Re: Controlled BP with Unusual SIde Effect

[Guest guest]

1 is most likely due to high salivary K. 2 is due to Spiro and occurs in most men unless they can dash well enough to minimize dose of Spiro. If thnq is not possible then inspra will get rid of it if due to MCR blockages crossing to estrogen receptors. Tiped sad Send form miiPhone ;-)May your pressure be low!CE Grim MDSpecializing in DifficultHypertension

My BP is controlled but I have been experiencing an unusual side effect of the PA treatment. Has anyone experienced strange taste sensations since taking Inspra (Eplerenone)? For some odd reason, I have become super-sensitive to the taste of sugar. When I eat meats, they taste very sugary/starchy to me. I noticed this taste about a year ago but dismissed it. It happens quite often now but not always. Does this indicate another medical condition? Anyone else experienced this side effect?

MEN ONLY:

I'm not sure whether weight gain or Inspra is causing gynecomastia that seems to come and go. It's getting to the point that my self image is being affected, especially by my physical profile. I'm in my 50s and understand that this could also be due to aging. Exercise does not reduce the gynecomastia and seems to only make it more noticeable. Any ideas other than surgery?

[Guest guest]

I belive he is taking inspra not Spiro.

>

> > My BP is controlled but I have been experiencing an unusual side effect of

the PA treatment. Has anyone experienced strange taste sensations since taking

Inspra (Eplerenone)? For some odd reason, I have become super-sensitive to the

taste of sugar. When I eat meats, they taste very sugary/starchy to me. I

noticed this taste about a year ago but dismissed it. It happens quite often now

but not always. Does this indicate another medical condition? Anyone else

experienced this side effect?

> >

> > MEN ONLY:

> >

> > I'm not sure whether weight gain or Inspra is causing gynecomastia that

seems to come and go. It's getting to the point that my self image is being

affected, especially by my physical profile. I'm in my 50s and understand that

this could also be due to aging. Exercise does not reduce the gynecomastia and

seems to only make it more noticeable. Any ideas other than surgery?

> >

> >

>

[Guest guest]

May be left over from Spiro then. Or need to look for other causes. Spiro gyneco may take some time to reverse. Maybe others here can give us some idea of how long theirs persisted AGFree going on inspra. Tiped sad Send form miiPhone ;-)May your pressure be low!CE Grim MDSpecializing in DifficultHypertension

I belive he is taking inspra not Spiro.

>

> > My BP is controlled but I have been experiencing an unusual side effect of the PA treatment. Has anyone experienced strange taste sensations since taking Inspra (Eplerenone)? For some odd reason, I have become super-sensitive to the taste of sugar. When I eat meats, they taste very sugary/starchy to me. I noticed this taste about a year ago but dismissed it. It happens quite often now but not always. Does this indicate another medical condition? Anyone else experienced this side effect?

> >

> > MEN ONLY:

> >

> > I'm not sure whether weight gain or Inspra is causing gynecomastia that seems to come and go. It's getting to the point that my self image is being affected, especially by my physical profile. I'm in my 50s and understand that this could also be due to aging. Exercise does not reduce the gynecomastia and seems to only make it more noticeable. Any ideas other than surgery?

> >

> >

>

[Guest guest]

As an 18 year PA sufferer I can tell you that I experienced Gynomastia on Spironolactone. When I changed to Epleronone the Gynomastia problem was gone in 4 to 6 weeks. Hopefully you have an excellent drug insurance plan, because the Epleronone is expensive. Can anyone tell me if my regimen of 32 MEQ of Potassium (K) and 50 mg of Epleronone is a typical dosage? I am doing well on that dosage and since CT studies were inconclusive and Adrenal vein sampling attempts were a complete failure, I am content with simply taking the medication..........RodTo: "hyperaldosteronism " <hyperaldosteronism >Sent: Sun, November 28, 2010 9:42:44 AMSubject: Re: Re: Controlled BP with Unusual SIde Effect

May be left over from Spiro then. Or need to look for other causes. Spiro gyneco may take some time to reverse. Maybe others here can give us some idea of how long theirs persisted AGFree going on inspra. Tiped sad Send form miiPhone ;-)May your pressure be low!CE Grim MDSpecializing in DifficultHypertension

I belive he is taking inspra not Spiro.

>

> > My BP is controlled but I have been experiencing an unusual side effect of the PA treatment. Has anyone experienced strange taste sensations since taking Inspra (Eplerenone)? For some odd reason, I have become super-sensitive to the taste of sugar. When I eat meats, they taste very sugary/starchy to me. I noticed this taste about a year ago but dismissed it. It happens quite often now but not always. Does this indicate another medical condition? Anyone else experienced this side effect?

> >

> > MEN ONLY:

> >

> > I'm not sure whether weight gain or Inspra is causing gynecomastia that seems to come and go. It's getting to the point that my self image is being affected, especially by my physical profile. I'm in my 50s and understand that this could also be due to aging. Exercise does not reduce the gynecomastia and seems to only make it more noticeable. Any ideas other than surgery?

> >

> >

>

[Guest guest]

Here is his posting again. Maybe missed something or he is taking other meds as

well.

You are NOT alone. I have been living with Conn's Syndrome for almost 3 years

and am unable to have surgery due to bilateral hyperplasia. I have gained

almost 40 pounds since being placed on the medication regimen that is keeping my

BP controlled. Weight gain of 25 lbs. occured within the first four weeks of

taking the meds. (Inspra & Minoxidil are the culprits). DASHing, exercising,

and caloric intake seem to have no effect in countering this condition. My

doctors have advised me to continue treatment and accept the side effect since

it is cosmetic, not medical. This esaier for guys to do than for women to

accept more than likely. I still retain fluid but this has been associated with

valve damage in the veins of my legs due to height, weight, and 15 years of

uncontrolled BP. Just wanted to add my 3 cents!

> > >

> > > > My BP is controlled but I have been experiencing an unusual side effect

of the PA treatment. Has anyone experienced strange taste sensations since

taking Inspra (Eplerenone)? For some odd reason, I have become super-sensitive

to the taste of sugar. When I eat meats, they taste very sugary/starchy to me. I

noticed this taste about a year ago but dismissed it. It happens quite often now

but not always. Does this indicate another medical condition? Anyone else

experienced this side effect?

> > > >

> > > > MEN ONLY:

> > > >

> > > > I'm not sure whether weight gain or Inspra is causing gynecomastia that

seems to come and go. It's getting to the point that my self image is being

affected, especially by my physical profile. I'm in my 50s and understand that

this could also be due to aging. Exercise does not reduce the gynecomastia and

seems to only make it more noticeable. Any ideas other than surgery?

> > > >

> > > >

> > >

> >

> >

>

[Guest guest]

Hey group,

Since I am new to this group and new to using spironolactone, I have a question maybe someone can answer.

