Re: Re: 42 yo woman runner who has had aldo 52 and renin 3.3 normal bp

[Guest guest]

Everyone her had a normal BP AT ONE time. If u look at my article we would not expect Bp to go up until you develop personal aldosteronism. Individual Aldo I call it in the article bTiped sad Send form miiPhone ;-)May your pressure be low!CE Grim MDSpecializing in DifficultHypertension

Thanks Val. Sorry, I didn't know about clearing old messages. **** no, I haven't been ill. I have been dealing with a thyroid issue and while dealing with that I had a urine test come up with high aldosterone. So after that I ran blood aldosterone and it also came up high. That is when I found this support group.Yes, my blood pressure is ok, at

times on the low side.So you said based on these numbers I do not have PA, does that also mean I do not have Secondary Hyperaldosteronism?Thanks Val, I appreciate your time! Suzanne

BLOOD

( my sodium intake the day before was around 2100mg) I was sitting upright for

the blood draw)

-aldosterone

22 (*standing reference range 4-31)

(* recumbent 1-16)

-renin

1.4 (random

ambulatory 0.8-2.5) (random non ambulatory 1.5-5.2)

aldost/renin

ratio= 16

-creat.

0.77 (0.44-1.00)

-NA

138 (135-145)

-K

4.2

(3.5-5.0)

24

HOUR URINE RESULTS -done the day before blood draw

sodium,

timed 102 (40-220)

NA,random

ur 40(k) no ref.

creat.

random 40.86 L (80.-170)

creat.

ur quant 1.0 (0.6-1.8)

POT.

ur per day 45.9 (25.0-150)

K+,

rand ur 18(k) no ref.

aldosterone

15.8 (normal sodium intake 6-25)

creat,ur

24hr 1096 (700-1600)

Thank

you! Dr Grim I would be happy to pay you for your time reviewing these! Suzanne

decided

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[Guest guest]

Always tell us the normals for the lab you were tested in. What meds were u on. How much na k was in. Urine ?on the dAy of the blood draw?Tiped sad Send form miiPhone ;-)May your pressure be low!CE Grim MDSpecializing in DifficultHypertension

Thanks Val. Sorry, I didn't know about clearing old messages. **** no, I haven't been ill. I have been dealing with a thyroid issue and while dealing with that I had a urine test come up with high aldosterone. So after that I ran blood aldosterone and it also came up high. That is when I found this support group.Yes, my blood pressure is ok, at

times on the low side.So you said based on these numbers I do not have PA, does that also mean I do not have Secondary Hyperaldosteronism?Thanks Val, I appreciate your time! Suzanne

BLOOD

( my sodium intake the day before was around 2100mg) I was sitting upright for

the blood draw)

-aldosterone

22 (*standing reference range 4-31)

(* recumbent 1-16)

-renin

1.4 (random

ambulatory 0.8-2.5) (random non ambulatory 1.5-5.2)

aldost/renin

ratio= 16

-creat.

0.77 (0.44-1.00)

-NA

138 (135-145)

-K

4.2

(3.5-5.0)

24

HOUR URINE RESULTS -done the day before blood draw

sodium,

timed 102 (40-220)

NA,random

ur 40(k) no ref.

creat.

random 40.86 L (80.-170)

creat.

ur quant 1.0 (0.6-1.8)

POT.

ur per day 45.9 (25.0-150)

K+,

rand ur 18(k) no ref.

aldosterone

15.8 (normal sodium intake 6-25)

creat,ur

24hr 1096 (700-1600)

Thank

you! Dr Grim I would be happy to pay you for your time reviewing these! Suzanne

decided

[Guest guest]

Dr. Grim,I think I have included all the normals for the labs. If I've overlooked one let me know.The only med I was taking was Cynomel (thyroid med.)Not sure what you mean about how much na k was in urine on the day of the blood draw. I listed the na k 24 hour urine. Was there suppose to be another urine test on the day OF the blood draw??Sodium timed 102 (40-220) urinepot. 45.9 (25-150)

Always tell us the normals for the lab you were tested in. What meds were u on. How much na k was in. Urine ?on the dAy of the blood draw?

BLOOD

( my sodium intake the day before was around 2100mg) I was sitting upright for

the blood draw)

-aldosterone

22 (*standing reference range 4-31)

(* recumbent 1-16)

-renin

1.4 (random

ambulatory 0.8-2.5) (random non ambulatory 1.5-5.2)

aldost/renin

ratio= 16

-creat.

0.77 (0.44-1.00)

-NA

138 (135-145)

-K

4.2

(3.5-5.0)

24

HOUR URINE RESULTS -done the day before blood draw

sodium,

timed 102 (40-220)

NA,random

ur 40(k) no ref.

creat.

random 40.86 L (80.-170)

creat.

ur quant 1.0 (0.6-1.8)

POT.

ur per day 45.9 (25.0-150)

K+,

rand ur 18(k) no ref.

aldosterone

15.8 (normal sodium intake 6-25)

creat,ur

24hr 1096 (700-1600)

Thank

you! Dr Grim I would be happy to pay you for your time reviewing these! Suzanne

decided

[Guest guest]

Sorry could not see these on my iPhone.Dr. Grim,I think I have included all the normals for the labs. If I've overlooked one let me know.The only med I was taking was Cynomel (thyroid med.)Not sure what you mean about how much na k was in urine on the day of the blood draw. I listed the na k 24 hour urine. Was there suppose to be another urine test on the day OF the blood draw??Sodium timed 102 (40-220) urinepot. 45.9 (25-150)So your sodium intake on this day was 102 mM = 102mM x 23 mg/mM = 2346 mg a day at least. This is lower than most Americans eat. Congrats.Your K intake was about 46 mM x 40 mg/mM = 1840 mg. This low of a K intake may lower aldo.If you are DASHing it should be 1500 Na and 4700 KWhen testing for PA we like to have the ENa of 200 x 23 =4600 mg. So I trust the lab has normal values for you low sodium and low K intake. Probably not.'So your renin is lowish but your aldo is not.If you read my article this looks like early or individual or personal PA.So if BP and K are normal I would just DASH like my life depended on it.CE Grim MDpassively supported, i.e. resting on lap. Always tell us the normals for the lab you were tested in. What meds were u on. How much na k was in. Urine ?on the dAy of the blood draw? BLOOD ( my sodium intake the day before was around 2100mg) I was sitting upright for the blood draw) -aldosterone 22 (*standing reference range 4-31) (* recumbent 1-16) -renin 1.4 (random ambulatory 0.8-2.5) (random non ambulatory 1.5-5.2) aldost/renin ratio= 16 -creat. 0.77 (0.44-1.00)-NA 138 (135-145)-K 4.2 (3.5-5.0) 24 HOUR URINE RESULTS -done the day before blood draw sodium, timed 102 (40-220)NA,random ur 40(k) no ref.creat. random 40.86 L (80.-170)creat. ur quant 1.0 (0.6-1.8)POT. ur per day 45.9 (25.0-150)K+, rand ur 18(k) no ref.aldosterone 15.8 (normal sodium intake 6-25)creat,ur 24hr 1096 (700-1600) Thank you! Dr Grim I would be happy to pay you for your time reviewing these! Suzanne decided

[Guest guest]

I am not a doctor nor even a PA

expert, but IMHO, you do not have PA,k especially since your BP is lowish.  I think with secondary, renin is high.  Yours is nice.  That is assuming the current numbers are

good.  Your lack of HTN is

important.  Have you every had low K?  I'd be interested in seeing your thyroid test

results. 

Thanks for clearing

messages.  I was getting ready to set a

rule to send your messages to delete because of the computer lock ups.  Had I not responded to you, I wouldn't have become

aware of all the cluttter below.  Note

that I left only your last message?

Val

From: hyperaldosteronism

[mailto:hyperaldosteronism ] On Behalf Of Suzanne Kann

Thanks Val. Sorry, I didn't know about clearing old messages.

**** no, I haven't been ill. I have been dealing

with a thyroid issue and while dealing with that I had a urine test come up

with high aldosterone. So after that I ran blood aldosterone and it also came

up high. That is when I found this support group.

Yes,

my blood pressure is ok, at times on the low side.

So you said based on these numbers I do not have PA, does

that also mean I do not have Secondary Hyperaldosteronism?

Thanks

Val, I appreciate your time! Suzanne

[Guest guest]

So, Dr. Grim, you have come to the conclusion that I have early stage PA based on the possibility that my low k intake could have lowered my aldosterone result? If this is correct would it be safe to assume I could redo the test with a higher potassium/sodium intake and see how the results might change. Could doing this rule out or confirm PA?Sent from my iPad

Sorry could not see these on my iPhone.Dr. Grim,I think I have included all the normals for the labs. If I've overlooked one let me know.The only med I was taking was Cynomel (thyroid med.)Not sure what you mean

about how much na k was in urine on the day of the blood draw. I listed the na k 24 hour urine. Was there suppose to be another urine test on the day OF the blood draw??Sodium timed 102 (40-220) urinepot. 45.9 (25-150)So your sodium intake on this day was 102 mM = 102mM x 23 mg/mM = 2346 mg a day at least. This is lower than most Americans eat. Congrats.Your K intake was about 46 mM x 40 mg/mM = 1840 mg. This low of a K intake may lower aldo.If you are DASHing it should be 1500 Na and 4700 KWhen testing for PA we like to have the ENa of 200 x 23 =4600 mg. So I trust the lab has normal values for you low sodium and low K intake. Probably

not.'So your renin is lowish but your aldo is not.If you read my article this looks like early or individual or personal PA.So if BP and K are normal I would just DASH like my life depended on it.CE Grim MDpassively supported, i.e. resting on lap. Always tell us the normals for the lab you were tested in. What meds were u on. How much na k was in. Urine ?on the dAy of the

blood draw? BLOOD ( my sodium intake the day before was around 2100mg) I was sitting upright for the blood draw) -aldosterone 22 (*standing reference range 4-31) (* recumbent 1-16) -renin 1.4 (random ambulatory 0.8-2.5) (random non ambulatory 1.5-5.2) aldost/renin ratio= 16 -creat. 0.77 (0.44-1.00)-NA 138 (135-145)-K 4.2 (3.5-5.0) 24 HOUR URINE RESULTS -done the day before blood draw sodium, timed 102 (40-220)NA,random ur 40(k) no ref.creat. random 40.86 L (80.-170)creat. ur quant 1.0 (0.6-1.8)POT. ur per day 45.9 (25.0-150)K+, rand ur 18(k) no ref.aldosterone 15.8 (normal sodium intake 6-25)creat,ur 24hr 1096 (700-1600) Thank you! Dr Grim I would be happy to pay you for your time reviewing these! Suzanne decided/

div>

[Guest guest]

