Re: Symptoms and Thanks

January 10, 2012

This is what a visit to ED on 02/22/2009 has listed

Obesity

Hearing Loss

Fatigue Syndrome , Chronic

Sensorineural hearing loss of combined tSubjective tinnitus

Dizziness

Hypertension

Unspecified Sleep APNEA

A/P SOB of unclear cause (Possible deconditioning) . No signs of cardiac

ischemia , infection , systolic chf . PE less likely in light of normal 02 sats

and absence of tachycardia . Currently patient with uncontrolled HTN

Have had tachycardia show up in past EKG. What is not listed but in my record

Frequent, isolated, asymptomatic PVC's, lightheadness, pitting edema, dry skin,

Sleep Apnea and shaking.

Still have all problems. The lightheadness or brain fog never goes aways

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

> > > > > > > > > > > > > > > > > >> > >> > According to your analyses and

symptoms, it

> > > > > > > > > > > seems that you

> > > > > > > > > > > > > > > > > >> have the same Conn's that most of us have.

Start to

> > > > > > > > > > > Dash

> > > > > > > > > > > > > > > > > >> IMMEDIATELY, if you feel better and if you

are not

> > > > > > > > > > > afraid, try

> > > > > > > > > > > > > > > > > >> spiro or eplerenone, even small dosage. If

your BP

> > > > > > > > > > > behaves better

> > > > > > > > > > > > > > > > > >> with this medication, that's it! Don't wait

6

> > > > > > > > > months

> > > > > > > > > > > until your

> > > > > > > > > > > > > > > > > >> appointment and some more years until you

are going

> > > > > > > > > > > to be

> > > > > > > > > > > > > > > > > >> diagnosed. Some of us, including myself,

are still

> > > > > > > > > > > undiagnosed

> > > > > > > > > > > > > > > > > >> after several years and many doctors.

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

> > > > > > > > > > > > > > > > > >> > >> > ÃƒÆ'Ã¢â‚¬Å¡

> > > > > > > > > > > > > > > > > >> > >> > Natalia Kamneva 67 Russian F with 2

cm left

> > > > > > > > > > > adrenal adenoma,

> > > > > > > > > > > > > > > > > >> diabetic; on 100 mg eplerenone, 80 mg

Micardis,

> > > > > > > > > 2000

> > > > > > > > > > > mg metformin,

> > > > > > > > > > > > > > > > > >> 60 mg Dexilant and 2 mg Lorazepam; Dashing;

still

> > > > > > > > > > > have some

> > > > > > > > > > > > > > > > > >> occasional problems with BP, K and Na when

over-

> > > > > > > > > salt

> > > > > > > > > > > eplerenone ;

> > > > > > > > > > > > > > > > > >> on private consultation with Dr Grim.

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

> > > > > > > > > > > > > > > > > >> > >> > ________________________________

> > > > > > > > > > > > > > > > > >> > >> > From: lff_409 <.>

> > > > > > > > > > > > > > > > > >> > >> > To:

> > > > > > > > > > > > > > > > > >> > >> > Sent: Monday, January 2, 2012 1:45

PM

> > > > > > > > > > > > > > > > > >> > >> > Subject:

Symptoms and

> > > > > > > > > > > Thanks

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

> > > > > > > > > > > > > > > > > >> > >> > ÃƒÆ'Ã¢â‚¬Å¡

> > > > > > > > > > > > > > > > > >> > >> > First of all, thanks to all that

responded.

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

> > > > > > > > > > > > > > > > > >> > >> > My GP sent me to the Endo for new

sudden

> > > > > > > > > onset

> > > > > > > > > > > hypertension,

> > > > > > > > > > > > > > > > > >> slightly Low K (3.1), heat intolerance,

weakness,

> > > > > > > > > > > tachycardia,

> > > > > > > > > > > > > > > > > >> headache, fatigue, and emotional swings. I

am a

> > > > > > > > > 58 yo

> > > > > > > > > > > male, retired

> > > > > > > > > > > > > > > > > >> firefighter. Only other medical Hx is small

Pineal

> > > > > > > > > > > gland tumor and

> > > > > > > > > > > > > > > > > >> hashimoto thyroiditis controlled with

synthesis for

> > > > > > > > > > > past 20 years.

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

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

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

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

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

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

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

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

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

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

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

> > > > > > > > > > >

> > > > > > > > > >

> > > > > > > > >

> > > > > > > >

> > > > > > >

> > > > > >

> > > > >

> > > >

> > >

> >

>

January 10, 2012

Francis, This is about New Hampshire's exploding epidemic. New Hampshire has the distinction of being #1 in the nation.http://www.wmur.com/r/24181311/detail.html Val From: hyperaldosteronism [mailto:hyperaldosteronism ] On Behalf Of Francis Bill SUSPECTED PAThis is what a visit to ED on 02/22/2009 has listed ObesityHearing LossFatigue Syndrome , ChronicSensorineural hearing loss of combined tSubjective tinnitusDizzinessHypertensionUnspecified Sleep APNEAA/P SOB of unclear cause (Possible deconditioning) . No signs of cardiacischemia , infection , systolic chf . PE less likely in light of normal 02 sats and absence of tachycardia . Currently patient with uncontrolled HTNHave had tachycardia show up in past EKG. What is not listed but in my record Frequent, isolated, asymptomatic PVC's, lightheadness, pitting edema, dry skin, Sleep Apnea and shaking.Still have all problems. The lightheadness or brain fog never goes aways >> What u want is a trial of Spiro to see if it helps BP K AND you. Most important you. Only u can tell them u are not feeling well. No one else can measure that. So give us a review of how you do not feel well zoned can help get it organized. .

January 10, 2012

Thank you, Val. Could you, please, tell me why 2.51 is so bad, if their reference range is 0.4 - 4.5?I could not find T3 in my tests, but T4 Free was done in March 2011, see below. Should I ask the endo to repeat them?

T4, FREE

1.2 NG/DL

REFERENCE RANGE

0.80-1.8

From: Valarie <val@...> hyperaldosteronism Sent: Saturday, January 7, 2012 12:40 AM Subject: RE: Re: Symptoms and Thanks

Natalia, I would be barely able to drag my body around with a TSH of 2.51 mIU/L. A good level for TSH is about 1.00, but you need FreeT3 and Free T4 to get the whole picture. If your pituitary is not up to snuff, a TSH is no good because it measures a pituitary hormone (TSH) and not actual thyroid hormones. Val From: hyperaldosteronism [mailto:hyperaldosteronism ] On Behalf Of

Natalia Kamneva [Attachment(s) from Natalia Kamneva included below] Dr. Grim, you looked at this file back in October, when I have sent it to you directly.

January 10, 2012

No, no, Francis, is right. It's blood sodium, it should not be low. Mine is always low since I am on eplerenone. Natalia From: Francis Bill SUSPECTED PA <georgewbill@...> hyperaldosteronism Sent: Saturday, January 7, 2012 8:27 AM Subject: Re: Symptoms and Thanks

One of the reasons to give epler is to help lower sodium.

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

> > > > > > > > > > > >> > >> > According to your analyses and symptoms, it seems that you

> > > > > > > > > > > >> have the same Conn's that most of us have. Start to Dash

> > > > > > > > > > > >> IMMEDIATELY, if you feel better and if you are not afraid, try

> > > > > > > > > > > >> spiro or eplerenone, even small dosage. If your BP behaves better

> > > > > > > > > > > >> with this medication, that's it! Don't wait 6 months until your

> > > > > > > > > > > >> appointment and some more years until you are going to be

> > > > > > > > > > > >> diagnosed. Some of us, including myself, are still undiagnosed

> > > > > > > > > > > >> after several years and many doctors.

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

> > > > > > > > > > > >> > >> > Ãƒâ€š

> > > > > > > > > > > >> > >> > Natalia Kamneva 67 Russian F with 2 cm left adrenal adenoma,

> > > > > > > > > > > >> diabetic; on 100 mg eplerenone, 80 mg Micardis, 2000 mg metformin,

> > > > > > > > > > > >> 60 mg Dexilant and 2 mg Lorazepam; Dashing; still have some

> > > > > > > > > > > >> occasional problems with BP, K and Na when over-salt eplerenone ;

> > > > > > > > > > > >> on private consultation with Dr Grim.

