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

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Could 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 |>

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Feel your pulse at the wrist as the device takes your BP. Note the reading at which the pulse stops on the way up and then reappears on the way down. this should be within 10 of what it reads for the systolic if you are a good pulse feeler and the device is accurate.CE Grim MD Ok, started taking blood pressure in both arms and they are the same. Today I am 110/65. The last few days I was 110/70 ( had been reading it wrong thought I was at 115 the whole time but realize it was actually 110.)Sent from my iPad Trust BP is the same in both arms?And device is accurate on you.CE Grim, MDSuzanne, I am a 47 yo woman who has high aldo, low K, and low bp. My pressure generally runs 100/60 and it's not unusual to run lower especially when my K is low. This puzzles my endo but we are working on it. Like you I am fit, and I eat an organic whole food gluten free diet. I have taken Dr. Grims advice and am following the DASH diet even though bp isn't an issue, but I have found it makes me feel better. I find that when my hands and feet tingle I need to take extra K (but thats just me). I hope we both get the info we are looking for so we can figure this out and move forward. LaurieTo: "hyperaldosteronism " <hyperaldosteronism >Sent: Thu, October 28, 2010 5:08:19 PMSubject: Re: Re: 42 yo woman runner who has had aldo 52 and renin 3.3 normal bp My blood pressure is running 115/70 (no meds) does this give any clues to cortisol/aldosterone relationship?Really trying to figure out why I have high aldosterone! ThanksSent from my iPad 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 |

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Can I do the 24 hr urine (sodium) test during menses?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 |>

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Depends on how much blood gets into the urine. Which depends on what you use for blood flow control.CE Grim MDCan I do the 24 hr urine (sodium) test during menses?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 |>

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Is 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]

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]

Is there any connection between high aldosterone and low ferritin?

Authors:

Kakigi, AkinobuOkada, TeruhikoTakeda, TaizoTaguchi, DaizoNishioka, Rie

Source: Acta Oto-Laryngologica; Mar2008, Vol. 128 Issue 3, p233-238, 6p, 1 Black and White Photograph, 1 Diagram, 1 Chart

Document Type: Article

Subject Terms: SODIUM channelsENDOCYTOSISFERRITINPEROXIDASEENDOSOMESAMILORIDE

Abstract:

Conclusion. This study indicates that epithelial Na+-selective channels (ENaC) recycle Na+ via clathrin-mediated endocytosis in the marginal cells of the stria vascularis and that clathrin-independent endocytosis appeared to be modulated by the amount of Na+ transported. These results suggest the presence of ENaC in the luminal membrane of marginal cells and that ENaC are an efficient pathway for the uptake of Na+ from the endolymph. Objective. The ENaC found in many transporting epithelia play a key role in the regulation of salts and water homeostasis, cellular pH, cell volume, and cell function. Both biochemical and physiological approaches have been used to identify, characterize, and quantify this important channel, but its location in the marginal cells of the stria vascularis has not been fully clarified. The aim of this study was to determine the localization and regulation of ENaC. Materials and methods. Forty healthy female guinea pigs were used: 20 for the control experiment, 10 for the amiloride experiment, and 10 for the aldosterone experiment. We perfused cationized ferritin (CF) and microperoxidase (MPO) as tracers for clathrin-mediated and clathrin-independent endocytosis, respectively, into the cochlear duct. After 30 min of endolymphatic perfusion, the tissues were fixed and CF- and MPO-loaded endosomes within the marginal cell were observed by transmission electron microscopy. The numbers of CF- and MPO-loaded endosomes were compared between the three groups.

Results. In the amiloride group, the numbers of CF- and MPO-loaded endosomes decreased in comparison with the control. In the aldosterone group, the numbers of CF- and MPO-loaded endosomes decreased and increased, respectively. Recently, it has been reported that ENaC are endocytosed via clathrin-mediated endosomes and aldosterone decreases the rate of endocytosis of ENaC. In this study, the results of the aldosterone experiment were consistent with those of recent studies. [ABSTRACT FROM AUTHOR]

Copyright of Acta Oto-Laryngologica is the property of & Francis Ltd and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

ISSN:

0001-6489

DOI:

10.1080/00016480701413821

Accession Number:

29435121

Database:

Psychology and Behavioral Sciences Collection

[Guest guest]

I appreciate this info but I don't understand what it means! would you mind explaining in layman terms?Sent from my iPad

Is there any connection between high aldosterone and low ferritin?

