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

October 3, 2010

yeah yeah yeah---give us the numbers and conditions under which they were collected.So your BP used to be 90 on the top and now is 138 but still "normal" and you dont call this high blood pressure for YOU?Need details and numbers.Even from an iPad owner. Covet covet.CE Grim MDHigh aldosteroneHigh reninLow sodiumNormal potassiumNormal blood pressureSent from my iPad Don't know the details of your history. Tiped sad Send form miiPhone ;-)May your pressure be low!CE Grim MDSpecializing in DifficultHypertension Luckly I have a friend who is a general surgeon and got me an appointment with an inertnist tomorrow. Is there anything I should know to be best prepared? I will have all labs with me. Are there questions I should make sure to ask or test I should ask for?DSent from my iPad My guess is the non amb amb is mixed up. Should be higher amb. Tiped sad Send form miiPhone ;-)May your pressure be low!CE Grim MDSpecializing in DifficultHypertension Renin. 3.3Non ambulatory 1.5-5.2Ambulatory. 0.8-2.5I was sitting for the draw. Would I be ambulatory or non ambulatory? >> Yes review my article. But your renin does not seem low but need normal values for that lab. > > Tiped sad Send form mi> iPhone ;-)> > May your pressure be low!> > CE Grim MD> Specializing in Difficult> Hypertension> > > > > Is it possible to have primary hyperaldosteronism and NOT have high blood pressure?> > > > Sent from my iPad> > > > > > > >> > >> Excellent. How do you like the iPad. There is a new BP app for it but I don't have one--an iPad.> >> > >> > >> It tracks BP. > >> > >> > >> > >> > >>> > >>> > >>> > >>> Sent from my iPad> >>> > >>> > >>> > >>>> > >>>> > >>>> > >>>> > >>>> > >>>> > >>>> Why was the aldo done in the first place?> >>> > >>> After I stopped nursing my third child I started having "hormonal" issues. So I went to see a ND and he ran a 24 hour urine test to see what sex hormones were doing. Test included estrogens, progesterone, all the androgens, thyroid, and aldosterone. That's when the high aldosterone was picked up. That was two years ago. The dr ignored those results because he said the high aldosterone didn't make sense. The urine test showed low estrogen , androgens,and low t4. Progesterone was high along with the aldosterone. He started treating the thyroid and sex hormones.> >>> > >>> My "hormonal" issues have not resolved so we are still looking for answers. I knew that my thyroid issue could cause low aldosterone and I was having low aldosterone symptoms so we had those test run again.Only this time through blood. What I thought was going to be low came back high! So the search for answers continues. > >>>> > >>>> > >>>> CE Grim MD > >>>> > >>>> > >>>>> > >>>>> The renin was 3.3> >>>>> > >>>>> Sent from my iPad> >>>>> > >>>>> > >>>>> > >>>>>> > >>>>>> Not if you are running unless you do not replace the salt. > >>>>>> > >>>>>> > >>>>>> Still need to verify renin numbers. 3.3 or 33?> >>>>>> > >>>>>> One needs renin and aldo and 24 hr urine to test.> >>>>>> > >>>>>> > >>>>>> > >>>>>> > >>>>>>> > >>>>>>> Is it possible that I am salt wasting?> >>>>>>> > >>>>>>> Sent from my iPad> >>>>>>> > >>>>>>> > >>>>>>> > >>>>>>>> > >>>>>>>> I read 3.3 on first message. Was it 33 or 3.3?> >>>>>>>> > >>>>>>>> > >>>>>>>> > >>>>>>>>> > >>>>>>>>> I do have a renin lab it is on the lower part of the first message.> >>>>>>>>> > >>>>>>>>> Renin 33. (non ambulatory 0.8-2.5, ambulatory 1.5-5 .2)> >>>>>>>>> > >>>>>>>>> My ND is trying to lower it with spironolactone, however, I want to explore this more to know "why" it's high.> >>>>>>>>> > >>>>>>>>> > >>>>>>>>> > >>>>>>>>> Sent from my iPad> >>>>>>>>> > >>>>>>>>> > >>>>>>>>> > >>>>>>>>>> > >>>>>>>>>> > >>>>>>>>>> You need a renin level and your ND should be able to lower it. Can also do a 24 hr urine 4 Na K and creat. If you are really in a low na diet that may be controlling the BP. > >>>>>>>>>> > >>>>>>>>>> Tiped sad Send form mi> >>>>>>>>>> iPhone ;-)> >>>>>>>>>> > >>>>>>>>>> May your pressure be low!> >>>>>>>>>> > >>>>>>>>>> CE Grim MD> >>>>>>>>>> Specializing in Difficult> >>>>>>>>>> Hypertension> >>>>>>>>>> > >>>>>>>>>> > >>>>>>>>>> > >>>>>>>>>>> > >>>>>>>>>>> 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 | Reply to group | Reply via web post | Start a New TopicMessages in this topic (9)RECENT ACTIVITY:

October 3, 2010

I think you might have me confused with someone else!!! I've never had a blood pressure of 138! Not sure where you got this info cause it wasn't from me. On the bottom of this thread dated September 14th I gave my story, labs, and conditioned in which these labs were run. It's all I got cannot give any more info.I saw an Internist last week. She took me off Spiro and will be running test in six weeks. She is doing blood and urine. Anything I should do before these test: in example salt fasting, salt loading?Thanks,SuzanneSent from my iPad

yeah yeah yeah---give us the numbers and conditions under which they were collected.So your BP used to be 90 on the top and now is 138 but still "normal" and you dont call this high blood pressure for YOU?Need details and numbers.Even from an iPad owner. Covet covet.CE Grim MDHigh aldosteroneHigh reninLow sodiumNormal potassiumNormal blood pressureSent from my iPad Don't know the details of your history. Tiped sad Send form miiPhone ;-)May your pressure be low!CE Grim MDSpecializing in DifficultHypertensionOn Sep 23, 2010, at 11:02 AM, Suzanne Kann

wrote: Luckly I have a friend who is a general surgeon and got me an appointment with an inertnist tomorrow. Is there anything I should know to be best prepared? I will have all labs with me. Are there questions I should make sure to ask or test I should ask for?DSent from my iPad My guess is the non amb amb is mixed up. Should be higher amb. Tiped sad Send form miiPhone ;-)May your pressure be low!CE Grim MDSpecializing in DifficultHypertension Renin. 3.3Non ambulatory 1.5-5.2Ambulatory. 0.8-2.5I was sitting for the draw. Would I be ambulatory or non ambulatory? >> Yes review my article. But your renin does not seem low but need normal values for that lab. > > Tiped sad Send form mi> iPhone ;-)> > May your pressure be low!> > CE Grim

MD> Specializing in Difficult> Hypertension> > > > > Is it possible to have primary hyperaldosteronism and NOT have high blood pressure?> > > > Sent from my iPad> > > > > > > >> > >> Excellent. How do you like the iPad. There is a new BP app for it but I don't have one--an iPad.> >> > >> > >> It tracks BP. > >> > >> > >> > >> > >>> > >>> > >>> > >>> Sent from my iPad> >>> > >>> > >>> > >>>> >

>>>> > >>>> > >>>> > >>>> > >>>> > >>>> Why was the aldo done in the first place?> >>> > >>> After I stopped nursing my third child I started having "hormonal" issues. So I went to see a ND and he ran a 24 hour urine test to see what sex hormones were doing. Test included estrogens, progesterone, all the androgens, thyroid, and aldosterone. That's when the high aldosterone was picked up. That was two years ago. The dr ignored those results because he said the high aldosterone didn't make sense. The urine test showed low estrogen ,

androgens,and low t4. Progesterone was high along with the aldosterone. He started treating the thyroid and sex hormones.> >>> > >>> My "hormonal" issues have not resolved so we are still looking for answers. I knew that my thyroid issue could cause low aldosterone and I was having low aldosterone symptoms so we had those test run again.Only this time through blood. What I thought was going to be low came back high! So the search for answers continues. > >>>> > >>>> > >>>> CE Grim MD > >>>> > >>>> > >>>>> > >>>>> The renin was 3.3> >>>>> > >>>>> Sent from my iPad> >>>>> > >>>>> > >>>>> > >>>>>> > >>>>>> Not if you are running unless you do not replace the salt. > >>>>>> > >>>>>> >

>>>>>> Still need to verify renin numbers. 3.3 or 33?> >>>>>> > >>>>>> One needs renin and aldo and 24 hr urine to test.> >>>>>> > >>>>>> > >>>>>> > >>>>>> > >>>>>>> > >>>>>>> Is it possible that I am salt wasting?> >>>>>>> > >>>>>>> Sent from my iPad> >>>>>>> >

>>>>>>> > >>>>>>> > >>>>>>>> > >>>>>>>> I read 3.3 on first message. Was it 33 or 3.3?> >>>>>>>> > >>>>>>>> > >>>>>>>> > >>>>>>>>> > >>>>>>>>> I do have a renin lab it is on the lower part of the first message.> >>>>>>>>> >