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

> > > > > > > > > > > >> > >> > ________________________________

> > > > > > > > > > > >> > >> > From: lff_409 <.>

> > > > > > > > > > > >> > >> > To:

> > > > > > > > > > > >> > >> > Sent: Monday, January 2, 2012 1:45 PM

> > > > > > > > > > > >> > >> > Subject: Symptoms and Thanks

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

> > > > > > > > > > > >> > >> > Ãƒâ€š

> > > > > > > > > > > >> > >> > First of all, thanks to all that responded.

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

> > > > > > > > > > > >> > >> > My GP sent me to the Endo for new sudden onset hypertension,

> > > > > > > > > > > >> slightly Low K (3.1), heat intolerance, weakness, tachycardia,

> > > > > > > > > > > >> headache, fatigue, and emotional swings. I am a 58 yo male, retired

> > > > > > > > > > > >> firefighter. Only other medical Hx is small Pineal gland tumor and

> > > > > > > > > > > >> hashimoto thyroiditis controlled with synthesis for past 20 years.

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

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

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

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

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

> > > > > > > > > > >

> > > > > > > > > >

> > > > > > > > >

> > > > > > > >

> > > > > > >

> > > > > >

> > > > >

> > > >

> > >

> >

>

January 10, 2012

>Something else will likely end your life before that problem need to be adderssed. Thanks, Francis, you are generous :-)

Natalia From: Francis Bill SUSPECTED PA <georgewbill@...> hyperaldosteronism Sent: Saturday, January 7, 2012 9:20 AM Subject: Re: Symptoms and Thanks

When A Dr that you know you can trust what they say says there is nothing alarming may be right. Doesn't always mean every thing is normal just what is abnormal isn't likely to be a real problem for many years. Something else will likely end your life before that problem need to be adderssed.

What you need to know is based on you kidney test would Dr Grim tell you to have or not have contast dye during scans.

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

> > > > > > > > > > >> > >> > According to your analyses and symptoms, it seems that you

> > > > > > > > > > >> have the same Conn's that most of us have. Start to Dash

> > > > > > > > > > >> IMMEDIATELY, if you feel better and if you are not afraid, try

> > > > > > > > > > >> spiro or eplerenone, even small dosage. If your BP behaves better

> > > > > > > > > > >> with this medication, that's it! Don't wait 6 months until your

> > > > > > > > > > >> appointment and some more years until you are going to be

> > > > > > > > > > >> diagnosed. Some of us, including myself, are still undiagnosed

> > > > > > > > > > >> after several years and many doctors.

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

> > > > > > > > > > >> > >> > Ãƒâ€š

> > > > > > > > > > >> > >> > Natalia Kamneva 67 Russian F with 2 cm left adrenal adenoma,

> > > > > > > > > > >> diabetic; on 100 mg eplerenone, 80 mg Micardis, 2000 mg metformin,

> > > > > > > > > > >> 60 mg Dexilant and 2 mg Lorazepam; Dashing; still have some

> > > > > > > > > > >> occasional problems with BP, K and Na when over-salt eplerenone ;

> > > > > > > > > > >> on private consultation with Dr Grim.

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

> > > > > > > > > > >> > >> > ________________________________

> > > > > > > > > > >> > >> > From: lff_409 <.>

> > > > > > > > > > >> > >> > To:

> > > > > > > > > > >> > >> > Sent: Monday, January 2, 2012 1:45 PM

> > > > > > > > > > >> > >> > Subject: Symptoms and Thanks

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

> > > > > > > > > > >> > >> > Ãƒâ€š

> > > > > > > > > > >> > >> > First of all, thanks to all that responded.

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

> > > > > > > > > > >> > >> > My GP sent me to the Endo for new sudden onset hypertension,

> > > > > > > > > > >> slightly Low K (3.1), heat intolerance, weakness, tachycardia,

> > > > > > > > > > >> headache, fatigue, and emotional swings. I am a 58 yo male, retired

> > > > > > > > > > >> firefighter. Only other medical Hx is small Pineal gland tumor and

> > > > > > > > > > >> hashimoto thyroiditis controlled with synthesis for past 20 years.

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

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

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

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

> > > > > > > > > > >

> > > > > > > > > >

> > > > > > > > >

> > > > > > > >

> > > > > > >

> > > > > >

> > > > >

> > > >

> > >

> >

>

January 10, 2012

I don't drink beer and I was restricted to 6 -7 glasses of liquid a day. From this source:"Hyponatremia is more likely to occur in people whose kidneys do not function properly"Everything points to this problem. I started epler on December 2010, a little bit more than a year ago. Is anybody else here who are on epler longer than I am and who have the same problems????? I think a is? Natalia From: <jclark24p@...> hyperaldosteronism Sent: Saturday, January 7, 2012 12:41 PM Subject: Re: Symptoms and Thanks

I pointed out sodium because it appears to be trending down BUT I don't know what else was going; diarrhea, too much beer or water, etc. Probably easier to review yourself at:

http://www.diagnose-me.com/cond/C549291.html

If I had to guess I might think your doctor is looking for a larger database to determine if changes are needed. When did you start Epler?

- 65 yo super ob. male - 12mm X 13mm rt. a.adnoma with previous rt. flank pain. Treating with DASH. 2-Day ave w/o meds = BP 133/77 HR 61 BS 132. D/C Spironolactone 12/20/2011 due to adverse SX.

Other Issues/Opportunities: OSA w Bi-Pap settings 13/19, DM2, Gynecomastia, MDD and PTSD.

Meds: Duloxetine hcl 80 MG, Metoprolol Tartrate 200 MG, 81mg aspirin and Metformin 2000MG. Started washing Spironolactone 12/20/11 to prepare for AVS.

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

> > > > > > > > > > > > >> > >> > According to your analyses and symptoms, it seems that you

> > > > > > > > > > > > >> have the same Conn's that most of us have. Start to Dash

> > > > > > > > > > > > >> IMMEDIATELY, if you feel better and if you are not afraid, try

> > > > > > > > > > > > >> spiro or eplerenone, even small dosage. If your BP behaves better

> > > > > > > > > > > > >> with this medication, that's it! Don't wait 6 months until your

> > > > > > > > > > > > >> appointment and some more years until you are going to be

> > > > > > > > > > > > >> diagnosed. Some of us, including myself, are still undiagnosed

> > > > > > > > > > > > >> after several years and many doctors.

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

> > > > > > > > > > > > >> > >> > Ãƒâ€š

> > > > > > > > > > > > >> > >> > Natalia Kamneva 67 Russian F with 2 cm left adrenal adenoma,

> > > > > > > > > > > > >> diabetic; on 100 mg eplerenone, 80 mg Micardis, 2000 mg metformin,

> > > > > > > > > > > > >> 60 mg Dexilant and 2 mg Lorazepam; Dashing; still have some

> > > > > > > > > > > > >> occasional problems with BP, K and Na when over-salt eplerenone ;

> > > > > > > > > > > > >> on private consultation with Dr Grim.

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

> > > > > > > > > > > > >> > >> > ________________________________

> > > > > > > > > > > > >> > >> > From: lff_409 <.>

> > > > > > > > > > > > >> > >> > To:

> > > > > > > > > > > > >> > >> > Sent: Monday, January 2, 2012 1:45 PM

> > > > > > > > > > > > >> > >> > Subject: Symptoms and Thanks

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

> > > > > > > > > > > > >> > >> > Ãƒâ€š

> > > > > > > > > > > > >> > >> > First of all, thanks to all that responded.

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

> > > > > > > > > > > > >> > >> > My GP sent me to the Endo for new sudden onset hypertension,

> > > > > > > > > > > > >> slightly Low K (3.1), heat intolerance, weakness, tachycardia,

> > > > > > > > > > > > >> headache, fatigue, and emotional swings. I am a 58 yo male, retired

> > > > > > > > > > > > >> firefighter. Only other medical Hx is small Pineal gland tumor and

> > > > > > > > > > > > >> hashimoto thyroiditis controlled with synthesis for past 20 years.

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

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

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

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

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

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

> > > > > > > > > > >

> > > > > > > > > >

> > > > > > > > >

> > > > > > > >

> > > > > > >

> > > > > >

> > > > >

> > > >

> > >

> >

>

January 10, 2012

The something else can be old age.

