Re: ATACAND (Candesartan) and Liver Damage

[Guest guest]

Actually when I showed this chart at the time of its peak ALT to my doc warning him about ATACAND's liver damage side effect, he looked very dismayed that he had ignored my ALT test results. ATACAND was originally prescribed to me by my doc from his sample supplies in the basement of his office and I learned later that those drugs coming out of the basement are samples given to him by drug companies to be tested on his patients! and he might have been suspecting ATACAND's liver damage because he added ALT test to my req form.

Max.

61M L adenoma NP59 Spiro=100, Amlo=10, Indap=2.5, Ramip=5, Metf=1000, Prav=40, Feno=67, K.cl=120 mEq

Hopefully a good EMR system will be doing these sorts of things automatically.

And notify the team when one is out of bounds.

ATACAND (Candesartan) and Liver Damage

Max.

[Guest guest]

Someone is trying to bleed you to death I fear. Well we used to do this to lower BP. Did it to GW and may have contributed to his death. How old is ur dr?Tiped sad Send form miiPhone ;-)May your pressure be low!CE Grim MDSpecializing in DifficultHypertension

Yes, I look very much anemic with a blood requisition form and regular monthly blood tests!!

Nice plot again. But you must be anemic with all the blood draws.

[Guest guest]

My doc is about 52, from med school in China then UK...Anemic: I thought you were pulling my leg! No I am not really anemic, all blood work now are normal...

Max.

61M L adenoma NP59 Spiro=100, Amlo=10, Indap=2.5, Ramip=5, Metf=1000, Prav=40, Feno=67, K.cl=120 mEq

Someone is trying to bleed you to death I fear. Well we used to do this to lower BP. Did it to GW and may have contributed to his death. How old is ur dr?Tiped sad Send form mi

iPhone ;-)

May your pressure be low!

CE Grim MD

Specializing in Difficult

Hypertension

Yes, I look very much anemic with a blood requisition form and regular monthly blood tests!!

Nice plot again. But you must be anemic with all the blood draws.

[Guest guest]

My experience with China trained Drs is that many lack in depth training and knowledge but that is not always the rule. So might be good to get a second opinion. Where did he train in US?CE Grim MDMy doc is about 52, from med school in China then UK...Anemic: I thought you were pulling my leg! No I am not really anemic, all blood work now are normal... Max.61M L adenoma NP59 Spiro=100, Amlo=10, Indap=2.5, Ramip=5, Metf=1000, Prav=40, Feno=67, K.cl=120 mEqSomeone is trying to bleed you to death I fear. Well we used to do this to lower BP. Did it to GW and may have contributed to his death. How old is ur dr?Tiped sad Send form miiPhone ;-)May your pressure be low!CE Grim MDSpecializing in DifficultHypertension Yes, I look very much anemic with a blood requisition form and regular monthly blood tests!!Nice plot again. But you must be anemic with all the blood draws.

[Guest guest]

My doc is : BM (UK), CCFP ©, LMCC, Cert, MAc Family Practitioner, Acupuncturist >25 years experience, confessed I am the only PA patient he ever had during his practice...so for 10 years he had no clue I had PA until a university prof. diagnosed me with PA last year...looks promissing!

Max.

61M L adenoma NP59 Spiro=100, Amlo=10, Indap=2.5, Ramip=5, Metf=1000, Prav=40, Feno=67, K.cl=120 mEq

My experience with China trained Drs is that many lack in depth training and knowledge but that is not always the rule.

So might be good to get a second opinion. Where did he train in US?

CE Grim MD

[Guest guest]

No low K? r u kidding?! Actually in 1999 I had a very severe back pain that I could not roll out of bed,,,I dragged myself to this doc and he dx muscle spasm...and tests indicated K as low as 3.4 or 3.2 + HTN and I started my bp med by Indapamide 1.25 alone....I then realized I had had HTN before 1999 and had no clue about what HTN was until back muscle spasm sent me to doc.

My doc still claims I am the only case he has ever encountered! I remember when in 2003 he desparately could not control my bp, at a visit he had a visiting resident doc who suggested Spiro and for trial doc prescribed me 25 mg Spiro but he originally prescribed it as potassium-sparing diuretic (what a miserable misleading name) and there was no mention of aldo at all untill end of 2009.

I guess for my case he has received so much feedback from university hospital that now he knows something about PA but I have made a CD of your article etc for him.

Max.

61M L adenoma NP59 Spiro=100, Amlo=10, Indap=2.5, Ramip=5, Metf=1000, Prav=40, Feno=67, K.cl=120 mEq

Damm. Think of all the PAs he has missed. Scary.

I assume you did not have low k or difficult to control HTN. If you did then he has not been reading anything for at least 10 years.