Authors:

Kakigi, AkinobuOkada, TeruhikoTakeda, TaizoTaguchi, DaizoNishioka, Rie

Source: Acta Oto-Laryngologica; Mar2008, Vol. 128 Issue 3, p233-238, 6p, 1 Black and White Photograph, 1 Diagram, 1 Chart

Document Type: Article

Subject Terms: SODIUM channelsENDOCYTOSISFERRITINPEROXIDASEENDOSOMESAMILORIDE

Abstract:

Conclusion. This study indicates that epithelial Na+-selective channels (ENaC) recycle Na+ via clathrin-mediated endocytosis in the marginal cells of the stria vascularis and that clathrin-independent endocytosis appeared to be modulated by the amount of Na+ transported. These results suggest the presence of ENaC in the luminal membrane of marginal cells and that ENaC are an efficient pathway for the uptake of Na+ from the endolymph. Objective. The ENaC found in many transporting epithelia play a key role in the regulation of salts and water homeostasis, cellular pH, cell volume, and cell function. Both biochemical and physiological approaches have been used to identify, characterize, and quantify this important channel, but its location in the marginal cells of the stria vascularis has not been fully clarified. The aim of this study was to determine the localization and regulation of ENaC. Materials and methods. Forty healthy female guinea pigs were used: 20 for the control experiment, 10 for the amiloride experiment, and 10 for the aldosterone experiment. We perfused cationized ferritin (CF) and microperoxidase (MPO) as tracers for clathrin-mediated and clathrin-independent endocytosis, respectively, into the cochlear duct. After 30 min of endolymphatic perfusion, the tissues were fixed and CF- and MPO-loaded endosomes within the marginal cell were observed by transmission electron microscopy. The numbers of CF- and MPO-loaded endosomes were compared between the three groups.

Results. In the amiloride group, the numbers of CF- and MPO-loaded endosomes decreased in comparison with the control. In the aldosterone group, the numbers of CF- and MPO-loaded endosomes decreased and increased, respectively. Recently, it has been reported that ENaC are endocytosed via clathrin-mediated endosomes and aldosterone decreases the rate of endocytosis of ENaC. In this study, the results of the aldosterone experiment were consistent with those of recent studies. [ABSTRACT FROM AUTHOR]

Copyright of Acta Oto-Laryngologica is the property of & Francis Ltd and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

ISSN:

0001-6489

DOI:

10.1080/00016480701413821

Accession Number:

29435121

Database:

Psychology and Behavioral Sciences Collection

[Guest guest]

I dont speak this lingo very well. Maybe someone else can. You might want to study genetics for a year and then come back to it.CEI appreciate this info but I don't understand what it means! would you mind explaining in layman terms?Sent from my iPad Is there any connection between high aldosterone and low ferritin?Authors:Kakigi, AkinobuOkada, TeruhikoTakeda, TaizoTaguchi, DaizoNishioka, RieSource: Acta Oto-Laryngologica; Mar2008, Vol. 128 Issue 3, p233-238, 6p, 1 Black and White Photograph, 1 Diagram, 1 ChartDocument Type: ArticleSubject Terms: SODIUM channelsENDOCYTOSISFERRITINPEROXIDASEENDOSOMESAMILORIDEAbstract:Conclusion. This study indicates that epithelial Na+-selective channels (ENaC) recycle Na+ via clathrin-mediated endocytosis in the marginal cells of the stria vascularis and that clathrin-independent endocytosis appeared to be modulated by the amount of Na+ transported. These results suggest the presence of ENaC in the luminal membrane of marginal cells and that ENaC are an efficient pathway for the uptake of Na+ from the endolymph. Objective. The ENaC found in many transporting epithelia play a key role in the regulation of salts and water homeostasis, cellular pH, cell volume, and cell function. Both biochemical and physiological approaches have been used to identify, characterize, and quantify this important channel, but its location in the marginal cells of the stria vascularis has not been fully clarified. The aim of this study was to determine the localization and regulation of ENaC. Materials and methods. Forty healthy female guinea pigs were used: 20 for the control experiment, 10 for the amiloride experiment, and 10 for the aldosterone experiment. We perfused cationized ferritin (CF) and microperoxidase (MPO) as tracers for clathrin-mediated and clathrin-independent endocytosis, respectively, into the cochlear duct. After 30 min of endolymphatic perfusion, the tissues were fixed and CF- and MPO-loaded endosomes within the marginal cell were observed by transmission electron microscopy. The numbers of CF- and MPO-loaded endosomes were compared between the three groups.Results. In the amiloride group, the numbers of CF- and MPO-loaded endosomes decreased in comparison with the control. In the aldosterone group, the numbers of CF- and MPO-loaded endosomes decreased and increased, respectively. Recently, it has been reported that ENaC are endocytosed via clathrin-mediated endosomes and aldosterone decreases the rate of endocytosis of ENaC. In this study, the results of the aldosterone experiment were consistent with those of recent studies. [ABSTRACT FROM AUTHOR] Copyright of Acta Oto-Laryngologica is the property of & Francis Ltd and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)ISSN:0001-6489DOI:10.1080/00016480701413821Accession Number:29435121Database:Psychology and Behavioral Sciences Collection