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

> > > > > > > > > > > >> > >> > According to your analyses and symptoms, it

seems that you

> > > > > > > > > > > >> have the same Conn's that most of us have. Start to

Dash

> > > > > > > > > > > >> IMMEDIATELY, if you feel better and if you are not

afraid, try

> > > > > > > > > > > >> spiro or eplerenone, even small dosage. If your BP

behaves better

> > > > > > > > > > > >> with this medication, that's it! Don't wait 6 months

until your

> > > > > > > > > > > >> appointment and some more years until you are going to

be

> > > > > > > > > > > >> diagnosed. Some of us, including myself, are still

undiagnosed

> > > > > > > > > > > >> after several years and many doctors.

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

> > > > > > > > > > > >> > >> > Ãƒâ€š

> > > > > > > > > > > >> > >> > Natalia Kamneva 67 Russian F with 2 cm left

adrenal adenoma,

> > > > > > > > > > > >> diabetic; on 100 mg eplerenone, 80 mg Micardis, 2000 mg

metformin,

> > > > > > > > > > > >> 60 mg Dexilant and 2 mg Lorazepam; Dashing; still have

some

> > > > > > > > > > > >> occasional problems with BP, K and Na when over-salt

eplerenone ;

> > > > > > > > > > > >> on private consultation with Dr Grim.

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

> > > > > > > > > > > >> > >> > ________________________________

> > > > > > > > > > > >> > >> > From: lff_409 <.>

> > > > > > > > > > > >> > >> > To:

> > > > > > > > > > > >> > >> > Sent: Monday, January 2, 2012 1:45 PM

> > > > > > > > > > > >> > >> > Subject: Symptoms and

Thanks

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

> > > > > > > > > > > >> > >> > Ãƒâ€š

> > > > > > > > > > > >> > >> > First of all, thanks to all that responded.

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

> > > > > > > > > > > >> > >> > My GP sent me to the Endo for new sudden onset

hypertension,

> > > > > > > > > > > >> slightly Low K (3.1), heat intolerance, weakness,

tachycardia,

> > > > > > > > > > > >> headache, fatigue, and emotional swings. I am a 58 yo

male, retired

> > > > > > > > > > > >> firefighter. Only other medical Hx is small Pineal

gland tumor and

> > > > > > > > > > > >> hashimoto thyroiditis controlled with synthesis for

past 20 years.

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

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

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

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

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

> > > > > > > > > > >

> > > > > > > > > >

> > > > > > > > >

> > > > > > > >

> > > > > > >

> > > > > >

> > > > >

> > > >

> > >

> >

>

January 10, 2012

Who long do you recommend to wait on epler until switching it to sipro, Dr. Grim? Natalia From: Clarence Grim <lowerbp2@...> hyperaldosteronism Cc: Clarence Grim <lowerbp2@...> Sent: Saturday, January 7, 2012 1:18 PM Subject: Re: Re: Symptoms

and Thanks

A fall in eGFR with epeler or any other drug that lowers BP may well be the result of lowering the perfusion pressure to a damaged glomerlus (kidney). If the damage was due to the HTN or high salt/aldo then we expect it to improve over time. This has been documented over 40 years ago with older BP meds. So the issue is does the Dr. have enough experience to wait this out and see if renal function improves. If not, and low diet Na is documented by urine testing if pt has PA, then may want to choose another BP med. And watch eGFR as well with it.CE Grim. On Jan 7, 2012, at 10:41 AM, wrote: I pointed out sodium because it appears to be trending down BUT I don't

know what else was going; diarrhea, too much beer or water, etc. Probably easier to review yourself at: http://www.diagnose-me.com/cond/C549291.html If I had to guess I might think your doctor is looking for a larger database to determine if changes are needed. When did you start Epler? - 65 yo super ob. male - 12mm X 13mm rt. a.adnoma with previous rt. flank pain. Treating with DASH. 2-Day ave w/o meds = BP 133/77 HR 61 BS 132. D/C Spironolactone 12/20/2011 due to adverse SX. Other Issues/Opportunities: OSA w Bi-Pap settings 13/19, DM2, Gynecomastia, MDD and PTSD. Meds: Duloxetine hcl 80 MG, Metoprolol Tartrate 200 MG, 81mg aspirin and Metformin 2000MG. Started washing Spironolactone 12/20/11 to prepare for AVS. > > > > > > > > > > > > >> > >> > > > > > > > > > > > > > >> > >> > According to your analyses and symptoms, it seems that you > > > > > > > > > > > > >> have the same Conn's that most of us have. Start to Dash > > > > > > > > > > > > >> IMMEDIATELY, if you feel better and if you are not afraid, try > > > > > > > > > > > > >> spiro or eplerenone, even small dosage. If your BP behaves better > > > > > > > > > > > > >>

with this medication, that's it! Don't wait 6 months until your > > > > > > > > > > > > >> appointment and some more years until you are going to be > > > > > > > > > > > > >> diagnosed. Some of us, including myself, are still undiagnosed > > > > > > > > > > > > >> after several years and many doctors. > > > > > > > > > > > > >> > >> > > > > > > > > > > > > > >> > >> > Ãƒâ€š > > > > > > > > > > > > >> > >> > Natalia Kamneva 67 Russian F with 2 cm left adrenal adenoma, > > > > > > > > > > > > >> diabetic; on 100 mg eplerenone, 80 mg Micardis, 2000 mg metformin, > > > > > >

> > > > > > >> 60 mg Dexilant and 2 mg Lorazepam; Dashing; still have some > > > > > > > > > > > > >> occasional problems with BP, K and Na when over-salt eplerenone ; > > > > > > > > > > > > >> on private consultation with Dr Grim. > > > > > > > > > > > > >> > >> > > > > > > > > > > > > > >> > >> > > > > > > > > > > > > > >> > >> > ________________________________ > > > > > > > > > > > > >> > >> > From: lff_409 <.> > > > > > > > > > > > > >> > >> > > > > > > > > > > > > > >> > >> >

Sent: Monday, January 2, 2012 1:45 PM > > > > > > > > > > > > >> > >> > Subject: Symptoms and Thanks > > > > > > > > > > > > >> > >> > > > > > > > > > > > > > >> > >> > > > > > > > > > > > > > >> > >> > Ãƒâ€š > > > > > > > > > > > > >> > >> > First of all, thanks to all that responded. > > > > > > > > > > > > >> > >> > > > > > > > > > > > > > >> > >> > My GP sent me to the Endo for new sudden onset hypertension, > > > > > > > > > > > > >> slightly Low K (3.1), heat intolerance, weakness,

tachycardia, > > > > > > > > > > > > >> headache, fatigue, and emotional swings. I am a 58 yo male, retired > > > > > > > > > > > > >> firefighter. Only other medical Hx is small Pineal gland tumor and > > > > > > > > > > > > >> hashimoto thyroiditis controlled with synthesis for past 20 years. > > > > > > > > > > > > >> > >> > > > > > > > > > > > > > >> > >> > > > > > > > > > > > > >> > >> > > > > > > > > > > > > >> > >> > > > > > > > > > > > > >> > >> > > > > > > > > > > > > >> > >

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

January 10, 2012

So, in my case it might be low Na intake + epler ? It also might be renin secreting tumor, but how likely it's if my renin was 0.1 before starting epler? Tumor was there before. Natalia From: Clarence Grim <lowerbp2@...> hyperaldosteronism Cc: Clarence Grim <lowerbp2@...> Sent: Saturday, January 7, 2012 1:28 PM Subject: Re: Re: Symptoms and Thanks

low Na intake, BP lowering drugs, renin secreting tumor, estrogens, pregnancy, rare syndromes like Bartter's but low BP. On Jan 6, 2012, at 10:31 PM, wrote: Dr. Grim, what causes the high renin? 74.16 (0.25-5.82) - 65 yo super ob. male - 12mm X 13mm rt. a.adnoma with previous rt. flank pain. Treating with DASH. 2-Day ave w/o meds = BP 133/77 HR 61 BS 132. D/C Spironolactone 12/20/2011 due to adverse SX. Other Issues/Opportunities: OSA w Bi-Pap settings 13/19, DM2, Gynecomastia, MDD and PTSD. Meds: Duloxetine hcl 80 MG, Metoprolol Tartrate 200 MG, 81mg aspirin and Metformin 2000MG. Started washing Spironolactone 12/20/11 to prepare for AVS. > >> > > > > > > > > > >> > >> > > > > > > > > > >> > >> > > > > > > > > > >> Did I answer your question, ? > >> > > > > > > > > > >> In the time when I had this visit to my PCP I already subscribed > >> > > > > > > > > > >> to this group and learned about spiro and eplerenone, but I didn't > >> > > > > > > > > > >> communicate either with group or with Dr. Grim yet. I started > >> > > > > > > > > > >> eplerenone without any proof and hope, just out of desperation, > >> >

