Secondary Hyperaldosteronism

[Guest guest]

Can you send renin and aldo numbers and the normal values for that lab.Interesting about the generic eplerenone. Are you DASHing? See below in case you did not get this before. Welcome to the exciting world of Hyperaldosteronism You are in the right place! I am Dr. CE Grim a retired Professor of Medicine and Endocrinology. I have had a long standing interest is Primary Aldosteronism since medical school days when I saw my first patient with Primary Aldosteronism in 1963. I trained with Dr. Conn in Endocrinology and Metabolism 1969-70 and have published over 240 papers and book chapters in most areas of the broad discipline of High Blood Pressure. My CV is in our files for details. The goal of our group is to teach you and your health care team about the ins and outs of the causes, diagnosis and control of the many forms of hyperaldosteronism. The steps below will introduce you into the fascinating world of high blood pressure, salt and potassium and the role of the adrenal hormone aldosterone in health and disease. Doing these in sequence will save you time and effort in getting up to speed in taking control of you health and educating your own health care team. While we can’t make you a doctor we will make you into a pretty good BP doctor-a skill that you will have for life. 1. Overview: Read my article in our files on the evolution of PA (Evolution_of_PA-Grim.pdf ) and take to all members of health care team. Tell us what stage you believe you are in. This is a brief review of most causes of hyperaldosteronism, high blood pressure, low potassium (K). 2. Other patients with hyperaldosteronism (Conn’s syndrome). Read our Conn's stories in our files and then give us your own in as much detail as you can. Dr. Conn was the first to describe this disease process and the syndrome is named after him.To see others' stories, on the Hyperaldosteronism home page, go to Files/Conn’s Stories. You'll find instructions in "A - How to put your story here.doc " First send us your story in an email and they we may have questions and suggestions before you upload it to our files. 3. Eating Plan to control high blood pressure due to hyperaldosteronism and most others with high blood pressure. This will reduce your need for medications and in many will get your BP and K to goal without meds.. Get the DASH diet book by T. et al, read it and use it: $8 in paperback at your local bookstore. If they don’t have it ask them to order it for you. Learning to eat the DASH way will play a major role in your road to good BP and K control and, in many of our folks here, will revolutionize your life. Go to chapter 9 and do the 14 day challenge. Tell your Dr you are doing this as your BP may plummet if you are on other meds. or go to http://www.nhlbi.nih.gov/health/public/heart/hbp/dash/new_dash.pdf download this 64 page booklet free and do the Week on the DASH Diet for 2 weeks. If you are on BP meds be prepared for a large fall in BP and let your Dr. know you are doing this. Or go to (but costs money) DASH Diet for Health ProgramThe DASH Diet for Health Program is designed to help you improve your eating and exercise habits. Twice each week we will provide you with information on our website about food, food preparation, eating out, losing weight, getting fit and much more. In addition to providing new information each week on our website, we create a web page specially for you where you can track progress in areas such as your weight, blood pressure, and exercise.http://www.dashforhealth.com/ I strongly recommend you get this book and read it. 4. Measure your BP: Measure your BP daily so you can see if it is getting better. If you are taking meds be sure to tell your health care team you are doing this as your BP may plummet to normal quickly. We recommend you use a device you listen to and will help you learn how to do this. If this is not something you want to do we can teach a significant other how to do it. See sharedcareinc.com or email to sharedcare@... to order a video on how to do this. If you already have one we will teach you how to teach your health care team how to validate your device. Your life and health depends on accurate BP measurements. Go to the amricanheart.org and download the Guidelines for Human Blood Pressure Measurement. Insist the your health care team do BP the AHA way. Never trust your life to an automatic BP machine unless you know it is accurate on YOU. 5. Genetics and your BP: Go to familyhistory.hhs.gov and do your detailed family medical history so we can review with you to help Dx familial causes of high blood pressure and heart disease. If BP runs in your family you may save lives in your family by checking their BP yourself. 6. How to DX and treat PA: Go to our file/Conn's Articles of Note/Medications/Bravo spir 1973.pdf and read this article and take to your health care team. It is old but still one of the best in the medical management of PA. Also see our file from the Endocrine Society Guidelines on PA. Dr. Grim's Perfect Primary Aldosteronism Blood and Urine Testing to diagnose PA in one day. 1. Eat a regular to high salt diet for 2 weeks.2. No BP meds in last 4-12 weeks depending on meds.3. Collect 24 hr urine for Na, K and creatinine and aldosterone. Do not lose a drop of this liquid gold. It is impossible to interpret the renin and aldo without this.4. The morning you finish the 24 hr urine have fasting blood drawn for renin, aldo and K using our guidelines to get an accurate K. Try to get this done about 4 hours after you have been out of bed.5. Send us the results with the normal values for your lab.6. If you ever have a salt (saline) infusion test for PA be certain to ask them to measure how much you pee during the 4 hours of the infusion. If it is 1-1.5 liter of urine it strongly suggests that you may have PA. If more tha 1.5 L you almost certainly have PA. Our PA Registry: If you have been Dxed with PA already and are on Rx or have had surgery please go to http://www.kwiksurveys.com/online-survey.php?surveyID=HIJIO_f2685379 and complete our survey with as much information as you know. If there is some information you don't know ask us and we will help. If you need to update this as you journey thru the diagnostic/treatment process you can add another entry but label it as Nameyymmdd. For example today 6/12/09 for me would be Grim090612. This ever increasing number will allow us and you to sort your multiple entries into a dated order. 8. Learn the language: If you are new to medical lingo then download the acroyms from http://health.groups.yahoo.com/group/bloodpressureline/message/291869. Salt and high blood pressure: To learn the state of the science of salt and blood pressure please spend some time looking at http://www.worldactiononsalt.com/evidence/treatment_trials.htm10. Become a HBP expert consumer: Expect that it will take at least several weeks to get all this digested and to learn the new language of high blood pressure health care. As most doctors and nurses in practice have had very little training in high blood pressure you must become an expert yourself. For example most have never had anyone listen with them with a double stethoscope to verify that they can hear BP sounds. We cannot make you a doctor but we will make you a pretty good BP doctor.11. How High Blood Pressure should be managed: Go to nih.gov and download and read the Joint National Commission (JNC) Report 7 to get an overview on current guidelines. I ask all my secretaries to read this so they can communicate the importance of high blood pressure to my patients. JNC 8 will be out soon.Then: get (and study) the Hypertension Primer from americanheart.org. This is the most up-to-date compendium of what is known about high blood pressure and what every Dr. should know when they graduate from Medical School. Every chapter is only 2-3 pages. Read one chapter every week-night and you will finish it in about a year. I am working on a reading guide for lay people for the Primer. Stay tuned.12. Ask us questions: Ask any questions about high blood pressure you want answered. That is what we are here for.13. One-on-one Consulting: I can provide individual consulting if you do not want to go public. If you want individual one-on-one consulting for you and your Doctor contract me directly at lowerbp2@....May your pressure be low!Clarence E. Grim BS, MS, MD, FACP, FACCBoard Certified in Internal Medicine, Geriatrics, and High Blood Pressure Retired Faculty/Professor of Medicine (U of MO, Indiana, UCLA/DREW, Medical College of Wisconsin and Cardiology, Endocrinology, Nephrology, and Epidemiology. Specializing in Primary Aldosteronism and Difficult to Control High Blood Pressure. I am new to this group but have been fighting Rx resitant BP for over 15 years. I am a 44 year old male. I am going to briefly share my story in an attempt to verify whether this site addresses secondary hyperaldosteronism (HA) as well as PA. ABout two years ago I was experiencing consistent headaches in the back of my head and to my neck. PCP was providing medication to treat headaches. He was suspiscious that I might have HA. Endo had taken me off meds and had changed them up for salt test. Headaches became continuous and I became very emotional and nausious. Went to ER. Cranial CT and MRI didn't show much. Spinal fluid pressure was very high and the removed a large unit. I was flown to UU in Salt lake City with concerns of a blood clot in my sinus vein. After 10 days there treating the possible blood clot discovered there was no blood clot. Saught treatment at UU for HA. Renal doctor performed a few blood tests and confirmed that i had HA. No salt test performed. Had three CT's and one MRI no tumor visible on adrenal glands. Had renal sampling performed. One of the needles "slipt out" of the adrenal gland. Other sample showed high aldosterone levels. Was prescribed spiro for about 1.5 years. Bothered by gynocamastia. Went on eplerenone about 6 months ago. 50mg worked for several months. A few months back raised dose to 100 mg. Eplerenone mfr chaged from Sandoz to Greenstone. BP recently wnet up again (180/110). It has dropped recently for no appearant reason. Just ordered Pfizers version of Eplerenone (Inspra) and am going to take it and see if it performs better.Ongoing sysmptoms: headache, weakness and shales in legs and sometimes arms, recent cramping with diuretic, depressiona and anxiety.I would appreciate some input. Thnaks for your help!!!

