RE: Re: can I leave well enough alone?

[Guest guest]

Thank you and Francis. My doctor said, "I'm glad your BP numbers are down and you lost 10 lbs. but you need a MRI to determine if there is a benign tumor on your adrenal gland" and mentioned an adrenalectomy. I postponed my appt. by a month since I'm not sure I want that radiation just to confirm what's going on inside, as long as I'm doing well and not hurting something I'm not aware of. The rest of my test numbers are: eGFR-60.000 Normal 60.000-120.000 Chloride-101.000 Normal 95.000-108.000CO2-31.00 Normal 21.000-33.000 BUN-11.00 Normal

8.000-23.000 Creatine-.810 Normal .700-1.400Glucose-100.000 Normal 65.000-99.000 (I'm working on this) HIGH Calcium-9.500 Normal 8.500-10.500 Phosphorus-4.100 Normal 2.400-4.100 Albumin-4.000 Normal 3.500-5.500 Renin,plasma-.720 Normal .200-4.000 Aldosterone, serum, supine-24.000 Normal 0.000-16.000 HIGHPotassium-3.600 Normal 3.400-5.300Sodium-141.000. Normal 132.000-148.000Yes, I read about the V8 juice. Will do. Thanks. From: <jclark24p@...> hyperaldosteronism Sent: Friday, July 6, 2012 12:02 PM Subject: Re: can I leave well enough alone?

Is there a reason your doctor suspected PA other than your BP? It looks like excess NA and fluid retention was your major problem. To be more accurate we need your normal ranges from your labs. In fact the only number I would have any concern about is your potassium (K+) which is at the low end of normal, you might cosider a glass of low sodium V-8 to get that up a little.

I see no reason to test further if what you are doing leaves you feeling great. In fact they do not recommend casual screening for adenomas due to excess radiation and costs. KEEP UP THE GOOD WORK!

> >

> > I did not eat any salt except what is naturally in food for 1 month, then had blood work done. My renal doctor said I have PA. He put me on indapamide 2.5mg. I have been a vegan for 8 yrs. My BP was 240/110 before I stopped salt. Now it's 118/67. I have no symptoms like the ones I'm reading about on this site. I feel great infact. My doc wants a MRI to see if I have a tumor on my adrenal gland. Do I have to have treatment if my BP is normal and I feel great? What are the reprecussions if I do nothing?

> >

> > Ann Churchill 12/07/06

> > Aldosterone,serum,supine-24.000 Renin,plasma-.720 Potassium-3.6 Sodium-141.000

> > all other lab results are within normal

> >

>

[Guest guest]

I looked up what GFR meant. Could this be why I was seeing bubbles in my urine? As soon as I stopped the salt, the bubbles disappeared. From: Francis Bill SUSPECTED PA <georgewbill@...> hyperaldosteronism Sent: Friday, July 6, 2012 2:48 PM Subject: Re: can I leave well enough

alone?

Don't think with MRI you have to worry about radiation. May not want to have contrast used as your GFR is somewhat low.

> > >

> > > I did not eat any salt except what is naturally in food for 1 month, then had blood work done. My renal doctor said I have PA. He put me on indapamide 2.5mg. I have been a vegan for 8 yrs. My BP was 240/110 before I stopped salt. Now it's 118/67. I have no symptoms like the ones I'm reading about on this site. I feel great infact. My doc wants a MRI to see if I have a tumor on my adrenal gland. Do I have to have treatment if my BP is normal and I feel great? What are the reprecussions if I do nothing?

> > >

> > > Ann Churchill 12/07/06

> > > Aldosterone,serum,supine-24.000 Renin,plasma-.720 Potassium-3.6 Sodium-141.000

> > > all other lab results are within normal

> > >

> >

>

[Guest guest]

that's very possible. I started eating eggs a few months back to insure I'm eating enough protein. I shoot for 44 grams. per day. thanks. From: Francis Bill SUSPECTED PA <georgewbill@...> hyperaldosteronism Sent: Friday, July 6, 2012 4:43 PM Subject: Re: can I leave well enough alone?