Hi Val,Well I like your response much better than Dr. Grim's. If I understood his response he is saying my low potassium intake during the urine test could have caused the lower aldosterone reading. Not sure if that is concrete or speculation. I think the only way to know for sure is to redo the test with a higher potassium intake.So would you mind telling me which range I am looking at with the renin: non ambulatory or ambulatory. Sorry, but what is HTN?I have only tested potassium through blood and it is always around mid range, 4.2 (3.5-5.0) This was the first urine K I have done and I guess it is a reflection of intake.My thyroid situation is called reverse t3. Is that something you are familiar with? I make plenty of t4 but I convert it to mostly rt3 (which is the inactive form of

t3). Usually people do this because they have low iron, adrenal fatigue, or electrolye imbalance. Basically treating this is like how you treat for hypo. If you are still interested I'll post my labs prior to treatment.Thanks for your help,Suzanne

[Guest guest]

It would help to review your story in more detail if you can do that.Unless you team reads you evolution of PA they will not understand this concept.CE Grim MDI don't recall the exact details of the reason why P aldo was suspected in the first place.So if no HTN and not low K ever you must fit into the syndrome or personal hyper aldo. CE Grim MD>So, Dr. Grim, you have come to the conclusion that I have early stage PA based on the possibility that my low k intake could have lowered my aldosterone result? If this is correct would it be safe to assume I could redo the test with a higher potassium/sodium intake and see how the results might change. Could doing this rule out or confirm PA?Sent from my iPad Sorry could not see these on my iPhone.Dr. Grim,I think I have included all the normals for the labs. If I've overlooked one let me know.The only med I was taking was Cynomel (thyroid med.)Not sure what you mean about how much na k was in urine on the day of the blood draw. I listed the na k 24 hour urine. Was there suppose to be another urine test on the day OF the blood draw??Sodium timed 102 (40-220) urinepot. 45.9 (25-150)So your sodium intake on this day was 102 mM = 102mM x 23 mg/mM = 2346 mg a day at least. This is lower than most Americans eat. Congrats.Your K intake was about 46 mM x 40 mg/mM = 1840 mg. This low of a K intake may lower aldo.If you are DASHing it should be 1500 Na and 4700 KWhen testing for PA we like to have the ENa of 200 x 23 =4600 mg. So I trust the lab has normal values for you low sodium and low K intake. Probably not.'So your renin is lowish but your aldo is not.If you read my article this looks like early or individual or personal PA.So if BP and K are normal I would just DASH like my life depended on it.CE Grim MDpassively supported, i.e. resting on lap. Always tell us the normals for the lab you were tested in. What meds were u on. How much na k was in. Urine ?on the dAy of the blood draw? BLOOD ( my sodium intake the day before was around 2100mg) I was sitting upright for the blood draw) -aldosterone 22 (*standing reference range 4-31) (* recumbent 1-16) -renin 1.4 (random ambulatory 0.8-2.5) (random non ambulatory 1.5-5.2) aldost/renin ratio= 16 -creat. 0.77 (0.44-1.00)-NA 138 (135-145)-K 4.2 (3.5-5.0) 24 HOUR URINE RESULTS -done the day before blood draw sodium, timed 102 (40-220)NA,random ur 40(k) no ref.creat. random 40.86 L (80.-170)creat. ur quant 1.0 (0.6-1.8)POT. ur per day 45.9 (25.0-150)K+, rand ur 18(k) no ref.aldosterone 15.8 (normal sodium intake 6-25)creat,ur 24hr 1096 (700-1600) Thank you! Dr Grim I would be happy to pay you for your time reviewing these! Suzanne decided/ div>

[Guest guest]

HTN is high blood pressure for you. See my article.My analysis is that adrenal fatigue is a myth or a myther.CE Grim MDHi Val,Well I like your response much better than Dr. Grim's. If I understood his response he is saying my low potassium intake during the urine test could have caused the lower aldosterone reading. Not sure if that is concrete or speculation. I think the only way to know for sure is to redo the test with a higher potassium intake.So would you mind telling me which range I am looking at with the renin: non ambulatory or ambulatory. Sorry, but what is HTN?I have only tested potassium through blood and it is always around mid range, 4.2 (3.5-5.0) This was the first urine K I have done and I guess it is a reflection of intake.My thyroid situation is called reverse t3. Is that something you are familiar with? I make plenty of t4 but I convert it to mostly rt3 (which is the inactive form of t3). Usually people do this because they have low iron, adrenal fatigue, or electrolye imbalance. Basically treating this is like how you treat for hypo. If you are still interested I'll post my labs prior to treatment.Thanks for your help,Suzanne

[Guest guest]

s maybe? Thyroid and s have a relationship. The low BP and some of the labs point that way. Still adrenal based

Subject: RE: Re: 42 yo woman runner who has had aldo 52 and renin 3.3 normal bpTo: hyperaldosteronism Date: Wednesday, December 8, 2010, 6:31 PM

I am not a doctor nor even a PA expert, but IMHO, you do not have PA,k especially since your BP is lowish. I think with secondary, renin is high. Yours is nice. That is assuming the current numbers are good. Your lack of HTN is important. Have you every had low K? I'd be interested in seeing your thyroid test results.

Thanks for clearing messages. I was getting ready to set a rule to send your messages to delete because of the computer lock ups. Had I not responded to you, I wouldn't have become aware of all the cluttter below. Note that I left only your last message?

Val

From: hyperaldosteronism [mailto:hyperaldosteronism ] On Behalf Of Suzanne KannThanks Val. Sorry, I didn't know about clearing old messages.

**** no, I haven't been ill. I have been dealing with a thyroid issue and while dealing with that I had a urine test come up with high aldosterone. So after that I ran blood aldosterone and it also came up high. That is when I found this support group.

Yes, my blood pressure is ok, at times on the low side.

So you said based on these numbers I do not have PA, does that also mean I do not have Secondary Hyperaldosteronism?

Thanks Val, I appreciate your time! Suzanne

[Guest guest]

Sorry another question. Would my blood potassium result mean anything? It is not low: 4.2 (3.5-5.0)Sent from my iPad

So, Dr. Grim, you have come to the conclusion that I have early stage PA based on the possibility that my low k intake could have lowered my aldosterone result? If this is correct would it be safe to assume I could redo the test with a higher potassium/sodium intake and see how the results might change. Could doing this rule out or confirm PA?Sent from my iPad

Sorry could not see these on my iPhone.Dr. Grim,I think I have included all the normals for the labs. If I've overlooked one let me know.The only med I was taking was Cynomel (thyroid med.)Not sure what you mean

about how much na k was in urine on the day of the blood draw. I listed the na k 24 hour urine. Was there suppose to be another urine test on the day OF the blood draw??Sodium timed 102 (40-220) urinepot. 45.9 (25-150)So your sodium intake on this day was 102 mM = 102mM x 23 mg/mM = 2346 mg a day at least. This is lower than most Americans eat. Congrats.Your K intake was about 46 mM x 40 mg/mM = 1840 mg. This low of a K intake may lower aldo.If you are DASHing it should be 1500 Na and 4700 KWhen testing for PA we like to have the ENa of 200 x 23 =4600 mg. So I trust the lab has normal values for you low sodium and low K intake. Probably

not.'So your renin is lowish but your aldo is not.If you read my article this looks like early or individual or personal PA.So if BP and K are normal I would just DASH like my life depended on it.CE Grim MDpassively supported, i.e. resting on lap. Always tell us the normals for the lab you were tested in. What meds were u on. How much na k was in. Urine ?on the dAy of the

blood draw? BLOOD ( my sodium intake the day before was around 2100mg) I was sitting upright for the blood draw) -aldosterone 22 (*standing reference range 4-31) (* recumbent 1-16) -renin 1.4 (random ambulatory 0.8-2.5) (random non ambulatory 1.5-5.2) aldost/renin ratio= 16 -creat. 0.77 (0.44-1.00)-NA 138 (135-145)-K 4.2 (3.5-5.0) 24 HOUR URINE RESULTS -done the day before blood draw sodium, timed 102 (40-220)NA,random ur 40(k) no ref.creat. random 40.86 L (80.-170)creat. ur quant 1.0 (0.6-1.8)POT. ur per day 45.9 (25.0-150)K+, rand ur 18(k) no ref.aldosterone 15.8 (normal sodium intake 6-25)creat,ur 24hr 1096 (700-1600) Thank you! Dr Grim I would be happy to pay you for your time reviewing these! Suzanne decided/

div>

[Guest guest]

But with 's aldo should be very low and renin high so not 'sCE Grim, MDs maybe? Thyroid and s have a relationship. The low BP and some of the labs point that way. Still adrenal basedSubject: RE: Re: 42 yo woman runner who has had aldo 52 and renin 3.3 normal bpTo: hyperaldosteronism Date: Wednesday, December 8, 2010, 6:31 PM I am not a doctor nor even a PA expert, but IMHO, you do not have PA,k especially since your BP is lowish. I think with secondary, renin is high. Yours is nice. That is assuming the current numbers are good. Your lack of HTN is important. Have you every had low K? I'd be interested in seeing your thyroid test results. Thanks for clearing messages. I was getting ready to set a rule to send your messages to delete because of the computer lock ups. Had I not responded to you, I wouldn't have become aware of all the cluttter below. Note that I left only your last message? Val From: hyperaldosteronism [mailto:hyperaldosteronism ] On Behalf Of Suzanne KannThanks Val. Sorry, I didn't know about clearing old messages. **** no, I haven't been ill. I have been dealing with a thyroid issue and while dealing with that I had a urine test come up with high aldosterone. So after that I ran blood aldosterone and it also came up high. That is when I found this support group.Yes, my blood pressure is ok, at times on the low side. So you said based on these numbers I do not have PA, does that also mean I do not have Secondary Hyperaldosteronism?Thanks Val, I appreciate your time! Suzanne

[Guest guest]

My cortisol is fine, 's is low cortisol right?Sent from my iPad

s maybe? Thyroid and s have a relationship. The low BP and some of the labs point that way. Still adrenal based

Subject: RE: Re: 42 yo woman runner who has had aldo 52 and renin 3.3 normal bpTo: hyperaldosteronism Date: Wednesday, December 8, 2010, 6:31 PM

I am not a doctor nor even a PA expert, but IMHO, you do not have PA,k especially since your BP is lowish. I think with secondary, renin is high. Yours is nice. That is assuming the current numbers are good. Your lack of HTN is important. Have you every had low K? I'd be interested in seeing your thyroid test results.