[Guest guest]

Have you had aldo/renin tests at

the same time?. What about a

urinary Na at the same time as aldo/renin?

Why do you say secondary instead of primary?

I had all your symptoms which I

referred to as my " brittle " until I got treatment for Lyme. I still have high aldosterone and still

take Inspra but my aldo blocking meds are about 1/4 of what I was on.

Val

From: hyperaldosteronism

[mailto:hyperaldosteronism ] On Behalf Of tom82609

I am new to this group but have been fighting

Rx resitant BP for over 15 years. I am a 44 year old male. I am going to

briefly share my story in an attempt to verify whether this site addresses

secondary hyperaldosteronism (HA) as well as PA.

ABout two years ago I was experiencing consistent headaches in the back of my

head and to my neck. PCP was providing medication to treat headaches. He was

suspiscious that I might have HA. Endo had taken me off meds and had changed

them up for salt test. Headaches became continuous and I became very emotional

and nausious. Went to ER. Cranial CT and MRI didn't show much. Spinal fluid

pressure was very high and the removed a large unit. I was flown to UU in Salt

lake City with concerns of a blood clot in my sinus vein. After 10 days there

treating the possible blood clot discovered there was no blood clot.

Saught treatment at UU for HA. Renal doctor performed a few blood tests and

confirmed that i had HA. No salt test performed. Had three CT's and one MRI no

tumor visible on adrenal glands. Had renal sampling performed. One of the

needles " slipt out " of the adrenal gland. Other sample showed high

aldosterone levels.

Was prescribed spiro for about 1.5 years. Bothered by gynocamastia. Went on

eplerenone about 6 months ago. 50mg worked for several months. A few months

back raised dose to 100 mg. Eplerenone mfr chaged from Sandoz to Greenstone. BP

recently wnet up again (180/110). It has dropped recently for no appearant

reason. Just ordered Pfizers version of Eplerenone (Inspra) and am going to

take it and see if it performs better.

Ongoing sysmptoms: headache, weakness and shales in legs and sometimes arms,

recent cramping with diuretic, depressiona and anxiety.

I would appreciate some input. Thnaks for your help!!!

[Guest guest]

I just got some Greenstone

eplerenone. It looks identical to

the Pfizer (Searle) brand name except it has a " G " stamped on the

face. The bottle is identical. Will note any changes.

Val

From:

hyperaldosteronism [mailto:hyperaldosteronism ] On

Behalf Of Clarence Grim

Interesting

about the generic eplerenone.

[Guest guest]

I just got some Greenstone

eplerenone. It looks identical to

the Pfizer (Searle) brand name except it has a " G " stamped on the

face. The bottle is identical. Will note any changes.

Val

From:

hyperaldosteronism [mailto:hyperaldosteronism ] On

Behalf Of Clarence Grim

Interesting

about the generic eplerenone.

[Guest guest]

Good keep it posted. Tiped sad Send form miiPhone ;-)May your pressure be low!CE Grim MDSpecializing in DifficultHypertension

I just got some Greenstone

eplerenone. It looks identical to

the Pfizer (Searle) brand name except it has a "G" stamped on the

face. The bottle is identical. Will note any changes.

Val

From:

hyperaldosteronism [mailto:hyperaldosteronism ] On

Behalf Of Clarence Grim

Interesting

about the generic eplerenone.

[Guest guest]

Good keep it posted. Tiped sad Send form miiPhone ;-)May your pressure be low!CE Grim MDSpecializing in DifficultHypertension

I just got some Greenstone

eplerenone. It looks identical to

the Pfizer (Searle) brand name except it has a "G" stamped on the

face. The bottle is identical. Will note any changes.

Val

From:

hyperaldosteronism [mailto:hyperaldosteronism ] On

Behalf Of Clarence Grim

Interesting

about the generic eplerenone.

[Guest guest]

I never had the salt test performed. They changed my BP meds and BP went

through the roof and went in the hospital. I had some renon and aldo test

performed by my PCP and by Dr. in SLC (a kidney doc). I am trying to

get that information now. Is the salt test absolutely necessary or is there

another renin and aldo test that can be performed while I am on Inspra?

Thanks so much for your input anbd help!!

>

> > I am new to this group but have been fighting Rx resitant BP for

> > over 15 years. I am a 44 year old male. I am going to briefly share

> > my story in an attempt to verify whether this site addresses

> > secondary hyperaldosteronism (HA) as well as PA.