The bubbles are a question for the medical people in this group. GFR is related to how much protein your kidneys process so may show you are not eating enough protein as well.

> > > >

> > > > I did not eat any salt except what is naturally in food for 1 month, then had blood work done. My renal doctor said I have PA. He put me on indapamide 2.5mg. I have been a vegan for 8 yrs. My BP was 240/110 before I stopped salt. Now it's 118/67. I have no symptoms like the ones I'm reading about on this site. I feel great infact. My doc wants a MRI to see if I have a tumor on my adrenal gland. Do I have to have treatment if my BP is normal and I feel great? What are the reprecussions if I do nothing?

> > > >

> > > > Ann Churchill 12/07/06

> > > > Aldosterone,serum,supine-24.000 Renin,plasma-.720 Potassium-3.6 Sodium-141.000

> > > > all other lab results are within normal

> > > >

> > >

> >

>

[Guest guest]

first I added dried fruit to take the place of the salt but have to limit that so you don't develope diabetes. I found balsamic vinegar very delicious on beans, rice, especially if it is the aged balsamic. Lemons and limes squeezed on veggies are also good. Then you just eat to taste what the food really tastes like and know you "Eat to Live" not live to eat, which is a book I read years ago and follow very closely. I suppose it's harder is you are eating meats. Hope that helps but you probably knew all this already. From: Francis Bill SUSPECTED PA <georgewbill@...> hyperaldosteronism Sent: Friday, July 6, 2012 4:52 PM Subject: Re: can I leave well enough alone?

What did you change to stop the salt?

> > > >

> > > > I did not eat any salt except what is naturally in food for 1 month, then had blood work done. My renal doctor said I have PA. He put me on indapamide 2.5mg. I have been a vegan for 8 yrs. My BP was 240/110 before I stopped salt. Now it's 118/67. I have no symptoms like the ones I'm reading about on this site. I feel great infact. My doc wants a MRI to see if I have a tumor on my adrenal gland. Do I have to have treatment if my BP is normal and I feel great? What are the reprecussions if I do nothing?

> > > >

> > > > Ann Churchill 12/07/06

> > > > Aldosterone,serum,supine-24.000 Renin,plasma-.720 Potassium-3.6 Sodium-141.000

> > > > all other lab results are within normal

> > > >

> > >

> >

>

[Guest guest]

I also stopped eating out. Think a veggie wrap w/guacamole at Chipotle's is healthy? It has 1910 of sodium, and my coffee mocha from Panera's was around 800mg. I think. You can check out their nutritional guides on line. Just being a vegan doesn't mean your healthy. That's just one component, I'm finding out. I also use a lot of spices, Indian, Italian, those are my favs. From: Francis Bill SUSPECTED PA <georgewbill@...> To:

hyperaldosteronism Sent: Friday, July 6, 2012 4:52 PM Subject: Re: can I leave well enough alone?

What did you change to stop the salt?

> > > >

> > > > I did not eat any salt except what is naturally in food for 1 month, then had blood work done. My renal doctor said I have PA. He put me on indapamide 2.5mg. I have been a vegan for 8 yrs. My BP was 240/110 before I stopped salt. Now it's 118/67. I have no symptoms like the ones I'm reading about on this site. I feel great infact. My doc wants a MRI to see if I have a tumor on my adrenal gland. Do I have to have treatment if my BP is normal and I feel great? What are the reprecussions if I do nothing?

> > > >

> > > > Ann Churchill 12/07/06

> > > > Aldosterone,serum,supine-24.000 Renin,plasma-.720 Potassium-3.6 Sodium-141.000

> > > > all other lab results are within normal

> > > >

> > >

> >

>

[Guest guest]

I do great on chicken and eggs. Doesn't affect me at all blood pressure wise, and I get the good source of protein.

From: Ann Churchill <mac.3377@...>Subject: Re: Re: can I leave well enough alone?"hyperaldosteronism " <hyperaldosteronism >Date: Friday, July 6, 2012, 3:51 PM

that's very possible. I started eating eggs a few months back to insure I'm eating enough protein. I shoot for 44 grams. per day. thanks.