> > > > > > > > >> since my BP and my condition were killing me and EVERY BB, Calcium > >> > > > > > > > > > >> channel, and other made me feel terrible. No mention that clonidine > >> > > > > > > > > > >> almost killed me. > >> > > > > > > > > > >> After the first day on eplerenone, my BP was 130/80 - I do not > >> > > > > > > > > > >> remember that I ever had this BP in my life. > >> > > > > > > > > > >> > >> > > > > > > > > > >> Natalia > >> > > > > > > > > > >> From: Bingham <jlkbbk2003@> > >> > > > > > > > > > >> "hyperaldosteronism " <hyperaldosteronism > >> > > > > > > > > > >> > > > > > > >

January 10, 2012

What is vv? Sorry. Natalia From: Clarence Grim <lowerbp2@...> hyperaldosteronism Cc: Clarence Grim <lowerbp2@...> Sent: Saturday, January 7, 2012 1:30 PM Subject: Re: Re: Symptoms and Thanks

BTH in general the lower the blood Na the lower the BP and vvSee G MacGregor et al. review.CE Grim MDOn Jan 6, 2012, at 11:41 PM, wrote: Maybe epler is too new! Here is what drugs.com says: "BUN/Creatinine: Serum creatinine increased in a dose-related manner. Mean increases ranged from 0.01 mg/dL at 50 mg daily to 0.03 mg/dL at 400 mg daily. Increases in blood urea nitrogen to greater than 30 mg/dL and serum creatinine to greater than 2 mg/dL were reported for 0.5% and 0.2%, respectively, of patients administered Eplerenone and 0% of placebo-treated patients. (Maybe they figured it was so little an effect it wasn't worth mentioning!) I also noticed this re: sodium "Sodium:

Serum sodium decreased in a dose-related manner. Mean decreases ranged from 0.7 mEq/L at 50 mg daily to 1.7 mEq/L at 400 mg daily. Decreases in sodium (<135 mEq/L) were reported for 2.3% of patients administered Eplerenone and 0.6% of placebo-treated patients." There some info for when you talk about your red numbers with your doctor. - 65 yo super ob. male - 12mm X 13mm rt. a.adnoma with previous rt. flank pain. Treating with DASH. 2-Day ave w/o meds = BP 133/77 HR 61 BS 132. D/C Spironolactone 12/20/2011 due to adverse SX. Other Issues/Opportunities: OSA w Bi-Pap settings 13/19, DM2, Gynecomastia, MDD and PTSD. Meds: Duloxetine hcl 80 MG, Metoprolol Tartrate 200 MG, 81mg aspirin and Metformin 2000MG. Started washing Spironolactone 12/20/11 to prepare for AVS. > > > > > > > > > > >> > >> > > > > > > > > > > > >> > >> > According to your analyses and symptoms, it seems that you > > > >

> > > > > > >> have the same Conn's that most of us have. Start to Dash > > > > > > > > > > >> IMMEDIATELY, if you feel better and if you are not afraid, try > > > > > > > > > > >> spiro or eplerenone, even small dosage. If your BP behaves better > > > > > > > > > > >> with this medication, that's it! Don't wait 6 months until your > > > > > > > > > > >> appointment and some more years until you are going to be > > > > > > > > > > >> diagnosed. Some of us, including myself, are still undiagnosed > > > > > > > > > > >> after several years and many doctors. > > > > > > > > > > >> > >> > > > > > > > > > > >

>> > >> > Ãƒâ€š > > > > > > > > > > >> > >> > Natalia Kamneva 67 Russian F with 2 cm left adrenal adenoma, > > > > > > > > > > >> diabetic; on 100 mg eplerenone, 80 mg Micardis, 2000 mg metformin, > > > > > > > > > > >> 60 mg Dexilant and 2 mg Lorazepam; Dashing; still have some > > > > > > > > > > >> occasional problems with BP, K and Na when over-salt eplerenone ; > > > > > > > > > > >> on private consultation with Dr Grim. > > > > > > > > > > >> > >> > > > > > > > > > > > >> > >> > > > > > > > > > > > >> > >> > ________________________________ > > > >

> > > > > > >> > >> > From: lff_409 <.> > > > > > > > > > > >> > >> > > > > > > > > > > > >> > >> > Sent: Monday, January 2, 2012 1:45 PM > > > > > > > > > > >> > >> > Subject: Symptoms and Thanks > > > > > > > > > > >> > >> > > > > > > > > > > > >> > >> > > > > > > > > > > > >> > >> > Ãƒâ€š > > > > > > > > > > >> > >> > First of all, thanks to all that responded. > > > > > > > > > > >> > >> > > > > > > > > > > > >> > >> > My GP

sent me to the Endo for new sudden onset hypertension, > > > > > > > > > > >> slightly Low K (3.1), heat intolerance, weakness, tachycardia, > > > > > > > > > > >> headache, fatigue, and emotional swings. I am a 58 yo male, retired > > > > > > > > > > >> firefighter. Only other medical Hx is small Pineal gland tumor and > > > > > > > > > > >> hashimoto thyroiditis controlled with synthesis for past 20 years. > > > > > > > > > > >> > >> > > > > > > > > > > > >> > >> > > > > > > > > > > >> > >> > > > > > > > > > > >> > >> > > > > > > > > > > >> >

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

January 10, 2012

Max, Could you, please, tell max-min on vertical ax? Cannot see them. Natalia From: Clarence Grim <lowerbp2@...> "hyperaldosteronism " <hyperaldosteronism > Sent: Sunday, January 8, 2012 2:12 AM Subject: Re: Re: Symptoms and Thanks

What caused the big drop do u think. CT?Recommend you give him a copy of the Hypertension Primer to get him up to speed. May your pressure be low!CE Grim MS, MDSpecializing in DifficultHypertensionOn Jan 7, 2012, at 18:30, StudyCircle <studycircle@...> wrote:

Thanks Dr. Grim for this info. When I noticed my GFR was improving and discussed it with my doc he rejected the possibility although I was showing him my GFR chart (attached). Max.62M L adenoma by NP59 scan. Aldos=1065â€¦2056 [28-860] pmol/L, Renin=6 [<30] ng/L. med combo #76={Spiro=100, Amlo=2x5mg, Indap=2.5mg, Ramip=2x2.5mg,

Metf=2x500mg, Crestor=20mg, Feno=67mg, K.Cl=6x20mEq, Motilium 3x10mg}{K=4.4}{not DASHing but low-salt diet just slightly above craving while keeping K/Na ratio constant, heat intolerance, insulin resistance} A fall in eGFR with epeler or any other drug that lowers BP may well be the result of lowering the perfusion pressure to a damaged glomerlus (kidney). If the damage was due

to the HTN or high salt/aldo then we expect it to improve over time. This has been documented over 40 years ago with older BP meds. So the issue is does the Dr. have enough experience to wait this out and see if renal function improves. If not, and low diet Na is documented by urine testing if pt has PA, then may want to choose another BP med. And watch eGFR as well with it. CE Grim. On Jan 7, 2012, at 10:41 AM, wrote:

January 10, 2012

vice verser

With the order or meaning reversed; conversely

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

> >> > > > > > > > > > >> > >> > According to your analyses and symptoms, it

seems that you

> >> > > > > > > > > > >> have the same Conn's that most of us have. Start to

Dash

> >> > > > > > > > > > >> IMMEDIATELY, if you feel better and if you are not

afraid, try

> >> > > > > > > > > > >> spiro or eplerenone, even small dosage. If your BP

behaves better

> >> > > > > > > > > > >> with this medication, that's it! Don't wait 6 months

until your

> >> > > > > > > > > > >> appointment and some more years until you are going to

be

> >> > > > > > > > > > >> diagnosed. Some of us, including myself, are still

undiagnosed

> >> > > > > > > > > > >> after several years and many doctors.