I saw incredible results after only 2 doses of the spiro, and for 2 weeks now I have averaged a BP of 120/70 after three years of NEVER having it below 160/110 (seriously!). Now, even though the spiro is working great I have noticed and felt my heart rate always over 110, sometimes up to 140. I am only 43yo, have had numerous heart studies (I have a left enlargement and now. as of weeks ago, a new murmur - thanks to no one ever diagnosing PA and letting my blood pressure stay high even on 5 medicines and it is a byproduct the cardiologist thinks of the uncontrolled high blood pressure.

I had some heart issues early this year and that is what cued them to find the hyperthyroidism (you want to live in hell HAVE PA and hyperthyroidism at the same time!) But the thyroid corrected itself and recent tests say it is fine. But I cannot get my heart rate down. I do take metoprolol and it works, but then pulse peaks back up.

Is this a byproduct of the spiro? Anyone else with this issue?

JB

I belive he is taking inspra not Spiro. > > > My BP is controlled but I have been experiencing an unusual side effect of the PA treatment. Has anyone experienced strange taste sensations since taking Inspra (Eplerenone)? For some odd reason, I have become super-sensitive to the taste of sugar. When I eat meats, they taste very sugary/starchy to me. I noticed this taste about a year ago but dismissed it. It happens quite often now but not always. Does this indicate another medical condition? Anyone else experienced this side effect? > > > > MEN ONLY:> > > > I'm not sure whether weight gain or Inspra is causing gynecomastia that seems to come and go. It's getting to the point that my self image is being affected, especially by my physical profile. I'm in my 50s and understand that this could also be due to aging. Exercise does not reduce the gynecomastia and seems to only

make it more noticeable. Any ideas other than surgery?> > > >>

[Guest guest]

Why are you taking both Inspra & Minoxidil?

What tests have been done to show you have valve damage in the veins of your

legs?

Gaining 40 pounds is more then cosmetic.

> > > >

> > > > > My BP is controlled but I have been experiencing an unusual side

effect of the PA treatment. Has anyone experienced strange taste sensations

since taking Inspra (Eplerenone)? For some odd reason, I have become

super-sensitive to the taste of sugar. When I eat meats, they taste very

sugary/starchy to me. I noticed this taste about a year ago but dismissed it. It

happens quite often now but not always. Does this indicate another medical

condition? Anyone else experienced this side effect?

> > > > >

> > > > > MEN ONLY:

> > > > >

> > > > > I'm not sure whether weight gain or Inspra is causing gynecomastia

that seems to come and go. It's getting to the point that my self image is being

affected, especially by my physical profile. I'm in my 50s and understand that

this could also be due to aging. Exercise does not reduce the gynecomastia and

seems to only make it more noticeable. Any ideas other than surgery?

> > > > >

> > > > >

> > > >

> > >

> > >

> >

>

[Guest guest]

What is your K doing?

> >

> > > My BP is controlled but I have been experiencing an unusual side effect of

the PA treatment. Has anyone experienced strange taste sensations since taking

Inspra (Eplerenone)? For some odd reason, I have become super-sensitive to the

taste of sugar. When I eat meats, they taste very sugary/starchy to me. I

noticed this taste about a year ago but dismissed it. It happens quite often now

but not always. Does this indicate another medical condition? Anyone else

experienced this side effect?

> > >

> > > MEN ONLY:

> > >

> > > I'm not sure whether weight gain or Inspra is causing gynecomastia that

seems to come and go. It's getting to the point that my self image is being

affected, especially by my physical profile. I'm in my 50s and understand that

this could also be due to aging. Exercise does not reduce the gynecomastia and

seems to only make it more noticeable. Any ideas other than surgery?

> > >

> > >

> >

>

[Guest guest]

K was just .1 above normal...usually low of course

Subject: Re: Controlled BP with Unusual SIde EffectTo: hyperaldosteronism Date: Sunday, November 28, 2010, 5:37 PM

What is your K doing?> > > > > My BP is controlled but I have been experiencing an unusual side effect of the PA treatment. Has anyone experienced strange taste sensations since taking Inspra (Eplerenone)? For some odd reason, I have become super-sensitive to the taste of sugar. When I eat meats, they taste very sugary/starchy to me. I noticed this taste about a year ago but dismissed it. It happens quite often now but not always. Does this indicate another medical condition? Anyone else experienced this side effect? > > > > > > MEN ONLY:> > > > > > I'm not sure whether weight gain or Inspra is causing gynecomastia that seems to come and go. It's getting to the point that my self image is being affected, especially by my physical profile. I'm in my 50s and understand that this could also be due to aging. Exercise does not reduce the

gynecomastia and seems to only make it more noticeable. Any ideas other than surgery?> > > > > >> >>

[Guest guest]

My BP straightened up right away after the spiro too and my heart rate stays around 90-115 most of the time. I'm having an adrenalectomy soon so it will be interesting to see what happens with my heart rate after the surgery and no more spiro. As a side note, I have been on spiro for about 6 years and take 75 mg once a day and Spiro/HCTZ 25/25 once a day. I was on the 75 mg once a day and the spiro/HCTZ 25/25 twice a day but after a couple of months of that my liver function was off d/t being overdiuresed so my Nephrologist cut it down to my current dose.

Subject: Re: Controlled BP with Unusual SIde EffectTo: hyperaldosteronism Date: Sunday, November 28, 2010, 5:37 PM

What is your K doing?> > > > > My BP is controlled but I have been experiencing an unusual side effect of the PA treatment. Has anyone

experienced strange taste sensations since taking Inspra (Eplerenone)? For some odd reason, I have become super-sensitive to the taste of sugar. When I eat meats, they taste very sugary/starchy to me. I noticed this taste about a year ago but dismissed it. It happens quite often now but not always. Does this indicate another medical condition? Anyone else experienced this side effect? > > > > > > MEN ONLY:> > > > > > I'm not sure whether weight gain or Inspra is causing gynecomastia that seems to come and go. It's getting to the point that my self image is being affected, especially by my physical profile. I'm in my 50s and understand that this could also be due to aging. Exercise does not reduce the gynecomastia and seems to only make it more noticeable. Any ideas other than surgery?> > > > > >>

>>

[Guest guest]