Thanks for clearing messages. I was getting ready to set a rule to send your messages to delete because of the computer lock ups. Had I not responded to you, I wouldn't have become aware of all the cluttter below. Note that I left only your last message?

Val

From: hyperaldosteronism [mailto:hyperaldosteronism ] On Behalf Of Suzanne KannThanks Val. Sorry, I didn't know about clearing old messages.

**** no, I haven't been ill. I have been dealing with a thyroid issue and while dealing with that I had a urine test come up with high aldosterone. So after that I ran blood aldosterone and it also came up high. That is when I found this support group.

Yes, my blood pressure is ok, at times on the low side.

So you said based on these numbers I do not have PA, does that also mean I do not have Secondary Hyperaldosteronism?

Thanks Val, I appreciate your time! Suzanne

[Guest guest]

Read my article. Low blood K only occurs with group or advance PA.Plasma K, properly drawn as in no fist clenching no toruniquet, indicates advance PA or group PA or classical PA.CE Grim MD CE Grim MDSorry another question. Would my blood potassium result mean anything? It is not low: 4.2 (3.5-5.0)Sent from my iPad So, Dr. Grim, you have come to the conclusion that I have early stage PA based on the possibility that my low k intake could have lowered my aldosterone result? If this is correct would it be safe to assume I could redo the test with a higher potassium/sodium intake and see how the results might change. Could doing this rule out or confirm PA?Sent from my iPad Sorry could not see these on my iPhone.Dr. Grim,I think I have included all the normals for the labs. If I've overlooked one let me know.The only med I was taking was Cynomel (thyroid med.)Not sure what you mean about how much na k was in urine on the day of the blood draw. I listed the na k 24 hour urine. Was there suppose to be another urine test on the day OF the blood draw??Sodium timed 102 (40-220) urinepot. 45.9 (25-150)So your sodium intake on this day was 102 mM = 102mM x 23 mg/mM = 2346 mg a day at least. This is lower than most Americans eat. Congrats.Your K intake was about 46 mM x 40 mg/mM = 1840 mg. This low of a K intake may lower aldo.If you are DASHing it should be 1500 Na and 4700 KWhen testing for PA we like to have the ENa of 200 x 23 =4600 mg. So I trust the lab has normal values for you low sodium and low K intake. Probably not.'So your renin is lowish but your aldo is not.If you read my article this looks like early or individual or personal PA.So if BP and K are normal I would just DASH like my life depended on it.CE Grim MDpassively supported, i.e. resting on lap. Always tell us the normals for the lab you were tested in. What meds were u on. How much na k was in. Urine ?on the dAy of the blood draw? BLOOD ( my sodium intake the day before was around 2100mg) I was sitting upright for the blood draw) -aldosterone 22 (*standing reference range 4-31) (* recumbent 1-16) -renin 1.4 (random ambulatory 0.8-2.5) (random non ambulatory 1.5-5.2) aldost/renin ratio= 16 -creat. 0.77 (0.44-1.00)-NA 138 (135-145)-K 4.2 (3.5-5.0) 24 HOUR URINE RESULTS -done the day before blood draw sodium, timed 102 (40-220)NA,random ur 40(k) no ref.creat. random 40.86 L (80.-170)creat. ur quant 1.0 (0.6-1.8)POT. ur per day 45.9 (25.0-150)K+, rand ur 18(k) no ref.aldosterone 15.8 (normal sodium intake 6-25)creat,ur 24hr 1096 (700-1600) Thank you! Dr Grim I would be happy to pay you for your time reviewing these! Suzanne decided/ div>

[Guest guest]

Usually and depends on what stage of Addision's you are in.Depends on how and when it was measured. CE Grim MDMy cortisol is fine, 's is low cortisol right?Sent from my iPad s maybe? Thyroid and s have a relationship. The low BP and some of the labs point that way. Still adrenal basedSubject: RE: Re: 42 yo woman runner who has had aldo 52 and renin 3.3 normal bpTo: hyperaldosteronism Date: Wednesday, December 8, 2010, 6:31 PM I am not a doctor nor even a PA expert, but IMHO, you do not have PA,k especially since your BP is lowish. I think with secondary, renin is high. Yours is nice. That is assuming the current numbers are good. Your lack of HTN is important. Have you every had low K? I'd be interested in seeing your thyroid test results. Thanks for clearing messages. I was getting ready to set a rule to send your messages to delete because of the computer lock ups. Had I not responded to you, I wouldn't have become aware of all the cluttter below. Note that I left only your last message? Val From: hyperaldosteronism [mailto:hyperaldosteronism ] On Behalf Of Suzanne KannThanks Val. Sorry, I didn't know about clearing old messages. **** no, I haven't been ill. I have been dealing with a thyroid issue and while dealing with that I had a urine test come up with high aldosterone. So after that I ran blood aldosterone and it also came up high. That is when I found this support group.Yes, my blood pressure is ok, at times on the low side. So you said based on these numbers I do not have PA, does that also mean I do not have Secondary Hyperaldosteronism?Thanks Val, I appreciate your time! Suzanne

[Guest guest]

I will send you a more detailed story later tonight. I will also reread the evolution of PA, but would tell me what you mean by "syndrome". Can I read about that and about personal hyer aldo in that article?Sent from my iPad

HTN is high blood pressure for you. See my article.My analysis is that adrenal fatigue is a myth or a myther.CE Grim MDHi Val,Well I like your response much better than Dr. Grim's. If I understood his response he is

saying my low potassium intake during the urine test could have caused the lower aldosterone reading. Not sure if that is concrete or speculation. I think the only way to know for sure is to redo the test with a higher potassium intake.So would you mind telling me which range I am looking at with the renin: non ambulatory or ambulatory. Sorry, but what is HTN?I have only tested potassium through blood and it is always around mid range, 4.2 (3.5-5.0) This was the first urine K I have done and I guess it is a reflection of intake.My thyroid situation is called reverse t3. Is that something you are familiar with? I make plenty of t4 but I convert it to mostly rt3 (which is the inactive form of t3). Usually people do this because they have low iron, adrenal fatigue, or electrolye imbalance. Basically treating this is like how you treat for hypo. If

you are still interested I'll post my labs prior to treatment.Thanks for your help,Suzanne

[Guest guest]

suggest you look up syndrome a dictonary.com for a strict def.Usually a constellation of history and signs( physical and lab) that is found in a disease such as Conn's Syndrome.CE Grim MDI will send you a more detailed story later tonight. I will also reread the evolution of PA, but would tell me what you mean by "syndrome". Can I read about that and about personal hyer aldo in that article?Sent from my iPad HTN is high blood pressure for you. See my article.My analysis is that adrenal fatigue is a myth or a myther.CE Grim MDHi Val,Well I like your response much better than Dr. Grim's. If I understood his response he is saying my low potassium intake during the urine test could have caused the lower aldosterone reading. Not sure if that is concrete or speculation. I think the only way to know for sure is to redo the test with a higher potassium intake.So would you mind telling me which range I am looking at with the renin: non ambulatory or ambulatory. Sorry, but what is HTN?I have only tested potassium through blood and it is always around mid range, 4.2 (3.5-5.0) This was the first urine K I have done and I guess it is a reflection of intake.My thyroid situation is called reverse t3. Is that something you are familiar with? I make plenty of t4 but I convert it to mostly rt3 (which is the inactive form of t3). Usually people do this because they have low iron, adrenal fatigue, or electrolye imbalance. Basically treating this is like how you treat for hypo. If you are still interested I'll post my labs prior to treatment.Thanks for your help,Suzanne

