Re: Is it ever a good idea to retest for PA?

[Guest guest]

A good diet affects PA also, and fitness helps too. It seems your logic is a bit skewed on that one (I don't mean that as if I am picking on you, just trying to understand your thinking as an outsider) because you are on spiro AND you changed your diet = the two most important things - outside of maybe surgery - that makes PA better - and yours got better after spiro and better diet (I am also wondering why, if you're this disciplined and ambitious why are you not really "dashing" as you say? Seems like you are to me) . And what if they do the test again, but some variable that went unaccounted for, or it is actually your diet and fitness improving your PA, and it makes the test come back "inconclusive" or borderline, then what? You could be more confused after a second test.

The brain lesion ? What do they think made it disappear? or...I'd make sure they were looking at your MRI and not someone elses, or get a second opinion on both MRI's, or.....wlecome to a miracle. But 5mm on the brain is good size in a not-so-good way and our brain doesn't like visitors or any overcrowding in it and usually we have some symptoms - also important to know WHERE in the brain it was, and were there any symptoms? Cysts can disappear like that, but odd to do so in the brain. But to have one, and that is now gone, and that correlates to you also having had improvement in your PA like symptoms could mean it was the lesion and maybe not PA that was causing a rise in BP and other things. and not spiro or exercise making it better, but the decrease in the lesion size.

- On Fri, 7/6/12, crzylnebkr <smort@...> wrote:

From: crzylnebkr <smort@...>Subject: Is it ever a good idea to retest for PA?hyperaldosteronism Date: Friday, July 6, 2012, 11:22 AM

I recently asked my endo to retest me for PA. He kind of laughed at me and replied, "Dude, you have PA!". I am on pretty good terms with him and trust his opinion. He elaborated that since my urine sodium at Mayo was over 400 and my aldosterone was high there is no doubt in his mind that due to that salt loading test result I have PA like it or not.However, at Mayo I only salt loaded for 3 days. I ate a lot of crappy food and salted everything. I am concerned that perhaps my results were off for some reason.I was out of shape when this testing took place. I had a 5 mm brain lesion on an MRI. I also had low K under 3.0 on a random blood test. This triggered 1 year of testing and a final diagnosis of PA based on the salt loading test I described.I now exercise on a regular basis, eat healthy, watch sodium, and try to eat at least 5 servings of veggies and 5 servings of fruit per day (not exact DASH but same idea). My blood

pressure is 118/76 average for the last 3 months on 50mg of Spiro 25mg morning and 25mg night. I feel fine. On a recent follow up MRI the 5mm lesion on my brain has disappeared.My thoughts are that the salt loading test was not done accurately (due to my salt loading). I think my results might have been skewed due to only being off beta blockers for a couple of days before the salt loading started.The spiro seems to work great, but it could also be my better overall fitness, lower weight (40 lbs down), and better diet. My endo wants me to get an AVS due to my age and my response to Spiro. I am wanting another round of tests before the AVS just to make sure I have PA. Has anyone ever retested to confirm PA? Is this recommended? Would Spiro tend to work well on someone without PA?Thanks in advance for your help!35 year old male. Diagnosed April 2011. CT Scan normal. Abnormal pituitary on MRI. Low

testosterone at times (either over 400 or under 200). Tested for GRA. Results negative for GRA. 50 mg Spiro (25 mg morning/25 mg night).

[Guest guest]

,

Although it is probably not inconceivable that the wrong MRI was looked at, I

don't think this was the case. I have had a follow up MRI every 6 months since

August of 2010 when the 5mm lesion was found. The lesion was in the right

temporal lobe. The pituitary abnormality is mentioned in the recent report and

it was mentioned that the 5mm lesion was no longer visible. I have gotten my

MRIs at Mayo Clinic and Washington University.

The lesion was followed to rule out a glioma. Without a biopsy it is impossible

to determine what it was. However, I am thankful it is gone and the neurologist

at Mayo told me an MRI every two years now instead of 6 months.