PS: Do we have Rod's Story? Sounds like an long and interesting one.CE Grim MDAs an 18 year PA sufferer I can tell you that I experienced Gynomastia on Spironolactone. When I changed to Epleronone the Gynomastia problem was gone in 4 to 6 weeks. Hopefully you have an excellent drug insurance plan, because the Epleronone is expensive. Can anyone tell me if my regimen of 32 MEQ of Potassium (K) and 50 mg of Epleronone is a typical dosage? I am doing well on that dosage and since CT studies were inconclusive and Adrenal vein sampling attempts were a complete failure, I am content with simply taking the medication..........RodTo: "hyperaldosteronism " <hyperaldosteronism >Sent: Sun, November 28, 2010 9:42:44 AMSubject: Re: Re: Controlled BP with Unusual SIde EffectMay be left over from Spiro then. Or need to look for other causes. Spiro gyneco may take some time to reverse. Maybe others here can give us some idea of how long theirs persisted AGFree going on inspra. Tiped sad Send form miiPhone ;-)May your pressure be low!CE Grim MDSpecializing in DifficultHypertension I belive he is taking inspra not Spiro. > > > My BP is controlled but I have been experiencing an unusual side effect of the PA treatment. Has anyone experienced strange taste sensations since taking Inspra (Eplerenone)? For some odd reason, I have become super-sensitive to the taste of sugar. When I eat meats, they taste very sugary/starchy to me. I noticed this taste about a year ago but dismissed it. It happens quite often now but not always. Does this indicate another medical condition? Anyone else experienced this side effect? > > > > MEN ONLY:> > > > I'm not sure whether weight gain or Inspra is causing gynecomastia that seems to come and go. It's getting to the point that my self image is being affected, especially by my physical profile. I'm in my 50s and understand that this could also be due to aging. Exercise does not reduce the gynecomastia and seems to only make it more noticeable. Any ideas other than surgery?> > > >>

[Guest guest]

, many here have had an

improvement in left ventricular enlargement after being on spiro or Inspra for

a while.  Is your metoprolol

time-release.  I have no idea why you're

having the fast heart-rate.  I'm not

aware of anyone else in this group reporting that.  I'm sure Dr. Grim has more information.  Have you talked to your favorite PA?

Val

From:

hyperaldosteronism [mailto:hyperaldosteronism ] On

Behalf Of Bingham

Hey

group,

Since

I am new to this group and new to using spironolactone, I have a question

maybe someone can answer.

I

saw incredible results after only 2 doses of the spiro, and for 2 weeks now I

have averaged a BP of 120/70 after three years of NEVER having it below

160/110 (seriously!). Now, even though the spiro is working great I have

noticed and felt my heart rate always over 110, sometimes up to 140. I am

only 43yo, have had numerous heart studies (I have a left enlargement

and now. as of weeks ago, a new murmur - thanks to no one ever

diagnosing PA and letting my blood pressure stay high even on 5 medicines and

it is a byproduct the cardiologist thinks of the uncontrolled high blood

pressure.

I

had some heart issues early this year and that is what cued them to find the

hyperthyroidism (you want to live in hell HAVE PA and hyperthyroidism at the

same time!) But the thyroid corrected itself and recent tests say it is fine.

But I cannot get my heart rate down. I do take metoprolol and it works, but

then pulse peaks back up.

Is

this a byproduct of the spiro? Anyone else with this issue?

JB

[Guest guest]

1. The incredible results are called getting the correct treatment for what you have!2. List all other BP meds you are on and they should prob be stopped but talk with your team. In the am would be good.You BP control systems are trying to do what they are made to do. Keep the BP where it has been. Thus you baroreceptors are thinking: Hey the BP is falling we must speed up the heart to keep the BP up. This will extinguish over a week or so in most.3. Your enlarged heart is almost certainly due to your HTN and the murmur will go away as the BP is controlled.Take you CARDs my evolution of PA article in our files so he won't miss anymore of the many he will see and is seeing like you.metoprolol must be taken every day or the heart rate will bounce around. You should be able to get off it as the spiro kicks in.4. DASHing will also help. Did you CARDS mention that? I not tell him to read JNC 7 again- well most likely for the first time it would appear as if he had read it as well as JNC 1-6 he would have picked up your problem much sooner.CE Grim MDHey group, Since I am new to this group and new to using spironolactone, I have a question maybe someone can answer. I saw incredible results after only 2 doses of the spiro, and for 2 weeks now I have averaged a BP of 120/70 after three years of NEVER having it below 160/110 (seriously!). Now, even though the spiro is working great I have noticed and felt my heart rate always over 110, sometimes up to 140. I am only 43yo, have had numerous heart studies (I have a left enlargement and now. as of weeks ago, a new murmur - thanks to no one ever diagnosing PA and letting my blood pressure stay high even on 5 medicines and it is a byproduct the cardiologist thinks of the uncontrolled high blood pressure. I had some heart issues early this year and that is what cued them to find the hyperthyroidism (you want to live in hell HAVE PA and hyperthyroidism at the same time!) But the thyroid corrected itself and recent tests say it is fine. But I cannot get my heart rate down. I do take metoprolol and it works, but then pulse peaks back up. Is this a byproduct of the spiro? Anyone else with this issue?

[Guest guest]

Your 50 mg epleronone is equal

to about 25 mg of spironolactone.

With more epleronone and DASHing, you shouldn't need K. Are you getting brand name or

generic? I just finished a test of

the two for about a month each. Systolic

was 2 points higher on the generic but that is probably not significant since

other things were not held constant.

Val

From:

hyperaldosteronism [mailto:hyperaldosteronism ] On

Behalf Of Rod

As

an 18 year PA sufferer I can tell you that I experienced Gynomastia on

Spironolactone. When I changed to Epleronone the Gynomastia problem was

gone in 4 to 6 weeks. Hopefully you have an excellent drug insurance

plan, because the Epleronone is expensive. Can anyone tell me if my

regimen of 32 MEQ of Potassium (K) and 50 mg of Epleronone is a typical dosage?

I am doing well on that dosage and since CT studies were inconclusive and

Adrenal vein sampling attempts were a complete failure, I am content with

simply taking the medication.

..........Rod

[Guest guest]

I did not need any medicine for the hyperthyroidism except the metoprolol which greatly reduced the symptoms and heart rate at the time but not the BP. But 4 months after they found the thyroid issue it resolved spontaneously and I knew it had as I felt better, but the critical HTN, insomnia (while better), urinating all night (4-5 times and no DM history in me or ANY family member) is still there. The headaches, the feeling hot are better, but still occur sometimes, and anxiety is gone . Lower leg weakness is still pretty pronounced at times.

The hyperthyroidism was first found in April 2010 at an ER where I had to go as I had been having leg weakness that got so bad (felt almost paralyzed - though I was not actually) and felt like I had gotten something like Guillan-Barre. Studies by a good ER doc showed hyperthyroidism. My antibodies were normal though.

Last blood work 3 weeks ago and I was told it was "normal", but I have not seen the numbers myself yet. I have a .1 over normal K+ but that is a first in 3 years. Consistently, lab wise, my Testosterone runs low, cortisol low, calcium low, K+ ALWAYS low and some proteinuria in the UA, though all kidney studies are fine (though no CT or MRI yet of the abdomen, only U/S). Thyroid Scans were good, U/S of thyroid good, and pituitary and brain CT normal.

No one has ever scanned my belly even though I have asked them too. I have jokingly, but with some frustration, told my wife that the belly is the last place they need to look or WILL look and THAT's where the answer will be!

