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I eliminated night peeing wake ups by moving my 2 diuretics to morning breakfast. Since then when couple of times a month I wake up to pee I am sure I had too much salt in the past 12 hours. Max. On Jan 13, 2012, at 19:21, <jclark24p@...> wrote: Max might be onto something, my BP was great immediately after starting spiro. It took 10 months to get NA low enough to allow all SX of PA, including night urinating, to disappear. - 65 yo super ob. male - 12mm X 13mm rt. a.adnoma with previous rt. flank pain. Treating with DASH. Stats w/o meds = BP 175/90 HR 59 BS 125. 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.>> Several time going to bathroom at night I suspect means you still have too much salt (other than taking Eplr in the evening) :-(> > > > Max.> > > > > > BP is stable about 125/75 at day time. I take 50 mg of epler in the morning and 37.5 mg in the evening. How we are going to step down? Is it okay 50 mg + 25 mg? I prefer to decrease the evening dosage since I am still going many times to a bathroom during night. > > > > Natalia > > _____>

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Yes, I have them done. Aldo was 22 in July 2011. Renin was done in 2010 before taking eplerenone and was 0.1.I will repeat the blood test in February-March. Many thanks, Val. NataliaFrom: Valarie <val@...> hyperaldosteronism Sent: Friday, January 13, 2012 1:03

PM Subject: RE: Re: Symptoms and Thanks

Natalia, I would consider that a renin of 74 with aldo at 66 may be a lab error. Have you had the tests more than once? Val From: hyperaldosteronism [mailto:hyperaldosteronism ] On Behalf Of Natalia KamnevaThen why I am the only one in this group with so high renin as 74 and aldo as 66? Does it mean that I am Dashing much better than anyone else here? :-) Natalia

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To get true test results would need to stop eplerenone six weeks before blood

draw. Other wise can't trust test results.

>

> Yes, I have them done. Aldo was 22 in July 2011. Renin was done in 2010 before

taking eplerenone and was 0.1.

>

> I will repeat the blood test in February-March.

>

>

> Many thanks, Val.

>

>  

> Natalia

>

> ________________________________

> From: Valarie <val@...>

> hyperaldosteronism

> Sent: Friday, January 13, 2012 1:03 PM

> Subject: RE: Re: Symptoms and Thanks

>

>

>  

> Natalia, I would consider that a renin of 74 with aldo at 66 may be a lab

error.  Have you had the tests more than once?

>  

> Val

>  

> From:hyperaldosteronism

[mailto:hyperaldosteronism ] On Behalf Of Natalia Kamneva

>

>

> Then why I  am the only one in this group with so high renin as 74 and aldo

as 66? 

> Does it mean that I am Dashing much better than anyone else here? :-)

>  

> Natalia

>  

>

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Was drawn at Quest Lab. I printed their instruction from your posting and will bring it to them next time. That's what I am doing now with K drawing - bring the instruction to them. Thank you. NataliaFrom: Francis Bill SUSPECTED PA <georgewbill@...> hyperaldosteronism Sent: Friday, January 13, 2012 8:56 PM Subject: Re: Symptoms and Thanks

Was the blood drawn at a quest lab or only tested there?

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

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

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

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

> > > > > > > > >

> > > > > > > > >

> > > > > > > > >

> > > > > > > >

> > > > > > >

> > > > > > >

> > > > > >

> > > > >

> > > >

> > >

> > >

> > >

> > >

> >

>

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Yes. I take 37.5 mg Epl in the evening. Should I take the whole dosage in the morning?Thank you. Natalia From: StudyCircle <studycircle@...> hyperaldosteronism Sent: Friday, January 13, 2012 9:00 PM Subject: RE: Re: Symptoms and Thanks

Several time going to bathroom at night I suspect means you still have too much salt (other than taking Eplr in the evening) L Max.

BP is stable about 125/75 at day time. I take 50 mg of epler in the morning and 37.5 mg in the evening. How we are going to step down? Is it okay 50 mg + 25 mg? I prefer to decrease the evening dosage since I am still going many times to a bathroom during night. Natalia

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I am already on Epler about a year. All symptoms are better if I don't oversalt Epler, but night urinating is on the same bad level as usually, even before Epler - 5-6 times and more. It's very irritating and makes me take lorezapam. Natalia From: <jclark24p@...> hyperaldosteronism Sent: Friday, January 13, 2012 9:21 PM Subject: Re: Symptoms and Thanks

Max might be onto something, my BP was great immediately after starting spiro. It took 10 months to get NA low enough to allow all SX of PA, including night urinating, to disappear.