>

>

> From: crzylnebkr <smort@...>

> Subject: Is it ever a good idea to retest for PA?

> hyperaldosteronism

> Date: Friday, July 6, 2012, 11:22 AM

>

>

>

>  

>

>

>

> I recently asked my endo to retest me for PA. He kind of laughed at me and

replied, " Dude, you have PA! " . I am on pretty good terms with him and trust his

opinion. He elaborated that since my urine sodium at Mayo was over 400 and my

aldosterone was high there is no doubt in his mind that due to that salt loading

test result I have PA like it or not.

>

> However, at Mayo I only salt loaded for 3 days. I ate a lot of crappy food and

salted everything. I am concerned that perhaps my results were off for some

reason.

>

> I was out of shape when this testing took place. I had a 5 mm brain lesion on

an MRI. I also had low K under 3.0 on a random blood test. This triggered 1 year

of testing and a final diagnosis of PA based on the salt loading test I

described.

>

> I now exercise on a regular basis, eat healthy, watch sodium, and try to eat

at least 5 servings of veggies and 5 servings of fruit per day (not exact DASH

but same idea). My blood pressure is 118/76 average for the last 3 months on

50mg of Spiro 25mg morning and 25mg night. I feel fine.

>

> On a recent follow up MRI the 5mm lesion on my brain has disappeared.

>

> My thoughts are that the salt loading test was not done accurately (due to my

salt loading). I think my results might have been skewed due to only being off

beta blockers for a couple of days before the salt loading started.

>

> The spiro seems to work great, but it could also be my better overall fitness,

lower weight (40 lbs down), and better diet. My endo wants me to get an AVS due

to my age and my response to Spiro. I am wanting another round of tests before

the AVS just to make sure I have PA.

>

> Has anyone ever retested to confirm PA? Is this recommended? Would Spiro tend

to work well on someone without PA?

>

> Thanks in advance for your help!

>

>

> 35 year old male. Diagnosed April 2011. CT Scan normal. Abnormal pituitary on

MRI. Low testosterone at times (either over 400 or under 200). Tested for GRA.

Results negative for GRA. 50 mg Spiro (25 mg morning/25 mg night).

>

[Guest guest]

, have they checked you for subclinical cushing's? It is most often (80%

of the time) caused by a pituitary tumor. Many times they have to do a late

night cortisol test. (I have heard of adrenal adenomas disappearing but don't

know about pituitary.)

> >

> >

> > From: crzylnebkr <smort@>

> > Subject: Is it ever a good idea to retest for PA?

> > hyperaldosteronism

> > Date: Friday, July 6, 2012, 11:22 AM

> >

> >

> >

> >  

> >

> >

> >

> > I recently asked my endo to retest me for PA. He kind of laughed at me and

replied, " Dude, you have PA! " . I am on pretty good terms with him and trust his

opinion. He elaborated that since my urine sodium at Mayo was over 400 and my

aldosterone was high there is no doubt in his mind that due to that salt loading

test result I have PA like it or not.

> >

> > However, at Mayo I only salt loaded for 3 days. I ate a lot of crappy food

and salted everything. I am concerned that perhaps my results were off for some

reason.

> >

> > I was out of shape when this testing took place. I had a 5 mm brain lesion

on an MRI. I also had low K under 3.0 on a random blood test. This triggered 1

year of testing and a final diagnosis of PA based on the salt loading test I

described.

> >

> > I now exercise on a regular basis, eat healthy, watch sodium, and try to eat

at least 5 servings of veggies and 5 servings of fruit per day (not exact DASH

but same idea). My blood pressure is 118/76 average for the last 3 months on

50mg of Spiro 25mg morning and 25mg night. I feel fine.

> >

> > On a recent follow up MRI the 5mm lesion on my brain has disappeared.

> >

> > My thoughts are that the salt loading test was not done accurately (due to

my salt loading). I think my results might have been skewed due to only being

off beta blockers for a couple of days before the salt loading started.