Take him my article and tell him I said Hi and please for the sake of your other pts with PA read it.

I have been to UK to teach BP in Drs offices and can tell you most do not do it right. And this was in offices that do HTN research.

CE Grim MD

My doc is : BM (UK), CCFP ©, LMCC, Cert, MAc Family Practitioner, Acupuncturist >25 years experience, confessed I am the only PA patient he ever had during his practice...so for 10 years he had no clue I had PA until a university prof. diagnosed me with PA last year...looks promissing!

Max.

61M L adenoma NP59 Spiro=100, Amlo=10, Indap=2.5, Ramip=5, Metf=1000, Prav=40, Feno=67, K.cl=120 mEq

[Guest guest]

Then what was his explanation for the low K. I would recommend printing it out so he does not have to work at reading it.Spiro can be classified as a K sparing diuretic but only works by blocking ald. We have know this for about 50 years. CE Grim MDNo low K? r u kidding?! Actually in 1999 I had a very severe back pain that I could not roll out of bed,,,I dragged myself to this doc and he dx muscle spasm...and tests indicated K as low as 3.4 or 3.2 + HTN and I started my bp med by Indapamide 1.25 alone....I then realized I had had HTN before 1999 and had no clue about what HTN was until back muscle spasm sent me to doc. My doc still claims I am the only case he has ever encountered! I remember when in 2003 he desparately could not control my bp, at a visit he had a visiting resident doc who suggested Spiro and for trial doc prescribed me 25 mg Spiro but he originally prescribed it as potassium-sparing diuretic (what a miserable misleading name) and there was no mention of aldo at all untill end of 2009. I guess for my case he has received so much feedback from university hospital that now he knows something about PA but I have made a CD of your article etc for him. Max.61M L adenoma NP59 Spiro=100, Amlo=10, Indap=2.5, Ramip=5, Metf=1000, Prav=40, Feno=67, K.cl=120 mEqDamm. Think of all the PAs he has missed. Scary.I assume you did not have low k or difficult to control HTN. If you did then he has not been reading anything for at least 10 years. Take him my article and tell him I said Hi and please for the sake of your other pts with PA read it.I have been to UK to teach BP in Drs offices and can tell you most do not do it right. And this was in offices that do HTN research.CE Grim MDMy doc is : BM (UK), CCFP ©, LMCC, Cert, MAc Family Practitioner, Acupuncturist >25 years experience, confessed I am the only PA patient he ever had during his practice...so for 10 years he had no clue I had PA until a university prof. diagnosed me with PA last year...looks promissing! Max.61M L adenoma NP59 Spiro=100, Amlo=10, Indap=2.5, Ramip=5, Metf=1000, Prav=40, Feno=67, K.cl=120 mEq

[Guest guest]

How else do u propose I get experience with a new drug? Tiped sad Send form miiPhone ;-)May your pressure be low!CE Grim MDSpecializing in DifficultHypertension

Actually when I showed this chart at the time of its peak ALT to my doc warning him about ATACAND's liver damage side effect, he looked very dismayed that he had ignored my ALT test results. ATACAND was originally prescribed to me by my doc from his sample supplies in the basement of his office and I learned later that those drugs coming out of the basement are samples given to him by drug companies to be tested on his patients! and he might have been suspecting ATACAND's liver damage because he added ALT test to my req form.

Max.

61M L adenoma NP59 Spiro=100, Amlo=10, Indap=2.5, Ramip=5, Metf=1000, Prav=40, Feno=67, K.cl=120 mEq

Hopefully a good EMR system will be doing these sorts of things automatically.

And notify the team when one is out of bounds.

ATACAND (Candesartan) and Liver Damage

Max.

[Guest guest]

What about eplerenone? Is it also K sparing diuretic? I started to have cramps as soon as I started to take it. Did not have before.To: hyperaldosteronism Cc: Clarence Grim Sent: Sat, February 5, 2011 8:01:37

PMSubject: Re: ATACAND (Candesartan) and Liver Damage

Then what was his explanation for the low K. I would recommend printing it out so he does not have to work at reading it.Spiro can be classified as a K sparing diuretic but only works by blocking ald. We have know this for about 50 years. CE Grim MDNo low K? r u kidding?! Actually in 1999 I had a very severe back pain that I could not roll out of bed,,,I dragged myself to this doc and he dx muscle spasm...and tests indicated K as low as 3.4 or 3.2 + HTN and I started my bp med by Indapamide 1.25 alone....I then realized I had had HTN before 1999 and had no clue about what HTN was until back muscle spasm sent me to doc. My doc still claims I am the only case he has ever encountered! I remember when in 2003 he desparately could not control my bp, at a visit he had a visiting resident doc who suggested Spiro and for trial doc prescribed me 25 mg Spiro but he originally prescribed it as potassium-sparing diuretic