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Again for aldo testing most want ENa to be at least 200 mM/24 hrs.But your lab may have normal values on a lower E Na like you have. Ask them for the normogram that relates ENa to E aldo.CE Grim MD.Check with heHi everybody,I have some recent labs I would like to post. The results are very different from what they had been in the past. My past labs were always done salt fasting for at least a day. The labs I will post today were done following Dr. Grim/support group guidelines.I would love to hear any input. BLOOD ( my sodium intake the day before was around 2100mg) I was sitting upright for the blood draw)-aldosterone 22 (*standing reference range 4-31) (* recumbent 1-16)-renin 1.4 (random ambulatory 0.8-2.5) (random non ambulatory 1.5-5.2)aldost/renin ratio= 16-creat. 0.77 (0.44-1.00)-NA 138 (135-145)-K 4.2 (3.5-5.0)24 HOUR URINE RESULTS -done the day before blood drawsodium, timed 102 (40-220)NA,random ur 40(k) no ref.creat. random 40.86 L (80.-170)creat. ur quant 1.0 (0.6-1.8)POT. ur per day 45.9 (25.0-150)K+, rand ur 18(k) no ref.aldosterone 15.8 (normal sodium intake 6-25)creat,ur 24hr 1096 (700-1600)Thank you! Dr Grim I would be happy to pay you for your time reviewing these! Suzanne Sent from my iPad Hi Dr. Grim,I have been giving all of this some thought and have come up with a proposal for you.Would you considered looking over my labs for a fee smaller than $500.00 and after reviewing them if it looks as if I will need your help for a year then I will pay the full $500.00?The reason I ask to do it this way is because I have not been diagnosed with Hyperaldosteronism and question whether this is really even an issue for me. I don't have most of the issues most have here like high blood pressure, I am not on any meds other than thyroid, and from what I can tell from my labs I am not low on potassium. I do however always come up high on aldosterone. My situation just doesn't make sense. I do have a thyroid issue and I have learned that a lot of people with my thyroid condition have adrenal fatigue. Is this something you treat?I do respect your knowledge in this area and trust that if I do have hyperaldosteronism you will pick it up on my labs and hopefully put the missing piece of this puzzle together for me.Thanks, SuzanneSent from my iPad Thanks more layer todayTiped sad Send form miiPhone ;-)May your pressure be low!CE Grim MDSpecializing in DifficultHypertension so what's the support group for?Sent from my iPad Once again this is what I get paid for. Contact me at lowerbp2@... for details of accessing my expertise for a year for only $500.CE Grim MDThanks!!Would you mind explaining the difference between the creatinine random urine and the creatinine quantitative urine? I am concerned that my creat. rand is low meaning kidney trouble.I have been sitting here "researching" this for an hour or so and can't find an explanation.I won't been able to see my doctor until the end of this month and even then I don't think she is well educated in this area.I really wanted to rule out any kidney issues before December 28th.Thanks for your time and input! SuzanneSent from my iPad I assume your Dr. gets paid for doing this sort of interpretation.I can do it one on one for a fee. They all look good to me.CE Grim MDI have some test results back that are worrying me. I don't have all the results so I will post them as I get them. Right now I am concerned with what my creatinine levels mean. Please help!!!Blood creatinineCREAT 0.77 (0.44-1.00)BUN 14 (6-20)urine creatinine (there were two results for this)CREAT,RAND UR 40.86 L (80.00-170 mg./dl)CREAT, UR QUANT 1.0 (0.6-1.8 gm./dy)Should I be worried about the low CREAT, RAND UR?????THANKS, SUZANNESent from my iPad It varies. Do a pubmed.CE Grim MDWhat significance does our menstrual cycle play in blood pressure?During my luteal phase my blood pressure ranges from 115/65 to 120/75 but then once menses begins i run a lot lower 90/60.I am in the process of doing the 24 hour urine. should have those numbers in a few days.thanks,suzanneSent from my iPad Yea but you usually are an alcoholic who does not each much or cancer pt who cannot eat and is starving. CE Grim MDI have read that a magnesium deficiency can cause low K.Sent from my iPad Better to DASH I would think.If you can get it in food why take a pill?CE Grim MDare you serious? I am asking if I should take a b vitamin supplement?Sent from my iPad Still no question?CE Grim MD Was there a question here?Hi Dr. Grim,Is it recommended to take a b-complex vitamin?I have been holding off from taking mine (complete b-complex from life extension) because i am afraid it might encourage more aldosterone production! Am I crazy for worrying about this? I know the adrenals love b vitamins and I don't need anything that will cause me to produce more aldosterone. However, I know for a woman of my age and activity level that the b's are very important and could really benefit my body!!Thanks, SuzanneSent from my iPad They are all competitors for the receptors but I do not know the measures of association that permits one to quantitate the relative effect of aldo in occupying each of the receptors. Also they circulate in much greater quantities that aldo as I recall. So the effect would seem likely to be weak.CE Grim MD Hi Dr. Grim, I wanted to ask if high aldosterone levels will block progesterone, testosterone, and estrogen receptors? Thanks, SuzanneTo: hyperaldosteronism Cc: Clarence Grim Sent: Sun, November 7, 2010 7:36:01 PMSubject: Re: Re: 42 yo woman runner who has had aldo 52 and renin 3.3 normal bp That's what this paper says. No one has looked at in anymore detail that I can find.CE Grim MDOk, by doing this it will be ok to test any time of my cycle?Sent from my iPad Ask your lab to use plasma renin activity not direct renin assay.CE Grim MDThis is the article I did read. I didn't feel like it gave a definitive answer. I have read it is best to test aldosterone on the third day of the menstrual cycle but not sure how that will go seeing it is a urine test and not a simple blood draw. Any advice would be greatly appreciated. ThanksSent from my iPad Guess you did not search aldosterone renin ratio.Here is one.J Clin Endocrinol Metab. 2010 Oct 20. [Epub ahead of print]Are Women More at Risk of False-Positive Primary Aldosteronism Screening and Unnecessary Suppression Testing than Men?Ahmed AH, Gordon RD, PJ, Ward G, Pimenta E, Stowasser M.Endocrine Hypertension Research Centre (A.H.A., R.D.G., P.J.T., E.P., M.S.), University of Queensland School of Medicine, Greenslopes and Princess andra Hospitals, Brisbane, Queensland 4102, Australia; and Sullivan and Nicolaides Pathology (G.W.), Brisbane, 4068 Queensland, Australia.AbstractBackground: Because primary aldosteronism is not uncommon, specifically treatable and in some cases curable, and carries higher risks for cardiovascular morbidity and mortality than essential hypertension, screening hypertensive patients for its presence by measuring aldosterone to renin ratio (ARR) is increasingly common. A significantly higher false-positive ARR rate for women than men, resulting in unnecessary suppression tests has previously been reported. Methods: Using a new, highly accurate aldosterone assay and both of the currently widely used renin assays, ARR was measured in 19 normal, ovulating women at three time points in the menstrual cycle and compared with single measurements in 21 normal males of similar age. Results: ARRs in males were possibly too well down in the current normal range. Although normotensive and normokalemic, two women had raised ARRs in the luteal phase but only when direct renin concentration (DRC) was used. Their DRC levels were low at all sampling times [despite midrange plasma renin activity levels], whereas their progesterone and aldosterone levels were highest for the group. Saline suppression testing, performed in one of them, showed normal aldosterone suppressibility. Conclusion: False-positive ARRs in normal women during the luteal phase only when DRC is used may explain the higher incidence of false-positive ARRs in hypertensive women than men and suggest the following: 1) plasma renin activity is preferable to DRC in determination of ARR and 2) new reference ranges for ARR that take into account gender and sex hormone levels are required.Thanks, I did do some reading on pubmed like you suggested about testing and menses but never came up with an answer. Hoping you had the answer. I know aldosterone is naturally higher during the luteal phase but I only want to do this once and I want to get it exactly right . Sent from my iPad I think I sent an abstract recently on menses and testing. If you cant find it let me know.Dr. Grim's Perfect Primary Aldosteronism Blood and Urine Testing to diagnose PA in one day. 1. Eat a regular to high salt diet for 2 weeks.2. No BP meds in last 4-12 weeks depending on meds.3. Collect 24 hr urine for Na, K and creatinine and aldosterone. Do not lose a drop of this liquid gold. It is impossible to interpret the renin and aldo without this.4. The morning you finish the 24 hr urine have fasting blood drawn for renin, aldo and K using our guidelines to get an accurate K. Try to get this done about 4 hours after you have been out of bed.5. Send us the results with the normal values for your lab.6. If you ever have a salt (saline) infusion test for PA be certain to ask them to measure how much you pee during the 4 hours of the infusion. If it is 1-1.5 liter of urine it strongly suggests that you may have PA. If more tha 1.5 L you almost certainly have PA. Hi, I am calling my Natural Path tomorrow to have her order test to see if we can figure out why I have high alodsterone. Here are the test I am requesting: (PLEASE LET ME KNOW IF I AM MISSING SOMETHING) -24 hour urine NA, K, Creatinine, Aldosterone -blood draw Renin, Aldosterone, and K Anything else????Also where can I get the info on how to collect K correctly?See our files on how to draw blood.One last question, when during my menstrual cycle is the best time to do these test?'see a recent email re this issue.Thanks so much for you time, SuzanneTo: hyperaldosteronism Cc: Clarence Grim Sent: Fri, November 5, 2010 7:04:29 AMSubject: Re: Re: 42 yo woman runner who has had aldo 52 and renin 3.3 normal bp your team is who you have decided you want to manage your health. Can a Natural Path write prescriptions and order blood tests?CE Grim MDWhat if I don't have a team? Or do you consider a Natural Path my team?Sent from my iPad yes I can work with your team for $500 per year.CE Grim MDHi Dr Grim , I agree I am afraid I am going to make this 400 mile trip and get nowhere! I don't have a dr other than a Natural Path. Can you be my dr and take care of all of this online?Sent from my iPad she does not seem to understand PA as she did not order a renin.CE Grim MDSend her my article on the evolution of PA and the Endo guidelines in our files---BEFORE you see her. You want to know how many PAs she has treated and followed for at least 10 years.CE Grim MDThanks for the info. I am so frustrated with dr's in my area. It seems NO one knows the correct test around here! My natural path is very willing to order the test but she's the first one to admit that she won't know what to do with the results.I live in Whitefish, Montana and Kalispell is about 15 minutes away. Missoula is about 200 miles but I would drive it if someone could make a recommendation ( preferably first hand experience). I am doing Dr. grimes ideal test in December and then at the end of December I am scheduled to see an endocrinologist in Missoula. I don't have faith that the endo knows much about hyperaldosteronism but at this point she is my only hope. This endo's name is Dr. Eyler. She has ordered the following test ( which I don't believe are ideal): hypothyroid panel, comprehensive metabolic panel, vitamin d, hemogram, LH, FSH, 24 hr urine aldosterone.Any comments or feedback would be so appreciated! Thanks, SuzanneSent from my iPad See Dr Grim's ideal test.You cannot interpret the aldo/renin ratio without having a 24 hr urine Na. But maybe your health care team knows how to do this. If so they need to let us know.CE GrimMDWelcome to the exciting world of Hyperaldosteronism! You are in the right place! I am Dr. CE Grim a retired Professor of Medicine and Endocrinology. I have a long standing interest is Primary Aldosteronism since medical school days when I saw my first patient with Primary Aldosteronism in 1963. I trained with Dr. Conn in Endocrinology and Metabolism 1969-70 and have published over 240 papers and book chapters in most areas of the broad discipline of High Blood Pressure. My CV is in our files for details. The goal of our group is to teach you and your health care team about the ins and outs of the causes, diagnosis and control of the many forms of hyperaldosteronism. The steps below will introduce you into the fascinating world of high blood pressure, salt and potassium and the role of the adrenal hormone aldosterone in health and disease. Doing these in sequence will save you time and effort in getting up to speed in taking control of you health and educating your own health care team. While we can’t make you a doctor we will make you into a pretty good BP doctor-a skill that you will have for life. 1. A brief history of Primary Aldosteronsim and why it is so common today in drug resistant high blood pressure. Read my article in our files on the evolution of PA (Evolution_of_PA-Grim.pdf ) and take to all members of health care team. Tell us what stage you believe you are in. This is a brief review of most causes of hyperaldosteronism, high blood pressure, low potassium (K). 