> >

> > The spiro seems to work great, but it could also be my better overall

fitness, lower weight (40 lbs down), and better diet. My endo wants me to get an

AVS due to my age and my response to Spiro. I am wanting another round of tests

before the AVS just to make sure I have PA.

> >

> > Has anyone ever retested to confirm PA? Is this recommended? Would Spiro

tend to work well on someone without PA?

> >

> > Thanks in advance for your help!

> >

> >

> > 35 year old male. Diagnosed April 2011. CT Scan normal. Abnormal pituitary

on MRI. Low testosterone at times (either over 400 or under 200). Tested for

GRA. Results negative for GRA. 50 mg Spiro (25 mg morning/25 mg night).

> >

>

[Guest guest]

,

The pituitary abnormality is still there. I am monitored with blood tests etc.

It does not appear to be a pituitary adenoma. I have had 5 total MRIs to check

this so far. I was tested for cushings with a dex test. I supressed so much

that they tested me for GRA. The GRA test was negative.

I do have periods of very low testosterone. This was the case before starting

Spiro. My testosterone is either over 500 or under 200. It seems to

correspond to my weight training. When I am lifting weights I generally test

over 500. When I am not training and I have extra abdominal fat, I am under

200.

> > >

> > >

> > > From: crzylnebkr <smort@>

> > > Subject: Is it ever a good idea to retest for PA?

> > > hyperaldosteronism

> > > Date: Friday, July 6, 2012, 11:22 AM

> > >

> > >

> > >

> > >  

> > >

> > >

> > >

> > > I recently asked my endo to retest me for PA. He kind of laughed at me and

replied, " Dude, you have PA! " . I am on pretty good terms with him and trust his

opinion. He elaborated that since my urine sodium at Mayo was over 400 and my

aldosterone was high there is no doubt in his mind that due to that salt loading

test result I have PA like it or not.

> > >

> > > However, at Mayo I only salt loaded for 3 days. I ate a lot of crappy food

and salted everything. I am concerned that perhaps my results were off for some

reason.

> > >

> > > I was out of shape when this testing took place. I had a 5 mm brain lesion

on an MRI. I also had low K under 3.0 on a random blood test. This triggered 1

year of testing and a final diagnosis of PA based on the salt loading test I

described.

> > >

> > > I now exercise on a regular basis, eat healthy, watch sodium, and try to

eat at least 5 servings of veggies and 5 servings of fruit per day (not exact

DASH but same idea). My blood pressure is 118/76 average for the last 3 months

on 50mg of Spiro 25mg morning and 25mg night. I feel fine.

> > >

> > > On a recent follow up MRI the 5mm lesion on my brain has disappeared.

> > >

> > > My thoughts are that the salt loading test was not done accurately (due to

my salt loading). I think my results might have been skewed due to only being

off beta blockers for a couple of days before the salt loading started.

> > >

> > > The spiro seems to work great, but it could also be my better overall

fitness, lower weight (40 lbs down), and better diet. My endo wants me to get an

AVS due to my age and my response to Spiro. I am wanting another round of tests

before the AVS just to make sure I have PA.

> > >

> > > Has anyone ever retested to confirm PA? Is this recommended? Would Spiro

tend to work well on someone without PA?

> > >

> > > Thanks in advance for your help!

> > >

> > >

> > > 35 year old male. Diagnosed April 2011. CT Scan normal. Abnormal pituitary

on MRI. Low testosterone at times (either over 400 or under 200). Tested for

GRA. Results negative for GRA. 50 mg Spiro (25 mg morning/25 mg night).

> > >

> >

>

[Guest guest]

Cool, sounds like you have some good hands watching over you. We'll always ask questions as if you aren't in good hands, unless we know otherwise, so hope we don't offend.

Low T starts about that age for many of us. And the evidence is clear that active men - men who are into sports mainly, when they slow down later for whatever reason I ama sports fanatic and played in many many leagues up until a few years ago (I am 45 now, and in my case it was only due to the PA and the low K that was going undiagnosed that drained me of any energy), that we have bigger drops in our T compared to other men, but you're right in that exercise increases it, and we have more incidence of anxiety and depression - but that could be related to the low T also.