- 65 yo super ob. male - 12mm X 13mm rt. a.adnoma with previous rt. flank pain. Treating with DASH. Stats w/o meds = BP 175/90 HR 59 BS 125. 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.

>

> Several time going to bathroom at night I suspect means you still have too much salt (other than taking Eplr in the evening) :-(

>

>

>

> Max.

>

>

>

>

>

> BP is stable about 125/75 at day time. I take 50 mg of epler in the morning and 37.5 mg in the evening. How we are going to step down? Is it okay 50 mg + 25 mg? I prefer to decrease the evening dosage since I am still going many times to a bathroom during night.

>

>

>

> Natalia

>

> _____

>

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As far as I know, night wake-up urination is due to:1. Too much salt within 12 hours prior to going to bed2. Taking diuretics after noon3. Imbalance of salt intake with Spironolactone So, you can do a little experiment by taking all Spiro with breakfast (incl any other diuretic), if still get up then reduce salt, then if you have salt craving, take enough salt to eliminate salt craving and increase Spiro dose until no night wake-ups…these are steps I took to reach steady state of normal bp, no wake-ups at night, no salt craving. J Max. I am already on Epler about a year. All symptoms are better if I don't oversalt Epler, but night urinating is on the same bad level as usually, even before Epler - 5-6 times and more. It's very irritating and makes me take lorezapam. Natalia

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I take my whole 75 mg in the morning.  It seems to work fine for 24 hours or more. Val From: hyperaldosteronism [mailto:hyperaldosteronism ] On Behalf Of Natalia Kamneva Yes. I take 37.5 mg Epl in the evening. Should I take the whole dosage in the morning? Thank you. Natalia From: StudyCircle <studycircle@...> Several time going to bathroom at night I suspect means you still have too much salt (other than taking Eplr in the evening) L Max. BP is stable about 125/75 at day time. I take 50 mg of epler in the morning and 37.5 mg in the evening. How we are going to step down? Is it okay 50 mg + 25 mg? I prefer to decrease the evening dosage since I am still going many times to a bathroom during night. Natalia

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How does lorazepam help night urinating?

From: Natalia Kamneva <natalia_kamneva@...>Subject: Re: Re: Symptoms and Thanks"hyperaldosteronism " <hyperaldosteronism >Date: Saturday, January 14, 2012, 6:58 PM

Yes. I take 37.5 mg Epl in the evening. Should I take the whole dosage in the morning?

Thank you.

Natalia

From: StudyCircle <studycircle@...>hyperaldosteronism Sent: Friday, January 13, 2012 9:00 PMSubject: RE: Re: Symptoms and Thanks

Several time going to bathroom at night I suspect means you still have too much salt (other than taking Eplr in the evening) L

Max.

BP is stable about 125/75 at day time. I take 50 mg of epler in the morning and 37.5 mg in the evening. How we are going to step down? Is it okay 50 mg + 25 mg? I prefer to decrease the evening dosage since I am still going many times to a bathroom during night.

Natalia

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So, you think these numbers of renin and aldo are usual for Dash/Epler patients?Thank you, Natalia From: Clarence Grim <lowerbp2@...> hyperaldosteronism Cc: Clarence Grim <lowerbp2@...> Sent: Saturday, January 14, 2012 3:20 AM Subject: Re: Re: Symptoms and Thanks

Most have not had renin and aldo repeated on DASH or EplereOn Jan 12, 2012, at 9:51 PM, Natalia Kamneva wrote: >Sorry DASHing and eplere will kick the renin and aldo up. We dont have normal values to make judgements tho. Then why I am the only one in this group with so high renin as 74 and aldo as 66? Does it mean that I am Dashing much better than anyone else here? :-) Natalia From: Clarence Grim <lowerbp2@...> hyperaldosteronism Cc: Clarence Grim <lowerbp2@...> Sent: Thursday, January 12, 2012 1:09 AM Subject: Re: Re: Symptoms and Thanks Sorry DASHing and eplere will kick the renin and aldo up. We dont have normal values to make judgements tho. When we used to give Lasix and a low sodium diet for one day even PAs had an increase in renin and aldo but it was not normal. See my CV for some references. CE Grim MDOn Jan 11, 2012, at 5:35 PM, Natalia Kamneva wrote: >She he low renins