>>>>>>>>> Renin 33. (non ambulatory 0.8-2.5, ambulatory 1.5-5 .2)> >>>>>>>>> > >>>>>>>>> My ND is trying to lower it with spironolactone, however, I want to explore this more to know "why" it's high.> >>>>>>>>> > >>>>>>>>> > >>>>>>>>> > >>>>>>>>> Sent from my iPad> >>>>>>>>> > >>>>>>>>> > >>>>>>>>> > >>>>>>>>>> > >>>>>>>>>> > >>>>>>>>>> You need a renin level and your ND should be able to lower it. Can also do a 24 hr urine 4 Na K and creat. If you are really in a low na diet that may be controlling the BP. > >>>>>>>>>> > >>>>>>>>>> Tiped sad Send form mi> >>>>>>>>>> iPhone ;-)> >>>>>>>>>> > >>>>>>>>>> May your pressure be low!>

>>>>>>>>>> > >>>>>>>>>> CE Grim MD> >>>>>>>>>> Specializing in Difficult> >>>>>>>>>> Hypertension> >>>>>>>>>> > >>>>>>>>>> > >>>>>>>>>> > >>>>>>>>>>> > >>>>>>>>>>> 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 | Reply to group | Reply via

web post | Start a New TopicMessages in this topic (9)RECENT ACTIVITY:

October 21, 2010

I am sorry for asking this question because I know it is probably somewhere in the files I just cannot find it. I'm curious to know how much sodium is in the Dash diet? Thank youSent from my iPad

Then I need your complete story. See our files for examples. I am available for individual consulting if u prefer. $500 gets you access to my expertise for a year and your dr as well. Tiped sad Send form miiPhone ;-)May your pressure be low!CE Grim MDSpecializing in DifficultHypertension

I don't have a dr right now...waiting. Wondering what your opionion is?Sent from my iPad

I can't read his mind the drsTiped sad Send form miiPhone ;-)May your pressure be low!CE Grim MDSpecializing in DifficultHypertension

I don't know about na or k. I think I was supplementing 10meq of potassium around this time. Was not worried at the time with na. Never had trouble with bp so never really thought about salt other than knowing not to use table salt. I use Celtic sea salt. I didn't take any supplements the day I tested or use salt for a day or two. What do you think, is this looking like primary or secondary hyperaldosteronism? If secondary, what should I be looking at for the cause?Sent from my iPad

But how much Na and K a day. DASH goal is 1500 mg Na and 4000 KTiped sad Send form miiPhone ;-)May your pressure be low!CE Grim MDSpecializing in DifficultHypertension

T3 cytomel, only med at that time. Tested day four of menstrual cycle. Salt fasted for about 40 hours. Blood draw was at 8amDiet is pretty clean, organic meats,veggies,fruits and gluten free grains.Sent from my iPad

AmbWhat meds and diet and time of day and menstrual cycle details. Tiped sad Send form miiPhone ;-)May your pressure be low!CE Grim MDSpecializing in DifficultHypertension

Renin. 3.3Non ambulatory 1.5-5.2Ambulatory. 0.8-2.5I was sitting for the draw. Would I be ambulatory or non ambulatory?

>

> Yes review my article. But your renin does not seem low but need normal values for that lab.

>

> Tiped sad Send form mi

> iPhone ;-)

>

> May your pressure be low!

>

> CE Grim MD

> Specializing in Difficult

> Hypertension

>

> > Is it possible to have primary hyperaldosteronism and NOT have high blood pressure?

> >

> > Sent from my iPad

> >

> >>

> >> Excellent. How do you like the iPad. There is a new BP app for it but I don't have one--an iPad.

> >>

> >> It tracks BP.

> >>

> >>>

> >>> Sent from my iPad

> >>>

> >>>>

> >>>> Why was the aldo done in the first place?

> >>>

> >>> After I stopped nursing my third child I started having "hormonal" issues. So I went to see a ND and he ran a 24 hour urine test to see what sex hormones were doing. Test included estrogens, progesterone, all the androgens, thyroid, and aldosterone. That's when the high aldosterone was picked up. That was two years ago. The dr ignored those results because he said the high aldosterone didn't make sense. The urine test showed low estrogen , androgens,and low t4. Progesterone was high along with the aldosterone. He started treating the thyroid and sex hormones.

> >>>

> >>> My "hormonal" issues have not resolved so we are still looking for answers. I knew that my thyroid issue could cause low aldosterone and I was having low aldosterone symptoms so we had those test run again.Only this time through blood. What I thought was going to be low came back high! So the search for answers continues.

> >>>>

> >>>> CE Grim MD

> >>>>

> >>>>>

> >>>>> The renin was 3.3

> >>>>>

> >>>>> Sent from my iPad

> >>>>>

> >>>>>>

> >>>>>> Not if you are running unless you do not replace the salt.

