rest room once during the first bag, again during the second and immediatley when leaving the hospital. Then once more on our drive home which takes about an hour. Numbers expected by Wednesday. Thanks> > >> > > > Thank you. Appreciate your advice. Blood work from 2 days ago now> > > > shows K at 4.0; down from 5.7. However, I'm thinking this may be > > due> > > > to discontinuation of Spiro recently in prep for tomorrows saline> > > > suppression test, although its only been 5 days since such> > > > discontinuance. Not sure if K level would drop that quickly in > > this> > > > short of a time frame. Received prescription for K supplement > > 20MEQ> > > > ER twice a day. ENDO is reasonably confident that test will > > confirm> > > > PA and surgery will likely be highly beneficial in reducing BP to> > > > near normal levels, with at most a minimum of medications. I > > suspect> > > > that shortly after testing I will again go back on spiro at prior> > > > doseage of 125 and Chlorthalidone at 50mg until decision on > > surgery> > > > is made. I'll start working on DASHing to see if it will lower> > > > needed doseage of the spiro as you suggest.> > > >> > > > Side note that creatinine results are also changing---dropped from> > > > high of 2.22 in Sept. (after BP decreased on spiro) to 1.88 in > > Oct.> > > > and now 1.58. ENDO believes these changes are directly tied to > > blood> > > > pressure fluctuations. Increase being caused by drop in pressure> > > > when kidneys were used to years of the high pressure. And current> > > > decrease due to stabilization at lower pressure. Hopefully this is> > > > the case as ther was concern from PCP that we were seeing some > > signs> > > > of renal failure.> > >> >> >> >>

November 25, 2009

The total and LDL are likely wrong as the triglycerides are so high. Were you fasting for 12 hrs. If so you have an unusual lipid problem and should see a lipid specialist. Have they always been this way? How much do you weigh. I would recommend DASHing.What is your family Hx of early MI (men <55, women<65).CE Grim MDOn Nov 24, 2009, at 9:16 PM, dbonogofsky wrote:Still waiting on results of last Fridays saline suppression test. Hope to have numbers tomorrow to post. Did get back results of lipid panel and numbers not so good. Total cholesterol 401, HDL 35, LDL 117 and triglycerides 1,080. Have tried lipitor, Crestor, Vytorin and Niaspan in past with little change. Waiting for call from Cardio to determine what he wants to do. Question---is there any realtionship between these results and PA ? Also read about metabolic syndrome--difficult to control BP even while on multiple meds, type 2 diabetes (which I have been diagnosed with), etc. Any connection there ? Thanks> > > > >> > > > > > Thank you. Appreciate your advice. Blood work from 2 days > > ago now> > > > > > shows K at 4.0; down from 5.7. However, I'm thinking this > > may be> > > > due> > > > > > to discontinuation of Spiro recently in prep for tomorrows > > saline> > > > > > suppression test, although its only been 5 days since such> > > > > > discontinuance. Not sure if K level would drop that quickly in> > > > this> > > > > > short of a time frame. Received prescription for K supplement> > > > 20MEQ> > > > > > ER twice a day. ENDO is reasonably confident that test will> > > > confirm> > > > > > PA and surgery will likely be highly beneficial in reducing > > BP to> > > > > > near normal levels, with at most a minimum of medications. I> > > > suspect> > > > > > that shortly after testing I will again go back on spiro at > > prior> > > > > > doseage of 125 and Chlorthalidone at 50mg until decision on> > > > surgery> > > > > > is made. I'll start working on DASHing to see if it will lower> > > > > > needed doseage of the spiro as you suggest.> > > > > >> > > > > > Side note that creatinine results are also changing--- > > dropped from> > > > > > high of 2.22 in Sept. (after BP decreased on spiro) to 1.88 in> > > > Oct.> > > > > > and now 1.58. ENDO believes these changes are directly tied to> > > > blood> > > > > > pressure fluctuations. Increase being caused by drop in > > pressure> > > > > > when kidneys were used to years of the high pressure. And > > current> > > > > > decrease due to stabilization at lower pressure. Hopefully > > this is> > > > > > the case as ther was concern from PCP that we were seeing some> > > > signs> > > > > > of renal failure.> > > > >> > > >> > > >> > > >> > >> >> >> >>