before.True. My original renin was 0.1. >I recall this was when she was adItted when dehydrated. False. The blood test was done in October 5, 2011, when I was home, Dashing and on 100 eplerenone, feeling more or less okay, no dehydration and nothing special. NataliaFrom: Clarence Grim <lowerbp2@...> "hyperaldosteronism " <hyperaldosteronism > Sent: Monday, January 9, 2012 9:18 AM Subject: Re: Re: Symptoms and Thanks She he low renins before. I recall this was when she was adItted when dehydrated. This can cause high renin as both tKicks adrenal to make more aldo to hold onto salt to repair

dehydreationMay your pressure be low!CE Grim MS, MDSpecializing in DifficultHypertensionOn Jan 9, 2012, at 6:11, Francis Bill SUSPECTED PA <georgewbill@...> wrote: Isn't renin of 74.16 very high? If someone is diabetic and has somewhat high cholesterol at more as risk of having renal artery stenosis? With Renin this high isn't it more likely that DX would be secondary hyperaldosteronism? I do know she could have both Primary and secondary as she says she has adrenal tumor. > > > >> > > > > > > > > > >> > > > >> > > > > > > > > > >> > > > >> > > > > > > > > > >> 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 > > > >> > > > > > > > > > >> > > > > > > > > > > > > > > > > > > > >

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Thank you, Max. Very helpful, as usually. I will try to follow your methodical approach. Natalia From: StudyCircle <studycircle@...> hyperaldosteronism Sent: Saturday, January 14, 2012 7:52 PM Subject: RE: Re: Symptoms and Thanks

As far as I know, night wake-up urination is due to:1. Too much salt within 12 hours prior to going to bed2. Taking diuretics after noon3. Imbalance of salt intake with Spironolactone So, you can do a little experiment by taking all Spiro with breakfast (incl any other diuretic), if still get up then reduce salt,

then if you have salt craving, take enough salt to eliminate salt craving and increase Spiro dose until no night wake-ups…these are steps I took to reach steady state of normal bp, no wake-ups at night, no salt craving. J Max. I am already on Epler about a year. All symptoms are better if I don't oversalt Epler, but night urinating is on the same bad level as usually, even before Epler - 5-6 times and more. It's very irritating and makes me take lorezapam. Natalia

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Do not you have stomach's problem due to many medications in one time? Natalia From: StudyCircle <studycircle@...> hyperaldosteronism Sent: Saturday, January 14, 2012 12:26 PM Subject: RE: Re: Symptoms and Thanks

I eliminated night peeing wake ups by moving my 2 diuretics to morning breakfast. Since then when couple of times a month I wake up to pee I am sure I had too much salt in the past 12 hours. Max. On Jan 13, 2012, at 19:21, <jclark24p@...> wrote: Max might be onto something, my BP was great immediately after starting spiro. It took 10 months to get NA low enough to allow all SX of PA, including night urinating, to disappear. - 65 yo super ob. male - 12mm X 13mm rt. a.adnoma with previous rt. flank pain. Treating with DASH. Stats w/o meds = BP 175/90 HR 59 BS 125. 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.>> Several time going to bathroom at night I suspect means you still have too much salt (other than taking Eplr in the evening) :-(> > > > Max.> > > > > > BP is stable about 125/75 at day time. I take 50 mg of epler in the morning and 37.5 mg in the evening. How we are going to step down? Is it okay 50 mg + 25 mg? I prefer to decrease the evening dosage since I am still going many

times to a bathroom during night. > > > > Natalia > > _____>

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Thank you, Val. I will try my 87.5 in the morning starting tomorrow. Natalia From: Valarie <val@...> hyperaldosteronism Sent: Saturday, January 14, 2012 8:31 PM Subject: RE: Re: Symptoms and Thanks

I take my whole 75 mg in the morning. It seems to work fine for 24 hours or more. Val From: hyperaldosteronism [mailto:hyperaldosteronism ] On Behalf Of Natalia Kamneva Yes. I take 37.5 mg Epl in the evening. Should I take the whole dosage in the morning? Thank you. Natalia From: StudyCircle <studycircle@...> Several time going to bathroom at night I suspect means you still have too much salt (other than taking Eplr in the evening) L Max. BP is stable about 125/75 at day time. I take 50 mg of epler in the morning and 37.5 mg in the evening. How we are going to step down? Is it okay 50 mg + 25 mg? I prefer to decrease the evening dosage since I am still going many times to a bathroom during night. Natalia