2. Read about other patients with hyperaldosteronism (Conn’s syndrome). Read our Conn's stories in our files and then give us your own in as much detail as you can. Dr. Conn was the first to describe this disease process and the syndrome is named after him.To see others' stories, on the Hyperaldosteronism home page, go to Files/Conn’s Stories. You'll find instructions in "A - How to put your story here.doc " First send us your story in an email and they we may have questions and suggestions before you upload it to our files. 3. DASH to lower your BP. Your and my tax dollars funded the most important series of studies on how to improve blood pressure, blood sugar, blood lipids and make your heart smaller: The DASH Eating Plan to control high blood pressure due to hyperaldosteronism and most others with high blood pressure. This will reduce your need for medications and in many will get your BP and K to goal without meds.. Get the DASH diet book by T. et al, (http://www.amazon.com/DASH-Diet-Hypertension--/dp/0743202953) read it and use it: ~$8 in paperback at your local bookstore or online. If they don’t have it ask them to order it for you. You can also get the hardback larger print version as well at Amazon. Learning to eat the DASH way will play a major role in your road to good BP and K control and, in many of our folks here, will revolutionize your life. See http://en.wikipedia.org/wiki/DASH_diet for an overview and more details. In the book go to chapter 9 and do the 14 day challenge. Tell your Dr you are doing this as your BP may plummet if you are on other meds. Measure your BP every day and post to us. or go to http://www.nhlbi.nih.gov/health/public/heart/hbp/dash/new_dash.pdf download this 64 page booklet free and do the Week on the DASH Diet for 2 weeks. If you are on BP meds be prepared for a large fall in BP (20/10 mm Hg or more) and let your Dr. know you are doing this. And/Or go to (but costs money monthly) DASH Diet for Health Program (http://www.dashforhealth.com/pages/public/tour.php)The DASH Diet for Health Program is designed to help you improve your eating and exercise habits. Twice each week they will provide you with information on our website about food, food preparation, eating out, losing weight, getting fit and much more. In addition to providing new information each week on the website, they create a web page specially for you where you can track progress in areas such as your weight, blood pressure, and exercise. I strongly recommend you get this book and read it. 4. Measure your BP: Measure your BP daily so you can see if it is getting better. If you are taking meds be sure to tell your health care team you are doing this as your BP may plummet to normal quickly. We recommend you use a device you listen to and will help you learn how to do this. If this is not something you want to do we can teach a significant other how to do it. See sharedcareinc.com or email to sharedcare@... to order a video on how to do this. If you already have one we will teach you how to teach your health care team how to validate your device. Your life and health depends on accurate BP measurements. Go to the amricanheart.org and download the Guidelines for Human Blood Pressure Measurement. Insist the your health care team do BP the AHA way. Never trust your life to an automatic BP machine unless you know it is accurate on YOU. 5. Genetics and your BP: Go to familyhistory.hhs.gov and do your detailed family medical history so we can review with you to help Dx familial causes of high blood pressure and heart disease. If BP runs in your family you may save lives in your family by checking their BP yourself. 6. How to DX and treat PA: Go to our file/Conn's Articles of Note/Medications/Bravo spir 1973.pdf and read this article and take to your health care team. It is old but still one of the best in the medical management of PA. Also see our file from the Endocrine Society Guidelines on PA. Dr. Grim's Perfect Primary Aldosteronism Blood and Urine Testing to diagnose PA in one day. 1. Eat a regular to high salt diet for 2 weeks.2. No BP meds in last 4-12 weeks depending on meds.3. Collect 24 hr urine for Na, K and creatinine and aldosterone. Do not lose a drop of this liquid gold. It is impossible to interpret the renin and aldo without this.4. The morning you finish the 24 hr urine have fasting blood drawn for renin, aldo and K using our guidelines to get an accurate K. Try to get this done about 4 hours after you have been out of bed.5. Send us the results with the normal values for your lab.6. If you ever have a salt (saline) infusion test for PA be certain to ask them to measure how much you pee during the 4 hours of the infusion. If it is 1-1.5 liter of urine it strongly suggests that you may have PA. If more tha 1.5 L you almost certainly have PA. 8. Become a participant in our PA Registry and contribute to our large database on PA: If you have been Dxed with PA already and are on Rx or have had surgery please go to http://www.kwiksurveys.com/online-survey.php?surveyID=HIJIO_f2685379 and complete our survey with as much information as you know. If there is some information you don't know ask us and we will help. If you need to update this as you journey thru the diagnostic/treatment process you can add another entry but label it as Nameyymmdd. For example today 6/12/09 for me would be Grim090612. This ever increasing number will allow us and you to sort your multiple entries into a dated order. 9. Learn the language: If you are new to medical lingo then download the acroyms from http://health.groups.yahoo.com/group/bloodpressureline/message/2918610. Salt and high blood pressure: To learn the state of the science of salt and blood pressure please spend some time looking at http://www.worldactiononsalt.com/evidence/treatment_trials.htm11. Become a HBP expert consumer: Expect that it will take at least several weeks to get all this digested and to learn the new language of high blood pressure health care. As most doctors and nurses in practice have had very little training in high blood pressure you must become an expert yourself. For example most have never had anyone listen with them with a double stethoscope to verify that they can hear BP sounds. We cannot make you a doctor but we will make you a pretty good BP doctor.12. How High Blood Pressure should be managed: Go to nih.gov and download and read the Joint National Commission (JNC) Report 7 to get an overview on current guidelines. I ask all my secretaries to read this so they can communicate the importance of high blood pressure to my patients. JNC 8 will be out soon.Then: get (and study) the Hypertension Primer from americanheart.org. This is the most up-to-date compendium of what is known about high blood pressure and what every Dr. should know when they graduate from Medical School. Every chapter is only 2-3 pages. Read one chapter every week-night and you will finish it in about a year. I am working on a reading guide for lay people for the Primer. Stay tuned.13. Ask us questions: Ask any questions about high blood pressure you want answered. That is what we are here for. We have had this site for 10 years and over 30,000 emails are searchable. This is the largest collection of communications about Conn's Syndrome in the World. 14. One-on-one Consulting: I can provide individual consulting if you do not want to go public. If you want individual one-on-one consulting for you and your Doctor contract me directly at lowerbp2@....May your pressure be low!Clarence E. Grim BS, MS, MD, FACP, FACC, FAHABoard Certified in Internal Medicine, Geriatrics, and High Blood Pressure Retired Faculty/Professor of Medicine (U of MO, Indiana, UCLA/DREW, Medical College of Wisconsin and Cardiology, Endocrinology, Nephrology, and Epidemiology. Specializing in Primary Aldosteronism and Difficult to Control High Blood Pressure. I'm going in on Thursday for the following test: basic panel and serum aldosterone.Shouldn't there be a urine test? Are these test a waste of my time if I want real answers to why I have high aldosterone.What would be the ideal test? Please help I am feeling pressured for time! Thank youSent from my iPad Not that I know of or can make a connection to in my wildest Endocrine/Heme thoughs. But then another reason we need a good data base.Do you do data bases?CE Grim,MDIs there any connection between high aldosterone and low ferritin?Sent from my iPad If your BP and K is normal you may not need to DASH.Runners may have aldo if it was collected after a run.Drink when you are thirsty. A low Na suggests you are drinking too much.CE Grim MDCould I get some input on water intake? I tried searching the web-site about dashing but couldn't find what I was looking for.I know are bodies are constantly trying to keep things in balance so I feel like h2o consumption is just as important as sodium intake. However, I don't think I can assume the average 8 cups a day will be my norm.Here are a few things that I think might influence my sodium/h20 consumption: I have lowish serum sodium 138 (135-145), I have low blood pressure110/65, high aldosterone (24 hr urine 54.3 ( 17-44) and I am active ( runner)I feel it is reasonable that I keep my sodium intake at the higher end of the Dashing Diet , because of low sodium and low blood pressure and activity level, but I also want to try and lower aldosterone naturally ( if possible) and I'm hoping maybe it's a matter of the right amount of daily water and sodium consumption. Are there any right ratios for this? For example, if you consume 1,500 mg of sodium you should have 8 cups of h2o or maybe if you consume 2,300 mg of sodium you should shoot for 10 cups of h2o?Thanks so much! Really trying to get it right!Sent from my iPad Keep us posted. so you have high renin and high aldo and low K and low BP?CE Grim MDHi Dr. Grim, The following post grabbed my attention. I started following you and this site when I was thought to have primary hyperaldosteronism. I had all the expected abnormal lab results except for low to normal blood pressure. Eventually, labaratory results confirmed Bartters Syndrome and now I follow both yahoo groups. > > >>>>>>>>>> > > >>>>>>>>>>> > > >>>>>>>>>>> Hi everyone, just joined today. Thanks to all of you for this support!> > >>>>>>>>>>> > > >>>>>>>>>>> I tested high for aldosterone two years ago through a urine test. My ND at the time was not concerned, he thought it was due to the fact that I was a runner. I also thought that made since and was also following a low salt diet. So we ignored it.> > >>>>>>>>>>> > > >>>>>>>>>>> I am treAting a thyroid issue, thyroid hormone resistance, and through recent blood work tested high for aldosterone again. This time I decided not to ignore it! > > >>>>>>>>>>> > > >>>>>>>>>>> I do not have a high blood pressure. It runs pretty normal to low. I don't have issues with potassium. This is all Very confusing as to why I have high aldosterone.> > >>>>>>>>>>> > > >>>>>>>>>>> I am trying to get into a endocrinologist but will take about three months. I need some education and advise on where to start.> > >>>>>>>>>>> > > >>>>>>>>>>> I don't even know if this is primary or secondary.> > >>>>>>>>>>> > > >>>>>>>>>>> My only real "health" issue, that I know about, has been hair loss. This was one reason for exploring the thyroid but I am wondering if it has been the aldosterone all along. Maybe the aldosterone is what's causing my thyroid issues.> > >>>>>>>>>>> > > >>>>>>>>>>> Any comments or advice would be greatly appreciated.> > >>>>>>>>>>> > > >>>>>>>>>>> My labs:> > >>>>>>>>>>> > > >>>>>>>>>>> 9/26/2008> > >>>>>>>>>>> Aldosterone (urine)> > >>>>>>>>>>> High 54.3. (normal diet 6-25, low salt 17-44, high salt0-6)> > >>>>>>>>>>> > > >>>>>>>>>>> Other adrenal hormones were fine at that time. Cortisol was pretty middle of the road. *Progesterone however was really high too. I can post if necessary.> > >>>>>>>>>>> > > >>>>>>>>>>> Rbc potassium 7/14/2010> > >>>>>>>>>>> 97. (90-111)> > >>>>>>>>>>> > > >>>>>>>>>>> Blood aldosterone 7/18/2010> > >>>>>>>>>>> 52.0. (1-16)> > >>>>>>>>>>> > > >>>>>>>>>>> Blood aldosterone/renin 6/30/2010> > >>>>>>>>>>> Aldosterone 49. (1-16)> > >>>>>>>>>>> Renin. 3.3. (random ambulatory 0.8-2.5, non ambulatory 1.5-5.2)> > >>>>>>>>>>> I was sitting, fasting, taking two hours after waking before/around 8am> > >>>>>>>>>>> > > >>>>>>>>>>> Aldosterone renin ratio = 15> > >>>>>>>>>>> > > >>>>>>>>>>> Sodium. 138. (135-145)> > >>>>>>>>>>> Potassium. 4.5. (3.5-5.3)> > >>>>>>>>>>> Chloride. 106. (98-109)> > >>>>>>>>>>> Co2. 23. (22-31)> > >>>>>>>>>>> Anion gap. 9. (5-16)> > >>>>>>>>>>> > > >>>>>>>>>>> Saliva cortisol 5/23/2010> > >>>>>>>>>>> 7am. 3.7. (3.7-9.5)> > >>>>>>>>>>> 11am. 1.6. (1.2-3.0)> > >>>>>>>>>>> 5pm. 1.3. (0.6-1.9)> > >>>>>>>>>>> 9pm. 0.5. (0.4-1.0)> > >>>>>>>>>>> > > >>>>>>>>>>> Rbc magnesium 5/26/2010> > >>>>>>>>>>> 4.2. (4.0-6.4)> > >>>>>>>>>>> > > >>>>>>>>>>> Lot of test!!!!> > >>>>>>>>>>> > > >>>>>>>>>>> Thanks again for your kind support! Suzanne> > >>>>>>>>>>> > > >>>>>>>>>>> > > >>>>>>>>>> > > >>>>>>>>> > > >>>>>>>>> > > >>>>>>>> > > >>>>>>>> > > >>>>>>> > > >>>>>>> > > >>>>>> > > >>>>>> > > >>>>> > > >>>>> > > >>>> > > >>>> > > >>> > > >>> > > >> > > > > > >> >> > > Reply to sender |>