Now, the symptoms of hyperthyroidism (extreme extreme insomnia - as in days long - rapid heart rate, ALWAYS hot as sin, sick all the time, extreme physical fatigue though my brain was manic 24/7 with anxiety 24/7 that had really no peaks and valleys during this time, confusion, leg weakness,severe headaches,etc) hit a peak in 10/09 right after I got the H1N1 virus and felt like I could never recover after. I worked professionally at the time with good doctors and I would pick their brain, I had many ER visits over the three years and many more after I had the flu (most often due to headaches, severe HTN, and chest pains/SOB on exertion, but cardiac studies including chest CT's always normal) and could not figure out what was going on, and even I saw my private doc many times (and others looking for some kind of answer).

Given the symptomology I think I had hyperthyroidism, it seems, off and on, for years too.I did have some low TSH the few times it was checked but they would say because my t3, t4, and antibodies were "okay" that is wasn't really hyperthyroidism - but my endocrinologist now says a low TSH IS hyperthyroidism period. My endo is a bit different, but has never suggested or talked about anything outside of the testosterone (I couldn't afford it) and the thyroid. But for years I trusted my colleagues and providers plus I was pretty confused due to the combo of all these things going on.

Ironically, as an ER physician assistant I never let anyone out with a critical high blood pressure. They got a referral and transfer immediately (I worked rural) or we worked to get it down and at least try for an answer...me? ALWAYS sent home with no change in the BP and if the brain scan and ecg and cardiac labs were good then they were not concerned.

Can you sense my frustration?

No thyroid checks typically though, except a couple of times, and never did anyone look for pheo or PA. Most often, they heard from me about the "anxiety" feeling and insomnia and that triggered the idea that my BP of 170/130 (sometimes in their office) was "stress" and they tried the SSRI's all the time, but I never got them filled. I was game a few years back and tried a couple, but they never helped, actually made me start to feel depressed and worse and I knew something deeper was at play. Plus I am not the depressed type. Just me, but I am pretty positive thinker.

Sorry, a bit long winded, but had a lot at play this past year.

Also, I did have the last ER doc, when I was in and I suggested a possible pheo to them, do the test where they try to press on your kidney and when they do the right side my heart rate increases about 20, I get kind of flushed and hot, and my BP jumps about 10 higher. I asked the ER because I noticed at night, when I first roll over on my belly in my sleep (for some reason I tend to lay my arm right in the liver area when I sleep), it wakes me up and I am sweating, hot, so thirsty, and my heart is racing. Takes a while then it calms down. I wake up incredibly startled sometimes also. So I was concerned about that too and thought pheo.

What a mess for a guy who played any sport he could (all aerobic one's too), never held a cigarrette in his hands, do not drink, and who has never had a surgery or severe illness until recently. Hit 40 and it's all downhill

And even after 5 days I spent in the hospital a month or so ago I still had that BP of 160/120 as I left my room, no belly scans, and they did do a 24 urine, but it was normal they said. Mind you I have been on clonidine 2mg for years, metop, HCTZ, and lisonopril for years and they did not stop any of it for the tests. They added hydrazaline, but the SE's were too great and it did not work at all. No one tried to stop anything for the 24 hour urine, nor did any scans except a renal U/S and they said it can't be a pheo as the kidney ultrasound was normal. No thought or mention of PA and no use or suggestion of spiro. The 24 hour urine was to check the metanephrines.

That's my saga...and on it goes....BUT my blood pressure is now normal! And I will welcome that one for sure. The new cardiologist used it (the spiro) to help r/o PA and told me my age, my symptoms, and everything else pointed to an adrenal cause. Good man. We shall see what the future holds next visit to endo and cardio.

Now......I did marry a redhead 20 years ago and we have 6 children (aged 20, 17, 14, 11, 7, and 4!) ....maybe that's all it is......

Thanks everyone for the help and advice too!

, many here have had an improvement in left ventricular enlargement after being on spiro or Inspra for a while. Is your metoprolol time-release. I have no idea why you're having the fast heart-rate. I'm not aware of anyone else in this group reporting that. I'm sure Dr. Grim has more information. Have you talked to your favorite PA?

Val

From: hyperaldosteronism [mailto:hyperaldosteronism ] On Behalf Of Bingham

Hey group,

Since I am new to this group and new to using spironolactone, I have a question maybe someone can answer.

I saw incredible results after only 2 doses of the spiro, and for 2 weeks now I have averaged a BP of 120/70 after three years of NEVER having it below 160/110 (seriously!). Now, even though the spiro is working great I have noticed and felt my heart rate always over 110, sometimes up to 140. I am only 43yo, have had numerous heart studies (I have a left enlargement and now. as of weeks ago, a new murmur - thanks to no one ever diagnosing PA and letting my blood pressure stay high even on 5 medicines and it is a byproduct the cardiologist thinks of the uncontrolled high blood pressure.

I had some heart issues early this year and that is what cued them to find the hyperthyroidism (you want to live in hell HAVE PA and hyperthyroidism at the same time!) But the thyroid corrected itself and recent tests say it is fine. But I cannot get my heart rate down. I do take metoprolol and it works, but then pulse peaks back up.

Is this a byproduct of the spiro? Anyone else with this issue?

JB

[Guest guest]

Rod,

Cardio excersise is obviously good for us as you said, but I have found that it also really helps me with my mood too. I am a pretty even keel type guy, but it sure gives me that "pick me up" just knowing I did something to help myself and gets those endorphins naturally flowing.

I used to tell my patients to use the TV method that I use to excersise and I have done this for years now. I watch a show or two a week, plus mostly sports, but I try to take a one hour show at least a couple times a week (I personally like Psych, The Good Guys, and Lie to Me) and I take every commercial and do some excersise during that hour. I like to jump rope as I read that 10 minutes of jump roping is nearly equal to 1 hour of jogging! But I guess anything would help and I will do whatever idea comes to me and mix it up a little, but I try to work up a sweat and then enjoy my show when it comes back on.

At least it helps me feel all around good.

Subject: Re: Re: Controlled BP with Unusual SIde EffectTo: hyperaldosteronism Date: Sunday, November 28, 2010, 10:27 PM

Thanks for your reply Val. I normally take Inspra (50mg), I recently ran out and now I am temporarily taking 100mg spiro until I get the Inspra Rx renewed. So It sounds like it is about an equal dosage between the two. I just got the DASH book and I will try the diet since Dr Grim, yourself, and many others report such good results on DASH. So far the best way I have found to keep BP in good range is simply cardiovascular exercise. I think many people would find a good cardio exercise program easier to stay on than a strict DASH diet, your thoughts?

...........Rod

To: hyperaldosteronism Sent: Sun, November 28, 2010 6:55:46 PMSubject: RE: Re: Controlled BP with Unusual SIde Effect

Your 50 mg epleronone is equal to about 25 mg of spironolactone. With more epleronone and DASHing, you shouldn't need K. Are you getting brand name or generic? I just finished a test of the two for about a month each. Systolic was 2 points higher on the generic but that is probably not significant since other things were not held constant.