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Only upset stomach was due to K-Cl before bed that I reduced its dose and I am taking it with a small snack 1-1.5 hrs before bed and no longer feel acidic stomach in bed. I learned that taking pills during meals is the best without upset stomach. I also learned that my fear of salt was unfounded because when I was not using much salt I developed salt craving and I felt without energy…and then when I increased salt until craving vanished I found that increasing K.Cl helped…energy became normal as well as bp. However, I am keeping track of progress on my medical tests and keep asking until find better solutions…combining Dr. Grim’s comments with those of my own doc gives me better insight in controlling my medical condition. Thanks to both. Max. Do not you have stomach's problem due to many medications in one time? Natalia

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And the body has a set point about which it regulates body fluid volume (salt and water). When too much salt is take. In the pBp rises till it goes out in the urine (pressure natriuresis) to bring voulme back to normal. If it cannot do this during day BP STAYS UP AT NIGHT PEE results. And wakes u up. May your pressure be low!CE Grim MS, MDSpecializing in DifficultHypertensionOn Jan 17, 2012, at 13:02, Natalia Kamneva <natalia_kamneva@...> wrote:

Thank you, Max. Very helpful, as usually. I will try to follow your methodical approach. Natalia From: StudyCircle <studycircle@...> hyperaldosteronism Sent: Saturday, January 14, 2012 7:52 PM Subject: RE: Re: Symptoms and Thanks

As far as I know, night wake-up urination is due to:1. Too much salt within 12 hours prior to going to bed2. Taking diuretics after noon3. Imbalance of salt intake with Spironolactone So, you can do a little experiment by taking all Spiro with breakfast (incl any other diuretic), if still get up then reduce salt,

then if you have salt craving, take enough salt to eliminate salt craving and increase Spiro dose until no night wake-ups…these are steps I took to reach steady state of normal bp, no wake-ups at night, no salt craving. J Max. I am already on Epler about a year. All symptoms are better if I don't oversalt Epler, but night urinating is on the same bad level as usually, even before Epler - 5-6 times and more. It's very irritating and makes me take lorezapam. Natalia

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Good decision. I almost never give diuretic in afternoon or after dinner. May your pressure be low!CE Grim MS, MDSpecializing in DifficultHypertensionOn Jan 17, 2012, at 13:08, Natalia Kamneva <natalia_kamneva@...> wrote:

Do not you have stomach's problem due to many medications in one time? Natalia From: StudyCircle <studycircle@...> hyperaldosteronism Sent: Saturday, January 14, 2012 12:26 PM Subject: RE: Re: Symptoms and Thanks

I eliminated night peeing wake ups by moving my 2 diuretics to morning breakfast. Since then when couple of times a month I wake up to pee I am sure I had too much salt in the past 12 hours. Max. On Jan 13, 2012, at

19:21, <jclark24p@...> wrote: Max might be onto something, my BP was great immediately after starting spiro. It took 10 months to get NA low enough to allow all SX of PA, including night urinating, to disappear. - 65 yo super ob. male - 12mm X 13mm rt. a.adnoma with previous rt. flank pain. Treating with DASH. Stats w/o meds = BP 175/90 HR 59 BS 125. 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.>> Several time going to bathroom at night I suspect means you still have too much salt (other than taking Eplr in the evening) :-(> > > > Max.> > > > > > BP is stable about 125/75 at day time. I take 50 mg of epler in the morning and 37.5 mg in the evening. How we are going to step down? Is it okay 50 mg + 25 mg? I prefer to decrease the evening dosage since I am still going many

times to a bathroom during night. > > > > Natalia > > _____>

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Most can take spiro once a day. Long 1/2 life.CE Grim MDOn Jan 14, 2012, at 6:31 PM, Valarie wrote: I take my whole 75 mg in the morning. It seems to work fine for 24 hours or more. Val From: hyperaldosteronism [mailto:hyperaldosteronism ] On Behalf Of Natalia Kamneva Yes. I take 37.5 mg Epl in the evening. Should I take the whole dosage in the morning? Thank you. Natalia From: StudyCircle <studycircle@...> Several time going to bathroom at night I suspect means you still have too much salt (other than taking Eplr in the evening) L Max. BP is stable about 125/75 at day time. I take 50 mg of epler in the morning and 37.5 mg in the evening. How we are going to step down? Is it okay 50 mg + 25 mg? I prefer to decrease the evening dosage since I am still going many times to a bathroom during night. Natalia