> >

> > ABout two years ago I was experiencing consistent headaches in the

> > back of my head and to my neck. PCP was providing medication to

> > treat headaches. He was suspiscious that I might have HA. Endo had

> > taken me off meds and had changed them up for salt test. Headaches

> > became continuous and I became very emotional and nausious. Went to

> > ER. Cranial CT and MRI didn't show much. Spinal fluid pressure was

> > very high and the removed a large unit. I was flown to UU in Salt

> > lake City with concerns of a blood clot in my sinus vein. After 10

> > days there treating the possible blood clot discovered there was no

> > blood clot.

> >

> > Saught treatment at UU for HA. Renal doctor performed a few blood

> > tests and confirmed that i had HA. No salt test performed. Had three

> > CT's and one MRI no tumor visible on adrenal glands. Had renal

> > sampling performed. One of the needles " slipt out " of the adrenal

> > gland. Other sample showed high aldosterone levels.

> >

> > Was prescribed spiro for about 1.5 years. Bothered by gynocamastia.

> > Went on eplerenone about 6 months ago. 50mg worked for several

> > months. A few months back raised dose to 100 mg. Eplerenone mfr

> > chaged from Sandoz to Greenstone. BP recently wnet up again

> > (180/110). It has dropped recently for no appearant reason. Just

> > ordered Pfizers version of Eplerenone (Inspra) and am going to take

> > it and see if it performs better.

> >

> > Ongoing sysmptoms: headache, weakness and shales in legs and

> > sometimes arms, recent cramping with diuretic, depressiona and

> > anxiety.

> >

> > I would appreciate some input. Thnaks for your help!!!

> >

> >

> >

>

[Guest guest]

Thanks but I suggest from now on we just give the person a link.Or put this in a file so we can refer them to it.You do not site where this came from so its veracity can be checked.CE Grim MDOn Sep 21, 2010, at 6:35 PM, Francis Bill SUSPECTED PA wrote:Early Lyme Disease. The disease starts after an infected tick expels its salivary gland and abdominal contents into the skin of a human. In about 60-70% of cases, a rash may develop at the site of the tick bite. This rash is most often circular with a clear edge, but oblong and other shaped rashes may occur as well in response to the tick bite. This rash is known as erythema migrans or EM. This rash usually starts about 3-30 days after the tick bite. Sometimes this rash is mistaken as a "spider bite". It is called "migrans" because it grows in size, gradually expanding over several days to greater than 2 inches across; some rashes can cover very large areas, such as an entire back. If the center of the rash clears, the rash may take on a bull's-eye appearance. The rash is usually not itchy or painful. Sometimes, other rashes occur in other parts of the body far away from the initial tick bite. This is because the spirochete gets transmitted quite rapidly in the bloodstream after the initial tick bite. Whereever the blood goes, there too will the Borrelia spirochete travel. In early Lyme disease, patients often experience moderate to severe flu-like symptoms (fatigue, chills, fever, headache, and muscle and joint aches, swollen lymph nodes). In about 18% of cases, the classic well known CDC clinical features of Lyme disease are not present. In these cases, the only symptoms may be marked fatigue and flu-like symptoms. Given that fatigue and flu-like symptoms may often arise from other causes, Lyme disease may not even be considered in the differential diagnosis and the patient may suffer for many months with an unrecognized, untreated infectious illness. Late Disseminated Lyme Disease. If not caught early, the infection may then spread to many other parts of the body. This can occur over a period of days, affecting the central nervous system (brain), the peripheral nervous system (nerves), the cardiovascular system (causing pericarditis and/or 2nd or 3rd degree heart block and possible death if not treated immediately), the liver (causing mild hepatitis), the eyes (causing conjunctivitis). and the muscles and joints (causing migrating swelling, tenderness, and/or pain). The typical constellation of symptoms associated with disseminated Lyme disease may include severe fatigue with a need for naps during the day, low grade fevers, muscle and joint pains, sleep disturbance, irritability, headaches, light or sound sensitivity, sharp stabbing or shooting pains, and/or numbness and tingling. When Lyme disease first affects the nervous system, one may see symptoms of meningitis, encephalitis, or cranial neuritis.a. Meningitis is characterized by headaches that fluctuate in intensity from mild to severe with or without associated nausea, vomiting, light sensitivity, neck stiffness, or pain on eye motion. If a spinal tap is done at this time, the spinal fluid (CSF) will usually show elevated white blood cells and elevated protein. b. Encephalitis is commonly accompanied sleepiness, mood swings and irritiability, atypical spontaneous tearfulness or personality change, cognitive problems (typically with word finding problems, memory loss, slowed mental speed), balance problems, and sensory hyperarousal (e.g., vision, hearing). An EEG at this stage may show mild slowing. A brain MRI may be normal or show white matter hyperintensities suggestive of inflammation. c. Cranial neuritis. CN VII Palsy (facial nerve weakness) is a form of cranial neuritis that is thought by many physicians to be common, however studies suggest that it may be seen in as few as 10% of patients with neurologic Lyme disease. However, in a patient from a Lyme endemic area or in an individual who has previously visited a Lyme endemic area, a presentation of a facial nerve palsy should lead the physician to test for Lyme disease. If the CN VII palsy affects both sides of the face, then Lyme disease should be even more strongly considered as very few diseases cause a bilateral facial nerve palsy. Typically, a cranial neuritis occurs within days to weeks of the initial infection bya tick. If patients experience abnormalities in facial sensation, the cause may be inflammation of the trigeminal cranial nerve (CN V). If central vision appears cloudy or if there is pain on eye movements, these could be signs of an optic neuritis. Pseudotumor cerebri is an intracranial increase in pressure that is not due to a tumor but because of the increase in pressure, there may be pressure on the optic nerve. This pressure could cause visual loss; in rare cases of Lyme optic neuritis from Lyme-induced pseudotumor cerebri, blindness may occur if not detected and treated early. If CN III, IV, or VI are affected, the patient may present with double vision. With involvement of CN VIII, patients may experience ringing in the ears (tinnitus), loss of hearing, vertigo, or ataxia. d. Radiculoneuritis. When the infection in Lyme disease affects the nerve roots, it is called radiculoneuropathy. Typical symptoms include radicular pain and symmetric or asymmetric sensory abnormalities, such as numbness or tingling. The radicular pain may be experienced as sharp stabbing or burning or shooting pains that radiate down a dermatomal distribution, such as into the limbs or across the trunk. There may also be elements of motor weakness. Differential diagnosis should exclude other causes of distal paresthesias, such as diabetic and toxic-metabolic neuropathies, or other causes of radicular pain, such as structural compression.Late Neurologic Lyme Diseasea. Encephalopathy. Patients may develop cognitive problems from Lyme disease either early or many months or years after the initial infection. The cognitive problems most commonly include problems with short-term memory, problems with verbal fluency such as in name or word retrieval, and problems with slower speed of thinking. Patients typically report that they have "Brain Fog". On a practical level, adults may have difficultly in following the normal speed of conversations, children may find it difficult to write down the homework assignments quickly enough or even forget whether or not they did the homework the night before. Because of the slower processing speed, normal tasks take on a greater burden and the individual may feel mentally slow. In untreated neurologic Lyme disease, the encephalopathy can be moderate to severe, while in later stage treated Lyme disease the encephalopathy is often more subtle – mild to moderate in magnitude. Rarely the encephalopathy may manifest as dementia. b. Encephalomyelitis. This is more common in Europe than in the United States, perhaps because there are other genospecies of Borrelia burgdorferi in Europe, including Borrelia garinii which is more neurotropic. Encephalomyelitis may be characterized by encephalitis with confusion and/or severe psychiatric disorders, chorea, cerebellar ataxia, and/or seizures. Patients may have a constellation of symptoms and signs (such as white matter hyperintensities) that appear quite similar to the manifestations of multiple sclerosis. In MS, typically there are oligoclonal bands in the CSF while in Lyme disease these would be less common.c. Neuropsychiatric Lyme Disease. Neuropsychiatric symptoms can emerge either early or late in the disseminated phase of infection. These symptoms commonly appear as cognitive symptoms (as in the encephalopathy above) and as irritability, easy tearfulness, anxiety, and depression. Rarely, patients with undetected Lyme disease may present with obsessive compulsive disorder, paranoia, auditory/visual hallucinations, or full blown mania. Sleep disturbances are also common in Lyme disease, with patients more often reporting a need for many hours of sleep, including daytime naps. Sensory hyperarousal occurs in about 50% of patients with later stage neurologic Lyme disease, most often affecting hearing and/or vision. These patients may resort to wearing earplugs, sound protectors, and/or sunglasses indoors. Normal sensory stimulation may over-stimulate, causing confusion and triggering a limbic alarm as if one had been assaulted. While psychiatric problems can arise during the course of Lyme disease (or many other central nervous system infections), it is critical to remember that most psychiatric disorders have nothing to do with Lyme disease. It is also important to note that when patients with Lyme disease experience a psychiatric disorder, treatment for the psychiatric disorder should not be delayed; psychiatric consultation should be obtained so that an adjunctive treatment plan with the internist can be initiated.> >> > Have you had aldo/renin tests at the same time?. What about a urinary Na at> > the same time as aldo/renin? Why do you say secondary instead of primary?> > > > I had all your symptoms which I referred to as my "brittle" until I got> > treatment for Lyme. I still have high aldosterone and still take Inspra but> > my aldo blocking meds are about 1/4 of what I was on.> > > > Val> > > > > > From: hyperaldosteronism > > [mailto:hyperaldosteronism ] On Behalf Of tom82609> > > > I am new to this group but have been fighting Rx resitant BP for over 15> > years. I am a 44 year old male. I am going to briefly share my story in an> > attempt to verify whether this site addresses secondary hyperaldosteronism> > (HA) as well as PA. > > > > ABout two years ago I was experiencing consistent headaches in the back of> > my head and to my neck. PCP was providing medication to treat headaches. He> > was suspiscious that I might have HA. Endo had taken me off meds and had> > changed them up for salt test. Headaches became continuous and I became very> > emotional and nausious. Went to ER. Cranial CT and MRI didn't show much.> > Spinal fluid pressure was very high and the removed a large unit. I was> > flown to UU in Salt lake City with concerns of a blood clot in my sinus> > vein. After 10 days there treating the possible blood clot discovered there> > was no blood clot. > > > > Saught treatment at UU for HA. Renal doctor performed a few blood tests and> > confirmed that i had HA. No salt test performed. Had three CT's and one MRI> > no tumor visible on adrenal glands. Had renal sampling performed. One of the> > needles "slipt out" of the adrenal gland. Other sample showed high> > aldosterone levels. > > > > Was prescribed spiro for about 1.5 years. Bothered by gynocamastia. Went on> > eplerenone about 6 months ago. 50mg worked for several months. A few months> > back raised dose to 100 mg. Eplerenone mfr chaged from Sandoz to Greenstone.> > BP recently wnet up again (180/110). It has dropped recently for no> > appearant reason. Just ordered Pfizers version of Eplerenone (Inspra) and am> > going to take it and see if it performs better.> > > > Ongoing sysmptoms: headache, weakness and shales in legs and sometimes arms,> > recent cramping with diuretic, depressiona and anxiety.> > > > I would appreciate some input. Thnaks for your help!!!> >>