> >>>>>>

> >>>>>> Still need to verify renin numbers. 3.3 or 33?

> >>>>>>

> >>>>>> One needs renin and aldo and 24 hr urine to test.

> >>>>>>

> >>>>>>>

> >>>>>>> Is it possible that I am salt wasting?

> >>>>>>>

> >>>>>>> Sent from my iPad

> >>>>>>>

> >>>>>>>>

> >>>>>>>> I read 3.3 on first message. Was it 33 or 3.3?

> >>>>>>>>

> >>>>>>>>>

> >>>>>>>>> I do have a renin lab it is on the lower part of the first message.

> >>>>>>>>>

> >>>>>>>>> Renin 33. (non ambulatory 0.8-2.5, ambulatory 1.5-5 .2)

> >>>>>>>>>

> >>>>>>>>> My ND is trying to lower it with spironolactone, however, I want to explore this more to know "why" it's high.

> >>>>>>>>>

> >>>>>>>>> Sent from my iPad

> >>>>>>>>>

> >>>>>>>>>>

> >>>>>>>>>> You need a renin level and your ND should be able to lower it. Can also do a 24 hr urine 4 Na K and creat. If you are really in a low na diet that may be controlling the BP.

> >>>>>>>>>>

> >>>>>>>>>> Tiped sad Send form mi

> >>>>>>>>>> iPhone ;-)

> >>>>>>>>>>

> >>>>>>>>>> May your pressure be low!