(what a miserable misleading name) and there was no mention of aldo at all untill end of 2009. I guess for my case he has received so much feedback from university hospital that now he knows something about PA but I have made a CD of your article etc for him. Max.61M L adenoma NP59 Spiro=100, Amlo=10, Indap=2.5, Ramip=5, Metf=1000, Prav=40, Feno=67, K.cl=120 mEqDamm. Think of all the PAs he has missed. Scary.I assume you did not have low k or difficult to control HTN. If you did then he has not been reading anything for at least 10 years. Take him my article and tell him I said Hi and please for the sake of your other pts with PA read it.I have been to UK to teach BP in Drs offices and can tell you most do not do it right. And this was in offices that do HTN research.CE Grim MDMy doc is : BM (UK), CCFP ©, LMCC, Cert, MAc Family Practitioner, Acupuncturist >25 years experience, confessed I am the only PA patient he ever had during his practice...so for 10 years he had no clue I had PA until a university prof. diagnosed me with PA last year...looks promissing! Max.61M L adenoma NP59 Spiro=100, Amlo=10, Indap=2.5, Ramip=5, Metf=1000, Prav=40, Feno=67, K.cl=120 mEq

[Guest guest]

Who are you?eplere is an MCBWhat about eplerenone? Is it also K sparing diuretic? I started to have cramps as soon as I started to take it. Did not have before.To: hyperaldosteronism Cc: Clarence Grim Sent: Sat, February 5, 2011 8:01:37 PMSubject: Re: ATACAND (Candesartan) and Liver Damage Then what was his explanation for the low K. I would recommend printing it out so he does not have to work at reading it.Spiro can be classified as a K sparing diuretic but only works by blocking ald. We have know this for about 50 years. CE Grim MDNo low K? r u kidding?! Actually in 1999 I had a very severe back pain that I could not roll out of bed,,,I dragged myself to this doc and he dx muscle spasm...and tests indicated K as low as 3.4 or 3.2 + HTN and I started my bp med by Indapamide 1.25 alone....I then realized I had had HTN before 1999 and had no clue about what HTN was until back muscle spasm sent me to doc. My doc still claims I am the only case he has ever encountered! I remember when in 2003 he desparately could not control my bp, at a visit he had a visiting resident doc who suggested Spiro and for trial doc prescribed me 25 mg Spiro but he originally prescribed it as potassium-sparing diuretic (what a miserable misleading name) and there was no mention of aldo at all untill end of 2009. I guess for my case he has received so much feedback from university hospital that now he knows something about PA but I have made a CD of your article etc for him. Max.61M L adenoma NP59 Spiro=100, Amlo=10, Indap=2.5, Ramip=5, Metf=1000, Prav=40, Feno=67, K.cl=120 mEqDamm. Think of all the PAs he has missed. Scary.I assume you did not have low k or difficult to control HTN. If you did then he has not been reading anything for at least 10 years. Take him my article and tell him I said Hi and please for the sake of your other pts with PA read it.I have been to UK to teach BP in Drs offices and can tell you most do not do it right. And this was in offices that do HTN research.CE Grim MDMy doc is : BM (UK), CCFP ©, LMCC, Cert, MAc Family Practitioner, Acupuncturist >25 years experience, confessed I am the only PA patient he ever had during his practice...so for 10 years he had no clue I had PA until a university prof. diagnosed me with PA last year...looks promissing! Max.61M L adenoma NP59 Spiro=100, Amlo=10, Indap=2.5, Ramip=5, Metf=1000, Prav=40, Feno=67, K.cl=120 mEq

[Guest guest]

you must have been eating in the salt mines as well. I have never given anyone this much K in pills. Can cause GI upset diarrhea etc.But maybe not you. Trust you have taken him my article by now.CE Grim MDWhen my doc who did not have any clue about PA prescribed Spiro, he was very very afraid to give me K supp because he used to think that Spiro will elevate my serum K so high that I die!!! after few months or let me say few years he was still adding to my K supp dose and my K was not moving! So finally he found the guts to increase my K supp to 180 mEq while on Spiro=25 So you can gradually add to your K supp and see if spasms disappear. I suspect Inspra is new and not much data we have here in this Group on it yet. Max.61M L adenoma NP59 med combo #75={Spiro=100, Amlo=10, Indap=2.5, Ramip=5, Metf=1000, Prav=40, Feno=67, K.cl=120 mEq}What about eplerenone? Is it also K sparing diuretic? I started to have cramps as soon as I started to take it. Did not have before.