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

> >> > > > > > > > > > >> > >> > Ãƒâ€š

> >> > > > > > > > > > >> > >> > Natalia Kamneva 67 Russian F with 2 cm left

adrenal adenoma,

> >> > > > > > > > > > >> diabetic; on 100 mg eplerenone, 80 mg Micardis, 2000

mg metformin,

> >> > > > > > > > > > >> 60 mg Dexilant and 2 mg Lorazepam; Dashing; still have

some

> >> > > > > > > > > > >> occasional problems with BP, K and Na when over-salt

eplerenone ;

> >> > > > > > > > > > >> on private consultation with Dr Grim.

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

> >> > > > > > > > > > >> > >> > ________________________________

> >> > > > > > > > > > >> > >> > From: lff_409 <.>

> >> > > > > > > > > > >> > >> > To:

> >> > > > > > > > > > >> > >> > Sent: Monday, January 2, 2012 1:45 PM

> >> > > > > > > > > > >> > >> > Subject: Symptoms and

Thanks

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

> >> > > > > > > > > > >> > >> > Ãƒâ€š

> >> > > > > > > > > > >> > >> > First of all, thanks to all that responded.

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

> >> > > > > > > > > > >> > >> > My GP sent me to the Endo for new sudden onset

hypertension,

> >> > > > > > > > > > >> slightly Low K (3.1), heat intolerance, weakness,

tachycardia,

> >> > > > > > > > > > >> headache, fatigue, and emotional swings. I am a 58 yo

male, retired

> >> > > > > > > > > > >> firefighter. Only other medical Hx is small Pineal

gland tumor and

> >> > > > > > > > > > >> hashimoto thyroiditis controlled with synthesis for

past 20 years.

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

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

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

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

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

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

> >> > > > > > > > >

> >> > > > > > > >

> >> > > > > > >

> >> > > > > >

> >> > > > >

> >> > > >

> >> > >

> >> >

> >>

> >

>

January 10, 2012

Natalia, Click on ORIGINAL and see the graph in original size you can see all the text. Max. From: hyperaldosteronism [mailto:hyperaldosteronism ] On Behalf Of Natalia KamnevaSent: 2012-Jan-10 18:31hyperaldosteronism Subject: Re: Re: Symptoms and Thanks Max, Could you, please, tell max-min on vertical ax? Cannot see them. Natalia From: Clarence Grim <lowerbp2@...> " hyperaldosteronism " <hyperaldosteronism > Sent: Sunday, January 8, 2012 2:12 AMSubject: Re: Re: Symptoms and Thanks What caused the big drop do u think. CT?Recommend you give him a copy of the Hypertension Primer to get him up to speed. May your pressure be low! CE Grim MS, MDSpecializing in DifficultHypertensionOn Jan 7, 2012, at 18:30, StudyCircle <studycircle@...> wrote: Thanks Dr. Grim for this info. When I noticed my GFR was improving and discussed it with my doc he rejected the possibility although I was showing him my GFR chart (attached). Max.62M L adenoma by NP59 scan. Aldos=1065â€¦2056 [28-860] pmol/L, Renin=6 [<30] ng/L. med combo #76={Spiro=100, Amlo=2x5mg, Indap=2.5mg, Ramip=2x2.5mg, Metf=2x500mg, Crestor=20mg, Feno=67mg, K.Cl=6x20mEq, Motilium 3x10mg}{K=4.4}{not DASHing but low-salt diet just slightly above craving while keeping K/Na ratio constant, heat intolerance, insulin resistance} A fall in eGFR with epeler or any other drug that lowers BP may well be the result of lowering the perfusion pressure to a damaged glomerlus (kidney). If the damage was due to the HTN or high salt/aldo then we expect it to improve over time. This has been documented over 40 years ago with older BP meds. So the issue is does the Dr. have enough experience to wait this out and see if renal function improves. If not, and low diet Na is documented by urine testing if pt has PA, then may want to choose another BP med. And watch eGFR as well with it. CE Grim. On Jan 7, 2012, at 10:41 AM, wrote:

January 10, 2012

Natalia, remind me why you are switching from epler to spiro. If you have been

following my research lately, I don't know of anything in spiro that you need.

In fact, IMHO, there may be things you don't need! I particularily zeroed in on

the lorazepam which appears to potentially be affected by cortisol. Cortisol

appears to be affected by spironolactone. Cymbalta appears to be similarily

affected and I will be discussing it with my doctors tomorrow. (I have not

researched elpereone so I do not know if there is a similr issue.)

I did a quick look/see and found one study that might show you some of what is

going on. (I admit I don't have the knowledge and education to understand most

of it but that is why I refer it to my doctors!) I didn't have much time to

research tonight becuse I need to update info for my appt. tomorrow, sorry.)

Here is a summary of the trial: (BTW, you are on double the dose they tested.)

Source:

http://www.nature.com/npp/journal/v29/n3/full/1300365a.html

Interdose Elevation in Plasma Cortisol During Chronic Treatment with Alprazolam

but not Lorazepam in the Elderly

Nunzio Pomara1,2, M Willoughby1, C Ritchie3, J Sidtis1,2,

J Greenblatt4 and B Nemeroff5

1Geriatric Psychiatry Program, S Kline Institute for Psychiatric

Research, Orangeburg, NY, USA

2Department of Psychiatry, New York University School of Medicine, New York, NY,

USA

3Department of Pathology, Emory School of Medicine, Atlanta, GA, USA

4Department of Pharmacology and Experimental Therapeutics, Tufts University

School of Medicine Boston, MA, USA

5Department of Psychiatry, Emory School of Medicine, Atlanta, GA, USA

Correspondence: N Pomara, Geriatric Psychiatry Program, S. Kline

Institute for Psychiatric Research, 140 Old Orangeburg Rd, Bldg. 35, Orangeburg,

NY 10962, USA. Tel: +845 398 5579; Fax:+845 398 5575; E-mail:

pomara@...

Summary

Neither the low alprazolam nor the high and low lorazepam dose had any

significant effect on plasma cortisol either acutely or during chronic

treatment. The reductions in plasma cortisol that have been reported in response

to acute doses of these compounds have involved higher doses than those employed

in the current study. For instance, Loach and Fisher (1975) reported that 1.5 mg

of lorazepam attenuated cortisol response to presurgical stress and, more

recently, Collomp et al (1994) reported a similar effect of a 2 mg lorazepam

dose on the cortisol response to exercise. The lack of a significant cortisol

response to lorazepam in the present report may well be due to the low doses

used. Additionally, although anxiolytic activity of a 1.0 mg lorazepam dose is

generally thought to be equivalent to 0.50 mg alprazolam (Ashton, 1994), only

the latter resulted in reduced plasma cortisol levels. Thus, it is possible that

nonequivalence of doses, or differences in potency, and/or in their intrinsic

pharmacological effects in geriatric subjects might have contributed to these

observations.

In summary, our results suggest that chronic treatment with alprazolam, but not

lorazepam, is associated with plasma cortisol elevations prior to the first

morning dose. This increase may reflect an early stage of drug withdrawal. At

the same time, a tolerance for cognitive toxicity appears to develop. Since

alprazolam and lorazepam remain widely prescribed BZPs and are often taken for

months or years, especially in the elderly, it is of potential clinical

significance to confirm the differential effects on interdose cortisol levels

and HPA axis activation. This may lead to a better understanding of factors that

may contribute to an increased risk for drug escalation and dependence during

chronic treatments with these compounds.

- 65 yo super ob. male - 12mm X 13mm rt. a.adnoma with previous rt. flank

pain. Treating with DASH. 2-Day ave w/o meds = BP 133/77 HR 61 BS 132. D/C

Spironolactone 12/20/2011 due to adverse SX.

Other Issues/Opportunities: OSA w Bi-Pap settings 13/19, DM2, Gynecomastia, MDD

and PTSD.

Meds: Duloxetine hcl 80 MG, Metoprolol Tartrate 200 MG, 81mg aspirin and

Metformin 2000MG. Started washing Spironolactone 12/20/11 to prepare for AVS.

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

> >> > > > > > > > > > > > >> > >> > According to your analyses and symptoms, it

seems that you

> >> > > > > > > > > > > > >> have the same Conn's that most of us have. Start

to Dash

> >> > > > > > > > > > > > >> IMMEDIATELY, if you feel better and if you are not

afraid, try

> >> > > > > > > > > > > > >> spiro or eplerenone, even small dosage. If your BP

behaves better

> >> > > > > > > > > > > > >> with this medication, that's it! Don't wait 6

months until your

> >> > > > > > > > > > > > >> appointment and some more years until you are

going to be

> >> > > > > > > > > > > > >> diagnosed. Some of us, including myself, are still

undiagnosed

> >> > > > > > > > > > > > >> after several years and many doctors.