November 26, 2009

PA has no effect on lipids. Metabolic syndrome can be caused by PA.I would either doing the DASH rigidly or if you live where you can get Seattle Sutton do that for 6 months and recheck. My LDL decreased by 50%. If that fails then consider the Rice diet. You likely have familial hypercholesterolemia and every blood relative needs to have a cholesterol checked now not matter the age or gender. If you have that 1/2 of them will to and they need to take steps to control it now. Get as complete as a family tree with blood cholesterol and age and cause of death in as many as you can find. Take this to your Dr. Write to every family member (blood relatives). The Univ of Utah Used to have a web site called MEDPED (make early diagnosis, prevent early death) but I have not looked at it recently and I think funding disappeared to keep it going. CE Grim MDOn Nov 26, 2009, at 6:57 PM, dbonogofsky wrote:Yes, I was fasting for about 13 hours in total prior to blood draw. CARDIO and ENDO are discussing and considering Trilipix instead of Vytorin and increasing doseage of Niaspan. Total cholesterol has been over 300 fairly consistently for a number of years, although no one mentioned the triglycerides as being abnormally high as it was this time. LDL was previously higher and HDL was lower. So this is actually an improvement over prior testing (if it's accurate). No known history of early heart attacks, with exception of Grandfather on Mother's side. Believe he passed at about 52. Weight varies between 186 and 192 and height is 5'9". Just picked up DASH reading materials. Does PA have a connection to lipid readings ? Any thoughts on this metabolic syndrome ? Does seem to fit most of my symptoms. ]HAPPY THANKSGIVING EVERYONE> > > > > > >> > > > > > > > Thank you. Appreciate your advice. Blood work from 2 days> > > > ago now> > > > > > > > shows K at 4.0; down from 5.7. However, I'm thinking this> > > > may be> > > > > > due> > > > > > > > to discontinuation of Spiro recently in prep for tomorrows> > > > saline> > > > > > > > suppression test, although its only been 5 days since such> > > > > > > > discontinuance. Not sure if K level would drop that > > quickly in> > > > > > this> > > > > > > > short of a time frame. Received prescription for K > > supplement> > > > > > 20MEQ> > > > > > > > ER twice a day. ENDO is reasonably confident that test > > will> > > > > > confirm> > > > > > > > PA and surgery will likely be highly beneficial in > > reducing> > > > BP to> > > > > > > > near normal levels, with at most a minimum of > > medications. I> > > > > > suspect> > > > > > > > that shortly after testing I will again go back on spiro > > at> > > > prior> > > > > > > > doseage of 125 and Chlorthalidone at 50mg until decision > > on> > > > > > surgery> > > > > > > > is made. I'll start working on DASHing to see if it will > > lower> > > > > > > > needed doseage of the spiro as you suggest.> > > > > > > >> > > > > > > > Side note that creatinine results are also changing---> > > > dropped from> > > > > > > > high of 2.22 in Sept. (after BP decreased on spiro) to > > 1.88 in> > > > > > Oct.> > > > > > > > and now 1.58. ENDO believes these changes are directly > > tied to> > > > > > blood> > > > > > > > pressure fluctuations. Increase being caused by drop in> > > > pressure> > > > > > > > when kidneys were used to years of the high pressure. And> > > > current> > > > > > > > decrease due to stabilization at lower pressure. Hopefully> > > > this is> > > > > > > > the case as ther was concern from PCP that we were > > seeing some> > > > > > signs> > > > > > > > of renal failure.> > > > > > >> > > > > >> > > > > >> > > > > >> > > > >> > > >> > > >> > > >> > >> >> >> >>

November 27, 2009

what do you eat everyday?

you could DASH or you could do a low carb diet such as Atkins or the Carb Addicts diet. Either one will be an improvement. It depends on whether you can keep to the DASH regimine. If you are addicted to sugars, DASHing will be like giving an alcoholic a gin diet.

Oh, do you drink? For either diet, that should be the one thing you must cut out. If you can't stop, help is available (it was for me).

Track both eating and drinking in a diet for a few days and give to your doc.

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From: dbonogofsky <dbonogofsky@...>Subject: Re: HA suspected and testinghyperaldosteronism Date: Thursday, November 26, 2009, 7:57 PM

Yes, I was fasting for about 13 hours in total prior to blood draw. CARDIO and ENDO are discussing and considering Trilipix instead of Vytorin and increasing doseage of Niaspan. Total cholesterol has been over 300 fairly consistently for a number of years, although no one mentioned the triglycerides as being abnormally high as it was this time. LDL was previously higher and HDL was lower. So this is actually an improvement over prior testing (if it's accurate). No known history of early heart attacks, with exception of Grandfather on Mother's side. Believe he passed at about 52. Weight varies between 186 and 192 and height is 5'9". Just picked up DASH reading materials. Does PA have a connection to lipid readings ? Any thoughts on this metabolic syndrome ? Does seem to fit most of my symptoms. ]HAPPY THANKSGIVING EVERYONE> > > > > > >> > > > > > > > Thank you. Appreciate your advice. Blood work from 2 days> > > > ago now> > > > > > > > shows K at 4.0; down from 5.7. However, I'm thinking

this> > > > may be> > > > > > due> > > > > > > > to discontinuation of Spiro recently in prep for tomorrows> > > > saline> > > > > > > > suppression test, although its only been 5 days since such> > > > > > > > discontinuance. Not sure if K level would drop that > > quickly in> > > > > > this> > > > > > > > short of a time frame. Received prescription for K > > supplement> > > > > > 20MEQ> > > > > > > > ER twice a day. ENDO is reasonably confident that test > > will> > > > > > confirm> > > > > > > > PA and surgery will likely be highly beneficial in > > reducing> > > > BP to> > > > > > >

> near normal levels, with at most a minimum of > > medications. I> > > > > > suspect> > > > > > > > that shortly after testing I will again go back on spiro > > at> > > > prior> > > > > > > > doseage of 125 and Chlorthalidone at 50mg until decision > > on> > > > > > surgery> > > > > > > > is made. I'll start working on DASHing to see if it will > > lower> > > > > > > > needed doseage of the spiro as you suggest.> > > > > > > >> > > > > > > > Side note that creatinine results are also changing---> > > > dropped from> > > > > > > > high of 2.22 in Sept. (after BP decreased on spiro) to > > 1.88 in> > > > > >

Oct.> > > > > > > > and now 1.58. ENDO believes these changes are directly > > tied to> > > > > > blood> > > > > > > > pressure fluctuations. Increase being caused by drop in> > > > pressure> > > > > > > > when kidneys were used to years of the high pressure. And> > > > current> > > > > > > > decrease due to stabilization at lower pressure. Hopefully> > > > this is> > > > > > > > the case as ther was concern from PCP that we were > > seeing some> > > > > > signs> > > > > > > > of renal failure.> > > > > > >> > > > > >> > > > > >> > > > > >> > > > >> > >

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

November 27, 2009

Do you count milk as a carb serving?