[Guest guest]

One reason family docs here don't show interest in going through hassle of reading PA articles, I suspect, is because PA is taken out of their hands and manipulated with better-than-family-docs, i.e., by specialists and university hospitals under jurisdiction of medical schools and so our family docs have received enough feeling of inferiority to refrain from delving into topics like PA. One perhaps can write an article on Apathy of Family Physicians to Learn PA!

My family doc once tells me that in his 25 years experience I am the only one he ever encountered with PA, and from the other side he claims that in university hospital (UH) they perform AVS and adrenalectomy thousands and thousands annually! Even if UH performs 1000 AVS annually that would amount to 25,000 in 25 years during my doc's practice here and guess what: he never seen even 1 out of those 25,000 PA patients!!

About too much K.Cl causing GI upset: yes it does and I must be careful to take tabs with enough food...for example K.Cl=40 mg at bedtime if I do not take it with a cup of yogurt and dried+fresh shallots, and/or if I take it less than 2 hrs before going to bed then I get severe GI upset like acidic stomach and I have to get up and take a Tums pill.

5 Years ago I lost a friend to intestine cancer due to perhaps too much acidic effects of HTN drugs. Dr. Grim should have a solution for this...other than DASH please!!

My salt is not more than 2000mg daily.

Diarrhea is not too bad...I lose some weight!!

Max.

61M L adenoma NP59 med combo #75={Spiro=100, Amlo=10, Indap=2.5, Ramip=5, Metf=1000, Prav=40, Feno=67, K.cl=120 mEq}

you must have been eating in the salt mines as well. I have never given anyone this much K in pills. Can cause GI upset diarrhea etc.

But maybe not you.

Trust you have taken him my article by now.

CE Grim MD

When my doc who did not have any clue about PA prescribed Spiro, he was very very afraid to give me K supp because he used to think that Spiro will elevate my serum K so high that I die!!! after few months or let me say few years he was still adding to my K supp dose and my K was not moving! So finally he found the guts to increase my K supp to 180 mEq while on Spiro=25

So you can gradually add to your K supp and see if spasms disappear. I suspect Inspra is new and not much data we have here in this Group on it yet.

Max.

61M L adenoma NP59 med combo #75={Spiro=100, Amlo=10, Indap=2.5, Ramip=5, Metf=1000, Prav=40, Feno=67, K.cl=120 mEq}

What about eplerenone? Is it also K sparing diuretic? I started to have cramps as soon as I started to take it. Did not have before.

[Guest guest]

Didn't you show a few posting that you K was 5 Ir it is why are you taking K

pills?

>

>

>

>

>

> When my doc who did not have any clue about PA prescribed Spiro, he was very

> very afraid to give me K supp because he used to think that Spiro will

> elevate my serum K so high that I die!!! after few months or let me say few

> years he was still adding to my K supp dose and my K was not moving! So

> finally he found the guts to increase my K supp to 180 mEq while on Spiro=25

>

> So you can gradually add to your K supp and see if spasms disappear. I

> suspect Inspra is new and not much data we have here in this Group on it

> yet.

>

> Max.

>

> 61M L adenoma NP59 med combo #75={Spiro=100, Amlo=10, Indap=2.5, Ramip=5,

> Metf=1000, Prav=40, Feno=67, K.cl=120 mEq}

>

>

>

>

> What about eplerenone? Is it also K sparing diuretic? I started to have

> cramps as soon as I started to take it. Did not have before.

>

[Guest guest]

My serum K values vary based on med combo #...since 1999 they range from 3.1 to 5.0. Right now it is steady at 4.6 mmol/L.

Max.

61M L adenoma NP59 med combo #75={Spiro=100, Amlo=10, Indap=2.5, Ramip=5, Metf=1000, Prav=40, Feno=67, K.cl=120 mEq}

|||Didn't you show a few posting that you K was 5 Ir it is why|are you taking K pills?|

[Guest guest]

Sorry again. Natalia Kamneva 66 Russian F with adrenal

adenoma, HTN and low renin , low aldesteron and high cortisol, K=3.4. To: hyperaldosteronism Cc: Clarence Grim Sent: Sun, February 6, 2011 4:56:19 PMSubject: Re: ATACAND (Candesartan) and Liver Damage