> >>>>>>>>>>

> >>>>>>>>>> CE Grim MD

> >>>>>>>>>> Specializing in Difficult

> >>>>>>>>>> Hypertension

> >>>>>>>>>>

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

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

> >>>>>>>>>>

October 21, 2010

Guess you did not get the welcome and buy the book?See item 3 below. Did you miss this or not believe me? Welcome 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 had 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. Overview: 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. 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. 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, read it and use it: $8 in paperback at your local bookstore. If they don’t have it ask them to order it for you. 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. 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. 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 and let your Dr. know you are doing this. Or go to (but costs money) DASH Diet for Health ProgramThe DASH Diet for Health Program is designed to help you improve your eating and exercise habits. Twice each week we 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 our website, we create a web page specially for you where you can track progress in areas such as your weight, blood pressure, and exercise.http://www.dashforhealth.com/ 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. Our PA Registry: 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. 8. Learn the language: If you are new to medical lingo then download the acroyms from http://health.groups.yahoo.com/group/bloodpressureline/message/291869. 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.htm10. 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.11. 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.12. Ask us questions: Ask any questions about high blood pressure you want answered. That is what we are here for.13. 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, FACCBoard 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 am sorry for asking this question because I know it is probably somewhere in the files I just cannot find it. I'm curious to know how much sodium is in the Dash diet? Thank youSent from my iPad Then I need your complete story. See our files for examples. I am available for individual consulting if u prefer. $500 gets you access to my expertise for a year and your dr as well. Tiped sad Send form miiPhone ;-)May your pressure be low!CE Grim MDSpecializing in DifficultHypertension I don't have a dr right now...waiting. Wondering what your opionion is?Sent from my iPad I can't read his mind the drsTiped sad Send form miiPhone ;-)May your pressure be low!CE Grim MDSpecializing in DifficultHypertension I don't know about na or k. I think I was supplementing 10meq of potassium around this time. Was not worried at the time with na. Never had trouble with bp so never really thought about salt other than knowing not to use table salt. I use Celtic sea salt. I didn't take any supplements the day I tested or use salt for a day or two. What do you think, is this looking like primary or secondary hyperaldosteronism? If secondary, what should I be looking at for the cause?Sent from my iPad But how much Na and K a day. DASH goal is 1500 mg Na and 4000 KTiped sad Send form miiPhone ;-)May your pressure be low!CE Grim MDSpecializing in DifficultHypertension T3 cytomel, only med at that time. Tested day four of menstrual cycle. Salt fasted for about 40 hours. Blood draw was at 8amDiet is pretty clean, organic meats,veggies,fruits and gluten free grains.Sent from my iPad AmbWhat meds and diet and time of day and menstrual cycle details. Tiped sad Send form miiPhone ;-)May your pressure be low!CE Grim MDSpecializing in DifficultHypertension Renin. 3.3Non ambulatory 1.5-5.2Ambulatory. 0.8-2.5I was sitting for the draw. Would I be ambulatory or non ambulatory? >> Yes review my article. But your renin does not seem low but need normal values for that lab. > > Tiped sad Send form mi> iPhone ;-)> > May your pressure be low!> > CE Grim MD> Specializing in Difficult> Hypertension> > > > > Is it possible to have primary hyperaldosteronism and NOT have high blood pressure?> > > > Sent from my iPad> > > > > > > >> > >> Excellent. How do you like the iPad. There is a new BP app for it but I don't have one--an iPad.> >> > >> > >> It tracks BP. > >> > >> > >> > >> > >>> > >>> > >>> > >>> Sent from my iPad> >>> > >>> > >>> > >>>> > >>>> > >>>> > >>>> > >>>> > >>>> > >>>> Why was the aldo done in the first place?> >>> > >>> After I stopped nursing my third child I started having "hormonal" issues. So I went to see a ND and he ran a 24 hour urine test to see what sex hormones were doing. Test included estrogens, progesterone, all the androgens, thyroid, and aldosterone. That's when the high aldosterone was picked up. That was two years ago. The dr ignored those results because he said the high aldosterone didn't make sense. The urine test showed low estrogen , androgens,and low t4. Progesterone was high along with the aldosterone. He started treating the thyroid and sex hormones.> >>> > >>> My "hormonal" issues have not resolved so we are still looking for answers. I knew that my thyroid issue could cause low aldosterone and I was having low aldosterone symptoms so we had those test run again.Only this time through blood. What I thought was going to be low came back high! So the search for answers continues. > >>>> > >>>> > >>>> CE Grim MD > >>>> > >>>> > >>>>> > >>>>> The renin was 3.3> >>>>> > >>>>> Sent from my iPad> >>>>> > >>>>> > >>>>> > >>>>>> > >>>>>> Not if you are running unless you do not replace the salt. > >>>>>> > >>>>>> > >>>>>> Still need to verify renin numbers. 3.3 or 33?> >>>>>> > >>>>>> One needs renin and aldo and 24 hr urine to test.> >>>>>> > >>>>>> > >>>>>> > >>>>>> > >>>>>>> > >>>>>>> Is it possible that I am salt wasting?> >>>>>>> > >>>>>>> Sent from my iPad> >>>>>>> > >>>>>>> > >>>>>>> > >>>>>>>> > >>>>>>>> I read 3.3 on first message. Was it 33 or 3.3?> >>>>>>>> > >>>>>>>> > >>>>>>>> > >>>>>>>>> > >>>>>>>>> I do have a renin lab it is on the lower part of the first message.> >>>>>>>>> > >>>>>>>>> Renin 33. (non ambulatory 0.8-2.5, ambulatory 1.5-5 .2)> >>>>>>>>> > >>>>>>>>> My ND is trying to lower it with spironolactone, however, I want to explore this more to know "why" it's high.> >>>>>>>>> > >>>>>>>>> > >>>>>>>>> > >>>>>>>>> Sent from my iPad> >>>>>>>>> > >>>>>>>>> > >>>>>>>>> > >>>>>>>>>> > >>>>>>>>>> > >>>>>>>>>> You need a renin level and your ND should be able to lower it. Can also do a 24 hr urine 4 Na K and creat. If you are really in a low na diet that may be controlling the BP. > >>>>>>>>>> > >>>>>>>>>> Tiped sad Send form mi> >>>>>>>>>> iPhone ;-)> >>>>>>>>>> > >>>>>>>>>> May your pressure be low!> >>>>>>>>>> > >>>>>>>>>> CE Grim MD> >>>>>>>>>> Specializing in Difficult> >>>>>>>>>> Hypertension> >>>>>>>>>> > >>>>>>>>>> > >>>>>>>>>> > >>>>>>>>>>> > >>>>>>>>>>> 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> >>>>>>>>>>

October 21, 2010

Just didn't get to right place. Thanks! Got it!Sent from my iPad

Guess you did not get the welcome and buy the book?See item 3 below. Did you miss this or not believe me? Welcome 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 had 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 canâ€™t make you a doctor we will make you into a pretty good BP doctor-a skill that you will have for life. 1. Overview: 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. Other patients with hyperaldosteronism (Connâ€™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/Connâ€™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. 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, read it and use it: $8 in paperback at your local bookstore. If they donâ€™t have it ask them to order it for you. 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. 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. 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 and let your Dr. know you are doing this. Or go to (but costs money) DASH Diet for Health ProgramThe DASH Diet for Health Program is

designed to help you improve your eating and exercise habits. Twice each week we 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 our website, we create a web page specially for you where you can track progress in areas such as your weight, blood pressure, and exercise.http://www.dashforhealth.com/ 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. Our PA Registry: 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. 8. Learn the language: If you are new to medical lingo then

download the acroyms from http://health.groups.yahoo.com/group/bloodpressureline/message/291869. 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.htm10. 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.11. 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.12. Ask us questions: Ask any questions about high blood pressure you want answered. That is what we are here for.13. 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, FACCBoard 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 am sorry for asking this question because I know it is probably somewhere in the files I just cannot find it. I'm curious to know how much sodium is in the Dash diet? Thank youSent from my iPad Then I need your complete story. See our files for examples. I am available for individual consulting if u prefer. $500 gets you access to my expertise for a year and your dr as well. Tiped sad Send form miiPhone