12 is an awful lot, since carbs make cholesterol in your body.

If you can keep to DASH, than do that. If it becomes impossible, however, try a low carb diet.

Bindner

From: dbonogofsky <dbonogofsky@...>Subject: Re: HA suspected and testinghyperaldosteronism Date: Friday, November 27, 2009, 9:44 AM

Thanks . My diet is not the best, although I have minimized most sweets/sugars and tried to keep carbs down on a daily basis to no more than 12 carb servings. This was the amount the dietician recommended when I first saw her after the Type 2 diagnosis. I could definitely stand to lose somewhere between 10-15 pounds. I have begun to increase fresh fruits/vegetables in my eating plan. And will be starting to DASH now based on Dr. Grim's suggestion. I think my balance of food is OK, but need some more effort at portion control and exercise. A1C reading when first diagnosed was 6.9. Readings since then have been between 6.1 and 6.4. No drinking of any consequence. Occasional glass of wine on holidays. Perhaps once every couple of months, if that much. By the way, congrats on your testing and surgery. Hoping everything turns out great for you and this gets you back to a much more normal state of health. > > > > > > > >> > > > > > > > > Thank you. Appreciate your advice. Blood work from 2 days> > > > > ago now> > > > > > > > > shows K at 4.0; down from 5.7. However, I'm thinking this> > > > > may be> > > > > > > due> > > > > > > >

> to discontinuation of Spiro recently in prep for tomorrows> > > > > saline> > > > > > > > > suppression test, although its only been 5 days since such> > > > > > > > > discontinuance. Not sure if K level would drop that > > > quickly in> > > > > > > this> > > > > > > > > short of a time frame. Received prescription for K > > > supplement> > > > > > > 20MEQ> > > > > > > > > ER twice a day. ENDO is reasonably confident that test > > > will> > > > > > > confirm> > > > > > > > > PA and surgery will likely be highly beneficial in > > > reducing> > > > > BP to> > > > > > > > > near normal levels, with at most

a minimum of > > > medications. I> > > > > > > suspect> > > > > > > > > that shortly after testing I will again go back on spiro > > > at> > > > > prior> > > > > > > > > doseage of 125 and Chlorthalidone at 50mg until decision > > > on> > > > > > > surgery> > > > > > > > > is made. I'll start working on DASHing to see if it will > > > lower> > > > > > > > > needed doseage of the spiro as you suggest.> > > > > > > > >> > > > > > > > > Side note that creatinine results are also changing---> > > > > dropped from> > > > > > > > > high of 2.22 in Sept. (after BP decreased on spiro) to > > > 1.88

in> > > > > > > Oct.> > > > > > > > > and now 1.58. ENDO believes these changes are directly > > > tied to> > > > > > > blood> > > > > > > > > pressure fluctuations. Increase being caused by drop in> > > > > pressure> > > > > > > > > when kidneys were used to years of the high pressure. And> > > > > current> > > > > > > > > decrease due to stabilization at lower pressure. Hopefully> > > > > this is> > > > > > > > > the case as ther was concern from PCP that we were > > > seeing some> > > > > > > signs> > > > > > > > > of renal failure.> > > > > > > >> > > > > >