Who are you?eplere is an MCBWhat about eplerenone? Is it also K sparing diuretic? I started to have cramps as soon as I started to take it. Did not have before.To: hyperaldosteronism Cc: Clarence Grim Sent: Sat, February 5, 2011 8:01:37 PMSubject: Re: ATACAND (Candesartan) and Liver Damage Then what was his explanation for the low K. I would recommend printing it out so he does not have to work at reading it.Spiro can be classified as a K sparing diuretic but only works by blocking ald. We have know this for about 50 years. CE Grim MDNo low K? r u kidding?! Actually in 1999 I had a very severe back pain that I could not roll out of bed,,,I dragged myself to this doc and he dx muscle spasm...and tests indicated K as low as 3.4 or 3.2 + HTN and I started my bp med by Indapamide 1.25 alone....I then realized I had had HTN before 1999 and had no clue about what HTN was until back muscle spasm sent me to doc. My doc still claims I am the only case he has ever encountered! I remember when in 2003 he desparately could not control my bp, at a visit he had a visiting resident doc who suggested Spiro and for trial doc prescribed me 25 mg Spiro but he originally prescribed it as potassium-sparing diuretic (what a miserable misleading name) and there was no mention of aldo at all untill end of 2009. I guess for my case he has received so much feedback from university hospital that now he knows something about PA but I have made a CD of your article etc for him. Max.61M L adenoma NP59 Spiro=100, Amlo=10, Indap=2.5, Ramip=5, Metf=1000, Prav=40, Feno=67, K.cl=120 mEqDamm. Think of all the PAs he has missed. Scary.I assume you did not have low k or difficult to control HTN. If you did then he has not been reading anything for at least 10 years. Take him my article and tell him I said Hi and please for the sake of your other pts with PA read it.I have been to UK to teach BP in Drs offices and can tell you most do not do it right. And this was in offices that do HTN research.CE Grim MDMy doc

is : BM (UK), CCFP ©, LMCC, Cert, MAc Family Practitioner, Acupuncturist >25 years experience, confessed I am the only PA patient he ever had during his practice...so for 10 years he had no clue I had PA until a university prof. diagnosed me with PA last year...looks promissing! Max.61M L adenoma NP59 Spiro=100, Amlo=10, Indap=2.5, Ramip=5, Metf=1000, Prav=40, Feno=67, K.cl=120 mEq

[Guest guest]

I had gotten up to taking 150 meq/day. My Nephrologist increased Spiro to 100 mg (125 mg daily started to reflect in poor liver function in labs) and got me down to 100 meq/day until my adrenalectomy.

Juli

40y F, Post R Adrenalectomy 12.15.10

When my doc who did not have any clue about PA prescribed Spiro, he was very very afraid to give me K supp because he used to think that Spiro will elevate my serum K so high that I die!!! after few months or let me say few years he was still adding to my K supp dose and my K was not moving! So finally he found the guts to increase my K supp to 180 mEq while on Spiro=25

So you can gradually add to your K supp and see if spasms disappear. I suspect Inspra is new and not much data we have here in this Group on it yet.

Max.

61M L adenoma NP59 med combo #75={Spiro=100, Amlo=10, Indap=2.5, Ramip=5, Metf=1000, Prav=40, Feno=67, K.cl=120 mEq}

What about eplerenone? Is it also K sparing diuretic? I started to have cramps as soon as I started to take it. Did not have before.

[Guest guest]

If K is 5 you should not be taking K pills. CE Grim MDDidn't you show a few posting that you K was 5 Ir it is why are you taking K pills?> > > > > > When my doc who did not have any clue about PA prescribed Spiro, he was very> very afraid to give me K supp because he used to think that Spiro will> elevate my serum K so high that I die!!! after few months or let me say few> years he was still adding to my K supp dose and my K was not moving! So> finally he found the guts to increase my K supp to 180 mEq while on Spiro=25> > So you can gradually add to your K supp and see if spasms disappear. I> suspect Inspra is new and not much data we have here in this Group on it> yet.> > Max.> > 61M L adenoma NP59 med combo #75={Spiro=100, Amlo=10, Indap=2.5, Ramip=5,> Metf=1000, Prav=40, Feno=67, K.cl=120 mEq}> > > > > What about eplerenone? Is it also K sparing diuretic? I started to have> cramps as soon as I started to take it. Did not have before.>

[Guest guest]

REcommend stepping down Ram (cough) and Indap (not needed) and if feet swell Amlod.and certainly K if you are taking spiro.CE Grim MDMy serum K values vary based on med combo #...since 1999 they range from 3.1 to 5.0. Right now it is steady at 4.6 mmol/L. Max.61M L adenoma NP59 med combo #75={Spiro=100, Amlo=10, Indap=2.5, Ramip=5, Metf=1000, Prav=40, Feno=67, K.cl=120 mEq} |||Didn't you show a few posting that you K was 5 Ir it is why|are you taking K pills?|

[Guest guest]