From: Francis Bill SUSPECTED PA <georgewbill@...>hyperaldosteronism Sent: Friday, July 6, 2012 4:43 PMSubject: Re: can I leave well enough alone?

The bubbles are a question for the medical people in this group. GFR is related to how much protein your kidneys process so may show you are not eating enough protein as well. > > > >> > > > I did not eat any salt except what is naturally in food for 1 month, then had blood work done. My renal doctor said I have

PA. He put me on indapamide 2.5mg. I have been a vegan for 8 yrs. My BP was 240/110 before I stopped salt. Now it's 118/67. I have no symptoms like the ones I'm reading about on this site. I feel great infact. My doc wants a MRI to see if I have a tumor on my adrenal gland. Do I have to have treatment if my BP is normal and I feel great? What are the reprecussions if I do nothing?> > > > > > > > Ann Churchill 12/07/06> > > > Aldosterone,serum,supine-24.000 Renin,plasma-.720 Potassium-3.6 Sodium-141.000> > > > all other lab results are within normal> > > >> > >> >>

[Guest guest]

It can be the build up of proteins in the urine causing the bubbles (a GFR problem MAYBE) but we all have bubbles in our urine. Us little boys "shoot" the bubbles - of course we create as many as we shoot, but hey, we have little minds anyway. Have to keep it buys somehow.

From: Francis Bill SUSPECTED PA <georgewbill@...>Subject: Re: can I leave well enough alone?hyperaldosteronism Date: Friday, July 6, 2012, 3:43 PM

The bubbles are a question for the medical people in this group. GFR is related to how much protein your kidneys process so may show you are not eating enough protein as well. > > > >> > > > I did not eat any salt except what is naturally in food for 1 month, then had blood work done. My renal doctor said I have

PA. He put me on indapamide 2.5mg. I have been a vegan for 8 yrs. My BP was 240/110 before I stopped salt. Now it's 118/67. I have no symptoms like the ones I'm reading about on this site. I feel great infact. My doc wants a MRI to see if I have a tumor on my adrenal gland. Do I have to have treatment if my BP is normal and I feel great? What are the reprecussions if I do nothing?> > > > > > > > Ann Churchill 12/07/06> > > > Aldosterone,serum,supine-24.000 Renin,plasma-.720 Potassium-3.6 Sodium-141.000> > > > all other lab results are within normal> > > >> > >> >>

[Guest guest]

"A women that will tell you her age, will tell you anything." ZaZa Gabor I'm 64 this month! Let me go read your link. Thanks From: <jclark24p@...> hyperaldosteronism Sent: Friday, July 6, 2012 6:54 PM Subject: Re: can I leave well enough alone?

Bubbles in your urine may mean whoever cleaned the toilet didn't get all the soap out! OR if that is not the case it is often a sign of protein leaking into your urine and possible problems with your kidneys. How old are you? eGFR becomes less reliable as we age, I think 60 or 70 is the age most use. They will use Urine Albumin-to-Creatinine Ratio (UARC) to check this, see here: http://www.nkdep.nih.gov/resources/quick-reference-uacr-gfr.shtml

> > > >> > > > I did not eat any salt except what is naturally in food for 1 month, then had blood work done. My renal doctor said I have PA. He put me on indapamide 2.5mg. I have been a vegan for 8 yrs. My BP was 240/110 before I stopped salt. Now it's 118/67. I have no symptoms like the ones I'm reading about on this site. I feel great infact. My doc wants a MRI to see if I have a tumor on my adrenal gland. Do I have to have treatment if my BP is normal and I feel great? What are

the reprecussions if I do nothing?> > > > > > > > Ann Churchill 12/07/06> > > > Aldosterone,serum,supine-24.000 Renin,plasma-.720 Potassium-3.6 Sodium-141.000> > > > all other lab results are within normal> > > >> > >> >>

[Guest guest]

Dr. Grim, Does a lower than normal GFR mean you are eating not enough or too much protein?  Or does it matter? Val

[Guest guest]

Keep on DASHING. IF U only eat fresh and do not add salt the. Your intake should below 1500. But if any thing is not made fresh by you the. Read every label. May your pressure be low!CE Grim MS, MDSpecializing in DifficultHypertensionOn Jul 7, 2012, at 10:54, Francis Bill SUSPECTED PA <georgewbill@...> wrote:

As to that non-existant DX there are some on here that wouldn't have the PA Dx if they went with there first test for PA. Like me they were tested on meds and had s somewhat normal aldo renin ratio but when meds were stopped they had a very high ratio.