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

November 27, 2009

You can also go to DASHforlife.com for help.But it costs. A lot cheaper than lipid meds tho. And safer if it does the job.CE Grim MDOn Nov 27, 2009, at 5:23 AM, Bindner wrote:what do you eat everyday? you could DASH or you could do a low carb diet such as Atkins or the Carb Addicts diet. Either one will be an improvement. It depends on whether you can keep to the DASH regimine. If you are addicted to sugars, DASHing will be like giving an alcoholic a gin diet. Oh, do you drink? For either diet, that should be the one thing you must cut out. If you can't stop, help is available (it was for me). Track both eating and drinking in a diet for a few days and give to your doc. Bindner Web Directory (links to my sites and blogs):http://www.geocities.com/mikeybdc/index.htmlhttp://mikeybdc.blogspot.com --- On Thu, 11/26/09, dbonogofsky <dbonogofsky > wrote:From: dbonogofsky <dbonogofsky >Subject: Re: HA suspected and testinghyperaldosteronism Date: Thursday, November 26, 2009, 7:57 PM Yes, I was fasting for about 13 hours in total prior to blood draw. CARDIO and ENDO are discussing and considering Trilipix instead of Vytorin and increasing doseage of Niaspan. Total cholesterol has been over 300 fairly consistently for a number of years, although no one mentioned the triglycerides as being abnormally high as it was this time. LDL was previously higher and HDL was lower. So this is actually an improvement over prior testing (if it's accurate). No known history of early heart attacks, with exception of Grandfather on Mother's side. Believe he passed at about 52. Weight varies between 186 and 192 and height is 5'9". Just picked up DASH reading materials. Does PA have a connection to lipid readings ? Any thoughts on this metabolic syndrome ? Does seem to fit most of my symptoms. ]HAPPY THANKSGIVING EVERYONE> > > > > > >> > > > > > > > Thank you. Appreciate your advice. Blood work from 2 days> > > > ago now> > > > > > > > shows K at 4.0; down from 5.7. However, I'm thinking this> > > > may be> > > > > > due> > > > > > > > to discontinuation of Spiro recently in prep for tomorrows> > > > saline> > > > > > > > suppression test, although its only been 5 days since such> > > > > > > > discontinuance. Not sure if K level would drop that > > quickly in> > > > > > this> > > > > > > > short of a time frame. Received prescription for K > > supplement> > > > > > 20MEQ> > > > > > > > ER twice a day. ENDO is reasonably confident that test > > will> > > > > > confirm> > > > > > > > PA and surgery will likely be highly beneficial in > > reducing> > > > BP to> > > > > > > > near normal levels, with at most a minimum of > > medications. I> > > > > > suspect> > > > > > > > that shortly after testing I will again go back on spiro > > at> > > > prior> > > > > > > > doseage of 125 and Chlorthalidone at 50mg until decision > > on> > > > > > surgery> > > > > > > > is made. I'll start working on DASHing to see if it will > > lower> > > > > > > > needed doseage of the spiro as you suggest.> > > > > > > >> > > > > > > > Side note that creatinine results are also changing---> > > > dropped from> > > > > > > > high of 2.22 in Sept. (after BP decreased on spiro) to > > 1.88 in> > > > > > Oct.> > > > > > > > and now 1.58. ENDO believes these changes are directly > > tied to> > > > > > blood> > > > > > > > pressure fluctuations. Increase being caused by drop in> > > > pressure> > > > > > > > when kidneys were used to years of the high pressure. And> > > > current> > > > > > > > decrease due to stabilization at lower pressure. Hopefully> > > > this is> > > > > > > > the case as ther was concern from PCP that we were > > seeing some> > > > > > signs> > > > > > > > of renal failure.> > > > > > >> > > > > >> > > > > >> > > > > >> > > > >> > > >> > > >> > > >> > >> >> >> >>

November 27, 2009

I don't think that this is the right link.From: dbonogofsky <dbonogofsky>Subject: [hyperaldosteronism ] Re: HA suspected and testinghyperaldosteronismDate: Thursday, November 26, 2009, 7:57 PM Yes, I was fasting for about 13 hours in total prior to blood draw. CARDIO and ENDO are discussing and considering Trilipix instead of Vytorin and increasing doseage of Niaspan. Total cholesterol has been over 300 fairly consistently for a number of years, although no one mentioned the triglycerides as being abnormally high as it was this time. LDL was previously higher and HDL was lower. So

this is actually an improvement over prior testing (if it's accurate). No known history of early heart attacks, with exception of Grandfather on Mother's side. Believe he passed at about 52. Weight varies between 186 and 192 and height is 5'9". Just picked up DASH reading materials. Does PA have a connection to lipid readings ? Any thoughts on this metabolic syndrome ? Does seem to fit most of my symptoms. ]HAPPY THANKSGIVING EVERYONE> > > > > > >> > > > > > > > Thank you. Appreciate your advice. Blood work from 2 days> > > > ago now>

> > > > > > > shows K at 4.0; down from 5.7. However, I'm thinking this> > > > may be> > > > > > due> > > > > > > > to discontinuation of Spiro recently in prep for tomorrows> > > > saline> > > > > > > > suppression test, although its only been 5 days since such> > > > > > > > discontinuance. Not sure if K level would drop that > > quickly in> > > > > > this> > > > > > > > short of a time frame. Received prescription for K > > supplement> > > > > > 20MEQ> > > > > > > > ER twice a day. ENDO is reasonably confident that test > > will> > > > > > confirm> > > > > > > > PA and surgery will likely be highly beneficial in > > reducing> > > > BP to> > > > > > > > near normal levels, with at most a minimum of > > medications. I> > > > > > suspect> > > > > > > > that shortly after testing I will again go back on spiro > > at> > > > prior> > > > > > > > doseage of 125 and Chlorthalidone at 50mg until decision > > on> > > > > > surgery> > > > > > > > is made. I'll start working on DASHing to see if it will > > lower> > > > > > > > needed doseage of the spiro

as you suggest.> > > > > > > >> > > > > > > > Side note that creatinine results are also changing---> > > > dropped from> > > > > > > > high of 2.22 in Sept. (after BP decreased on spiro) to > > 1.88 in> > > > > > Oct.> > > > > > > > and now 1.58. ENDO believes these changes are directly > > tied to> > > > > > blood> > > > > > > > pressure fluctuations.