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

> >> > > > > > > > > > > > >> > >> > Ãƒâ€š

> >> > > > > > > > > > > > >> > >> > Natalia Kamneva 67 Russian F with 2 cm left

adrenal adenoma,

> >> > > > > > > > > > > > >> diabetic; on 100 mg eplerenone, 80 mg Micardis,

2000 mg metformin,

> >> > > > > > > > > > > > >> 60 mg Dexilant and 2 mg Lorazepam; Dashing; still

have some

> >> > > > > > > > > > > > >> occasional problems with BP, K and Na when

over-salt eplerenone ;

> >> > > > > > > > > > > > >> on private consultation with Dr Grim.

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

> >> > > > > > > > > > > > >> > >> > ________________________________

> >> > > > > > > > > > > > >> > >> > From: lff_409 <.>

> >> > > > > > > > > > > > >> > >> > To:

> >> > > > > > > > > > > > >> > >> > Sent: Monday, January 2, 2012 1:45 PM

> >> > > > > > > > > > > > >> > >> > Subject: Symptoms and

Thanks

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

> >> > > > > > > > > > > > >> > >> > Ãƒâ€š

> >> > > > > > > > > > > > >> > >> > First of all, thanks to all that responded.

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

> >> > > > > > > > > > > > >> > >> > My GP sent me to the Endo for new sudden

onset hypertension,

> >> > > > > > > > > > > > >> slightly Low K (3.1), heat intolerance, weakness,

tachycardia,

> >> > > > > > > > > > > > >> headache, fatigue, and emotional swings. I am a 58

yo male, retired

> >> > > > > > > > > > > > >> firefighter. Only other medical Hx is small Pineal

gland tumor and

> >> > > > > > > > > > > > >> hashimoto thyroiditis controlled with synthesis

for past 20 years.

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

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

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

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

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

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

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

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

> >> > > > > > > > >

> >> > > > > > > >

> >> > > > > > >

> >> > > > > >

> >> > > > >

> >> > > >

> >> > >

> >> >

> >>

> >

>

January 10, 2012

Not sure what u mean. If doing well I would not change. May your pressure be low!CE Grim MS, MDSpecializing in DifficultHypertensionOn Jan 10, 2012, at 16:28, Natalia Kamneva <natalia_kamneva@...> wrote:

Who long do you recommend to wait on epler until switching it to sipro, Dr. Grim? Natalia From: Clarence Grim <lowerbp2@...> hyperaldosteronism Cc: Clarence Grim <lowerbp2@...> Sent: Saturday, January 7, 2012 1:18 PM Subject: Re: Re: Symptoms

and Thanks

A fall in eGFR with epeler or any other drug that lowers BP may well be the result of lowering the perfusion pressure to a damaged glomerlus (kidney). If the damage was due to the HTN or high salt/aldo then we expect it to improve over time. This has been documented over 40 years ago with older BP meds. So the issue is does the Dr. have enough experience to wait this out and see if renal function improves. If not, and low diet Na is documented by urine testing if pt has PA, then may want to choose another BP med. And watch eGFR as well with it.CE Grim. On Jan 7, 2012, at 10:41 AM, wrote: I pointed out sodium because it appears to be trending down BUT I don't

know what else was going; diarrhea, too much beer or water, etc. Probably easier to review yourself at: http://www.diagnose-me.com/cond/C549291.html If I had to guess I might think your doctor is looking for a larger database to determine if changes are needed. When did you start Epler? - 65 yo super ob. male - 12mm X 13mm rt. a.adnoma with previous rt. flank pain. Treating with DASH. 2-Day ave w/o meds = BP 133/77 HR 61 BS 132. D/C Spironolactone 12/20/2011 due to adverse SX. Other Issues/Opportunities: OSA w Bi-Pap settings 13/19, DM2, Gynecomastia, MDD and PTSD. Meds: Duloxetine hcl 80 MG, Metoprolol Tartrate 200 MG, 81mg aspirin and Metformin 2000MG. Started washing Spironolactone 12/20/11 to prepare for AVS. > > > > > > > > > > > > >> > >> > > > > > > > > > > > > > >> > >> > According to your analyses and symptoms, it seems that you > > > > > > > > > > > > >> have the same Conn's that most of us have. Start to Dash > > > > > > > > > > > > >> IMMEDIATELY, if you feel better and if you are not afraid, try > > > > > > > > > > > > >> spiro or eplerenone, even small dosage. If your BP behaves better > > > > > > > > > > > > >>

with this medication, that's it! Don't wait 6 months until your > > > > > > > > > > > > >> appointment and some more years until you are going to be > > > > > > > > > > > > >> diagnosed. Some of us, including myself, are still undiagnosed > > > > > > > > > > > > >> after several years and many doctors. > > > > > > > > > > > > >> > >> > > > > > > > > > > > > > >> > >> > Ãƒâ€š > > > > > > > > > > > > >> > >> > Natalia Kamneva 67 Russian F with 2 cm left adrenal adenoma, > > > > > > > > > > > > >> diabetic; on 100 mg eplerenone, 80 mg Micardis, 2000 mg metformin, > > > > > >

> > > > > > >> 60 mg Dexilant and 2 mg Lorazepam; Dashing; still have some > > > > > > > > > > > > >> occasional problems with BP, K and Na when over-salt eplerenone ; > > > > > > > > > > > > >> on private consultation with Dr Grim. > > > > > > > > > > > > >> > >> > > > > > > > > > > > > > >> > >> > > > > > > > > > > > > > >> > >> > ________________________________ > > > > > > > > > > > > >> > >> > From: lff_409 <.> > > > > > > > > > > > > >> > >> > > > > > > > > > > > > > >> > >> >

Sent: Monday, January 2, 2012 1:45 PM > > > > > > > > > > > > >> > >> > Subject: Symptoms and Thanks > > > > > > > > > > > > >> > >> > > > > > > > > > > > > > >> > >> > > > > > > > > > > > > > >> > >> > Ãƒâ€š > > > > > > > > > > > > >> > >> > First of all, thanks to all that responded. > > > > > > > > > > > > >> > >> > > > > > > > > > > > > > >> > >> > My GP sent me to the Endo for new sudden onset hypertension, > > > > > > > > > > > > >> slightly Low K (3.1), heat intolerance, weakness,

tachycardia, > > > > > > > > > > > > >> headache, fatigue, and emotional swings. I am a 58 yo male, retired > > > > > > > > > > > > >> firefighter. Only other medical Hx is small Pineal gland tumor and > > > > > > > > > > > > >> hashimoto thyroiditis controlled with synthesis for past 20 years. > > > > > > > > > > > > >> > >> > > > > > > > > > > > > > >> > >> > > > > > > > > > > > > >> > >> > > > > > > > > > > > > >> > >> > > > > > > > > > > > > >> > >> > > > > > > > > > > > > >> > >

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

January 10, 2012

Not a renin tumor. May your pressure be low!CE Grim MS, MDSpecializing in DifficultHypertensionOn Jan 10, 2012, at 17:23, Natalia Kamneva <natalia_kamneva@...> wrote:

So, in my case it might be low Na intake + epler ? It also might be renin secreting tumor, but how likely it's if my renin was 0.1 before starting epler? Tumor was there before. Natalia From: Clarence Grim <lowerbp2@...> hyperaldosteronism Cc: Clarence Grim <lowerbp2@...> Sent: Saturday, January 7, 2012 1:28 PM Subject: Re: Re: Symptoms and Thanks

low Na intake, BP lowering drugs, renin secreting tumor, estrogens, pregnancy, rare syndromes like Bartter's but low BP. On Jan 6, 2012, at 10:31 PM, wrote: Dr. Grim, what causes the high renin? 74.16 (0.25-5.82) - 65 yo super ob. male - 12mm X 13mm rt. a.adnoma with previous rt. flank pain. Treating with DASH. 2-Day ave w/o meds = BP 133/77 HR 61 BS 132. D/C Spironolactone 12/20/2011 due to adverse SX. Other Issues/Opportunities: OSA w Bi-Pap settings 13/19, DM2, Gynecomastia, MDD and PTSD. Meds: Duloxetine hcl 80 MG, Metoprolol Tartrate 200 MG, 81mg aspirin and Metformin 2000MG. Started washing Spironolactone 12/20/11 to prepare for AVS. > >> > > > > > > > > > >> > >> > > > > > > > > > >> > >> > > > > > > > > > >> Did I answer your question, ? > >> > > > > > > > > > >> In the time when I had this visit to my PCP I already subscribed > >> > > > > > > > > > >> to this group and learned about spiro and eplerenone, but I didn't > >> > > > > > > > > > >> communicate either with group or with Dr. Grim yet. I started > >> > > > > > > > > > >> eplerenone without any proof and hope, just out of desperation, > >> >