[Guest guest]

renin and also needed. off all drugs. No need to do salt test unless surgery is an option IMHO.BP response to inspra should be good test as well. If BP and K do not get better on max doses then no PA.CE Grim MDI never had the salt test performed. They changed my BP meds and BP went through the roof and went in the hospital. I had some renon and aldo test performed by my PCP and by Dr. in SLC (a kidney doc). I am trying to get that information now. Is the salt test absolutely necessary or is there another renin and aldo test that can be performed while I am on Inspra?Thanks so much for your input anbd help!!> > > I am new to this group but have been fighting Rx resitant BP for > > over 15 years. I am a 44 year old male. I am going to briefly share > > my story in an attempt to verify whether this site addresses > > secondary hyperaldosteronism (HA) as well as PA.> >> > ABout two years ago I was experiencing consistent headaches in the > > back of my head and to my neck. PCP was providing medication to > > treat headaches. He was suspiscious that I might have HA. Endo had > > taken me off meds and had changed them up for salt test. Headaches > > became continuous and I became very emotional and nausious. Went to > > ER. Cranial CT and MRI didn't show much. Spinal fluid pressure was > > very high and the removed a large unit. I was flown to UU in Salt > > lake City with concerns of a blood clot in my sinus vein. After 10 > > days there treating the possible blood clot discovered there was no > > blood clot.> >> > Saught treatment at UU for HA. Renal doctor performed a few blood > > tests and confirmed that i had HA. No salt test performed. Had three > > CT's and one MRI no tumor visible on adrenal glands. Had renal > > sampling performed. One of the needles "slipt out" of the adrenal > > gland. Other sample showed high aldosterone levels.> >> > Was prescribed spiro for about 1.5 years. Bothered by gynocamastia. > > Went on eplerenone about 6 months ago. 50mg worked for several > > months. A few months back raised dose to 100 mg. Eplerenone mfr > > chaged from Sandoz to Greenstone. BP recently wnet up again > > (180/110). It has dropped recently for no appearant reason. Just > > ordered Pfizers version of Eplerenone (Inspra) and am going to take > > it and see if it performs better.> >> > Ongoing sysmptoms: headache, weakness and shales in legs and > > sometimes arms, recent cramping with diuretic, depressiona and > > anxiety.> >> > I would appreciate some input. Thnaks for your help!!!> >> >> >>

[Guest guest]

Here is the link http://www.columbia-lyme.org/index.html Columbia is where a lot

of research is done on lyme.