Val

From: hyperaldosteronism [mailto:hyperaldosteronism ] On Behalf Of Rod

As an 18 year PA sufferer I can tell you that I experienced Gynomastia on Spironolactone. When I changed to Epleronone the Gynomastia problem was gone in 4 to 6 weeks. Hopefully you have an excellent drug insurance plan, because the Epleronone is expensive. Can anyone tell me if my regimen of 32 MEQ of Potassium (K) and 50 mg of Epleronone is a typical dosage? I am doing well on that dosage and since CT studies were inconclusive and Adrenal vein sampling attempts were a complete failure, I am content with simply taking the medication.

..........Rod

[Guest guest]

Lets refer to it as a DASH eating plan not at diet. CE Grim MDThanks for your reply Val. I normally take Inspra (50mg), I recently ran out and now I am temporarily taking 100mg spiro until I get the Inspra Rx renewed. So It sounds like it is about an equal dosage between the two. I just got the DASH book and I will try the diet since Dr Grim, yourself, and many others report such good results on DASH. So far the best way I have found to keep BP in good range is simply cardiovascular exercise. I think many people would find a good cardio exercise program easier to stay on than a strict DASH diet, your thoughts?..........Rod To: hyperaldosteronism Sent: Sun, November 28, 2010 6:55:46 PMSubject: RE: Re: Controlled BP with Unusual SIde EffectYour 50 mg epleronone is equal to about 25 mg of spironolactone. With more epleronone and DASHing, you shouldn't need K. Are you getting brand name or generic? I just finished a test of the two for about a month each. Systolic was 2 points higher on the generic but that is probably not significant since other things were not held constant. Val From: hyperaldosteronism [mailto:hyperaldosteronism ] On Behalf Of Rod As an 18 year PA sufferer I can tell you that I experienced Gynomastia on Spironolactone. When I changed to Epleronone the Gynomastia problem was gone in 4 to 6 weeks. Hopefully you have an excellent drug insurance plan, because the Epleronone is expensive. Can anyone tell me if my regimen of 32 MEQ of Potassium (K) and 50 mg of Epleronone is a typical dosage? I am doing well on that dosage and since CT studies were inconclusive and Adrenal vein sampling attempts were a complete failure, I am content with simply taking the medication..........Rod

[Guest guest]