[Guest guest]

Again for aldo testing most want ENa to be at least 200 mM/24 hrs.But your lab may have normal values on a lower E Na like you have. Ask them for the normogram that relates ENa to E aldo.CE Grim MD.Check with heHi everybody,I have some recent labs I would like to post. The results are very different from what they had been in the past. My past labs were always done salt fasting for at least a day. The labs I will post today were done following Dr. Grim/support group guidelines.I would love to hear any input. BLOOD ( my sodium intake the day before was around 2100mg) I was sitting upright for the blood draw)-aldosterone 22 (*standing reference range 4-31) (* recumbent 1-16)-renin 1.4 (random ambulatory 0.8-2.5) (random non ambulatory 1.5-5.2)aldost/renin ratio= 16-creat. 0.77 (0.44-1.00)-NA 138 (135-145)-K 4.2 (3.5-5.0)24 HOUR URINE RESULTS -done the day before blood drawsodium, timed 102 (40-220)NA,random ur 40(k) no ref.creat. random 40.86 L (80.-170)creat. ur quant 1.0 (0.6-1.8)POT. ur per day 45.9 (25.0-150)K+, rand ur 18(k) no ref.aldosterone 15.8 (normal sodium intake 6-25)creat,ur 24hr 1096 (700-1600)Thank you! Dr Grim I would be happy to pay you for your time reviewing these! Suzanne Sent from my iPad Hi Dr. Grim,I have been giving all of this some thought and have come up with a proposal for you.Would you considered looking over my labs for a fee smaller than $500.00 and after reviewing them if it looks as if I will need your help for a year then I will pay the full $500.00?The reason I ask to do it this way is because I have not been diagnosed with Hyperaldosteronism and question whether this is really even an issue for me. I don't have most of the issues most have here like high blood pressure, I am not on any meds other than thyroid, and from what I can tell from my labs I am not low on potassium. I do however always come up high on aldosterone. My situation just doesn't make sense. I do have a thyroid issue and I have learned that a lot of people with my thyroid condition have adrenal fatigue. Is this something you treat?I do respect your knowledge in this area and trust that if I do have hyperaldosteronism you will pick it up on my labs and hopefully put the missing piece of this puzzle together for me.Thanks, SuzanneSent from my iPad Thanks more layer todayTiped sad Send form miiPhone ;-)May your pressure be low!CE Grim MDSpecializing in DifficultHypertension so what's the support group for?Sent from my iPad Once again this is what I get paid for. Contact me at lowerbp2@... for details of accessing my expertise for a year for only $500.CE Grim MDThanks!!Would you mind explaining the difference between the creatinine random urine and the creatinine quantitative urine? I am concerned that my creat. rand is low meaning kidney trouble.I have been sitting here "researching" this for an hour or so and can't find an explanation.I won't been able to see my doctor until the end of this month and even then I don't think she is well educated in this area.I really wanted to rule out any kidney issues before December 28th.Thanks for your time and input! SuzanneSent from my iPad I assume your Dr. gets paid for doing this sort of interpretation.I can do it one on one for a fee. They all look good to me.CE Grim MDI have some test results back that are worrying me. I don't have all the results so I will post them as I get them. Right now I am concerned with what my creatinine levels mean. Please help!!!Blood creatinineCREAT 0.77 (0.44-1.00)BUN 14 (6-20)urine creatinine (there were two results for this)CREAT,RAND UR 40.86 L (80.00-170 mg./dl)CREAT, UR QUANT 1.0 (0.6-1.8 gm./dy)Should I be worried about the low CREAT, RAND UR?????THANKS, SUZANNESent from my iPad It varies. Do a pubmed.CE Grim MDWhat significance does our menstrual cycle play in blood pressure?During my luteal phase my blood pressure ranges from 115/65 to 120/75 but then once menses begins i run a lot lower 90/60.I am in the process of doing the 24 hour urine. should have those numbers in a few days.thanks,suzanneSent from my iPad Yea but you usually are an alcoholic who does not each much or cancer pt who cannot eat and is starving. CE Grim MDI have read that a magnesium deficiency can cause low K.Sent from my iPad Better to DASH I would think.If you can get it in food why take a pill?CE Grim MDare you serious? I am asking if I should take a b vitamin supplement?Sent from my iPad Still no question?CE Grim MD Was there a question here?Hi Dr. Grim,Is it recommended to take a b-complex vitamin?I have been holding off from taking mine (complete b-complex from life extension) because i am afraid it might encourage more aldosterone production! Am I crazy for worrying about this? I know the adrenals love b vitamins and I don't need anything that will cause me to produce more aldosterone. However, I know for a woman of my age and activity level that the b's are very important and could really benefit my body!!Thanks, SuzanneSent from my iPad They are all competitors for the receptors but I do not know the measures of association that permits one to quantitate the relative effect of aldo in occupying each of the receptors. Also they circulate in much greater quantities that aldo as I recall. So the effect would seem likely to be weak.CE Grim MD Hi Dr. Grim, I wanted to ask if high aldosterone levels will block progesterone, testosterone, and estrogen receptors? Thanks, SuzanneTo: hyperaldosteronism Cc: Clarence Grim Sent: Sun, November 7, 2010 7:36:01 PMSubject: Re: Re: 42 yo woman runner who has had aldo 52 and renin 3.3 normal bp That's what this paper says. No one has looked at in anymore detail that I can find.CE Grim MDOk, by doing this it will be ok to test any time of my cycle?Sent from my iPad Ask your lab to use plasma renin activity not direct renin assay.CE Grim MDThis is the article I did read. I didn't feel like it gave a definitive answer. I have read it is best to test aldosterone on the third day of the menstrual cycle but not sure how that will go seeing it is a urine test and not a simple blood draw. Any advice would be greatly appreciated. ThanksSent from my iPad Guess you did not search aldosterone renin ratio.Here is one.J Clin Endocrinol Metab. 2010 Oct 20. [Epub ahead of print]Are Women More at Risk of False-Positive Primary Aldosteronism Screening and Unnecessary Suppression Testing than Men?Ahmed AH, Gordon RD, PJ, Ward G, Pimenta E, Stowasser M.Endocrine Hypertension Research Centre (A.H.A., R.D.G., P.J.T., E.P., M.S.), University of Queensland School of Medicine, Greenslopes and Princess andra Hospitals, Brisbane, Queensland 4102, Australia; and Sullivan and Nicolaides Pathology (G.W.), Brisbane, 4068 Queensland, Australia.AbstractBackground: Because primary aldosteronism is not uncommon, specifically treatable and in some cases curable, and carries higher risks for cardiovascular morbidity and mortality than essential hypertension, screening hypertensive patients for its presence by measuring aldosterone to renin ratio (ARR) is increasingly common. A significantly higher false-positive ARR rate for women than men, resulting in unnecessary suppression tests has previously been reported. Methods: Using a new, highly accurate aldosterone assay and both of the currently widely used renin assays, ARR was measured in 19 normal, ovulating women at three time points in the menstrual cycle and compared with single measurements in 21 normal males of similar age. Results: ARRs in males were possibly too well down in the current normal range. Although normotensive and normokalemic, two women had raised ARRs in the luteal phase but only when direct renin concentration (DRC) was used. Their DRC levels were low at all sampling times [despite midrange plasma renin activity levels], whereas their progesterone and aldosterone levels were highest for the group. Saline suppression testing, performed in one of them, showed normal aldosterone suppressibility. Conclusion: False-positive ARRs in normal women during the luteal phase only when DRC is used may explain the higher incidence of false-positive ARRs in hypertensive women than men and suggest the following: 1) plasma renin activity is preferable to DRC in determination of ARR and 2) new reference ranges for ARR that take into account gender and sex hormone levels are required.Thanks, I did do some reading on pubmed like you suggested about testing and menses but never came up with an answer. Hoping you had the answer. I know aldosterone is naturally higher during the luteal phase but I only want to do this once and I want to get it exactly right . Sent from my iPad I think I sent an abstract recently on menses and testing. If you cant find it let me know.Dr. Grim's Perfect Primary Aldosteronism Blood and Urine Testing to diagnose PA in one day. 1. Eat a regular to high salt diet for 2 weeks.2. No BP meds in last 4-12 weeks depending on meds.3. Collect 24 hr urine for Na, K and creatinine and aldosterone. Do not lose a drop of this liquid gold. It is impossible to interpret the renin and aldo without this.4. The morning you finish the 24 hr urine have fasting blood drawn for renin, aldo and K using our guidelines to get an accurate K. Try to get this done about 4 hours after you have been out of bed.5. Send us the results with the normal values for your lab.6. If you ever have a salt (saline) infusion test for PA be certain to ask them to measure how much you pee during the 4 hours of the infusion. If it is 1-1.5 liter of urine it strongly suggests that you may have PA. If more tha 1.5 L you almost certainly have PA. Hi, I am calling my Natural Path tomorrow to have her order test to see if we can figure out why I have high alodsterone. Here are the test I am requesting: (PLEASE LET ME KNOW IF I AM MISSING SOMETHING) -24 hour urine NA, K, Creatinine, Aldosterone -blood draw Renin, Aldosterone, and K Anything else????Also where can I get the info on how to collect K correctly?See our files on how to draw blood.One last question, when during my menstrual cycle is the best time to do these test?'see a recent email re this issue.Thanks so much for you time, SuzanneTo: hyperaldosteronism Cc: Clarence Grim Sent: Fri, November 5, 2010 7:04:29 AMSubject: Re: Re: 42 yo woman runner who has had aldo 52 and renin 3.3 normal bp your team is who you have decided you want to manage your health. Can a Natural Path write prescriptions and order blood tests?CE Grim MDWhat if I don't have a team? Or do you consider a Natural Path my team?Sent from my iPad yes I can work with your team for $500 per year.CE Grim MDHi Dr Grim , I agree I am afraid I am going to make this 400 mile trip and get nowhere! I don't have a dr other than a Natural Path. Can you be my dr and take care of all of this online?Sent from my iPad she does not seem to understand PA as she did not order a renin.CE Grim MDSend her my article on the evolution of PA and the Endo guidelines in our files---BEFORE you see her. You want to know how many PAs she has treated and followed for at least 10 years.CE Grim MDThanks for the info. I am so frustrated with dr's in my area. It seems NO one knows the correct test around here! My natural path is very willing to order the test but she's the first one to admit that she won't know what to do with the results.I live in Whitefish, Montana and Kalispell is about 15 minutes away. Missoula is about 200 miles but I would drive it if someone could make a recommendation ( preferably first hand experience). I am doing Dr. grimes ideal test in December and then at the end of December I am scheduled to see an endocrinologist in Missoula. I don't have faith that the endo knows much about hyperaldosteronism but at this point she is my only hope. This endo's name is Dr. Eyler. She has ordered the following test ( which I don't believe are ideal): hypothyroid panel, comprehensive metabolic panel, vitamin d, hemogram, LH, FSH, 24 hr urine aldosterone.Any comments or feedback would be so appreciated! Thanks, SuzanneSent from my iPad See Dr Grim's ideal test.You cannot interpret the aldo/renin ratio without having a 24 hr urine Na. But maybe your health care team knows how to do this. If so they need to let us know.CE GrimMDWelcome to the exciting world of Hyperaldosteronism! You are in the right place! I am Dr. CE Grim a retired Professor of Medicine and Endocrinology. I have a long standing interest is Primary Aldosteronism since medical school days when I saw my first patient with Primary Aldosteronism in 1963. I trained with Dr. Conn in Endocrinology and Metabolism 1969-70 and have published over 240 papers and book chapters in most areas of the broad discipline of High Blood Pressure. My CV is in our files for details. The goal of our group is to teach you and your health care team about the ins and outs of the causes, diagnosis and control of the many forms of hyperaldosteronism. The steps below will introduce you into the fascinating world of high blood pressure, salt and potassium and the role of the adrenal hormone aldosterone in health and disease. Doing these in sequence will save you time and effort in getting up to speed in taking control of you health and educating your own health care team. While we can’t make you a doctor we will make you into a pretty good BP doctor-a skill that you will have for life. 1. A brief history of Primary Aldosteronsim and why it is so common today in drug resistant high blood pressure. Read my article in our files on the evolution of PA (Evolution_of_PA-Grim.pdf ) and take to all members of health care team. Tell us what stage you believe you are in. This is a brief review of most causes of hyperaldosteronism, high blood pressure, low potassium (K). 