Spasiba!Sorry again. Natalia Kamneva 66 Russian F with adrenal adenoma, HTN and low renin , low aldesteron and high cortisol, K=3.4. To: hyperaldosteronism Cc: Clarence Grim Sent: Sun, February 6, 2011 4:56:19 PMSubject: Re: ATACAND (Candesartan) and Liver Damage Who are you?eplere is an MCBWhat about eplerenone? Is it also K sparing diuretic? I started to have cramps as soon as I started to take it. Did not have before.To: hyperaldosteronism Cc: Clarence Grim Sent: Sat, February 5, 2011 8:01:37 PMSubject: Re: ATACAND (Candesartan) and Liver Damage Then what was his explanation for the low K. I would recommend printing it out so he does not have to work at reading it.Spiro can be classified as a K sparing diuretic but only works by blocking ald. We have know this for about 50 years. CE Grim MDNo low K? r u kidding?! Actually in 1999 I had a very severe back pain that I could not roll out of bed,,,I dragged myself to this doc and he dx muscle spasm...and tests indicated K as low as 3.4 or 3.2 + HTN and I started my bp med by Indapamide 1.25 alone....I then realized I had had HTN before 1999 and had no clue about what HTN was until back muscle spasm sent me to doc. My doc still claims I am the only case he has ever encountered! I remember when in 2003 he desparately could not control my bp, at a visit he had a visiting resident doc who suggested Spiro and for trial doc prescribed me 25 mg Spiro but he originally prescribed it as potassium-sparing diuretic (what a miserable misleading name) and there was no mention of aldo at all untill end of 2009. I guess for my case he has received so much feedback from university hospital that now he knows something about PA but I have made a CD of your article etc for him. Max.61M L adenoma NP59 Spiro=100, Amlo=10, Indap=2.5, Ramip=5, Metf=1000, Prav=40, Feno=67, K.cl=120 mEqDamm. Think of all the PAs he has missed. Scary.I assume you did not have low k or difficult to control HTN. If you did then he has not been reading anything for at least 10 years. Take him my article and tell him I said Hi and please for the sake of your other pts with PA read it.I have been to UK to teach BP in Drs offices and can tell you most do not do it right. And this was in offices that do HTN research.CE Grim MDMy doc is : BM (UK), CCFP ©, LMCC, Cert, MAc Family Practitioner, Acupuncturist >25 years experience, confessed I am the only PA patient he ever had during his practice...so for 10 years he had no clue I had PA until a university prof. diagnosed me with PA last year...looks promissing! Max.61M L adenoma NP59 Spiro=100, Amlo=10, Indap=2.5, Ramip=5, Metf=1000, Prav=40, Feno=67, K.cl=120 mEq

[Guest guest]

You must have been eating at the salt mines.AgainExcess aldo and excess in diet = HTN, low K heart and kidney damageExcess aldo and low salt diet = none of the above.CE Grim MEI had gotten up to taking 150 meq/day. My Nephrologist increased Spiro to 100 mg (125 mg daily started to reflect in poor liver function in labs) and got me down to 100 meq/day until my adrenalectomy. Juli40y F, Post R Adrenalectomy 12.15.10When my doc who did not have any clue about PA prescribed Spiro, he was very very afraid to give me K supp because he used to think that Spiro will elevate my serum K so high that I die!!! after few months or let me say few years he was still adding to my K supp dose and my K was not moving! So finally he found the guts to increase my K supp to 180 mEq while on Spiro=25 So you can gradually add to your K supp and see if spasms disappear. I suspect Inspra is new and not much data we have here in this Group on it yet. Max.61M L adenoma NP59 med combo #75={Spiro=100, Amlo=10, Indap=2.5, Ramip=5, Metf=1000, Prav=40, Feno=67, K.cl=120 mEq}What about eplerenone? Is it also K sparing diuretic? I started to have cramps as soon as I started to take it. Did not have before.

[Guest guest]

Please remember my data are function of time because I do not refer to my latest values for charts but rather to values for specific periods of time. So at a time my K(t)=5.0 t=is not now. Med combo #s also indicate that they were in the past.

Max.

61M L adenoma NP59 med combo #75={Spiro=100, Amlo=10, Indap=2.5, Ramip=5, Metf=1000, Prav=40, Feno=67, K.cl=120 mEq}

If K is 5 you should not be taking K pills.

CE Grim MD

[Guest guest]

I have to take some action on this.

Max.

61M L adenoma NP59 med combo #75={Spiro=100, Amlo=10, Indap=2.5, Ramip=5, Metf=1000, Prav=40, Feno=67, K.cl=120 mEq}

REcommend stepping down Ram (cough) and Indap (not needed) and if feet swell Amlod.

and certainly K if you are taking spiro.

CE Grim MD

My serum K values vary based on med combo #...since 1999 they range from 3.1 to 5.0. Right now it is steady at 4.6 mmol/L.

Max.

61M L adenoma NP59 med combo #75={Spiro=100, Amlo=10, Indap=2.5, Ramip=5, Metf=1000, Prav=40, Feno=67, K.cl=120 mEq}

|||Didn't you show a few posting that you K was 5 Ir it is why|are you taking K pills?|

[Guest guest]

Really it's SPASIBO.