2. Read about other patients with hyperaldosteronism (Conn’s syndrome). Read our Conn's stories in our files and then give us your own in as much detail as you can. Dr. Conn was the first to describe this disease process and the syndrome is named after him.To see others' stories, on the Hyperaldosteronism home page, go to Files/Conn’s Stories. You'll find instructions in "A - How to put your story here.doc " First send us your story in an email and they we may have questions and suggestions before you upload it to our files. Welcome to the exciting world of Hyperaldosteronism! You are in the right place! I am Dr. CE Grim a retired Professor of Medicine and Endocrinology. I have a long standing interest is Primary Aldosteronism since medical school days when I saw my first patient with Primary Aldosteronism in 1963. I trained with Dr. Conn in Endocrinology and Metabolism 1969-70 and have published over 240 papers and book chapters in most areas of the broad discipline of High Blood Pressure. My CV is in our files for details. The goal of our group is to teach you and your health care team about the ins and outs of the causes, diagnosis and control of the many forms of hyperaldosteronism. The steps below will introduce you into the fascinating world of high blood pressure, salt and potassium and the role of the adrenal hormone aldosterone in health and disease. Doing these in sequence will save you time and effort in getting up to speed in taking control of you health and educating your own health care team. While we can’t make you a doctor we will make you into a pretty good BP doctor-a skill that you will have for life. 1. A brief history of Primary Aldosteronsim and why it is so common today in drug resistant high blood pressure. Read my article in our files on the evolution of PA (Evolution_of_PA-Grim.pdf ) and take to all members of health care team. Tell us what stage you believe you are in. This is a brief review of most causes of hyperaldosteronism, high blood pressure, low potassium (K). 2. Read about other patients with hyperaldosteronism (Conn’s syndrome). Read our Conn's stories in our files and then give us your own in as much detail as you can. Dr. Conn was the first to describe this disease process and the syndrome is named after him.To see others' stories, on the Hyperaldosteronism home page, go to Files/Conn’s Stories. You'll find instructions in "A - How to put your story here.doc " First send us your story in an email and they we may have questions and suggestions before you upload it to our files. 3. DASH to lower your BP. Your and my tax dollars funded the most important series of studies on how to improve blood pressure, blood sugar, blood lipids and make your heart smaller: The DASH Eating Plan to control high blood pressure due to hyperaldosteronism and most others with high blood pressure. This will reduce your need for medications and in many will get your BP and K to goal without meds.. Get the DASH diet book by T. et al, (http://www.amazon.com/DASH-Diet-Hypertension--/dp/0743202953) read it and use it: ~$8 in paperback at your local bookstore or online. If they don’t have it ask them to order it for you. You can also get the hardback larger print version as well at Amazon. Learning to eat the DASH way will play a major role in your road to good BP and K control and, in many of our folks here, will revolutionize your life. See http://en.wikipedia.org/wiki/DASH_diet for an overview and more details. In the book go to chapter 9 and do the 14 day challenge. Tell your Dr you are doing this as your BP may plummet if you are on other meds. Measure your BP every day and post to us. or go to http://www.nhlbi.nih.gov/health/public/heart/hbp/dash/new_dash.pdf download this 64 page booklet free and do the Week on the DASH Diet for 2 weeks. If you are on BP meds be prepared for a large fall in BP (20/10 mm Hg or more) and let your Dr. know you are doing this. And/Or go to (but costs money monthly) DASH Diet for Health Program (http://www.dashforhealth.com/pages/public/tour.php)The DASH Diet for Health Program is designed to help you improve your eating and exercise habits. Twice each week they will provide you with information on our website about food, food preparation, eating out, losing weight, getting fit and much more. In addition to providing new information each week on the website, they create a web page specially for you where you can track progress in areas such as your weight, blood pressure, and exercise. I strongly recommend you get this book and read it. 4. Measure your BP: Measure your BP daily so you can see if it is getting better. If you are taking meds be sure to tell your health care team you are doing this as your BP may plummet to normal quickly. We recommend you use a device you listen to and will help you learn how to do this. If this is not something you want to do we can teach a significant other how to do it. See sharedcareinc.com or email to sharedcare@... to order a video on how to do this. If you already have one we will teach you how to teach your health care team how to validate your device. Your life and health depends on accurate BP measurements. Go to the amricanheart.org and download the Guidelines for Human Blood Pressure Measurement. Insist the your health care team do BP the AHA way. Never trust your life to an automatic BP machine unless you know it is accurate on YOU. 5. Genetics and your BP: Go to familyhistory.hhs.gov and do your detailed family medical history so we can review with you to help Dx familial causes of high blood pressure and heart disease. If BP runs in your family you may save lives in your family by checking their BP yourself. 6. How to DX and treat PA: Go to our file/Conn's Articles of Note/Medications/Bravo spir 1973.pdf and read this article and take to your health care team. It is old but still one of the best in the medical management of PA. Also see our file from the Endocrine Society Guidelines on PA. Dr. Grim's Perfect Primary Aldosteronism Blood and Urine Testing to diagnose PA in one day. 1. Eat a regular to high salt diet for 2 weeks.2. No BP meds in last 4-12 weeks depending on meds.3. Collect 24 hr urine for Na, K and creatinine and aldosterone. Do not lose a drop of this liquid gold. It is impossible to interpret the renin and aldo without this.4. The morning you finish the 24 hr urine have fasting blood drawn for renin, aldo and K using our guidelines to get an accurate K. Try to get this done about 4 hours after you have been out of bed.5. Send us the results with the normal values for your lab.6. If you ever have a salt (saline) infusion test for PA be certain to ask them to measure how much you pee during the 4 hours of the infusion. If it is 1-1.5 liter of urine it strongly suggests that you may have PA. If more tha 1.5 L you almost certainly have PA. 8. Become a participant in our PA Registry and contribute to our large database on PA: If you have been Dxed with PA already and are on Rx or have had surgery please go to http://www.kwiksurveys.com/online-survey.php?surveyID=HIJIO_f2685379 and complete our survey with as much information as you know. If there is some information you don't know ask us and we will help. If you need to update this as you journey thru the diagnostic/treatment process you can add another entry but label it as Nameyymmdd. For example today 6/12/09 for me would be Grim090612. This ever increasing number will allow us and you to sort your multiple entries into a dated order. 9. Learn the language: If you are new to medical lingo then download the acroyms from http://health.groups.yahoo.com/group/bloodpressureline/message/2918610. Salt and high blood pressure: To learn the state of the science of salt and blood pressure please spend some time looking at http://www.worldactiononsalt.com/evidence/treatment_trials.htm11. Become a HBP expert consumer: Expect that it will take at least several weeks to get all this digested and to learn the new language of high blood pressure health care. As most doctors and nurses in practice have had very little training in high blood pressure you must become an expert yourself. For example most have never had anyone listen with them with a double stethoscope to verify that they can hear BP sounds. We cannot make you a doctor but we will make you a pretty good BP doctor.12. How High Blood Pressure should be managed: Go to nih.gov and download and read the Joint National Commission (JNC) Report 7 to get an overview on current guidelines. I ask all my secretaries to read this so they can communicate the importance of high blood pressure to my patients. JNC 8 will be out soon.Then: get (and study) the Hypertension Primer from americanheart.org. This is the most up-to-date compendium of what is known about high blood pressure and what every Dr. should know when they graduate from Medical School. Every chapter is only 2-3 pages. Read one chapter every week-night and you will finish it in about a year. I am working on a reading guide for lay people for the Primer. Stay tuned.13. Ask us questions: Ask any questions about high blood pressure you want answered. That is what we are here for. We have had this site for 10 years and over 30,000 emails are searchable. This is the largest collection of communications about Conn's Syndrome in the World. 14. One-on-one Consulting: I can provide individual consulting if you do not want to go public. If you want individual one-on-one consulting for you and your Doctor contract me directly at lowerbp2@....May your pressure be low!Clarence E. Grim BS, MS, MD, FACP, FACC, FAHABoard Certified in Internal Medicine, Geriatrics, and High Blood Pressure Retired Faculty/Professor of Medicine (U of MO, Indiana, UCLA/DREW, Medical College of Wisconsin and Cardiology, Endocrinology, Nephrology, and Epidemiology. Specializing in Primary Aldosteronism and Difficult to Control High Blood Pressure. Dr. Grim,I am new to your website and would find it very beneficial for my PA health to share my information. Please tell me how and where I would submit my case study.Many thanks for assisting all of us with PA. I am certain I share the frustration of many patients who find it difficult to find MD's (even endocrinologists) with a good working knowledge of PA...........Rod To: hyperaldosteronism Cc: Clarence Grim Sent: Sun, November 28, 2010 6:21:56 PMSubject: Re: Re: Controlled BP with Unusual SIde EffectPS: Do we have Rod's Story? Sounds like an long and interesting one.CE Grim MDAs an 18 year PA sufferer I can tell you that I experienced Gynomastia on Spironolactone. When I changed to Epleronone the Gynomastia problem was gone in 4 to 6 weeks. Hopefully you have an excellent drug insurance plan, because the Epleronone is expensive. Can anyone tell me if my regimen of 32 MEQ of Potassium (K) and 50 mg of Epleronone is a typical dosage? I am doing well on that dosage and since CT studies were inconclusive and Adrenal vein sampling attempts were a complete failure, I am content with simply taking the medication..........RodTo: "hyperaldosteronism " <hyperaldosteronism >Sent: Sun, November 28, 2010 9:42:44 AMSubject: Re: Re: Controlled BP with Unusual SIde EffectMay be left over from Spiro then. Or need to look for other causes. Spiro gyneco may take some time to reverse. Maybe others here can give us some idea of how long theirs persisted AGFree going on inspra. Tiped sad Send form miiPhone ;-)May your pressure be low!CE Grim MDSpecializing in DifficultHypertension I belive he is taking inspra not Spiro. > > > My BP is controlled but I have been experiencing an unusual side effect of the PA treatment. Has anyone experienced strange taste sensations since taking Inspra (Eplerenone)? For some odd reason, I have become super-sensitive to the taste of sugar. When I eat meats, they taste very sugary/starchy to me. I noticed this taste about a year ago but dismissed it. It happens quite often now but not always. Does this indicate another medical condition? Anyone else experienced this side effect? > > > > MEN ONLY:> > > > I'm not sure whether weight gain or Inspra is causing gynecomastia that seems to come and go. It's getting to the point that my self image is being affected, especially by my physical profile. I'm in my 50s and understand that this could also be due to aging. Exercise does not reduce the gynecomastia and seems to only make it more noticeable. Any ideas other than surgery?> > > >>

[Guest guest]

PS, Rod, I had an endocrinologist who also got the equivalency backwards at first. So you're not the first person to make that mistake. Part of the problem is that although eplerenone has been studied for primary aldosteronism (at dosages to 400 mg or maybe higher), that is an off-label use. Thus all the manufacturer's published recommendations relate to conditions like CHF where lower dosages are appropriate. To hear about dosages effective in primary aldosteronism, a doctor would have to be talking to other doctors who are successfully treating such cases.