> > > >

> > > > Have you had aldo/renin tests at the same time?. What about a

> > urinary Na at

> > > > the same time as aldo/renin? Why do you say secondary instead of

> > primary?

> > > >

> > > > I had all your symptoms which I referred to as my " brittle "

> > until I got

> > > > treatment for Lyme. I still have high aldosterone and still take

> > Inspra but

> > > > my aldo blocking meds are about 1/4 of what I was on.

> > > >

> > > > Val

> > > >

> > > >

> > > > From: hyperaldosteronism

> > > > [mailto:hyperaldosteronism ] On Behalf Of tom82609

> > > >

> > > > I am new to this group but have been fighting Rx resitant BP for

> > over 15

> > > > years. I am a 44 year old male. I am going to briefly share my

> > story in an

> > > > attempt to verify whether this site addresses secondary

> > hyperaldosteronism

> > > > (HA) as well as PA.

> > > >

> > > > ABout two years ago I was experiencing consistent headaches in

> > the back of

> > > > my head and to my neck. PCP was providing medication to treat

> > headaches. He

> > > > was suspiscious that I might have HA. Endo had taken me off meds

> > and had

> > > > changed them up for salt test. Headaches became continuous and I

> > became very

> > > > emotional and nausious. Went to ER. Cranial CT and MRI didn't

> > show much.

> > > > Spinal fluid pressure was very high and the removed a large

> > unit. I was

> > > > flown to UU in Salt lake City with concerns of a blood clot in

> > my sinus

> > > > vein. After 10 days there treating the possible blood clot

> > discovered there

> > > > was no blood clot.

> > > >

> > > > Saught treatment at UU for HA. Renal doctor performed a few

> > blood tests and

> > > > confirmed that i had HA. No salt test performed. Had three CT's

> > and one MRI

> > > > no tumor visible on adrenal glands. Had renal sampling

> > performed. One of the

> > > > needles " slipt out " of the adrenal gland. Other sample showed high

> > > > aldosterone levels.

> > > >

> > > > Was prescribed spiro for about 1.5 years. Bothered by

> > gynocamastia. Went on

> > > > eplerenone about 6 months ago. 50mg worked for several months. A

> > few months

> > > > back raised dose to 100 mg. Eplerenone mfr chaged from Sandoz to

> > Greenstone.

> > > > BP recently wnet up again (180/110). It has dropped recently for

> > no

> > > > appearant reason. Just ordered Pfizers version of Eplerenone

> > (Inspra) and am

> > > > going to take it and see if it performs better.

> > > >

> > > > Ongoing sysmptoms: headache, weakness and shales in legs and

> > sometimes arms,

> > > > recent cramping with diuretic, depressiona and anxiety.

> > > >

> > > > I would appreciate some input. Thnaks for your help!!!

> > > >

> > >

> >

> >

> >

>

[Guest guest]

Lyme (plus related co-infections)

is caused by bites of infected ticks.

Val

From:

hyperaldosteronism [mailto:hyperaldosteronism ] On

Behalf Of tom82609

What is Lyme?

I need to contact my DR. in SLC and get the test results that were performed. I

am efforting to collect the information addressed on this site. I will post as

I have the time to collect.

Thanks!!

>

> Have you had aldo/renin tests at the same time?. What about a urinary Na

at

> the same time as aldo/renin? Why do you say secondary instead of primary?

>

> I had all your symptoms which I referred to as my " brittle "

until I got

> treatment for Lyme. I still have high aldosterone and still take Inspra

but

> my aldo blocking meds are about 1/4 of what I was on.

[Guest guest]

I have looked at this site and it seems to be excellent.CE Grim MDOn Sep 21, 2010, at 7:30 PM, Francis Bill SUSPECTED PA wrote:Here is the link http://www.columbia-lyme.org/index.html Columbia is where a lot of research is done on lyme. > > > >> > > > Have you had aldo/renin tests at the same time?. What about a > > urinary Na at> > > > the same time as aldo/renin? Why do you say secondary instead of > > primary?> > > >> > > > I had all your symptoms which I referred to as my "brittle" > > until I got> > > > treatment for Lyme. I still have high aldosterone and still take > > Inspra but> > > > my aldo blocking meds are about 1/4 of what I was on.> > > >> > > > Val> > > >> > > >> > > > From: hyperaldosteronism > > > > [mailto:hyperaldosteronism ] On Behalf Of tom82609> > > >> > > > I am new to this group but have been fighting Rx resitant BP for > > over 15> > > > years. I am a 44 year old male. I am going to briefly share my > > story in an> > > > attempt to verify whether this site addresses secondary > > hyperaldosteronism> > > > (HA) as well as PA.> > > >> > > > ABout two years ago I was experiencing consistent headaches in > > the back of> > > > my head and to my neck. PCP was providing medication to treat > > headaches. He> > > > was suspiscious that I might have HA. Endo had taken me off meds > > and had> > > > changed them up for salt test. Headaches became continuous and I > > became very> > > > emotional and nausious. Went to ER. Cranial CT and MRI didn't > > show much.> > > > Spinal fluid pressure was very high and the removed a large > > unit. I was> > > > flown to UU in Salt lake City with concerns of a blood clot in > > my sinus> > > > vein. After 10 days there treating the possible blood clot > > discovered there> > > > was no blood clot.> > > >> > > > Saught treatment at UU for HA. Renal doctor performed a few > > blood tests and> > > > confirmed that i had HA. No salt test performed. Had three CT's > > and one MRI> > > > no tumor visible on adrenal glands. Had renal sampling > > performed. One of the> > > > needles "slipt out" of the adrenal gland. Other sample showed high> > > > aldosterone levels.> > > >> > > > Was prescribed spiro for about 1.5 years. Bothered by > > gynocamastia. Went on> > > > eplerenone about 6 months ago. 50mg worked for several months. A > > few months> > > > back raised dose to 100 mg. Eplerenone mfr chaged from Sandoz to > > Greenstone.> > > > BP recently wnet up again (180/110). It has dropped recently for > > no> > > > appearant reason. Just ordered Pfizers version of Eplerenone > > (Inspra) and am> > > > going to take it and see if it performs better.> > > >> > > > Ongoing sysmptoms: headache, weakness and shales in legs and > > sometimes arms,> > > > recent cramping with diuretic, depressiona and anxiety.> > > >> > > > I would appreciate some input. Thnaks for your help!!!> > > >> > >> >> >> >>

[Guest guest]

That is a whole lot to swallow! I have had two " spider bites " one approximately

26 years ago and one 18 years ago. Both resulted in absess forming. Both were

treated with antibiotics followed by steroids prior to being removed surgically.