;-)May your pressure be low!CE Grim MDSpecializing in DifficultHypertension I don't have a dr right now...waiting. Wondering what your opionion is?Sent from my iPad I can't read his mind the drsTiped sad Send form miiPhone ;-)May your pressure be low!CE Grim MDSpecializing in DifficultHypertension I don't know about na or k. I think I was supplementing 10meq of potassium around this time. Was not worried at the time with na. Never had trouble with bp so never really thought about salt other than knowing not to use table salt. I use Celtic sea salt. I didn't take any supplements the day I tested or use salt for a day or two. What do you think, is this looking like primary or secondary hyperaldosteronism? If secondary, what should I be looking at for the cause?Sent from my iPad But how much Na and K a day. DASH goal is 1500 mg Na and 4000 KTiped sad Send form miiPhone ;-)May your pressure be low!CE Grim MDSpecializing in DifficultHypertension T3 cytomel, only med at that time. Tested day four of menstrual cycle. Salt fasted for about 40 hours. Blood draw was at 8amDiet is pretty clean, organic meats,veggies,fruits and gluten free grains.Sent from my iPadOn Sep 23, 2010, at 8:33 AM, Clarence Grim

wrote: AmbWhat meds and diet and time of day and menstrual cycle details. Tiped sad Send form miiPhone ;-)May your pressure be low!CE Grim

MDSpecializing in DifficultHypertension Renin. 3.3Non ambulatory 1.5-5.2Ambulatory. 0.8-2.5I was sitting for the draw. Would I be ambulatory or non ambulatory? >> Yes review my article. But your renin does not seem low but need normal values for that lab. > > Tiped sad Send form mi> iPhone ;-)> > May your pressure be low!> > CE Grim MD> Specializing in Difficult> Hypertension> > On Sep 22, 2010, at 8:54 PM, Suzanne Kann

wrote:> > > Is it possible to have primary hyperaldosteronism and NOT have high blood pressure?> > > > Sent from my iPad> > > > > > > >> > >> Excellent. How do you like the iPad. There is a new BP app for it but I don't have one--an iPad.> >> > >> > >> It tracks BP. > >> > >> > >> > >> > >>> > >>> > >>> > >>> Sent from my iPad> >>> > >>> > >>> > >>>> > >>>> > >>>> > >>>> >

>>>> > >>>> > >>>> Why was the aldo done in the first place?> >>> > >>> After I stopped nursing my third child I started having "hormonal" issues. So I went to see a ND and he ran a 24 hour urine test to see what sex hormones were doing. Test included estrogens, progesterone, all the androgens, thyroid, and aldosterone. That's when the high aldosterone was picked up. That was two years ago. The dr ignored those results because he said the high aldosterone didn't make sense. The urine test showed low estrogen , androgens,and low t4. Progesterone was high along with the aldosterone. He started treating the thyroid and sex hormones.> >>> > >>> My

"hormonal" issues have not resolved so we are still looking for answers. I knew that my thyroid issue could cause low aldosterone and I was having low aldosterone symptoms so we had those test run again.Only this time through blood. What I thought was going to be low came back high! So the search for answers continues. > >>>> > >>>> > >>>> CE Grim MD > >>>> > >>>> > >>>>> > >>>>> The renin was 3.3> >>>>> >

>>>>> Sent from my iPad> >>>>> > >>>>> > >>>>> > >>>>>> > >>>>>> Not if you are running unless you do not replace the salt. > >>>>>> > >>>>>> > >>>>>> Still need to verify renin numbers. 3.3 or 33?> >>>>>> > >>>>>> One needs renin and aldo and 24 hr urine to test.> >>>>>> > >>>>>> > >>>>>> > >>>>>> > >>>>>>> > >>>>>>> Is it possible that I am salt wasting?> >>>>>>> > >>>>>>> Sent from my iPad> >>>>>>> > >>>>>>> > >>>>>>> > >>>>>>>> > >>>>>>>> I read 3.3 on first message. Was it 33 or 3.3?> >>>>>>>> > >>>>>>>> > >>>>>>>> > >>>>>>>>> > >>>>>>>>> I do have a renin lab it is on the lower part of the first message.> >>>>>>>>> > >>>>>>>>> Renin 33. (non ambulatory 0.8-2.5, ambulatory 1.5-5 .2)> >>>>>>>>> > >>>>>>>>> My ND is trying to

lower it with spironolactone, however, I want to explore this more to know "why" it's high.> >>>>>>>>> > >>>>>>>>> > >>>>>>>>> > >>>>>>>>> Sent from my iPad> >>>>>>>>> > >>>>>>>>> > >>>>>>>>> > >>>>>>>>>> > >>>>>>>>>> >