Increase being caused by drop in> > > > pressure> > > > > > > > when kidneys were used to years of the high pressure. And> > > > current> > > > > > > > decrease due to stabilization at lower pressure. Hopefully> > > > this is> > > > > > > > the case as ther was concern from PCP that we were > > seeing some> > > > > > signs> > > > > > > > of renal failure.> > > > > > >> >

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

November 27, 2009

Sorry I hand wrong name. I think DASH FOR life is better ;-)Tiped sad Send form miiPhone ;-)May your pressure be low!CE Grim MDSpecializing in DifficultHypertensionOn Nov 27, 2009, at 2:28 PM, Francis Bill <georgewbill@...> wrote:

Maybe this is the one http://www.dashforhealth.com/?gclid=CLGR3tOBrJ4CFYZM5QodlzcMqA

> > > > > > > >

> > > > > > > > > Thank you. Appreciate your advice. Blood work from 2 days

> > > > > ago now

> > > > > > > > > shows K at 4.0; down from 5.7. However, I'm thinking this

> > > > > may be

> > > > > > > due

> > > > > > > > > to discontinuation of Spiro recently in prep for tomorrows

> > > > > saline

> > > > > > > > > suppression test, although its only been 5 days since such

> > > > > > > > > discontinuance. Not sure if K level would drop that

> > > quickly in

> > > > > > > this

> > > > > > > > > short of a time frame. Received prescription for K

> > > supplement

> > > > > > > 20MEQ

> > > > > > > > > ER twice a day. ENDO is reasonably confident that test

> > > will

> > > > > > > confirm

> > > > > > > > > PA and surgery will likely be highly beneficial in

> > > reducing

> > > > > BP to

> > > > > > > > > near normal levels, with at most a minimum of

> > > medications. I

> > > > > > > suspect

> > > > > > > > > that shortly after testing I will again go back on spiro

> > > at

> > > > > prior

> > > > > > > > > doseage of 125 and Chlorthalidone at 50mg until decision

> > > on

> > > > > > > surgery

> > > > > > > > > is made. I'll start working on DASHing to see if it will

> > > lower

> > > > > > > > > needed doseage of the spiro as you suggest.

> > > > > > > > >

> > > > > > > > > Side note that creatinine results are also changing---

> > > > > dropped from

> > > > > > > > > high of 2.22 in Sept. (after BP decreased on spiro) to

> > > 1.88 in

> > > > > > > Oct.

> > > > > > > > > and now 1.58. ENDO believes these changes are directly

> > > tied to

> > > > > > > blood

> > > > > > > > > pressure fluctuations. Increase being caused by drop in

> > > > > pressure

> > > > > > > > > when kidneys were used to years of the high pressure. And

> > > > > current

> > > > > > > > > decrease due to stabilization at lower pressure. Hopefully

> > > > > this is

> > > > > > > > > the case as ther was concern from PCP that we were

> > > seeing some

> > > > > > > signs

> > > > > > > > > of renal failure.

> > > > > > > >

> > > > > > >

> > > > > >

> > > > >

> > > >

> > >

> >

>

Reply to sender

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Messages in this topic

(27)

Recent Activity:

November 27, 2009

And no good reason to do low carbs if DASH workes. Tiped sad Send form miiPhone ;-)May your pressure be low!CE Grim MDSpecializing in DifficultHypertensionOn Nov 27, 2009, at 9:20 AM, Bindner <mikeybdc@...> wrote:

Do you count milk as a carb serving?

12 is an awful lot, since carbs make cholesterol in your body.

If you can keep to DASH, than do that. If it becomes impossible, however, try a low carb diet.

Bindner

From: dbonogofsky <dbonogofsky >Subject: Re: HA suspected and testinghyperaldosteronism Date: Friday, November 27, 2009, 9:44 AM

Thanks . My diet is not the best, although I have minimized most sweets/sugars and tried to keep carbs down on a daily basis to no more than 12 carb servings. This was the amount the dietician recommended when I first saw her after the Type 2 diagnosis. I could definitely stand to lose somewhere between 10-15 pounds. I have begun to increase fresh fruits/vegetables in my eating plan. And will be starting to DASH now based on Dr. Grim's suggestion. I think my balance of food is OK, but need some more effort at portion control and exercise. A1C reading when first diagnosed was 6.9. Readings since then have been between 6.1 and 6.4. No drinking of any consequence. Occasional glass of wine on holidays. Perhaps once every couple of months, if that much. By the way, congrats on your testing and surgery. Hoping everything turns out great for you and this gets you back to a much more normal state of health. > > > > > > > >> > > > > > > > > Thank you. Appreciate your advice. Blood work from 2 days> > > > > ago now> > > > > > > > > shows K at 4.0; down from 5.7. However, I'm thinking this> > > > > may be> > > > > > > due> > > > > > > >

> to discontinuation of Spiro recently in prep for tomorrows> > > > > saline> > > > > > > > > suppression test, although its only been 5 days since such> > > > > > > > > discontinuance. Not sure if K level would drop that > > > quickly in> > > > > > > this> > > > > > > > > short of a time frame. Received prescription for K > > > supplement> > > > > > > 20MEQ> > > > > > > > > ER twice a day. ENDO is reasonably confident that test > > > will> > > > > > > confirm> > > > > > > > > PA and surgery will likely be highly beneficial in > > > reducing> > > > > BP to> > > > > > > > > near normal levels, with at most

a minimum of > > > medications. I> > > > > > > suspect> > > > > > > > > that shortly after testing I will again go back on spiro > > > at> > > > > prior> > > > > > > > > doseage of 125 and Chlorthalidone at 50mg until decision > > > on> > > > > > > surgery> > > > > > > > > is made. I'll start working on DASHing to see if it will > > > lower> > > > > > > > > needed doseage of the spiro as you suggest.> > > > > > > > >> > > > > > > > > Side note that creatinine results are also changing---> > > > > dropped from> > > > > > > > > high of 2.22 in Sept. (after BP decreased on spiro) to > > > 1.88

in> > > > > > > Oct.> > > > > > > > > and now 1.58. ENDO believes these changes are directly > > > tied to> > > > > > > blood> > > > > > > > > pressure fluctuations. Increase being caused by drop in> > > > > pressure> > > > > > > > > when kidneys were used to years of the high pressure. And> > > > > current> > > > > > > > > decrease due to stabilization at lower pressure. Hopefully> > > > > this is> > > > > > > > > the case as ther was concern from PCP that we were > > > seeing some> > > > > > > signs> > > > > > > > > of renal failure.> > > > > > > >> > > > > >