2. Read about other patients with hyperaldosteronism (Conn’s syndrome). Read our Conn's stories in our files and then give us your own in as much detail as you can. Dr. Conn was the first to describe this disease process and the syndrome is named after him.To see others' stories, on the Hyperaldosteronism home page, go to Files/Conn’s Stories. You'll find instructions in "A - How to put your story here.doc " First send us your story in an email and they we may have questions and suggestions before you upload it to our files. 3. DASH to lower your BP. Your and my tax dollars funded the most important series of studies on how to improve blood pressure, blood sugar, blood lipids and make your heart smaller: The DASH Eating Plan to control high blood pressure due to hyperaldosteronism and most others with high blood pressure. This will reduce your need for medications and in many will get your BP and K to goal without meds.. Get the DASH diet book by T. et al, (http://www.amazon.com/DASH-Diet-Hypertension--/dp/0743202953) read it and use it: ~$8 in paperback at your local bookstore or online. If they don’t have it ask them to order it for you. You can also get the hardback larger print version as well at Amazon. Learning to eat the DASH way will play a major role in your road to good BP and K control and, in many of our folks here, will revolutionize your life. See http://en.wikipedia.org/wiki/DASH_diet for an overview and more details. In the book go to chapter 9 and do the 14 day challenge. Tell your Dr you are doing this as your BP may plummet if you are on other meds. Measure your BP every day and post to us. or go to http://www.nhlbi.nih.gov/health/public/heart/hbp/dash/new_dash.pdf download this 64 page booklet free and do the Week on the DASH Diet for 2 weeks. If you are on BP meds be prepared for a large fall in BP (20/10 mm Hg or more) and let your Dr. know you are doing this. And/Or go to (but costs money monthly) DASH Diet for Health Program (http://www.dashforhealth.com/pages/public/tour.php)The DASH Diet for Health Program is designed to help you improve your eating and exercise habits. Twice each week they will provide you with information on our website about food, food preparation, eating out, losing weight, getting fit and much more. In addition to providing new information each week on the website, they create a web page specially for you where you can track progress in areas such as your weight, blood pressure, and exercise. I strongly recommend you get this book and read it. 4. Measure your BP: Measure your BP daily so you can see if it is getting better. If you are taking meds be sure to tell your health care team you are doing this as your BP may plummet to normal quickly. We recommend you use a device you listen to and will help you learn how to do this. If this is not something you want to do we can teach a significant other how to do it. See sharedcareinc.com or email to sharedcare@... to order a video on how to do this. If you already have one we will teach you how to teach your health care team how to validate your device. Your life and health depends on accurate BP measurements. Go to the amricanheart.org and download the Guidelines for Human Blood Pressure Measurement. Insist the your health care team do BP the AHA way. Never trust your life to an automatic BP machine unless you know it is accurate on YOU. 5. Genetics and your BP: Go to familyhistory.hhs.gov and do your detailed family medical history so we can review with you to help Dx familial causes of high blood pressure and heart disease. If BP runs in your family you may save lives in your family by checking their BP yourself. 6. How to DX and treat PA: Go to our file/Conn's Articles of Note/Medications/Bravo spir 1973.pdf and read this article and take to your health care team. It is old but still one of the best in the medical management of PA. Also see our file from the Endocrine Society Guidelines on PA. Dr. Grim's Perfect Primary Aldosteronism Blood and Urine Testing to diagnose PA in one day. 1. Eat a regular to high salt diet for 2 weeks.2. No BP meds in last 4-12 weeks depending on meds.3. Collect 24 hr urine for Na, K and creatinine and aldosterone. Do not lose a drop of this liquid gold. It is impossible to interpret the renin and aldo without this.4. The morning you finish the 24 hr urine have fasting blood drawn for renin, aldo and K using our guidelines to get an accurate K. Try to get this done about 4 hours after you have been out of bed.5. Send us the results with the normal values for your lab.6. If you ever have a salt (saline) infusion test for PA be certain to ask them to measure how much you pee during the 4 hours of the infusion. If it is 1-1.5 liter of urine it strongly suggests that you may have PA. If more tha 1.5 L you almost certainly have PA. 8. Become a participant in our PA Registry and contribute to our large database on PA: If you have been Dxed with PA already and are on Rx or have had surgery please go to http://www.kwiksurveys.com/online-survey.php?surveyID=HIJIO_f2685379 and complete our survey with as much information as you know. If there is some information you don't know ask us and we will help. If you need to update this as you journey thru the diagnostic/treatment process you can add another entry but label it as Nameyymmdd. For example today 6/12/09 for me would be Grim090612. This ever increasing number will allow us and you to sort your multiple entries into a dated order. 9. Learn the language: If you are new to medical lingo then download the acroyms from http://health.groups.yahoo.com/group/bloodpressureline/message/2918610. Salt and high blood pressure: To learn the state of the science of salt and blood pressure please spend some time looking at http://www.worldactiononsalt.com/evidence/treatment_trials.htm11. Become a HBP expert consumer: Expect that it will take at least several weeks to get all this digested and to learn the new language of high blood pressure health care. As most doctors and nurses in practice have had very little training in high blood pressure you must become an expert yourself. For example most have never had anyone listen with them with a double stethoscope to verify that they can hear BP sounds. We cannot make you a doctor but we will make you a pretty good BP doctor.12. How High Blood Pressure should be managed: Go to nih.gov and download and read the Joint National Commission (JNC) Report 7 to get an overview on current guidelines. I ask all my secretaries to read this so they can communicate the importance of high blood pressure to my patients. JNC 8 will be out soon.Then: get (and study) the Hypertension Primer from americanheart.org. This is the most up-to-date compendium of what is known about high blood pressure and what every Dr. should know when they graduate from Medical School. Every chapter is only 2-3 pages. Read one chapter every week-night and you will finish it in about a year. I am working on a reading guide for lay people for the Primer. Stay tuned.13. Ask us questions: Ask any questions about high blood pressure you want answered. That is what we are here for. We have had this site for 10 years and over 30,000 emails are searchable. This is the largest collection of communications about Conn's Syndrome in the World. 14. One-on-one Consulting: I can provide individual consulting if you do not want to go public. If you want individual one-on-one consulting for you and your Doctor contract me directly at lowerbp2@....May your pressure be low!Clarence E. Grim BS, MS, MD, FACP, FACC, FAHABoard Certified in Internal Medicine, Geriatrics, and High Blood Pressure Retired Faculty/Professor of Medicine (U of MO, Indiana, UCLA/DREW, Medical College of Wisconsin and Cardiology, Endocrinology, Nephrology, and Epidemiology. Specializing in Primary Aldosteronism and Difficult to Control High Blood Pressure. I'm going in on Thursday for the following test: basic panel and serum aldosterone.Shouldn't there be a urine test? Are these test a waste of my time if I want real answers to why I have high aldosterone.What would be the ideal test? Please help I am feeling pressured for time! Thank youSent from my iPad Not that I know of or can make a connection to in my wildest Endocrine/Heme thoughs. But then another reason we need a good data base.Do you do data bases?CE Grim,MDIs there any connection between high aldosterone and low ferritin?Sent from my iPad If your BP and K is normal you may not need to DASH.Runners may have aldo if it was collected after a run.Drink when you are thirsty. A low Na suggests you are drinking too much.CE Grim MDCould I get some input on water intake? I tried searching the web-site about dashing but couldn't find what I was looking for.I know are bodies are constantly trying to keep things in balance so I feel like h2o consumption is just as important as sodium intake. However, I don't think I can assume the average 8 cups a day will be my norm.Here are a few things that I think might influence my sodium/h20 consumption: I have lowish serum sodium 138 (135-145), I have low blood pressure110/65, high aldosterone (24 hr urine 54.3 ( 17-44) and I am active ( runner)I feel it is reasonable that I keep my sodium intake at the higher end of the Dashing Diet , because of low sodium and low blood pressure and activity level, but I also want to try and lower aldosterone naturally ( if possible) and I'm hoping maybe it's a matter of the right amount of daily water and sodium consumption. Are there any right ratios for this? For example, if you consume 1,500 mg of sodium you should have 8 cups of h2o or maybe if you consume 2,300 mg of sodium you should shoot for 10 cups of h2o?Thanks so much! Really trying to get it right!Sent from my iPad Keep us posted. so you have high renin and high aldo and low K and low BP?CE Grim MDHi Dr. Grim, The following post grabbed my attention. I started following you and this site when I was thought to have primary hyperaldosteronism. I had all the expected abnormal lab results except for low to normal blood pressure. Eventually, labaratory results confirmed Bartters Syndrome and now I follow both yahoo groups. > > >>>>>>>>>> > > >>>>>>>>>>> > > >>>>>>>>>>> Hi everyone, just joined today. Thanks to all of you for this support!> > >>>>>>>>>>> > > >>>>>>>>>>> I tested high for aldosterone two years ago through a urine test. My ND at the time was not concerned, he thought it was due to the fact that I was a runner. I also thought that made since and was also following a low salt diet. So we ignored it.> > >>>>>>>>>>> > > >>>>>>>>>>> I am treAting a thyroid issue, thyroid hormone resistance, and through recent blood work tested high for aldosterone again. This time I decided not to ignore it! > > >>>>>>>>>>> > > >>>>>>>>>>> I do not have a high blood pressure. It runs pretty normal to low. I don't have issues with potassium. This is all Very confusing as to why I have high aldosterone.> > >>>>>>>>>>> > > >>>>>>>>>>> I am trying to get into a endocrinologist but will take about three months. I need some education and advise on where to start.> > >>>>>>>>>>> > > >>>>>>>>>>> I don't even know if this is primary or secondary.> > >>>>>>>>>>> > > >>>>>>>>>>> My only real "health" issue, that I know about, has been hair loss. This was one reason for exploring the thyroid but I am wondering if it has been the aldosterone all along. Maybe the aldosterone is what's causing my thyroid issues.> > >>>>>>>>>>> > > >>>>>>>>>>> Any comments or advice would be greatly appreciated.> > >>>>>>>>>>> > > >>>>>>>>>>> My labs:> > >>>>>>>>>>> > > >>>>>>>>>>> 9/26/2008> > >>>>>>>>>>> Aldosterone (urine)> > >>>>>>>>>>> High 54.3. (normal diet 6-25, low salt 17-44, high salt0-6)> > >>>>>>>>>>> > > >>>>>>>>>>> Other adrenal hormones were fine at that time. Cortisol was pretty middle of the road. *Progesterone however was really high too. I can post if necessary.> > >>>>>>>>>>> > > >>>>>>>>>>> Rbc potassium 7/14/2010> > >>>>>>>>>>> 97. (90-111)> > >>>>>>>>>>> > > >>>>>>>>>>> Blood aldosterone 7/18/2010> > >>>>>>>>>>> 52.0. (1-16)> > >>>>>>>>>>> > > >>>>>>>>>>> Blood aldosterone/renin 6/30/2010> > >>>>>>>>>>> Aldosterone 49. (1-16)> > >>>>>>>>>>> Renin. 3.3. (random ambulatory 0.8-2.5, non ambulatory 1.5-5.2)> > >>>>>>>>>>> I was sitting, fasting, taking two hours after waking before/around 8am> > >>>>>>>>>>> > > >>>>>>>>>>> Aldosterone renin ratio = 15> > >>>>>>>>>>> > > >>>>>>>>>>> Sodium. 138. (135-145)> > >>>>>>>>>>> Potassium. 4.5. (3.5-5.3)> > >>>>>>>>>>> Chloride. 106. (98-109)> > >>>>>>>>>>> Co2. 23. (22-31)> > >>>>>>>>>>> Anion gap. 9. (5-16)> > >>>>>>>>>>> > > >>>>>>>>>>> Saliva cortisol 5/23/2010> > >>>>>>>>>>> 7am. 3.7. (3.7-9.5)> > >>>>>>>>>>> 11am. 1.6. (1.2-3.0)> > >>>>>>>>>>> 5pm. 1.3. (0.6-1.9)> > >>>>>>>>>>> 9pm. 0.5. (0.4-1.0)> > >>>>>>>>>>> > > >>>>>>>>>>> Rbc magnesium 5/26/2010> > >>>>>>>>>>> 4.2. (4.0-6.4)> > >>>>>>>>>>> > > >>>>>>>>>>> Lot of test!!!!> > >>>>>>>>>>> > > >>>>>>>>>>> Thanks again for your kind support! Suzanne> > >>>>>>>>>>> > > >>>>>>>>>>> > > >>>>>>>>>> > > >>>>>>>>> > > >>>>>>>>> > > >>>>>>>> > > >>>>>>>> > > >>>>>>> > > >>>>>>> > > >>>>>> > > >>>>>> > > >>>>> > > >>>>> > > >>>> > > >>>> > > >>> > > >>> > > >> > > > > > >> >> > > Reply to sender |>