> > > > > > > > >> since my BP and my condition were killing me and EVERY BB, Calcium > >> > > > > > > > > > >> channel, and other made me feel terrible. No mention that clonidine > >> > > > > > > > > > >> almost killed me. > >> > > > > > > > > > >> After the first day on eplerenone, my BP was 130/80 - I do not > >> > > > > > > > > > >> remember that I ever had this BP in my life. > >> > > > > > > > > > >> > >> > > > > > > > > > >> Natalia > >> > > > > > > > > > >> From: Bingham <jlkbbk2003@> > >> > > > > > > > > > >> "hyperaldosteronism " <hyperaldosteronism > >> > > > > > > > > > >> > > > > > > >

January 11, 2012

Every one should watch the videos on this link. Good information on how Dr

think.

> >

> > What u want is a trial of Spiro to see if it helps BP K AND you. Most

> important you. Only u can tell them u are not feeling well. No one else can

> measure that. So give us a review of how you do not feel well zoned can help

> get it organized.

>

> .

>

> <http://geo./serv?s=97359714/grpId=7299303/grpspId=1705132763/msgId

> =40019/stime=1326225085/nc1=3848642/nc2=5191949/nc3=5191951>

>

January 11, 2012

Every one should watch the videos on this link. Good information on how Dr

think.

> >

> > What u want is a trial of Spiro to see if it helps BP K AND you. Most

> important you. Only u can tell them u are not feeling well. No one else can

> measure that. So give us a review of how you do not feel well zoned can help

> get it organized.

>

> .

>

> <http://geo./serv?s=97359714/grpId=7299303/grpspId=1705132763/msgId

> =40019/stime=1326225085/nc1=3848642/nc2=5191949/nc3=5191951>

>

January 11, 2012

The though that I could have Lyme is in the back of my mind. The Dr Young in the

video is about 3/4 hours from me. Where they have support group is 1 1/2 hours

from me. With limited income I would have a hard time paying out of pocket for

testing and treatment. So would have to be sure it is Lyme and not PA that I

have.

> >

> > What u want is a trial of Spiro to see if it helps BP K AND you. Most

> important you. Only u can tell them u are not feeling well. No one else can

> measure that. So give us a review of how you do not feel well zoned can help

> get it organized.

>

> .

>

> <http://geo./serv?s=97359714/grpId=7299303/grpspId=1705132763/msgId

> =40019/stime=1326225085/nc1=3848642/nc2=5191949/nc3=5191951>

>

January 11, 2012

The though that I could have Lyme is in the back of my mind. The Dr Young in the

video is about 3/4 hours from me. Where they have support group is 1 1/2 hours

from me. With limited income I would have a hard time paying out of pocket for

testing and treatment. So would have to be sure it is Lyme and not PA that I

have.

> >

> > What u want is a trial of Spiro to see if it helps BP K AND you. Most

> important you. Only u can tell them u are not feeling well. No one else can

> measure that. So give us a review of how you do not feel well zoned can help

> get it organized.

>

> .

>

> <http://geo./serv?s=97359714/grpId=7299303/grpspId=1705132763/msgId

> =40019/stime=1326225085/nc1=3848642/nc2=5191949/nc3=5191951>

>

January 11, 2012

I also wounder what the low phosphate means. Very limited information on this.

Do not understand why they tested for it and then when it was low do not think

it is a problem. I have had a few tests where it is low with some normal but the

last one is getting close to where they say it is critically low PHOSPHATE 1.5

Low mg/dL (2.5-5.0) Will it change that much with meals? Interpretation: WIDE

VARIATION OCCURS WITH MEALS.

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

> > > > > > > > > > > > > > > > > > > >> > >> > According to your analyses and

symptoms, it

> > > > > > > > > > > > > seems that you

> > > > > > > > > > > > > > > > > > > >> have the same Conn's that most of us

have. Start to

> > > > > > > > > > > > > Dash

> > > > > > > > > > > > > > > > > > > >> IMMEDIATELY, if you feel better and if

you are not

> > > > > > > > > > > > > afraid, try

> > > > > > > > > > > > > > > > > > > >> spiro or eplerenone, even small dosage.

If your BP

> > > > > > > > > > > > > behaves better

> > > > > > > > > > > > > > > > > > > >> with this medication, that's it! Don't

wait 6

> > > > > > > > > > > months

> > > > > > > > > > > > > until your

> > > > > > > > > > > > > > > > > > > >> appointment and some more years until

you are going

> > > > > > > > > > > > > to be

> > > > > > > > > > > > > > > > > > > >> diagnosed. Some of us, including

myself, are still

> > > > > > > > > > > > > undiagnosed

> > > > > > > > > > > > > > > > > > > >> after several years and many doctors.

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

> > > > > > > > > > > > > > > > > > > >> > >> > ÃƒÆ'Ã†'ÃƒÂ¢Ã¢â€šÂ¬Ã…Â¡

> > > > > > > > > > > > > > > > > > > >> > >> > Natalia Kamneva 67 Russian F

with 2 cm left

> > > > > > > > > > > > > adrenal adenoma,

> > > > > > > > > > > > > > > > > > > >> diabetic; on 100 mg eplerenone, 80 mg

Micardis,

> > > > > > > > > > > 2000

> > > > > > > > > > > > > mg metformin,

> > > > > > > > > > > > > > > > > > > >> 60 mg Dexilant and 2 mg Lorazepam;

Dashing; still

> > > > > > > > > > > > > have some

> > > > > > > > > > > > > > > > > > > >> occasional problems with BP, K and Na

when over-

> > > > > > > > > > > salt

> > > > > > > > > > > > > eplerenone ;

> > > > > > > > > > > > > > > > > > > >> on private consultation with Dr Grim.

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

> > > > > > > > > > > > > > > > > > > >> > >> > ________________________________

> > > > > > > > > > > > > > > > > > > >> > >> > From: lff_409 <.>

> > > > > > > > > > > > > > > > > > > >> > >> > To:

> > > > > > > > > > > > > > > > > > > >> > >> > Sent: Monday, January 2, 2012

1:45 PM

> > > > > > > > > > > > > > > > > > > >> > >> > Subject:

Symptoms and

> > > > > > > > > > > > > Thanks

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

> > > > > > > > > > > > > > > > > > > >> > >> > ÃƒÆ'Ã†'ÃƒÂ¢Ã¢â€šÂ¬Ã…Â¡

> > > > > > > > > > > > > > > > > > > >> > >> > First of all, thanks to all that

responded.

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

> > > > > > > > > > > > > > > > > > > >> > >> > My GP sent me to the Endo for

new sudden

> > > > > > > > > > > onset

> > > > > > > > > > > > > hypertension,

> > > > > > > > > > > > > > > > > > > >> slightly Low K (3.1), heat intolerance,

weakness,

> > > > > > > > > > > > > tachycardia,

> > > > > > > > > > > > > > > > > > > >> headache, fatigue, and emotional

swings. I am a

> > > > > > > > > > > 58 yo

> > > > > > > > > > > > > male, retired

> > > > > > > > > > > > > > > > > > > >> firefighter. Only other medical Hx is

small Pineal

> > > > > > > > > > > > > gland tumor and

> > > > > > > > > > > > > > > > > > > >> hashimoto thyroiditis controlled with

synthesis for

> > > > > > > > > > > > > past 20 years.

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

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

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

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

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

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

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

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

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

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

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

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

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

> > > > > > > > > > >

> > > > > > > > > >

> > > > > > > > >

> > > > > > > >

> > > > > > >

> > > > > >

> > > > >

> > > >

> > >

> >

>

January 11, 2012

I also wounder what the low phosphate means. Very limited information on this.