What are the tests for lime disease?

Thanks for the information.

Tom

> > >

> > > Have you had aldo/renin tests at the same time?. What about a urinary Na

at

> > > the same time as aldo/renin? Why do you say secondary instead of primary?

> > >

> > > I had all your symptoms which I referred to as my " brittle " until I got

> > > treatment for Lyme. I still have high aldosterone and still take Inspra

but

> > > my aldo blocking meds are about 1/4 of what I was on.

> > >

> > > Val

> > >

> > >

> > > From: hyperaldosteronism

> > > [mailto:hyperaldosteronism ] On Behalf Of tom82609

> > >

> > > I am new to this group but have been fighting Rx resitant BP for over 15

> > > years. I am a 44 year old male. I am going to briefly share my story in an

> > > attempt to verify whether this site addresses secondary hyperaldosteronism

> > > (HA) as well as PA.

> > >

> > > ABout two years ago I was experiencing consistent headaches in the back of

> > > my head and to my neck. PCP was providing medication to treat headaches.

He

> > > was suspiscious that I might have HA. Endo had taken me off meds and had

> > > changed them up for salt test. Headaches became continuous and I became

very

> > > emotional and nausious. Went to ER. Cranial CT and MRI didn't show much.

> > > Spinal fluid pressure was very high and the removed a large unit. I was

> > > flown to UU in Salt lake City with concerns of a blood clot in my sinus

> > > vein. After 10 days there treating the possible blood clot discovered

there

> > > was no blood clot.

> > >

> > > Saught treatment at UU for HA. Renal doctor performed a few blood tests

and

> > > confirmed that i had HA. No salt test performed. Had three CT's and one

MRI

> > > no tumor visible on adrenal glands. Had renal sampling performed. One of

the

> > > needles " slipt out " of the adrenal gland. Other sample showed high

> > > aldosterone levels.

> > >

> > > Was prescribed spiro for about 1.5 years. Bothered by gynocamastia. Went

on

> > > eplerenone about 6 months ago. 50mg worked for several months. A few

months

> > > back raised dose to 100 mg. Eplerenone mfr chaged from Sandoz to

Greenstone.

> > > BP recently wnet up again (180/110). It has dropped recently for no

> > > appearant reason. Just ordered Pfizers version of Eplerenone (Inspra) and

am

> > > going to take it and see if it performs better.

> > >

> > > Ongoing sysmptoms: headache, weakness and shales in legs and sometimes

arms,

> > > recent cramping with diuretic, depressiona and anxiety.

> > >

> > > I would appreciate some input. Thnaks for your help!!!

> > >

> >

>

[Guest guest]

Only a handful of labs in the U.S. are competent to test for

Lyme. The primary one is IgeneX in

California. It can be done through

the mail with your doctor's order.

The typical test (ELISA) done in a doctor's office is reliable only 50%

of the time. A rash is not a

requirement for you to have Lyme.

In fact, the EM rash is present only about 50% of the time. Very few physicians understand testing

and treatment of late-stage Lyme. With

a proper lab, a combination of their tests provides higher than 90% sensitivity

and better than 95% specificity. I

had the Western Blot, both with and without an antibiotic challenge and both

times, they came back " equivocal. " Finally, I got a really strong positive

with a Lyme

Dot Blot/PCR Panel, done with an antibiotic challenge. Remember, there are no certain tests for

Parkinson's and MS either. The only

thing is that those diseases are more understood and more acceptable.

You have all the symptoms and testing would, IMHO, be judicious. In fact, your story sounds a lot like

mine. Steroids are a no-no. I wound up in ER after a cortisone knee

injection.

Lyme disease is, for some reason, very political. You should expect your doctor to abuse

you if you ask for proper testing.

IgeneX website: http://igenex.com/Website/

You can learn a lot there.

More good information: http://www.ilads.org/

Val

From:

hyperaldosteronism [mailto:hyperaldosteronism ] On

Behalf Of tom82609

That is a whole lot to swallow! I have had two " spider

bites " one approximately 26 years ago and one 18 years ago. Both resulted

in absess forming. Both were treated with antibiotics followed by steroids

prior to being removed surgically.

What are the tests for lime disease?

Thanks for the information.

Tom

> > >

> > > Have you had aldo/renin tests at the same time?. What about a

urinary Na at

> > > the same time as aldo/renin? Why do you say secondary instead of

primary?

> > >

> > > I had all your symptoms which I referred to as my

" brittle " until I got

> > > treatment for Lyme. I still have high aldosterone and still take

Inspra but

> > > my aldo blocking meds are about 1/4 of what I was on.

> > >

> > > Val

> > >

> > >

> > > From: hyperaldosteronism

> > > [mailto:hyperaldosteronism ] On

Behalf Of tom82609

> > >

> > > I am new to this group but have been fighting Rx resitant BP for

over 15

> > > years. I am a 44 year old male. I am going to briefly share my

story in an

> > > attempt to verify whether this site addresses secondary

hyperaldosteronism

> > > (HA) as well as PA.

> > >

> > > ABout two years ago I was experiencing consistent headaches in

the back of

> > > my head and to my neck. PCP was providing medication to treat

headaches. He

> > > was suspiscious that I might have HA. Endo had taken me off meds

and had

> > > changed them up for salt test. Headaches became continuous and I

became very

> > > emotional and nausious. Went to ER. Cranial CT and MRI didn't

show much.

> > > Spinal fluid pressure was very high and the removed a large

unit. I was

> > > flown to UU in Salt lake City with concerns of a blood clot in

my sinus

> > > vein. After 10 days there treating the possible blood clot

discovered there

> > > was no blood clot.

> > >

> > > Saught treatment at UU for HA. Renal doctor performed a few

blood tests and

> > > confirmed that i had HA. No salt test performed. Had three CT's

and one MRI

> > > no tumor visible on adrenal glands. Had renal sampling

performed. One of the

> > > needles " slipt out " of the adrenal gland. Other sample

showed high

> > > aldosterone levels.