One should never give up until they are tested off meds. If PA is then ruled out and they still can not fuction in a normal way then they can research other causes as to why they an not function in a normal way. Cushing being one of them.

> > > > >

> > > > > I did not eat any salt except what is naturally in food for 1 month, then had blood work done. My renal doctor said I have PA. He put me on indapamide 2.5mg. I have been a vegan for 8 yrs. My BP was 240/110 before I stopped salt. Now it's 118/67. I have no symptoms like the ones I'm reading about on this site. I feel great infact. My doc wants a MRI to see if I have a tumor on my adrenal gland. Do I have to have treatment if my BP is normal and I feel great? What are the reprecussions if I do nothing?

> > > > >

> > > > > Ann Churchill 12/07/06

> > > > > Aldosterone,serum,supine-24.000 Renin,plasma-.720 Potassium-3.6 Sodium-141.000

> > > > > all other lab results are within normal

> > > > >

> > > >

> > >

> >

>

[Guest guest]

Without knowing Na intake it is not possible to precisely interpret renin and also.May your pressure be low!CE Grim MS, MDSpecializing in DifficultHypertensionOn Jul 6, 2012, at 11:10, <jclark24p@...> wrote:

Both tests appear to be within "normal" ranges according to most labs. Since PA requires low renin I would think PA is unlikely. Since she reports feeling good and no adverse SXs, I stand by my suggestion!

Now she can persue an illusive, non-existant DX (like some do) if she likes but I see no reason to waste her time, money and potentially health!

> > > >

> > > > I did not eat any salt except what is naturally in food for 1 month, then had blood work done. My renal doctor said I have PA. He put me on indapamide 2.5mg. I have been a vegan for 8 yrs. My BP was 240/110 before I stopped salt. Now it's 118/67. I have no symptoms like the ones I'm reading about on this site. I feel great infact. My doc wants a MRI to see if I have a tumor on my adrenal gland. Do I have to have treatment if my BP is normal and I feel great? What are the reprecussions if I do nothing?

> > > >

> > > > Ann Churchill 12/07/06

> > > > Aldosterone,serum,supine-24.000 Renin,plasma-.720 Potassium-3.6 Sodium-141.000

> > > > all other lab results are within normal

> > > >

> > >

> >

>

[Guest guest]

Or check standing BP. CE Grim MDOn Jul 6, 2012, at 8:27 AM, Francis Bill SUSPECTED PA wrote: It is possable to not have enough salt so would want to have urine and blood tests to make sure you do not become salt depleted. Other then this should be OK without taking meds. > > I did not eat any salt except what is naturally in food for 1 month, then had blood work done. My renal doctor said I have PA. He put me on indapamide 2.5mg. I have been a vegan for 8 yrs. My BP was 240/110 before I stopped salt. Now it's 118/67. I have no symptoms like the ones I'm reading about on this site. I feel great infact. My doc wants a MRI to see if I have a tumor on my adrenal gland. Do I have to have treatment if my BP is normal and I feel great? What are the reprecussions if I do nothing? > > Ann Churchill 12/07/06 > Aldosterone,serum,supine-24.000 Renin,plasma-.720 Potassium-3.6 Sodium-141.000 > all other lab results are within normal >

[Guest guest]