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How much volume do you pee each time. Is this what wakes you up or something else?CE Grim MDOn Jan 14, 2012, at 5:02 PM, Natalia Kamneva wrote: I am already on Epler about a year. All symptoms are better if I don't oversalt Epler, but night urinating is on the same bad level as usually, even before Epler - 5-6 times and more. It's very irritating and makes me take lorezapam. Natalia From: <jclark24p@...> hyperaldosteronism Sent: Friday, January 13, 2012 9:21 PM Subject: Re: Symptoms and Thanks Max might be onto something, my BP was great immediately after starting spiro. It took 10 months to get NA low enough to allow all SX of PA, including night urinating, to disappear. - 65 yo super ob. male - 12mm X 13mm rt. a.adnoma with previous rt. flank pain. Treating with DASH. Stats w/o meds = BP 175/90 HR 59 BS 125. 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. > > Several time going to bathroom at night I suspect means you still have too much salt (other than taking Eplr in the evening) :-( > > > > Max. > > > > > > BP is stable about 125/75 at day time. I take 50 mg of epler in the morning and 37.5 mg in the evening. How we are going to step down? Is it okay 50 mg + 25 mg? I prefer to decrease the evening dosage since I am still going many times to a bathroom during night. > > > > Natalia > > _____ >

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Try all in am to see is only thing i can advise.CE Grim MDOn Jan 14, 2012, at 4:58 PM, Natalia Kamneva wrote: Yes. I take 37.5 mg Epl in the evening. Should I take the whole dosage in the morning?Thank you. Natalia From: StudyCircle <studycircle@...> hyperaldosteronism Sent: Friday, January 13, 2012 9:00 PM Subject: RE: Re: Symptoms and Thanks Several time going to bathroom at night I suspect means you still have too much salt (other than taking Eplr in the evening) L Max. BP is stable about 125/75 at day time. I take 50 mg of epler in the morning and 37.5 mg in the evening. How we are going to step down? Is it okay 50 mg + 25 mg? I prefer to decrease the evening dosage since I am still going many times to a bathroom during night. Natalia

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No, , lorazepam doesn't help nocturia, but it does help to get back to sleep after 5 - 6 times up :-) Natalia From: Bingham <jlkbbk2003@...> hyperaldosteronism Sent: Sunday, January 15, 2012 10:37 AM Subject: Re: Re: Symptoms and Thanks

How does lorazepam help night urinating?

From: Natalia Kamneva <natalia_kamneva@...>Subject: Re: Re: Symptoms and Thanks"hyperaldosteronism " <hyperaldosteronism >Date: Saturday, January 14, 2012, 6:58 PM

Yes. I take 37.5 mg Epl in the evening. Should I take the whole dosage in the morning?

Thank you.

Natalia

From: StudyCircle <studycircle@...>hyperaldosteronism Sent: Friday, January 13, 2012 9:00 PMSubject: RE: Re: Symptoms and Thanks

Several time going to bathroom at night I suspect means you still have too much salt (other than taking Eplr in the evening) L

Max.

BP is stable about 125/75 at day time. I take 50 mg of epler in the morning and 37.5 mg in the evening. How we are going to step down? Is it okay 50 mg + 25 mg? I prefer to decrease the evening dosage since I am still going many times to a bathroom during night.

Natalia

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Nocturia occurs when the urge to pee wakes you up. If lorazepam suppresses this then it might help nocturia.What time do you stop drinking water etc before bed.Remind us when you take all meds. CE Grim MDOn Jan 19, 2012, at 7:25 PM, Natalia Kamneva wrote: No, , lorazepam doesn't help nocturia, but it does help to get back to sleep after 5 - 6 times up :-) Natalia From: Bingham <jlkbbk2003@...> hyperaldosteronism Sent: Sunday, January 15, 2012 10:37 AM Subject: Re: Re: Symptoms and Thanks How does lorazepam help night urinating? From: Natalia Kamneva <natalia_kamneva@...>Subject: Re: Re: Symptoms and Thanks"hyperaldosteronism " <hyperaldosteronism >Date: Saturday, January 14, 2012, 6:58 PM Yes. I take 37.5 mg Epl in the evening. Should I take the whole dosage in the morning? Thank you. Natalia From: StudyCircle <studycircle@...>hyperaldosteronism Sent: Friday, January 13, 2012 9:00 PMSubject: RE: Re: Symptoms and Thanks Several time going to bathroom at night I suspect means you still have too much salt (other than taking Eplr in the evening) L Max. BP is stable about 125/75 at day time. I take 50 mg of epler in the morning and 37.5 mg in the evening. How we are going to step down? Is it okay 50 mg + 25 mg? I prefer to decrease the evening dosage since I am still going many times to a bathroom during night. Natalia