> > >

> > > Was prescribed spiro for about 1.5 years. Bothered by

gynocamastia. Went on

> > > eplerenone about 6 months ago. 50mg worked for several months. A

few months

> > > back raised dose to 100 mg. Eplerenone mfr chaged from Sandoz to

Greenstone.

> > > BP recently wnet up again (180/110). It has dropped recently for

no

> > > appearant reason. Just ordered Pfizers version of Eplerenone

(Inspra) and am

> > > going to take it and see if it performs better.

> > >

> > > Ongoing sysmptoms: headache, weakness and shales in legs and

sometimes arms,

> > > recent cramping with diuretic, depressiona and anxiety.

> > >

> > > I would appreciate some input. Thnaks for your help!!!

..

[Guest guest]

And we are all waiting for evidence that long term treatment helps more than it harms.Hope these sites are working on it.Meanwhile work on the BP issue first.Val: does anyone have data on what % of those with Lyme also have HTN that gets better with Rx? Would be a good number to know. At the average age one would expect about 50% to have HTN. If it is lower than that then maybe Lyme lowers BP?CE Grim MDOnly a handful of labs in the U.S. are competent to test for Lyme. The primary one is IgeneX in California. It can be done through the mail with your doctor's order. The typical test (ELISA) done in a doctor's office is reliable only 50% of the time. A rash is not a requirement for you to have Lyme. In fact, the EM rash is present only about 50% of the time. Very few physicians understand testing and treatment of late-stage Lyme. With a proper lab, a combination of their tests provides higher than 90% sensitivity and better than 95% specificity. I had the Western Blot, both with and without an antibiotic challenge and both times, they came back "equivocal." Finally, I got a really strong positive with a Lyme Dot Blot/PCR Panel, done with an antibiotic challenge. Remember, there are no certain tests for Parkinson's and MS either. The only thing is that those diseases are more understood and more acceptable. You have all the symptoms and testing would, IMHO, be judicious. In fact, your story sounds a lot like mine. Steroids are a no-no. I wound up in ER after a cortisone knee injection. Lyme disease is, for some reason, very political. You should expect your doctor to abuse you if you ask for proper testing. IgeneX website: http://igenex.com/Website/You can learn a lot there. More good information: http://www.ilads.org/ Val From: hyperaldosteronism [mailto:hyperaldosteronism ] On Behalf Of tom82609That is a whole lot to swallow! I have had two "spider bites" one approximately 26 years ago and one 18 years ago. Both resulted in absess forming. Both were treated with antibiotics followed by steroids prior to being removed surgically.What are the tests for lime disease?Thanks for the information.Tom> > >> > > Have you had aldo/renin tests at the same time?. What about a urinary Na at> > > the same time as aldo/renin? Why do you say secondary instead of primary?> > > > > > I had all your symptoms which I referred to as my "brittle" until I got> > > treatment for Lyme. I still have high aldosterone and still take Inspra but> > > my aldo blocking meds are about 1/4 of what I was on.> > > > > > Val> > > > > > > > > From: hyperaldosteronism > > > [mailto:hyperaldosteronism ] On Behalf Of tom82609> > > > > > I am new to this group but have been fighting Rx resitant BP for over 15> > > years. I am a 44 year old male. I am going to briefly share my story in an> > > attempt to verify whether this site addresses secondary hyperaldosteronism> > > (HA) as well as PA. > > > > > > ABout two years ago I was experiencing consistent headaches in the back of> > > my head and to my neck. PCP was providing medication to treat headaches. He> > > was suspiscious that I might have HA. Endo had taken me off meds and had> > > changed them up for salt test. Headaches became continuous and I became very> > > emotional and nausious. Went to ER. Cranial CT and MRI didn't show much.> > > Spinal fluid pressure was very high and the removed a large unit. I was> > > flown to UU in Salt lake City with concerns of a blood clot in my sinus> > > vein. After 10 days there treating the possible blood clot discovered there> > > was no blood clot. > > > > > > Saught treatment at UU for HA. Renal doctor performed a few blood tests and> > > confirmed that i had HA. No salt test performed. Had three CT's and one MRI> > > no tumor visible on adrenal glands. Had renal sampling performed. One of the> > > needles "slipt out" of the adrenal gland. Other sample showed high> > > aldosterone levels. > > > > > > Was prescribed spiro for about 1.5 years. Bothered by gynocamastia. Went on> > > eplerenone about 6 months ago. 50mg worked for several months. A few months> > > back raised dose to 100 mg. Eplerenone mfr chaged from Sandoz to Greenstone.> > > BP recently wnet up again (180/110). It has dropped recently for no> > > appearant reason. Just ordered Pfizers version of Eplerenone (Inspra) and am> > > going to take it and see if it performs better.> > > > > > Ongoing sysmptoms: headache, weakness and shales in legs and sometimes arms,> > > recent cramping with diuretic, depressiona and anxiety.> > > > > > I would appreciate some input. Thnaks for your help!!!.

[Guest guest]

Well the Loma Endo believes I have Secondary Aldo, not Conn's. Two weeks

off of diuretic, and my Aldo was 24 (lab high 18) and my renin was 7.2. Also did

a full chem panel, and my carbon dioxide was high, don't remember the #. He now

is doing a 24 hour urine for aldo/sodium with salt loading for 3 days prior. And

checking Thyroid (blood test) again. He's talking of eventually doing a kidney

angio for RAS even though I had the MRA (he feels it was inconclusive.

He also agreed with Dr. Grim's response to my my AVS #'s that my AVS the left

side was not correct and probably came from the Inferior Cava and not the left

adrenal vein.

I'm glad to know I'm not going to be having an unnecessary adrenalectomy....but

I'm more than beyond frustrated that after so damned long I'm back to square one

with no definitive diagnosis. And yet I can tell that whatever is wrong, is

getting worse and worse. I'm able to spend less and less time at work, and am on

the verge of going from part-time disability to full-time disability, which I

really can't afford.

Dr. Grim, can you please tell us what all of the possible causes of Secondary

Aldo are? I know RAS is one, but what else is there?

[Guest guest]

Perhaps when he said the renin is high, he meant as in its high for primary

aldo...

The Endocrine's Society PA Guideline says that Verapamil is ok to take during

testing for PA.

> >

> > > I recommend you get the AHA Hypertension Primer and look for others.

> > > Also this will answer many of your other questions. Used to be

> > able to

> > > get it free at heart.org.

> > **Jen** - I will look for this. The Endo at Loma feels my case

> > is very difficult...I have many of the symptoms of Primary, but

> > testing is proving to be Secondary Aldo...quite confusing really.

> > And those were his words...