So renin is not low (<0.2) so low sodium diet may have increased it. and aldo. Again without a 24 hr urine one cannot interpret renin and aldo.CE Grim MDOn Jul 6, 2012, at 10:59 AM, Ann Churchill wrote: Thank you and Francis. My doctor said, "I'm glad your BP numbers are down and you lost 10 lbs. but you need a MRI to determine if there is a benign tumor on your adrenal gland" and mentioned an adrenalectomy. I postponed my appt. by a month since I'm not sure I want that radiation just to confirm what's going on inside, as long as I'm doing well and not hurting something I'm not aware of. The rest of my test numbers are: eGFR-60.000 Normal 60.000-120.000 Chloride-101.000 Normal 95.000-108.000CO2-31.00 Normal 21.000-33.000 BUN-11.00 Normal 8.000-23.000 Creatine-.810 Normal .700-1.400Glucose-100.000 Normal 65.000-99.000 (I'm working on this) HIGH Calcium-9.500 Normal 8.500-10.500 Phosphorus-4.100 Normal 2.400-4.100 Albumin-4.000 Normal 3.500-5.500 Renin,plasma-.720 Normal .200-4.000 Aldosterone, serum, supine-24.000 Normal 0.000-16.000 HIGHPotassium-3.600 Normal 3.400-5.300Sodium-141.000. Normal 132.000-148.000Yes, I read about the V8 juice. Will do. Thanks. From: <jclark24p@...> hyperaldosteronism Sent: Friday, July 6, 2012 12:02 PM Subject: Re: can I leave well enough alone? Is there a reason your doctor suspected PA other than your BP? It looks like excess NA and fluid retention was your major problem. To be more accurate we need your normal ranges from your labs. In fact the only number I would have any concern about is your potassium (K+) which is at the low end of normal, you might cosider a glass of low sodium V-8 to get that up a little. I see no reason to test further if what you are doing leaves you feeling great. In fact they do not recommend casual screening for adenomas due to excess radiation and costs. KEEP UP THE GOOD WORK! > > > > I did not eat any salt except what is naturally in food for 1 month, then had blood work done. My renal doctor said I have PA. He put me on indapamide 2.5mg. I have been a vegan for 8 yrs. My BP was 240/110 before I stopped salt. Now it's 118/67. I have no symptoms like the ones I'm reading about on this site. I feel great infact. My doc wants a MRI to see if I have a tumor on my adrenal gland. Do I have to have treatment if my BP is normal and I feel great? What are the reprecussions if I do nothing? > > > > Ann Churchill 12/07/06 > > Aldosterone,serum,supine-24.000 Renin,plasma-.720 Potassium-3.6 Sodium-141.000 > > all other lab results are within normal > > >

[Guest guest]

urine bubbles when there is too much protein in it (albumin). High salt intake increases urine protein in PA and low Na will reverse this damage.CE Grim MDOn Jul 6, 2012, at 1:14 PM, Ann Churchill wrote: I looked up what GFR meant. Could this be why I was seeing bubbles in my urine? As soon as I stopped the salt, the bubbles disappeared. From: Francis Bill SUSPECTED PA <georgewbill@...> hyperaldosteronism Sent: Friday, July 6, 2012 2:48 PM Subject: Re: can I leave well enough alone? Don't think with MRI you have to worry about radiation. May not want to have contrast used as your GFR is somewhat low. > > > > > > I did not eat any salt except what is naturally in food for 1 month, then had blood work done. My renal doctor said I have PA. He put me on indapamide 2.5mg. I have been a vegan for 8 yrs. My BP was 240/110 before I stopped salt. Now it's 118/67. I have no symptoms like the ones I'm reading about on this site. I feel great infact. My doc wants a MRI to see if I have a tumor on my adrenal gland. Do I have to have treatment if my BP is normal and I feel great? What are the reprecussions if I do nothing? > > > > > > Ann Churchill 12/07/06 > > > Aldosterone,serum,supine-24.000 Renin,plasma-.720 Potassium-3.6 Sodium-141.000 > > > all other lab results are within normal > > > > > >

[Guest guest]