So we seem to see a fair number of instances (in people's messages here) where once their doctors accept that PA exists, their patient has it, and it's not your garden-variety hypertension, often they STILL try to give just a little taste of spironolactone or eplerenone " so that the other meds can do their work. " But no: the other meds for the most part WON'T ever do their work in such a patient and may make the hypertension worse. The aldosterone is at the heart of the problem. When we receive enough aldosterone-blocker, we no longer need potassium supplements and we often get no benefit (and potentially some harm) from the other hypertension meds. Many of us don't even need any other hypertension meds once we get enough aldosterone blocker, though some of us do if the hypertension has gone on for a long time.

Too many doctors just aren't comfortable trusting their results. If someone has a normal potassium level from 100-200 mg of spironolactone each day (or 200-400 mg eplerenone), it's not a high dose *for them*, regardless of all the people who take 25 mg -- a dose that some sources have recommended for some years now for people without diagnosed aldosteronism. Doctors need to know that normal doses of spironolactone for proven primary aldosteronism are often in the hundreds of milligrams (with double that amount for eplerenone, though that becomes expensive quickly).

These are more of my non-professional musings, mind you. But reality-based.

AG

Thanks for your reply Val. I normally take Inspra (50mg), I recently ran out and now I am temporarily taking 100mg spiro until I get the Inspra Rx renewed. So It sounds like it is about an equal dosage between the two. I just got the DASH book and I will try the diet since Dr Grim, yourself, and many others report such good results on DASH. So far the best way I have found to keep BP in good range is simply cardiovascular exercise. I think many people would find a good cardio exercise program easier to stay on than a strict DASH diet, your thoughts?

...........Rod

To: hyperaldosteronism

Sent: Sun, November 28, 2010 6:55:46 PM

Subject: RE: Re: Controlled BP with Unusual SIde Effect

Your 50 mg epleronone is equal to about 25 mg of spironolactone. With more epleronone and DASHing, you shouldn't need K. Are you getting brand name or generic? I just finished a test of the two for about a month each. Systolic was 2 points higher on the generic but that is probably not significant since other things were not held constant.

Val

From: hyperaldosteronism [mailto:hyperaldosteronism ] On Behalf Of Rod

As an 18 year PA sufferer I can tell you that I experienced Gynomastia on Spironolactone. When I changed to Epleronone the Gynomastia problem was gone in 4 to 6 weeks. Hopefully you have an excellent drug insurance plan, because the Epleronone is expensive. Can anyone tell me if my regimen of 32 MEQ of Potassium (K) and 50 mg of Epleronone is a typical dosage? I am doing well on that dosage and since CT studies were inconclusive and Adrenal vein sampling attempts were a complete failure, I am content with simply taking the medication.

..........Rod

[Guest guest]

Or DASH which is better than an extra diuretic.We do go up to 400 mg of Spiro a day.But rarely need to in those who DASH. Indeed in the experimental model called DOCA-salt or ALDO-salt hyprertension excess aldo does not increase BP or cause cardiac and kidney problems or lower K unless the diet sodium is high.CE Grim MDRod, you've got the equivalency backwards. If you normally take 50 mg Inspra, that's about the same as 25 mg spiro (not 100 mg). If you really need 100 mg spiro, that's about the same as 200 mg of Inspra. At the higher end, some people take 200 mg of spiro, which would be about the same as 400 mg of Inspra. But the Inspra seems often to need a bit of traditional diuretic to really match the electrolyte-altering effect of spironolactone. AG Thanks for your reply Val. I normally take Inspra (50mg), I recently ran out and now I am temporarily taking 100mg spiro until I get the Inspra Rx renewed. So It sounds like it is about an equal dosage between the two. I just got the DASH book and I will try the diet since Dr Grim, yourself, and many others report such good results on DASH. So far the best way I have found to keep BP in good range is simply cardiovascular exercise. I think many people would find a good cardio exercise program easier to stay on than a strict DASH diet, your thoughts?..........Rod To: hyperaldosteronism Sent: Sun, November 28, 2010 6:55:46 PMSubject: RE: Re: Controlled BP with Unusual SIde EffectYour 50 mg epleronone is equal to about 25 mg of spironolactone. With more epleronone and DASHing, you shouldn't need K. Are you getting brand name or generic? I just finished a test of the two for about a month each. Systolic was 2 points higher on the generic but that is probably not significant since other things were not held constant. Val From: hyperaldosteronism [mailto:hyperaldosteronism ] On Behalf Of Rod As an 18 year PA sufferer I can tell you that I experienced Gynomastia on Spironolactone. When I changed to Epleronone the Gynomastia problem was gone in 4 to 6 weeks. Hopefully you have an excellent drug insurance plan, because the Epleronone is expensive. Can anyone tell me if my regimen of 32 MEQ of Potassium (K) and 50 mg of Epleronone is a typical dosage? I am doing well on that dosage and since CT studies were inconclusive and Adrenal vein sampling attempts were a complete failure, I am content with simply taking the medication..........Rod

[Guest guest]

Inspra is also approved to treat hypertension. So treating HTN is not an off label use.Alden et al: please always mention the role of low sodium diet and high K diet in the control of HTN. Read the old paper by Bravo in which a pt with advanced classical aldo is controlled by low sodium diet alone. Some insurance companies don't follow this however.CE Grim MDPS, Rod, I had an endocrinologist who also got the equivalency backwards at first. So you're not the first person to make that mistake. Part of the problem is that although eplerenone has been studied for primary aldosteronism (at dosages to 400 mg or maybe higher), that is an off-label use. Thus all the manufacturer's published recommendations relate to conditions like CHF where lower dosages are appropriate. To hear about dosages effective in primary aldosteronism, a doctor would have to be talking to other doctors who are successfully treating such cases. So we seem to see a fair number of instances (in people's messages here) where once their doctors accept that PA exists, their patient has it, and it's not your garden-variety hypertension, often they STILL try to give just a little taste of spironolactone or eplerenone "so that the other meds can do their work." But no: the other meds for the most part WON'T ever do their work in such a patient and may make the hypertension worse. The aldosterone is at the heart of the problem. When we receive enough aldosterone-blocker, we no longer need potassium supplements and we often get no benefit (and potentially some harm) from the other hypertension meds. Many of us don't even need any other hypertension meds once we get enough aldosterone blocker, though some of us do if the hypertension has gone on for a long time. Too many doctors just aren't comfortable trusting their results. If someone has a normal potassium level from 100-200 mg of spironolactone each day (or 200-400 mg eplerenone), it's not a high dose *for them*, regardless of all the people who take 25 mg -- a dose that some sources have recommended for some years now for people without diagnosed aldosteronism. Doctors need to know that normal doses of spironolactone for proven primary aldosteronism are often in the hundreds of milligrams (with double that amount for eplerenone, though that becomes expensive quickly). These are more of my non-professional musings, mind you. But reality-based. AG Thanks for your reply Val. I normally take Inspra (50mg), I recently ran out and now I am temporarily taking 100mg spiro until I get the Inspra Rx renewed. So It sounds like it is about an equal dosage between the two. I just got the DASH book and I will try the diet since Dr Grim, yourself, and many others report such good results on DASH. So far the best way I have found to keep BP in good range is simply cardiovascular exercise. I think many people would find a good cardio exercise program easier to stay on than a strict DASH diet, your thoughts?..........Rod To: hyperaldosteronism Sent: Sun, November 28, 2010 6:55:46 PMSubject: RE: Re: Controlled BP with Unusual SIde EffectYour 50 mg epleronone is equal to about 25 mg of spironolactone. With more epleronone and DASHing, you shouldn't need K. Are you getting brand name or generic? I just finished a test of the two for about a month each. Systolic was 2 points higher on the generic but that is probably not significant since other things were not held constant. Val From: hyperaldosteronism [mailto:hyperaldosteronism ] On Behalf Of Rod As an 18 year PA sufferer I can tell you that I experienced Gynomastia on Spironolactone. When I changed to Epleronone the Gynomastia problem was gone in 4 to 6 weeks. Hopefully you have an excellent drug insurance plan, because the Epleronone is expensive. Can anyone tell me if my regimen of 32 MEQ of Potassium (K) and 50 mg of Epleronone is a typical dosage? I am doing well on that dosage and since CT studies were inconclusive and Adrenal vein sampling attempts were a complete failure, I am content with simply taking the medication..........Rod