We can also teach you

To: hyperaldosteronism Cc: Clarence Grim Sent: Sun, February 6, 2011 11:35:07 PMSubject: Re: ATACAND (Candesartan) and Liver Damage

Spasiba!

Sorry again. Natalia Kamneva 66 Russian F with adrenal adenoma, HTN and low renin , low aldesteron and high cortisol, K=3.4.

To: hyperaldosteronism Cc: Clarence Grim Sent: Sun, February 6, 2011 4:56:19

PMSubject: Re: ATACAND (Candesartan) and Liver Damage

Who are you?

eplere is an MCB

What about eplerenone? Is it also K sparing diuretic? I started to have cramps as soon as I started to take it. Did not have before.

To: hyperaldosteronism Cc: Clarence Grim Sent: Sat, February 5, 2011 8:01:37

PMSubject: Re: ATACAND (Candesartan) and Liver Damage

Then what was his explanation for the low K. I would recommend printing it out so he does not have to work at reading it.

Spiro can be classified as a K sparing diuretic but only works by blocking ald. We have know this for about 50 years.

CE Grim MD

No low K? r u kidding?! Actually in 1999 I had a very severe back pain that I could not roll out of bed,,,I dragged myself to this doc and he dx muscle spasm...and tests indicated K as low as 3.4 or 3.2 + HTN and I started my bp med by Indapamide 1.25 alone....I then realized I had had HTN before 1999 and had no clue about what HTN was until back muscle spasm sent me to doc.

My doc still claims I am the only case he has ever encountered! I remember when in 2003 he desparately could not control my bp, at a visit he had a visiting resident doc who suggested Spiro and for trial doc prescribed me 25 mg Spiro but he originally prescribed it as potassium-sparing diuretic (what a miserable misleading name) and there was no mention of aldo at all untill end of 2009.

I guess for my case he has received so much feedback from university hospital that now he knows something about PA but I have made a CD of your article etc for him.

Max.

61M L adenoma NP59 Spiro=100, Amlo=10, Indap=2.5, Ramip=5, Metf=1000, Prav=40, Feno=67, K.cl=120 mEq

Damm. Think of all the PAs he has missed. Scary.

I assume you did not have low k or difficult to control HTN. If you did then he has not been reading anything for at least 10 years.

Take him my article and tell him I said Hi and please for the sake of your other pts with PA read it.

I have been to UK to teach BP in Drs offices and can tell you most do not do it right. And this was in offices that do HTN research.

CE Grim MD

My doc is : BM (UK), CCFP ©, LMCC, Cert, MAc Family Practitioner, Acupuncturist >25 years experience, confessed I am the only PA patient he ever had during his practice...so for 10 years he had no clue I had PA until a university prof. diagnosed me with PA last year...looks promissing!

Max.

61M L adenoma NP59 Spiro=100, Amlo=10, Indap=2.5, Ramip=5, Metf=1000, Prav=40, Feno=67, K.cl=120 mEq

[Guest guest]

that must be the masculine?Dah?Really it's SPASIBO. We can also teach you To: hyperaldosteronism Cc: Clarence Grim Sent: Sun, February 6, 2011 11:35:07 PMSubject: Re: ATACAND (Candesartan) and Liver Damage Spasiba!Sorry again. Natalia Kamneva 66 Russian F with adrenal adenoma, HTN and low renin , low aldesteron and high cortisol, K=3.4. To: hyperaldosteronism Cc: Clarence Grim Sent: Sun, February 6, 2011 4:56:19 PMSubject: Re: ATACAND (Candesartan) and Liver Damage Who are you?eplere is an MCBWhat about eplerenone? Is it also K sparing diuretic? I started to have cramps as soon as I started to take it. Did not have before.To: hyperaldosteronism Cc: Clarence Grim Sent: Sat, February 5, 2011 8:01:37 PMSubject: Re: ATACAND (Candesartan) and Liver Damage Then what was his explanation for the low K. I would recommend printing it out so he does not have to work at reading it.Spiro can be classified as a K sparing diuretic but only works by blocking ald. We have know this for about 50 years. CE Grim MDNo low K? r u kidding?! Actually in 1999 I had a very severe back pain that I could not roll out of bed,,,I dragged myself to this doc and he dx muscle spasm...and tests indicated K as low as 3.4 or 3.2 + HTN and I started my bp med by Indapamide 1.25 alone....I then realized I had had HTN before 1999 and had no clue about what HTN was until back muscle spasm sent me to doc. My doc still claims I am the only case he has ever encountered! I remember when in 2003 he desparately could not control my bp, at a visit he had a visiting resident doc who suggested Spiro and for trial doc prescribed me 25 mg Spiro but he originally prescribed it as potassium-sparing diuretic (what a miserable misleading name) and there was no mention of aldo at all untill end of 2009. I guess for my case he has received so much feedback from university hospital that now he knows something about PA but I have made a CD of your article etc for him. Max.61M L adenoma NP59 Spiro=100, Amlo=10, Indap=2.5, Ramip=5, Metf=1000, Prav=40, Feno=67, K.cl=120 mEqDamm. Think of all the PAs he has missed. Scary.I assume you did not have low k or difficult to control HTN. If you did then he has not been reading anything for at least 10 years. Take him my article and tell him I said Hi and please for the sake of your other pts with PA read it.I have been to UK to teach BP in Drs offices and can tell you most do not do it right. And this was in offices that do HTN research.CE Grim MDMy doc is : BM (UK), CCFP ©, LMCC, Cert, MAc Family Practitioner, Acupuncturist >25 years experience, confessed I am the only PA patient he ever had during his practice...so for 10 years he had no clue I had PA until a university prof. diagnosed me with PA last year...looks promissing! Max.61M L adenoma NP59 Spiro=100, Amlo=10, Indap=2.5, Ramip=5, Metf=1000, Prav=40, Feno=67, K.cl=120 mEq