GFR has little to do with protein metabolism. It is related to muscle mass (where creatinine comes from) and renal function. So as the kidney dies the GFR falls. CE Grim MDOn Jul 6, 2012, at 1:43 PM, Francis Bill SUSPECTED PA wrote: The bubbles are a question for the medical people in this group. GFR is related to how much protein your kidneys process so may show you are not eating enough protein as well. > > > > > > > > I did not eat any salt except what is naturally in food for 1 month, then had blood work done. My renal doctor said I have PA. He put me on indapamide 2.5mg. I have been a vegan for 8 yrs. My BP was 240/110 before I stopped salt. Now it's 118/67. I have no symptoms like the ones I'm reading about on this site. I feel great infact. My doc wants a MRI to see if I have a tumor on my adrenal gland. Do I have to have treatment if my BP is normal and I feel great? What are the reprecussions if I do nothing? > > > > > > > > Ann Churchill 12/07/06 > > > > Aldosterone,serum,supine-24.000 Renin,plasma-.720 Potassium-3.6 Sodium-141.000 > > > > all other lab results are within normal > > > > > > > > > >

[Guest guest]

Good report on why one must read the labels of everything.CE Grim MDOn Jul 6, 2012, at 2:17 PM, Ann Churchill wrote: I also stopped eating out. Think a veggie wrap w/guacamole at Chipotle's is healthy? It has 1910 of sodium, and my coffee mocha from Panera's was around 800mg. I think. You can check out their nutritional guides on line. Just being a vegan doesn't mean your healthy. That's just one component, I'm finding out. I also use a lot of spices, Indian, Italian, those are my favs. From: Francis Bill SUSPECTED PA <georgewbill@...> hyperaldosteronism Sent: Friday, July 6, 2012 4:52 PM Subject: Re: can I leave well enough alone? What did you change to stop the salt? > > > > > > > > I did not eat any salt except what is naturally in food for 1 month, then had blood work done. My renal doctor said I have PA. He put me on indapamide 2.5mg. I have been a vegan for 8 yrs. My BP was 240/110 before I stopped salt. Now it's 118/67. I have no symptoms like the ones I'm reading about on this site. I feel great infact. My doc wants a MRI to see if I have a tumor on my adrenal gland. Do I have to have treatment if my BP is normal and I feel great? What are the reprecussions if I do nothing? > > > > > > > > Ann Churchill 12/07/06 > > > > Aldosterone,serum,supine-24.000 Renin,plasma-.720 Potassium-3.6 Sodium-141.000 > > > > all other lab results are within normal > > > > > > > > > >

[Guest guest]

It is mostly not relevant. Some studies (MDRD study) suggest a low protein intake will improve GFR but in that study BP control was more important. Only way to tell in an individual would be to try a very low protein intake for say 2 months. CE Grim MDOn Jul 6, 2012, at 7:02 PM, Valarie wrote: Dr. Grim, Does a lower than normal GFR mean you are eating not enough or too much protein? Or does it matter? Val

[Guest guest]

As we age glomeruli die. When a glomerulus no longer functions we call it dead. When severely damaged by HTN it may recover just before being dead if BP is controlled. Renal function is the sum of the function of all non-dead glomeruli. We measure the function mostly by creatinine clearance. Best on several 24 hr urines. BUN is a poor measure of total glomerular functions (number).May want to review renal function in the HTN Primer. ;-). Don't recall chapter at this time.CE Grim MDOn Jul 8, 2012, at 6:14 PM, wrote: I don't know if you consider the kidney "dying" as we age but I understand GFR reduces as we age so I believe they use BUN and creatinine. Here is good reference: http://www.kidneyfund.org/assets/pdf/gfr-fact-sheet.pdf > > > > > > > > > > > > I did not eat any salt except what is naturally in food for > > 1 month, then had blood work done. My renal doctor said I have PA. > > He put me on indapamide 2.5mg. I have been a vegan for 8 yrs. My BP > > was 240/110 before I stopped salt. Now it's 118/67. I have no > > symptoms like the ones I'm reading about on this site. I feel great > > infact. My doc wants a MRI to see if I have a tumor on my adrenal > > gland. Do I have to have treatment if my BP is normal and I feel > > great? What are the reprecussions if I do nothing? > > > > > > > > > > > > Ann Churchill 12/07/06 > > > > > > Aldosterone,serum,supine-24.000 Renin,plasma-.720 > > Potassium-3.6 Sodium-141.000 > > > > > > all other lab results are within normal > > > > > > > > > > > > > > > > > > > > > > >