> >

> > > Renin secreting tumor of the kidney, renin secreting tumor of the

> > > lung, renal cell cancer, hydronephroisis, polycystic kidney disease,

> > > Page Kidney, Very large renal cyst, pheochromocytoma, embolus to the

> > > kidney, for the heart or from the aorta (atheosclerotic embolus),

> > > renal artery tied off by mistake during other surgery, ureter tied

> > off

> > > by mistake such as during hysterectomy, tumor encasing kidney, or

> > > renal artery, retroperitonal fibrosis involving renal artery, lupus,

> > > scleroderma, polyarteritis nodosa, Takyashus (spelling?) arteritis,

> > > coarctation of the thoracic aorta, abdominal aorta coarctation,

> > > dissecting aortic aneurysm, cocaine use, ritalin abuse, amphetamine

> > > abuse, stab wound to the renal artery, stretching of the renal

> > artery

> > > with auto accident, many whites with HTN (rare in blacks),

> > > pyelonephritis, renal tuberculosis, pregnancy, radiation injury to

> > the

> > > kidney, bladder or ureter, carcinoma of the ureter, carcinoma of the

> > > renal pelvis, renal injury after lithotripsy, Neurofibromatosis (von

> > > Recklinghauen's syndrome) of the renal artery, " drooping kidney " .

> > >

> > > Trust you were off all drugs for at least 2 weeks and spiro for 2-3

> > > months.

> >

> > **Jen** - Yes off diuretic and diovan for 2 weeks, was only on

> > Verapamil and Potassium and prilosec at time of testing. No other

> > meds.

> >

> > > Once again you did not give us the normal values for renin. How many

> > > times do I have to request this?

> > **Jen** - Sorry gave the lab's aldo high, but now the lower, the lab

> > levels were Aldo: 3-18 upright and lab doesn't give level for renin.

> >

>

> Then how does your endo know renin is high.

> Hmmm don't know about Verapamil and renin.

>

> Keep us posted.

> >

> > >

> > >

> > > > Also did a full chem panel, and my carbon dioxide was high,

> > > >

> > >

> > > this suggest primary hyperaldo

> > **Jen** - but it shouldn't be high in secondary?

> >

> More likely high in primary

> >

> > > Only way to tell if renal artery or very small kidney tumor is

> > causing

> > > it is to to a proper selective renal arteriogram. Again you want an

> > > expert.

> > > As if they see a narrowing many are tempted to balloon it when it is

> > > not necessary.

> > **Jen** - Hoping that since it is Loma , they will have a Dr.

> > experienced in this. So far all of the dr's I've seen there have

> > been very experienced in all this.

> >

> > Also...two years ago I had a CT that showed excessive calcification

> > and stones in the kidneys, Dr's never did much to determine why at

> > that time (no insurance). Then a year and a half later, ultrasound

> > showed some calcification, but 1 month later CT done with a Triphase

> > Renalgram to determine flow through kidneys...no calfication could

> > be seen at all. So I guess my thoughts is that the secondary could

> > definitely be kidney related?

> >

> Disappearing calcium suggests kidney stones.

>

> CE Grim MD

> >

> >

>

[Guest guest]

And their data is????Need their normals to decide what is high.Never leave this to the unexperienced.CE Grim MDPerhaps when he said the renin is high, he meant as in its high for primary aldo...The Endocrine's Society PA Guideline says that Verapamil is ok to take during testing for PA.> >> > > I recommend you get the AHA Hypertension Primer and look for others.> > > Also this will answer many of your other questions. Used to be > > able to> > > get it free at heart.org.> > **Jen** - I will look for this. The Endo at Loma feels my case > > is very difficult...I have many of the symptoms of Primary, but > > testing is proving to be Secondary Aldo...quite confusing really. > > And those were his words...> >> > > Renin secreting tumor of the kidney, renin secreting tumor of the> > > lung, renal cell cancer, hydronephroisis, polycystic kidney disease,> > > Page Kidney, Very large renal cyst, pheochromocytoma, embolus to the> > > kidney, for the heart or from the aorta (atheosclerotic embolus),> > > renal artery tied off by mistake during other surgery, ureter tied > > off> > > by mistake such as during hysterectomy, tumor encasing kidney, or> > > renal artery, retroperitonal fibrosis involving renal artery, lupus,> > > scleroderma, polyarteritis nodosa, Takyashus (spelling?) arteritis,> > > coarctation of the thoracic aorta, abdominal aorta coarctation,> > > dissecting aortic aneurysm, cocaine use, ritalin abuse, amphetamine> > > abuse, stab wound to the renal artery, stretching of the renal > > artery> > > with auto accident, many whites with HTN (rare in blacks),> > > pyelonephritis, renal tuberculosis, pregnancy, radiation injury to > > the> > > kidney, bladder or ureter, carcinoma of the ureter, carcinoma of the> > > renal pelvis, renal injury after lithotripsy, Neurofibromatosis (von> > > Recklinghauen's syndrome) of the renal artery, "drooping kidney".> > >> > > Trust you were off all drugs for at least 2 weeks and spiro for 2-3> > > months.> >> > **Jen** - Yes off diuretic and diovan for 2 weeks, was only on > > Verapamil and Potassium and prilosec at time of testing. No other > > meds.> >> > > Once again you did not give us the normal values for renin. How many> > > times do I have to request this?> > **Jen** - Sorry gave the lab's aldo high, but now the lower, the lab > > levels were Aldo: 3-18 upright and lab doesn't give level for renin.> >> > Then how does your endo know renin is high.> Hmmm don't know about Verapamil and renin.> > Keep us posted.> >> > >> > >> > > > Also did a full chem panel, and my carbon dioxide was high,> > > >> > >> > > this suggest primary hyperaldo> > **Jen** - but it shouldn't be high in secondary?> >> More likely high in primary> >> > > Only way to tell if renal artery or very small kidney tumor is > > causing> > > it is to to a proper selective renal arteriogram. Again you want an> > > expert.> > > As if they see a narrowing many are tempted to balloon it when it is> > > not necessary.> > **Jen** - Hoping that since it is Loma , they will have a Dr. > > experienced in this. So far all of the dr's I've seen there have > > been very experienced in all this.> >> > Also...two years ago I had a CT that showed excessive calcification > > and stones in the kidneys, Dr's never did much to determine why at > > that time (no insurance). Then a year and a half later, ultrasound > > showed some calcification, but 1 month later CT done with a Triphase > > Renalgram to determine flow through kidneys...no calfication could > > be seen at all. So I guess my thoughts is that the secondary could > > definitely be kidney related?> >> Disappearing calcium suggests kidney stones.> > CE Grim MD> >> >>