[Guest guest]

No, no, no. It's not noun, so it doesn't have gender. The origin of this word is "СпаÑи Бог" -> "СпаÑибо" . It means something as "Bless you".

To: hyperaldosteronism Cc: Clarence Grim Sent: Mon, February 7, 2011 11:12:09 PMSubject: Re: ATACAND (Candesartan) and Liver Damage

that must be the masculine?

Dah?

Really it's SPASIBO.

We can also teach you

To: hyperaldosteronism Cc: Clarence Grim Sent: Sun, February 6, 2011 11:35:07

PMSubject: Re: ATACAND (Candesartan) and Liver Damage

Spasiba!

Sorry again. Natalia Kamneva 66 Russian F with adrenal adenoma, HTN and low renin , low aldesteron and high cortisol, K=3.4.

To: hyperaldosteronism Cc: Clarence Grim Sent: Sun, February 6, 2011 4:56:19

PMSubject: Re: ATACAND (Candesartan) and Liver Damage

Who are you?

eplere is an MCB

What about eplerenone? Is it also K sparing diuretic? I started to have cramps as soon as I started to take it. Did not have before.

To: hyperaldosteronism Cc: Clarence Grim Sent: Sat, February 5, 2011 8:01:37

PMSubject: Re: ATACAND (Candesartan) and Liver Damage

Then what was his explanation for the low K. I would recommend printing it out so he does not have to work at reading it.

Spiro can be classified as a K sparing diuretic but only works by blocking ald. We have know this for about 50 years.

CE Grim MD

No low K? r u kidding?! Actually in 1999 I had a very severe back pain that I could not roll out of bed,,,I dragged myself to this doc and he dx muscle spasm...and tests indicated K as low as 3.4 or 3.2 + HTN and I started my bp med by Indapamide 1.25 alone....I then realized I had had HTN before 1999 and had no clue about what HTN was until back muscle spasm sent me to doc.

My doc still claims I am the only case he has ever encountered! I remember when in 2003 he desparately could not control my bp, at a visit he had a visiting resident doc who suggested Spiro and for trial doc prescribed me 25 mg Spiro but he originally prescribed it as potassium-sparing diuretic (what a miserable misleading name) and there was no mention of aldo at all untill end of 2009.

I guess for my case he has received so much feedback from university hospital that now he knows something about PA but I have made a CD of your article etc for him.

Max.

61M L adenoma NP59 Spiro=100, Amlo=10, Indap=2.5, Ramip=5, Metf=1000, Prav=40, Feno=67, K.cl=120 mEq

Damm. Think of all the PAs he has missed. Scary.

I assume you did not have low k or difficult to control HTN. If you did then he has not been reading anything for at least 10 years.

Take him my article and tell him I said Hi and please for the sake of your other pts with PA read it.

I have been to UK to teach BP in Drs offices and can tell you most do not do it right. And this was in offices that do HTN research.

CE Grim MD

My doc is : BM (UK), CCFP ©, LMCC, Cert, MAc Family Practitioner, Acupuncturist >25 years experience, confessed I am the only PA patient he ever had during his practice...so for 10 years he had no clue I had PA until a university prof. diagnosed me with PA last year...looks promissing!

Max.

61M L adenoma NP59 Spiro=100, Amlo=10, Indap=2.5, Ramip=5, Metf=1000, Prav=40, Feno=67, K.cl=120 mEq