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

November 27, 2009

No PA and metabolic syndrome in u are likely due to PA. Tiped sad Send form miiPhone ;-)May your pressure be low!CE Grim MDSpecializing in DifficultHypertensionOn Nov 27, 2009, at 8:34 AM, dbonogofsky <dbonogofsky@...> wrote:

Thank you. Sounds as if I'm fighting at least 2 situations--PA and possibly metabolic syndrome. Will be DASHing starting today. Will corresponding BP results be noticeable quickly or will they manifest itself over time ? I'm back onto the Spirno, Norvasc and Chlorthalidone and average BP is running 135/77 for the past 4 days.

> > > > > > > > >

> > > > > > > > > > Thank you. Appreciate your advice. Blood work from 2

> > days

> > > > > > ago now

> > > > > > > > > > shows K at 4.0; down from 5.7. However, I'm thinking

> > this

> > > > > > may be

> > > > > > > > due

> > > > > > > > > > to discontinuation of Spiro recently in prep for

> > tomorrows

> > > > > > saline

> > > > > > > > > > suppression test, although its only been 5 days

> > since such

> > > > > > > > > > discontinuance. Not sure if K level would drop that

> > > > quickly in

> > > > > > > > this

> > > > > > > > > > short of a time frame. Received prescription for K

> > > > supplement

> > > > > > > > 20MEQ

> > > > > > > > > > ER twice a day. ENDO is reasonably confident that test

> > > > will

> > > > > > > > confirm

> > > > > > > > > > PA and surgery will likely be highly beneficial in

> > > > reducing

> > > > > > BP to

> > > > > > > > > > near normal levels, with at most a minimum of

> > > > medications. I

> > > > > > > > suspect

> > > > > > > > > > that shortly after testing I will again go back on

> > spiro

> > > > at

> > > > > > prior

> > > > > > > > > > doseage of 125 and Chlorthalidone at 50mg until

> > decision

> > > > on

> > > > > > > > surgery

> > > > > > > > > > is made. I'll start working on DASHing to see if it

> > will

> > > > lower

> > > > > > > > > > needed doseage of the spiro as you suggest.

> > > > > > > > > >

> > > > > > > > > > Side note that creatinine results are also changing---

> > > > > > dropped from

> > > > > > > > > > high of 2.22 in Sept. (after BP decreased on spiro) to

> > > > 1.88 in

> > > > > > > > Oct.

> > > > > > > > > > and now 1.58. ENDO believes these changes are directly

> > > > tied to

> > > > > > > > blood

> > > > > > > > > > pressure fluctuations. Increase being caused by drop

> > in

> > > > > > pressure

> > > > > > > > > > when kidneys were used to years of the high

> > pressure. And

> > > > > > current

> > > > > > > > > > decrease due to stabilization at lower pressure.

> > Hopefully

> > > > > > this is

> > > > > > > > > > the case as ther was concern from PCP that we were

> > > > seeing some

> > > > > > > > signs

> > > > > > > > > > of renal failure.

> > > > > > > > >

> > > > > > > >

> > > > > > >

> > > > > >

> > > > >

> > > >

> > >

> >

>

November 27, 2009

No Thats what causes DMTiped sad Send form miiPhone ;-)May your pressure be low!CE Grim MDSpecializing in DifficultHypertensionOn Nov 27, 2009, at 9:02 PM, Francis Bill <georgewbill@...> wrote:

If someone has Diabetes don't they have to eat a lot of carbs?

> > > > > > > > > >

> > > > > > > > > > > Thank you. Appreciate your advice. Blood work from

> > 2 days

> > > > > > > ago now

> > > > > > > > > > > shows K at 4.0; down from 5.7. However, I'm

> > thinking this

> > > > > > > may be

> > > > > > > > > due

> > > > > > > > > > > to discontinuation of Spiro recently in prep for

> > tomorrows

> > > > > > > saline

> > > > > > > > > > > suppression test, although its only been 5 days

> > since such

> > > > > > > > > > > discontinuance. Not sure if K level would drop that

> > > > > quickly in

> > > > > > > > > this

> > > > > > > > > > > short of a time frame. Received prescription for K

> > > > > supplement

> > > > > > > > > 20MEQ

> > > > > > > > > > > ER twice a day. ENDO is reasonably confident that

> > test

> > > > > will

> > > > > > > > > confirm

> > > > > > > > > > > PA and surgery will likely be highly beneficial in

> > > > > reducing

> > > > > > > BP to

> > > > > > > > > > > near normal levels, with at most a minimum of

> > > > > medications. I

> > > > > > > > > suspect

> > > > > > > > > > > that shortly after testing I will again go back on

> > spiro

> > > > > at

> > > > > > > prior

> > > > > > > > > > > doseage of 125 and Chlorthalidone at 50mg until

> > decision

> > > > > on

> > > > > > > > > surgery

> > > > > > > > > > > is made. I'll start working on DASHing to see if

> > it will

> > > > > lower

> > > > > > > > > > > needed doseage of the spiro as you suggest.