[Guest guest]

Although I don't know enough to appreciate the connection between ferritin and O2, I can add this: One of the clues I was working with when I first came to the conclusion I must have aldosteronism (and subsequently secured appropriate testing to confirm it) was that I began to catch myself unconsciously but deliberately under-breathing. I came to realize that I felt more comfortable that way. As the picture began to come together for me, I understood that my body was using the acidity of CO2, accumulated by sustained hypoventilation, in an attempt (not entirely successful, of course) to offset metabolic alkalosis from the condition.

Would that be the primary connection between K and O2?

Alden

On Tue, 02 Nov 2010 02:30 +0000, " Francis Bill SUSPECTED PA " wrote:

Some where in my searching I did see something about K helping with O2. Not sure if this is so as there is much misinformation out there.

>

> >

> > Is there any connection between high aldosterone and low ferritin?

> >

[Guest guest]

What is the best time of the menstrual cycle to do a 24 hr urine aldosterone test?Sent 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]

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]

Could someone please send me a list of all the appropriate labs I will need to have for testing aldosterone/renin so I can discuss with my doctor. There seems to be a lot of mistakes that I am paying for. I don't want this to happen again. I want to do it right this time!Much thanks!Sent 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]

I will send some details on this from The Australian group where they have civilized health care. and as you will see this is an important issue.you can pubmed this actually and get the details from Greenslopes.CE Grim MDWhat is the best time of the menstrual cycle to do a 24 hr urine aldosterone test?Sent 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]

see Dr. Grim's ideat test. You should have gotten this on acceptance. 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 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. Could someone please send me a list of all the appropriate labs I will need to have for testing aldosterone/renin so I can discuss with my doctor. There seems to be a lot of mistakes that I am paying for. I don't want this to happen again. I want to do it right this time!Much thanks!Sent 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]

Sorry for all the questions tonight. One more if I may?Can you help me understand why we run the same test through blood and then again through urine?( na,k, creatinine, aldosterone) I am not doubting the protocol but in case my dr does I want to be able to explain .Thanks againSent from my iPad

I will send some details on this from The Australian group where they have civilized health care. and as you will see this is an important issue.you can pubmed this actually and get the details from Greenslopes.CE Grim MDWhat

is the best time of the menstrual cycle to do a 24 hr urine aldosterone test?Sent 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]

Blood aldo/renin fluctuates from minute to minute. Urine integrates the fluctuations. As in the calculus you would never use.Blood Na and K change very little and do not reflect diet. Urine does.CE Grim MDSorry for all the questions tonight. One more if I may?Can you help me understand why we run the same test through blood and then again through urine?( na,k, creatinine, aldosterone) I am not doubting the protocol but in case my dr does I want to be able to explain .Thanks againSent from my iPad I will send some details on this from The Australian group where they have civilized health care. and as you will see this is an important issue.you can pubmed this actually and get the details from Greenslopes.CE Grim MDWhat is the best time of the menstrual cycle to do a 24 hr urine aldosterone test?Sent 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]

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 GrimMD 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 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]

Thanks 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 GrimMD 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 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. On Nov 2, 2010, at 1:49 PM, Suzanne Kann

wrote: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]

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 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 iPadOn Nov 1, 2010, at 8:02 PM, Clarence Grim

wrote: 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]

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]

What 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]

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, 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?

One last question, when during my menstrual cycle is the best time to do these test?

Thanks so much for you time, Suzanne

To: 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 MD

What 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 MD

Hi 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 MD

Send 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 MD

Thanks 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 GrimMD

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 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/29186

10. 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.htm

11. 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, FAHA

Board 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,MD

Is 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 MD

Could 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 MD

Hi 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 |>