Do not understand why they tested for it and then when it was low do not think

it is a problem. I have had a few tests where it is low with some normal but the

last one is getting close to where they say it is critically low PHOSPHATE 1.5

Low mg/dL (2.5-5.0) Will it change that much with meals? Interpretation: WIDE

VARIATION OCCURS WITH MEALS.

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

> > > > > > > > > > > > > > > > > > > >> > >> > According to your analyses and

symptoms, it

> > > > > > > > > > > > > seems that you

> > > > > > > > > > > > > > > > > > > >> have the same Conn's that most of us

have. Start to

> > > > > > > > > > > > > Dash

> > > > > > > > > > > > > > > > > > > >> IMMEDIATELY, if you feel better and if

you are not

> > > > > > > > > > > > > afraid, try

> > > > > > > > > > > > > > > > > > > >> spiro or eplerenone, even small dosage.

If your BP

> > > > > > > > > > > > > behaves better

> > > > > > > > > > > > > > > > > > > >> with this medication, that's it! Don't

wait 6

> > > > > > > > > > > months

> > > > > > > > > > > > > until your

> > > > > > > > > > > > > > > > > > > >> appointment and some more years until

you are going

> > > > > > > > > > > > > to be

> > > > > > > > > > > > > > > > > > > >> diagnosed. Some of us, including

myself, are still

> > > > > > > > > > > > > undiagnosed

> > > > > > > > > > > > > > > > > > > >> after several years and many doctors.

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

> > > > > > > > > > > > > > > > > > > >> > >> > ÃƒÆ'Ã†'ÃƒÂ¢Ã¢â€šÂ¬Ã…Â¡

> > > > > > > > > > > > > > > > > > > >> > >> > Natalia Kamneva 67 Russian F

with 2 cm left

> > > > > > > > > > > > > adrenal adenoma,

> > > > > > > > > > > > > > > > > > > >> diabetic; on 100 mg eplerenone, 80 mg

Micardis,

> > > > > > > > > > > 2000

> > > > > > > > > > > > > mg metformin,

> > > > > > > > > > > > > > > > > > > >> 60 mg Dexilant and 2 mg Lorazepam;

Dashing; still

> > > > > > > > > > > > > have some

> > > > > > > > > > > > > > > > > > > >> occasional problems with BP, K and Na

when over-

> > > > > > > > > > > salt

> > > > > > > > > > > > > eplerenone ;

> > > > > > > > > > > > > > > > > > > >> on private consultation with Dr Grim.

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

> > > > > > > > > > > > > > > > > > > >> > >> > ________________________________

> > > > > > > > > > > > > > > > > > > >> > >> > From: lff_409 <.>

> > > > > > > > > > > > > > > > > > > >> > >> > To:

> > > > > > > > > > > > > > > > > > > >> > >> > Sent: Monday, January 2, 2012

1:45 PM

> > > > > > > > > > > > > > > > > > > >> > >> > Subject:

Symptoms and

> > > > > > > > > > > > > Thanks

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

> > > > > > > > > > > > > > > > > > > >> > >> > ÃƒÆ'Ã†'ÃƒÂ¢Ã¢â€šÂ¬Ã…Â¡

> > > > > > > > > > > > > > > > > > > >> > >> > First of all, thanks to all that

responded.

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

> > > > > > > > > > > > > > > > > > > >> > >> > My GP sent me to the Endo for

new sudden

> > > > > > > > > > > onset

> > > > > > > > > > > > > hypertension,

> > > > > > > > > > > > > > > > > > > >> slightly Low K (3.1), heat intolerance,

weakness,

> > > > > > > > > > > > > tachycardia,

> > > > > > > > > > > > > > > > > > > >> headache, fatigue, and emotional

swings. I am a

> > > > > > > > > > > 58 yo

> > > > > > > > > > > > > male, retired

> > > > > > > > > > > > > > > > > > > >> firefighter. Only other medical Hx is

small Pineal

> > > > > > > > > > > > > gland tumor and

> > > > > > > > > > > > > > > > > > > >> hashimoto thyroiditis controlled with

synthesis for

> > > > > > > > > > > > > past 20 years.

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

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

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

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

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

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

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

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

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

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

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

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

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

> > > > > > > > > > >

> > > > > > > > > >

> > > > > > > > >

> > > > > > > >

> > > > > > >

> > > > > >

> > > > >

> > > >

> > >

> >

>

January 11, 2012

I have Lyme + PA, the PA likely caused by Lyme deregulating my endocrine system. There are groups who will help or even pay for your testing but it will take a Lyme-literate physician to order the correct testing. I spent thousands and thousands of dollars getting the wrong testing. If you're interested in more information about available help, write back. Val From: hyperaldosteronism [mailto:hyperaldosteronism ] On Behalf Of Francis Bill SUSPECTED PAThe though that I could have Lyme is in the back of my mind. The Dr Young in the video is about 3/4 hours from me. Where they have support group is 1 1/2 hours from me. With limited income I would have a hard time paying out of pocket for testing and treatment. So would have to be sure it is Lyme and not PA that I have. > >> > What u want is a trial of Spiro to see if it helps BP K AND you. Most> important you. Only u can tell them u are not feeling well. No one else can> measure that. So give us a review of how you do not feel well zoned can help> get it organized.

January 11, 2012

I have Lyme + PA, the PA likely caused by Lyme deregulating my endocrine system. There are groups who will help or even pay for your testing but it will take a Lyme-literate physician to order the correct testing. I spent thousands and thousands of dollars getting the wrong testing. If you're interested in more information about available help, write back. Val From: hyperaldosteronism [mailto:hyperaldosteronism ] On Behalf Of Francis Bill SUSPECTED PAThe though that I could have Lyme is in the back of my mind. The Dr Young in the video is about 3/4 hours from me. Where they have support group is 1 1/2 hours from me. With limited income I would have a hard time paying out of pocket for testing and treatment. So would have to be sure it is Lyme and not PA that I have. > >> > What u want is a trial of Spiro to see if it helps BP K AND you. Most> important you. Only u can tell them u are not feeling well. No one else can> measure that. So give us a review of how you do not feel well zoned can help> get it organized.

January 11, 2012

That ER report below.....was your K low at that ER visit? (IF they even drew it right as I garauntee they slapped a tourniquet on you and probably drew blood with an IV....MAYBE??)

From: Valarie <val@...>Subject: RE: Re: Symptoms and Thankshyperaldosteronism Date: Wednesday, January 11, 2012, 2:56 PM

I have Lyme + PA, the PA likely caused by Lyme deregulating my endocrine system. There are groups who will help or even pay for your testing but it will take a Lyme-literate physician to order the correct testing. I spent thousands and thousands of dollars getting the wrong testing. If you're interested in more information about available help, write back.

Val

From: hyperaldosteronism [mailto:hyperaldosteronism ] On Behalf Of Francis Bill SUSPECTED PA

The though that I could have Lyme is in the back of my mind. The Dr Young in the video is about 3/4 hours from me. Where they have support group is 1 1/2 hours from me. With limited income I would have a hard time paying out of pocket for testing and treatment. So would have to be sure it is Lyme and not PA that I have. > >> > What u want is a trial of Spiro to see if it helps BP K AND you. Most> important you. Only u can tell them u are not feeling well. No one else can> measure that. So give

us a review of how you do not feel well zoned can help> get it organized.

Sign In

Re: Symptoms and Thanks

Recommended Posts

Guest guest

Share this post

Link to post

Share on other sites

Guest guest

Share this post

Link to post

Share on other sites

Guest guest

Share this post

Link to post

Share on other sites

Guest guest

Share this post

Link to post

Share on other sites

Guest guest

Share this post

Link to post

Share on other sites

Guest guest

Share this post

Link to post

Share on other sites

Guest guest

Share this post

Link to post

Share on other sites

Guest guest

Share this post

Link to post

Share on other sites

Guest guest

Share this post

Link to post

Share on other sites

Guest guest

Share this post

Link to post

Share on other sites

Guest guest

Share this post

Link to post

Share on other sites

Guest guest

Share this post

Link to post

Share on other sites

Guest guest

Share this post

Link to post

Share on other sites

Guest guest

Share this post

Link to post

Share on other sites

Guest guest

Share this post

Link to post

Share on other sites

Guest guest

Share this post

Link to post

Share on other sites

Guest guest

Share this post

Link to post

Share on other sites

Guest guest

Share this post

Link to post

Share on other sites

Guest guest

Share this post

Link to post

Share on other sites

Guest guest