> > > > > > > > > > >

> > > > > > > > > > > Side note that creatinine results are also

> > changing---

> > > > > > > dropped from

> > > > > > > > > > > high of 2.22 in Sept. (after BP decreased on

> > spiro) to

> > > > > 1.88 in

> > > > > > > > > Oct.

> > > > > > > > > > > and now 1.58. ENDO believes these changes are

> > directly

> > > > > tied to

> > > > > > > > > blood

> > > > > > > > > > > pressure fluctuations. Increase being caused by

> > drop in

> > > > > > > pressure

> > > > > > > > > > > when kidneys were used to years of the high

> > pressure. And

> > > > > > > current

> > > > > > > > > > > decrease due to stabilization at lower pressure.

> > Hopefully

> > > > > > > this is

> > > > > > > > > > > the case as ther was concern from PCP that we were

> > > > > seeing some

> > > > > > > > > signs

> > > > > > > > > > > of renal failure.

> > > > > > > > > >

> > > > > > > > >

> > > > > > > >

> > > > > > >

> > > > > >

> > > > >

> > > >

> > >

> >

>

November 27, 2009

Bp effects max by 2 weeks in most. Tiped sad Send form miiPhone ;-)May your pressure be low!CE Grim MDSpecializing in DifficultHypertensionOn Nov 27, 2009, at 8:34 AM, dbonogofsky <dbonogofsky@...> wrote:

Thank you. Sounds as if I'm fighting at least 2 situations--PA and possibly metabolic syndrome. Will be DASHing starting today. Will corresponding BP results be noticeable quickly or will they manifest itself over time ? I'm back onto the Spirno, Norvasc and Chlorthalidone and average BP is running 135/77 for the past 4 days.

> > > > > > > > >

> > > > > > > > > > Thank you. Appreciate your advice. Blood work from 2

> > days

> > > > > > ago now

> > > > > > > > > > shows K at 4.0; down from 5.7. However, I'm thinking

> > this

> > > > > > may be

> > > > > > > > due

> > > > > > > > > > to discontinuation of Spiro recently in prep for

> > tomorrows

> > > > > > saline

> > > > > > > > > > suppression test, although its only been 5 days

> > since such

> > > > > > > > > > discontinuance. Not sure if K level would drop that

> > > > quickly in

> > > > > > > > this

> > > > > > > > > > short of a time frame. Received prescription for K

> > > > supplement

> > > > > > > > 20MEQ

> > > > > > > > > > ER twice a day. ENDO is reasonably confident that test

> > > > will

> > > > > > > > confirm

> > > > > > > > > > PA and surgery will likely be highly beneficial in

> > > > reducing

> > > > > > BP to

> > > > > > > > > > near normal levels, with at most a minimum of

> > > > medications. I

> > > > > > > > suspect

> > > > > > > > > > that shortly after testing I will again go back on

> > spiro

> > > > at

> > > > > > prior

> > > > > > > > > > doseage of 125 and Chlorthalidone at 50mg until

> > decision

> > > > on

> > > > > > > > surgery

> > > > > > > > > > is made. I'll start working on DASHing to see if it

> > will

> > > > lower

> > > > > > > > > > needed doseage of the spiro as you suggest.

> > > > > > > > > >

> > > > > > > > > > Side note that creatinine results are also changing---

> > > > > > dropped from

> > > > > > > > > > high of 2.22 in Sept. (after BP decreased on spiro) to

> > > > 1.88 in

> > > > > > > > Oct.

> > > > > > > > > > and now 1.58. ENDO believes these changes are directly

> > > > tied to

> > > > > > > > blood

> > > > > > > > > > pressure fluctuations. Increase being caused by drop

> > in

> > > > > > pressure

> > > > > > > > > > when kidneys were used to years of the high

> > pressure. And

> > > > > > current

> > > > > > > > > > decrease due to stabilization at lower pressure.

> > Hopefully

> > > > > > this is

> > > > > > > > > > the case as ther was concern from PCP that we were

> > > > seeing some

> > > > > > > > signs

> > > > > > > > > > of renal failure.

> > > > > > > > >

> > > > > > > >

> > > > > > >

> > > > > >

> > > > >

> > > >

> > >

> >

>

November 28, 2009

That's what I said, however it does not work for the carb addicted.

I'm wondering if removing the gland will effect the carb addiction. Would be nice. I'll let everyone know.