I would tell my patients when I was wrking full-time as a PA-C, well, I mainly tell the elderly wives, when they would say to me, "tell Joe he has to slow down and stop working in the yard so much!" or they say something like that, and I would ask them if they have ever been to a nursing home. Usually most have, but even if not I tell them it's about 10 to 1 females to males because we males are mentally and physically designed to work, and when we take away the things a man loves they tend to go down hill, so let them keep as busy as they can be - sure we are men and we love to complain about being too busy, but when were not we don't do well. I think some of that is T related too.

From: crzylnebkr <smort@...>Subject: Re: Is it ever a good idea to retest for PA?hyperaldosteronism Date: Friday, July 6, 2012, 1:44 PM

,Although it is probably not inconceivable that the wrong MRI was looked at, I don't think this was the case. I have had a follow up MRI every 6 months since August of 2010 when the 5mm lesion was found. The lesion was in the right temporal lobe. The pituitary abnormality is mentioned in the recent report and it was mentioned that the 5mm lesion was no longer visible. I have gotten my MRIs at Mayo Clinic and Washington University. The lesion was followed to rule out a glioma. Without a biopsy it is impossible to determine what it was. However, I am thankful it is gone and the neurologist at Mayo told me an MRI every two years now instead of 6 months.> > > From: crzylnebkr <smort@...>> Subject: Is it ever a good

idea to retest for PA?> hyperaldosteronism > Date: Friday, July 6, 2012, 11:22 AM> > > > Â > > > > I recently asked my endo to retest me for PA. He kind of laughed at me and replied, "Dude, you have PA!". I am on pretty good terms with him and trust his opinion. He elaborated that since my urine sodium at Mayo was over 400 and my aldosterone was high there is no doubt in his mind that due to that salt loading test result I have PA like it or not.> > However, at Mayo I only salt loaded for 3 days. I ate a lot of crappy food and salted everything. I am concerned that perhaps my results were off for some reason.> > I was out of shape when this testing took

place. I had a 5 mm brain lesion on an MRI. I also had low K under 3.0 on a random blood test. This triggered 1 year of testing and a final diagnosis of PA based on the salt loading test I described.> > I now exercise on a regular basis, eat healthy, watch sodium, and try to eat at least 5 servings of veggies and 5 servings of fruit per day (not exact DASH but same idea). My blood pressure is 118/76 average for the last 3 months on 50mg of Spiro 25mg morning and 25mg night. I feel fine. > > On a recent follow up MRI the 5mm lesion on my brain has disappeared.> > My thoughts are that the salt loading test was not done accurately (due to my salt loading). I think my results might have been skewed due to only being off beta blockers for a couple of days before the salt loading started.> > The spiro seems to work great, but it could also be my better overall fitness, lower weight (40 lbs down), and

better diet. My endo wants me to get an AVS due to my age and my response to Spiro. I am wanting another round of tests before the AVS just to make sure I have PA. > > Has anyone ever retested to confirm PA? Is this recommended? Would Spiro tend to work well on someone without PA?> > Thanks in advance for your help!> > > 35 year old male. Diagnosed April 2011. CT Scan normal. Abnormal pituitary on MRI. Low testosterone at times (either over 400 or under 200). Tested for GRA. Results negative for GRA. 50 mg Spiro (25 mg morning/25 mg night).>

[Guest guest]