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The question is: Are Spiro/Epler diuretics? We are talking about them. NataliaFrom: Clarence Grim <lowerbp2@...> "hyperaldosteronism " <hyperaldosteronism > Sent: Tuesday, January 17, 2012 8:21 PM Subject: Re: Re: Symptoms and

Thanks

Good decision. I almost never give diuretic in afternoon or after dinner. May your pressure be low!CE Grim MS, MDSpecializing in DifficultHypertensionOn Jan 17, 2012, at 13:08, Natalia Kamneva <natalia_kamneva@...> wrote:

Do not you have stomach's problem due to many medications in one time? Natalia From: StudyCircle <studycircle@...> hyperaldosteronism Sent: Saturday, January 14, 2012 12:26 PM Subject: RE: Re: Symptoms and Thanks

I eliminated night peeing wake ups by moving my 2 diuretics to morning breakfast. Since then when couple of times a month I wake up to pee I am sure I had too much salt in the past 12 hours. Max. On Jan 13, 2012, at

19:21, <jclark24p@...> wrote: Max might be onto something, my BP was great immediately after starting spiro. It took 10 months to get NA low enough to allow all SX of PA, including night urinating, to disappear. - 65 yo super ob. male - 12mm X 13mm rt. a.adnoma with previous rt. flank pain. Treating with DASH. Stats w/o meds = BP 175/90 HR 59 BS 125. 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.>> Several time going to bathroom at night I suspect means you still have too much salt (other than taking Eplr in the evening) :-(> > > > Max.> > > > > > BP is stable about 125/75 at day time. I take 50 mg of epler in the morning and 37.5 mg in the evening. How we are going to step down? Is it okay 50 mg + 25 mg? I prefer to decrease the evening dosage since I am still going many

times to a bathroom during night. > > > > Natalia > > _____>

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No, it's definitely not a volume. It's a little every time, sometimes very little, almost nothing.It's an urgency to go, that wakes me up every hour. It's not a normal urgency, it's worse. I almost never have this feeling during the day. As I think now, only if I overloaded with salt, especially after eating soup. Then I even cannot get a sleep, the feeling like I have urinary tract infection, but it's not, because it always disappear in the morning. Natalia From: Clarence

Grim <lowerbp2@...> hyperaldosteronism Cc: Clarence Grim <lowerbp2@...> Sent: Thursday, January 19, 2012 1:52 AM Subject: Re: Re: Symptoms and Thanks

How much volume do you pee each time. Is this what wakes you up or something else?CE Grim MDOn Jan 14, 2012, at 5:02 PM, Natalia Kamneva wrote: I am already on Epler about a year. All symptoms are better if I don't oversalt Epler, but night urinating is on the same bad level as usually, even before Epler - 5-6 times and more. It's very irritating and makes me take lorezapam. Natalia From: <jclark24p@...> hyperaldosteronism Sent: Friday, January 13, 2012 9:21 PM Subject: Re: Symptoms and Thanks Max might be onto something, my BP was great immediately after starting spiro. It took 10 months to get NA low

enough to allow all SX of PA, including night urinating, to disappear. - 65 yo super ob. male - 12mm X 13mm rt. a.adnoma with previous rt. flank pain. Treating with DASH. Stats w/o meds = BP 175/90 HR 59 BS 125. 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. > > Several time going to bathroom at night I suspect means you still have too much salt (other than taking Eplr in the evening) :-( > > > > Max.

> > > > > > BP is stable about 125/75 at day time. I take 50 mg of epler in the morning and 37.5 mg in the evening. How we are going to step down? Is it okay 50 mg + 25 mg? I prefer to decrease the evening dosage since I am still going many times to a bathroom during night. > > > > Natalia > > _____ >

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