Bindner

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From: dbonogofsky <dbonogofsky >Subject: [hyperaldosteronism ] Re: HA suspected and testinghyperaldosteronismDate: Friday, November 27, 2009, 9:44 AM

Thanks . My diet is not the best, although I have minimized most sweets/sugars and tried to keep carbs down on a daily basis to no more than 12 carb servings. This was the amount the dietician recommended when I first saw her after the Type 2 diagnosis. I could definitely stand to lose somewhere between 10-15 pounds. I have begun to increase fresh fruits/vegetables in my eating plan. And will be starting to DASH now based on Dr. Grim's suggestion. I think my balance of food is OK, but need some more effort at portion control and exercise. A1C reading when first diagnosed was 6.9. Readings since then have been between 6.1 and 6.4. No drinking of any consequence. Occasional glass of wine on holidays. Perhaps once every couple of months, if that much. By the way, congrats on your testing and surgery. Hoping everything turns out great for you and this gets you back to a much more normal state of health. > > > > > > > >> > > > > > > > > Thank you. Appreciate your advice. Blood work from 2 days> > > > > ago now> > > > > > > > > shows K at 4.0; down from 5.7. However, I'm thinking this> > > > > may be> > > > > > >

due> > > > > > > > > to discontinuation of Spiro recently in prep for tomorrows> > > > > saline> > > > > > > > > suppression test, although its only been 5 days since such> > > > > > > > > discontinuance. Not sure if K level would drop that > > > quickly in> > > > > > > this> > > > > > > > > short of a time frame. Received prescription for K > > > supplement> > > > > > > 20MEQ> > > > > > > > > ER twice a day. ENDO is reasonably confident that test > > > will> > > > > > > confirm> > > > > > > > > PA and surgery will likely be highly beneficial in > > > reducing> > > > > BP to> > > > > >

> > > near normal levels, with at most a minimum of > > > medications. I> > > > > > > suspect> > > > > > > > > that shortly after testing I will again go back on spiro > > > at> > > > > prior> > > > > > > > > doseage of 125 and Chlorthalidone at 50mg until decision > > > on> > > > > > > surgery> > > > > > > > > is made. I'll start working on DASHing to see if it will > > > lower> > > > > > > > > needed doseage of the spiro as you suggest.> > > > > > > > >> > > > > > > > > Side note that creatinine results are also changing---> > > > > dropped from> > > > > > > > > high of 2.22 in Sept. (after

BP decreased on spiro) to > > > 1.88 in> > > > > > > Oct.> > > > > > > > > and now 1.58. ENDO believes these changes are directly > > > tied to> > > > > > > blood> > > > > > > > > pressure fluctuations. Increase being caused by drop in> > > > > pressure> > > > > > > > > when kidneys were used to years of the high pressure. And> > > > > current> > > > > > > > > decrease due to stabilization at lower pressure. Hopefully> > > > > this is> > > > > > > > > the case as ther was concern from PCP that we were > > > seeing some> > > > > > > signs> > > > > > > > > of renal failure.> > > > >

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

November 28, 2009

http://dashdiet.org/From: Bill <georgewbill@...>hyperaldosteronism Sent: Sat, 28 November, 2009 8:51:27 AMSubject: Re: Re: HA suspected and testing

I don't think that this is the right link.From: dbonogofsky <dbonogofsky>Subject: [hyperaldosteronism ] Re: HA suspected and testinghyperaldosteronismDate: Thursday, November 26, 2009, 7:57 PM Yes, I was fasting for about 13 hours in total prior to

blood draw. CARDIO and ENDO are discussing and considering Trilipix instead of Vytorin and increasing doseage of Niaspan. Total cholesterol has been over 300 fairly consistently for a number of years, although no one mentioned the triglycerides as being abnormally high as it was this time. LDL was previously higher and HDL was lower. So

this is actually an improvement over prior testing (if it's accurate). No known history of early heart attacks, with exception of Grandfather on Mother's side. Believe he passed at about 52. Weight varies between 186 and 192 and height is 5'9". Just picked up DASH reading materials. Does PA have a connection to lipid readings ? Any thoughts on this metabolic syndrome ? Does seem to fit most of my symptoms. ]HAPPY THANKSGIVING EVERYONE> > > > > > >> > > > > > > > Thank you. Appreciate your advice. Blood work from 2 days> > > > ago now>

> > > > > > > shows K at 4.0; down from 5.7. However, I'm thinking this> > > > may be> > > > > > due> > > > > > > > to discontinuation of Spiro recently in prep for tomorrows> > > > saline> > > > > > > > suppression test, although its only been 5 days since such> > > > > > > > discontinuance. Not sure if K level would drop that > > quickly in> > > > > > this> > > > > > > > short of a time frame. Received prescription for K > > supplement> > > > > > 20MEQ> > > > > > > > ER twice a day. ENDO is reasonably confident that test > >

will> > > > > > confirm> > > > > > > > PA and surgery will likely be highly beneficial in > > reducing> > > > BP to> > > > > > > > near normal levels, with at most a minimum of > > medications. I> > > > > > suspect> > > > > > > > that shortly after testing I will again go back on spiro > > at> > > > prior> > > > > > > > doseage of 125 and Chlorthalidone at 50mg until decision > > on> > > > > > surgery> > > > > > > > is made. I'll start working on DASHing to see if it will > > lower> > > > > > > > needed doseage of the spiro

as you suggest.> > > > > > > >> > > > > > > > Side note that creatinine results are also changing---> > > > dropped from> > > > > > > > high of 2.22 in Sept. (after BP decreased on spiro) to > > 1.88 in> > > > > > Oct.> > > > > > > > and now 1.58. ENDO believes these changes are directly > > tied to> > > > > > blood> > > > > > > > pressure fluctuations.

Increase being caused by drop in> > > > pressure> > > > > > > > when kidneys were used to years of the high pressure. And> > > > current> > > > > > > > decrease due to stabilization at lower pressure. Hopefully> > > > this is> > > > > > > > the case as ther was concern from PCP that we were > > seeing some> > > > > > signs> > > > > > > > of renal failure.> > > > > > >> >

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

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November 28, 2009