[Guest guest]

Hi Suzanne,

The normal renin range is listed

for you on your lab report.  What you're

looking for is the ARR = aldosterone/renin ratio.  Anything over 20 is suggestive of PA.  The higher, the more suggestive.  Your blood K of 4.2 is fine.  HTN = hypertension.

Your wild vaiations in test

results suggests to me for you to relax, check your blood pressure once in a

while and maybe get re-tested in a year.

I've heard about rT3 and even

had mine tested once.  I'm not sure it is

a valid concept.  Is your Free T3 low?

Val

From:

hyperaldosteronism [mailto:hyperaldosteronism ] On

Behalf Of Suzanne Kann

Hi

Val,

Well

I like your response much better than Dr. Grim's. If I understood his response

he is saying my low potassium intake during the urine test could have caused

the lower aldosterone reading. Not sure if that is concrete or speculation. I

think the only way to know for sure is to redo the test with a higher potassium

intake.

So

would you mind telling me which range I am looking at with the renin: non

ambulatory or ambulatory.

Sorry,

but what is HTN?

I

have only tested potassium through blood and it is always around mid range, 4.2

(3.5-5.0) This was the first urine K I have done and I guess it is a reflection

of intake.

My

thyroid situation is called reverse t3. Is that something you are familiar with?

I make plenty of t4 but I convert it to mostly rt3 (which is the inactive form

of t3). Usually people do this because they have low iron, adrenal fatigue, or

electrolye imbalance. Basically treating this is like how you treat for hypo.

If you are still interested I'll post my labs prior to treatment.

Thanks for your help,Suzanne

[Guest guest]

K = 4.2 is nice.  You still need to trim messages.

From: hyperaldosteronism

[mailto:hyperaldosteronism ] On Behalf Of Suzanne Kann

Sorry

another question. Would my blood potassium result mean anything? It is not low:

4.2

(3.5-5.0)

Sent from my iPad

On Dec 8, 2010, at 5:42 PM, Suzanne Kann

wrote:

So,

Dr. Grim, you have come to the conclusion that I have early stage PA based on

the possibility that my low k intake could have lowered my aldosterone result?

If this is correct would it be safe to assume I could redo the test with a

higher potassium/sodium intake and see how the results might change. Could

doing this rule out or confirm PA?

Sent from my iPad

[Guest guest]

If you want to find for sure the effect of K on plasma aldo you should pubmed Dr. JH Bauer and potassium and renin and aldo. One of my former students.CE Grim MDHi Suzanne, The normal renin range is listed for you on your lab report. What you're looking for is the ARR = aldosterone/renin ratio. Anything over 20 is suggestive of PA. The higher, the more suggestive. Your blood K of 4.2 is fine. HTN = hypertension. Your wild vaiations in test results suggests to me for you to relax, check your blood pressure once in a while and maybe get re-tested in a year. I've heard about rT3 and even had mine tested once. I'm not sure it is a valid concept. Is your Free T3 low? Val From: hyperaldosteronism [mailto:hyperaldosteronism ] On Behalf Of Suzanne Kann Hi Val, Well I like your response much better than Dr. Grim's. If I understood his response he is saying my low potassium intake during the urine test could have caused the lower aldosterone reading. Not sure if that is concrete or speculation. I think the only way to know for sure is to redo the test with a higher potassium intake. So would you mind telling me which range I am looking at with the renin: non ambulatory or ambulatory. Sorry, but what is HTN? I have only tested potassium through blood and it is always around mid range, 4.2 (3.5-5.0) This was the first urine K I have done and I guess it is a reflection of intake. My thyroid situation is called reverse t3. Is that something you are familiar with? I make plenty of t4 but I convert it to mostly rt3 (which is the inactive form of t3). Usually people do this because they have low iron, adrenal fatigue, or electrolye imbalance. Basically treating this is like how you treat for hypo. If you are still interested I'll post my labs prior to treatment. Thanks for your help,Suzanne

[Guest guest]

Most with PA have normal K. Read my article.Most here do not but our folks tend to be the worst cases AKA classical PA in my article.CE Grim MDK = 4.2 is nice. You still need to trim messages. From: hyperaldosteronism [mailto:hyperaldosteronism ] On Behalf Of Suzanne Kann Sorry another question. Would my blood potassium result mean anything? It is not low: 4.2 (3.5-5.0)Sent from my iPad So, Dr. Grim, you have come to the conclusion that I have early stage PA based on the possibility that my low k intake could have lowered my aldosterone result? If this is correct would it be safe to assume I could redo the test with a higher potassium/sodium intake and see how the results might change. Could doing this rule out or confirm PA?Sent from my iPad

[Guest guest]

hi Val,I do have renin ranges on my labs but there are two: ambulatory and non ambulatory. Wasn't sure which range I should be looking at.I know what you mean about questioning rt3 being a valid concept. I did do a lot of research and there was enough evidence out there for me to decide it was worth a shot at "correcting". I have also met some people who have had the same issues, fixed the rt3, and changed their lives completely.So how did your test turn out? I would like to see those results. Yes, my free t3 was low and my free t4 was high so it made sense with my hypo symptoms to treat with t3 only. I also had low ferritin which is really common when not converting properly.Suzanne

[Guest guest]

Val you wrote" Anything over 20 is suggestive of PA."

IS IT 20 or 25? My labs say 25

Thanks for your help,Suzanne