That much salt in the urine makes it very likely you have PA with an elevated aldo.But you did not sent us the aldo number and their normal range based on Na in the urine.So you are doing well on spiro but do not mention DASHing. Recommend DASHing.Recall that HTN and low K etc from PA requires a high salt diet to develop.Call the aldosterone-salt model of hypertension. No excess salt no or few aldo problems.Spiro in men may lead to tender breasts so keep an eye that. If it develops then would stop fo 6 weeks and retest and do AVS or switch to eplere.CE Grim MDOn Jul 6, 2012, at 9:22 AM, crzylnebkr wrote: I recently asked my endo to retest me for PA. He kind of laughed at me and replied, "Dude, you have PA!". I am on pretty good terms with him and trust his opinion. He elaborated that since my urine sodium at Mayo was over 400 and my aldosterone was high there is no doubt in his mind that due to that salt loading test result I have PA like it or not. However, at Mayo I only salt loaded for 3 days. I ate a lot of crappy food and salted everything. I am concerned that perhaps my results were off for some reason. I was out of shape when this testing took place. I had a 5 mm brain lesion on an MRI. I also had low K under 3.0 on a random blood test. This triggered 1 year of testing and a final diagnosis of PA based on the salt loading test I described. I now exercise on a regular basis, eat healthy, watch sodium, and try to eat at least 5 servings of veggies and 5 servings of fruit per day (not exact DASH but same idea). My blood pressure is 118/76 average for the last 3 months on 50mg of Spiro 25mg morning and 25mg night. I feel fine. On a recent follow up MRI the 5mm lesion on my brain has disappeared. My thoughts are that the salt loading test was not done accurately (due to my salt loading). I think my results might have been skewed due to only being off beta blockers for a couple of days before the salt loading started. The spiro seems to work great, but it could also be my better overall fitness, lower weight (40 lbs down), and better diet. My endo wants me to get an AVS due to my age and my response to Spiro. I am wanting another round of tests before the AVS just to make sure I have PA. Has anyone ever retested to confirm PA? Is this recommended? Would Spiro tend to work well on someone without PA? Thanks in advance for your help! 35 year old male. Diagnosed April 2011. CT Scan normal. Abnormal pituitary on MRI. Low testosterone at times (either over 400 or under 200). Tested for GRA. Results negative for GRA. 50 mg Spiro (25 mg morning/25 mg night).

[Guest guest]

By CT scan I assume you mean of the adrenals?Good to get a second reading as I find bumps when others don't. I would do this before more testing. What was reason for CT?As you recall from the Evolution of PA article most with PA do not have bumps we can see on CT with current technology.CE Grim MDOn Jul 6, 2012, at 9:22 AM, crzylnebkr wrote: I recently asked my endo to retest me for PA. He kind of laughed at me and replied, "Dude, you have PA!". I am on pretty good terms with him and trust his opinion. He elaborated that since my urine sodium at Mayo was over 400 and my aldosterone was high there is no doubt in his mind that due to that salt loading test result I have PA like it or not. However, at Mayo I only salt loaded for 3 days. I ate a lot of crappy food and salted everything. I am concerned that perhaps my results were off for some reason. I was out of shape when this testing took place. I had a 5 mm brain lesion on an MRI. I also had low K under 3.0 on a random blood test. This triggered 1 year of testing and a final diagnosis of PA based on the salt loading test I described. I now exercise on a regular basis, eat healthy, watch sodium, and try to eat at least 5 servings of veggies and 5 servings of fruit per day (not exact DASH but same idea). My blood pressure is 118/76 average for the last 3 months on 50mg of Spiro 25mg morning and 25mg night. I feel fine. On a recent follow up MRI the 5mm lesion on my brain has disappeared. My thoughts are that the salt loading test was not done accurately (due to my salt loading). I think my results might have been skewed due to only being off beta blockers for a couple of days before the salt loading started. The spiro seems to work great, but it could also be my better overall fitness, lower weight (40 lbs down), and better diet. My endo wants me to get an AVS due to my age and my response to Spiro. I am wanting another round of tests before the AVS just to make sure I have PA. Has anyone ever retested to confirm PA? Is this recommended? Would Spiro tend to work well on someone without PA? Thanks in advance for your help! 35 year old male. Diagnosed April 2011. CT Scan normal. Abnormal pituitary on MRI. Low testosterone at times (either over 400 or under 200). Tested for GRA. Results negative for GRA. 50 mg Spiro (25 mg morning/25 mg night).