>>>>>>>>>> You need a renin level and your ND should be able to lower it. Can also do a 24 hr urine 4 Na K and creat. If you are really in a low na diet that may be controlling the BP. > >>>>>>>>>> > >>>>>>>>>> Tiped sad Send form mi> >>>>>>>>>> iPhone ;-)> >>>>>>>>>> > >>>>>>>>>> May your pressure be low!> >>>>>>>>>> > >>>>>>>>>> CE Grim MD> >>>>>>>>>> Specializing in Difficult> >>>>>>>>>>

Hypertension> >>>>>>>>>> > >>>>>>>>>> > >>>>>>>>>> > >>>>>>>>>>> > >>>>>>>>>>> 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> >>>>>>>>>>

October 27, 2010

Most likely K. but need more details. Who, what, when, where makes it come on/or get better. You can give us a too detailed description of what it is you are talking about. I cannot read you mind.CE Grim MDSubject: Re: Re: 42 yo woman runner who has had aldo 52 and renin 3.3 normal bpJust wondering if my symptom of tingly feet. ( both feet/bottoms) are due to sodium? Potassium? Aldosterone? ThanksSent from my iPadIs salt bad even if you have low to normal bp? Don't we need some salt?Sent from my iPad Killer salt is salt even CelticTiped sad Send form miiPhone ;-)May your pressure be low!CE Grim MDSpecializing in DifficultHypertension I don't know about na or k. I think I was supplementing 10meq of potassium around this time. Was not worried at the time with na. Never had trouble with bp so never really thought about salt other than knowing not to use table salt. I use Celtic sea salt. I didn't take any supplements the day I tested or use salt for a day or two. What do you think, is this looking like primary or secondary hyperaldosteronism? If secondary, what should I be looking at for the cause?Sent from my iPad But how much Na and K a day. DASH goal is 1500 mg Na and 4000 KTiped sad Send form miiPhone ;-)May your pressure be low!CE Grim MDSpecializing in DifficultHypertension T3 cytomel, only med at that time. Tested day four of menstrual cycle. Salt fasted for about 40 hours. Blood draw was at 8amDiet is pretty clean, organic meats,veggies,fruits and gluten free grains.Sent from my iPad AmbWhat meds and diet and time of day and menstrual cycle details. Tiped sad Send form miiPhone ;-)May your pressure be low!CE Grim MDSpecializing in DifficultHypertension Renin. 3.3Non ambulatory 1.5-5.2Ambulatory. 0.8-2.5I was sitting for the draw. Would I be ambulatory or non ambulatory? >> Yes review my article. But your renin does not seem low but need normal values for that lab. > > Tiped sad Send form mi> iPhone ;-)> > May your pressure be low!> > CE Grim MD> Specializing in Difficult> Hypertension> > > > > Is it possible to have primary hyperaldosteronism and NOT have high blood pressure?> > > > Sent from my iPad> > > > > > > >> > >> Excellent. How do you like the iPad. There is a new BP app for it but I don't have one--an iPad.> >> > >> > >> It tracks BP. > >> > >> > >> > >> > >>> > >>> > >>> > >>> Sent from my iPad> >>> > >>> > >>> > >>>> > >>>> > >>>> > >>>> > >>>> > >>>> > >>>> Why was the aldo done in the first place?> >>> > >>> After I stopped nursing my third child I started having "hormonal" issues. So I went to see a ND and he ran a 24 hour urine test to see what sex hormones were doing. Test included estrogens, progesterone, all the androgens, thyroid, and aldosterone. That's when the high aldosterone was picked up. That was two years ago. The dr ignored those results because he said the high aldosterone didn't make sense. The urine test showed low estrogen , androgens,and low t4. Progesterone was high along with the aldosterone. He started treating the thyroid and sex hormones.> >>> > >>> My "hormonal" issues have not resolved so we are still looking for answers. I knew that my thyroid issue could cause low aldosterone and I was having low aldosterone symptoms so we had those test run again.Only this time through blood. What I thought was going to be low came back high! So the search for answers continues. > >>>> > >>>> > >>>> CE Grim MD > >>>> > >>>> > >>>>> > >>>>> The renin was 3.3> >>>>> > >>>>> Sent from my iPad> >>>>> > >>>>> > >>>>> > >>>>>> > >>>>>> Not if you are running unless you do not replace the salt. > >>>>>> > >>>>>> > >>>>>> Still need to verify renin numbers. 3.3 or 33?> >>>>>> > >>>>>> One needs renin and aldo and 24 hr urine to test.> >>>>>> > >>>>>> > >>>>>> > >>>>>> > >>>>>>> > >>>>>>> Is it possible that I am salt wasting?> >>>>>>> > >>>>>>> Sent from my iPad> >>>>>>> > >>>>>>> > >>>>>>> > >>>>>>>> > >>>>>>>> I read 3.3 on first message. Was it 33 or 3.3?> >>>>>>>> > >>>>>>>> > >>>>>>>> > >>>>>>>>> > >>>>>>>>> I do have a renin lab it is on the lower part of the first message.> >>>>>>>>> > >>>>>>>>> Renin 33. (non ambulatory 0.8-2.5, ambulatory 1.5-5 .2)> >>>>>>>>> > >>>>>>>>> My ND is trying to lower it with spironolactone, however, I want to explore this more to know "why" it's high.> >>>>>>>>> > >>>>>>>>> > >>>>>>>>> > >>>>>>>>> Sent from my iPad> >>>>>>>>> > >>>>>>>>> > >>>>>>>>> > >>>>>>>>>> > >>>>>>>>>> > >>>>>>>>>> You need a renin level and your ND should be able to lower it. Can also do a 24 hr urine 4 Na K and creat. If you are really in a low na diet that may be controlling the BP. > >>>>>>>>>> > >>>>>>>>>> Tiped sad Send form mi> >>>>>>>>>> iPhone ;-)> >>>>>>>>>> > >>>>>>>>>> May your pressure be low!> >>>>>>>>>> > >>>>>>>>>> CE Grim MD> >>>>>>>>>> Specializing in Difficult> >>>>>>>>>> Hypertension> >>>>>>>>>> > >>>>>>>>>> > >>>>>>>>>> > >>>>>>>>>>> > >>>>>>>>>>> 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 |

October 28, 2010

Ok I'll do my best to give details. The tingly feet has been a symptom I've had on and off for a few years. When I have it is constantly tingling: morning,noon, and night. I can also go months without having tingly feet at all.I recently lowered my thyroid meds ( t3) thinking it's possible there is a connection there. I would try upping the thyroid meds a little to see if it makes a difference but I'm having labs done next week and want to wait until then.I also think it could be electrolyles but not sure which one is off. Even though I have tested high aldosterone my sodium is lowish and potassium is normal.SerumSodium. 138. (135-145)Potassium. 4.5. (3.5-5.3)Sent from my iPadOn Oct 27, 2010, at 7:14 PM, Clarence Grim

wrote:

Most likely K. but need more details. Who, what, when, where makes it come on/or get better. You can give us a too detailed description of what it is you are talking about. I cannot read you mind.CE Grim MDSubject: Re: Re: 42 yo woman runner who has had aldo 52 and renin 3.3 normal bpJust wondering if my symptom of tingly feet. ( both feet/bottoms) are due to sodium? Potassium? Aldosterone? ThanksSent from my iPadIs salt bad even if you have low to normal bp? Don't we need some salt?Sent from my iPad Killer salt is salt even CelticTiped sad Send form miiPhone ;-)May your pressure be low!CE Grim MDSpecializing in DifficultHypertension I don't know about na or k. I think I was supplementing 10meq of potassium around this time. Was not worried at the time with na. Never had trouble with bp so never really thought about salt other than knowing not to use table salt. I use Celtic sea salt. I didn't take any supplements the day I tested or use salt for a day or two. What do you think, is this looking like primary or secondary hyperaldosteronism? If secondary, what should I be looking at for the cause?Sent from my iPad But how much Na and K a day. DASH goal is 1500 mg Na and 4000 KTiped sad Send form miiPhone ;-)May your pressure be low!CE Grim MDSpecializing in DifficultHypertension T3 cytomel, only med at that time. Tested day four of menstrual cycle. Salt fasted for about 40 hours. Blood draw was at 8amDiet is pretty clean, organic meats,veggies,fruits and gluten free grains.Sent from my iPadOn Sep 23, 2010, at 8:33 AM,

Clarence Grim wrote: AmbWhat meds and diet and time of day and menstrual cycle details. Tiped sad Send form miiPhone ;-)May your pressure be low!CE Grim