[Guest guest]

My heart rate runs 100-110's if I'm not on a beta blocker, has for years. I'm not positive but I'm pretty sure I was tachycardic before starting spiro. Currently on metoprolol ER also.

a

I belive he is taking inspra not Spiro. > > > My BP is controlled

but I have been experiencing an unusual side effect of the PA treatment. Has anyone experienced strange taste sensations since taking Inspra (Eplerenone)? For some odd reason, I have become super-sensitive to the taste of sugar. When I eat meats, they taste very sugary/starchy to me. I noticed this taste about a year ago but dismissed it. It happens quite often now but not always. Does this indicate another medical condition? Anyone else experienced this side effect? > > > > MEN ONLY:> > > > I'm not sure whether weight gain or Inspra is causing gynecomastia that seems to come and go. It's getting to the point that my self image is being affected, especially by my physical profile. I'm in my 50s and understand that this could also be due to aging. Exercise does not reduce the gynecomastia and seems to only make it more noticeable. Any ideas other than surgery?> > >

>>

[Guest guest]

Dr. Grim,

My story is posted on there. Just joined the group last week and can't tell you how much of a help it is!

To: hyperaldosteronism Cc: Clarence Grim Sent: Sun, November 28, 2010 8:55:37 PMSubject: Re: Re: Controlled BP with Unusual SIde Effect

What did you AVS show or have we seen it already?

Don't think we have Juli's story yet.

CE Grim MD.

My BP straightened up right away after the spiro too and my heart rate stays around 90-115 most of the time. I'm having an adrenalectomy soon so it will be interesting to see what happens with my heart rate after the surgery and no more spiro. As a side note, I have been on spiro for about 6 years and take 75 mg once a day and Spiro/HCTZ 25/25 once a day. I was on the 75 mg once a day and the spiro/HCTZ 25/25 twice a day but after a couple of months of that my liver function was off d/t being overdiuresed so my Nephrologist cut it down to my current dose.

Subject: Re: Controlled BP with Unusual SIde EffectTo: hyperaldosteronism Date: Sunday, November 28, 2010, 5:37 PM

What is your K doing?> > > > > My BP is controlled but I have been experiencing an unusual side effect of the PA treatment. Has anyone experienced strange taste sensations since taking Inspra (Eplerenone)? For some odd reason, I have become super-sensitive to the taste of sugar. When I eat meats, they taste very sugary/starchy to me. I noticed this taste about a year ago but

dismissed it. It happens quite often now but not always. Does this indicate another medical condition? Anyone else experienced this side effect? > > > > > > MEN ONLY:> > > > > > I'm not sure whether weight gain or Inspra is causing gynecomastia that seems to come and go. It's getting to the point that my self image is being affected, especially by my physical profile. I'm in my 50s and understand that this could also be due to aging. Exercise does not reduce the gynecomastia and seems to only make it more noticeable. Any ideas other than surgery?> > > > > >>

>>

[Guest guest]

I would really like to hear from other people on their dosages of Spiro and K. I've read a lot on here about people taking Spiro in Inspra (never heard of that drug until this group) but not much about how much K one takes, if any.

To: hyperaldosteronism Sent: Mon, November 29, 2010 1:55:52 AMSubject: Re: Re: Controlled BP with Unusual SIde Effect

PS, Rod, I had an endocrinologist who also got the equivalency backwards at first. So you're not the first person to make that mistake. Part of the problem is that although eplerenone has been studied for primary aldosteronism (at dosages to 400 mg or maybe higher), that is an off-label use. Thus all the manufacturer's published recommendations relate to conditions like CHF where lower dosages are appropriate. To hear about dosages effective in primary aldosteronism, a doctor would have to be talking to other doctors who are successfully treating such cases.

So we seem to see a fair number of instances (in people's messages here) where once their doctors accept that PA exists, their patient has it, and it's not your garden-variety hypertension, often they STILL try to give just a little taste of spironolactone or eplerenone "so that the other meds can do their work." But no: the other meds for the most part WON'T ever do their work in such a patient and may make the hypertension worse. The aldosterone is at the heart of the problem. When we receive enough aldosterone-blocker, we no longer need potassium supplements and we often get no benefit (and potentially some harm) from the other hypertension meds. Many of us don't even need any other hypertension meds once we get enough aldosterone blocker, though some of us do if the hypertension has gone on for a long time.

Too many doctors just aren't comfortable trusting their results. If someone has a normal potassium level from 100-200 mg of spironolactone each day (or 200-400 mg eplerenone), it's not a high dose *for them*, regardless of all the people who take 25 mg -- a dose that some sources have recommended for some years now for people without diagnosed aldosteronism. Doctors need to know that normal doses of spironolactone for proven primary aldosteronism are often in the hundreds of milligrams (with double that amount for eplerenone, though that becomes expensive quickly).

These are more of my non-professional musings, mind you. But reality-based.

AG

Thanks for your reply Val. I normally take Inspra (50mg), I recently ran out and now I am temporarily taking 100mg spiro until I get the Inspra Rx renewed. So It sounds like it is about an equal dosage between the two. I just got the DASH book and I will try the diet since Dr Grim, yourself, and many others report such good results on DASH. So far the best way I have found to keep BP in good range is simply cardiovascular exercise. I think many people would find a good cardio exercise program easier to stay on than a strict DASH diet, your thoughts?

...........Rod

To: hyperaldosteronism Sent: Sun, November 28, 2010 6:55:46 PMSubject: RE: Re: Controlled BP with Unusual SIde Effect

Your 50 mg epleronone is equal to about 25 mg of spironolactone. With more epleronone and DASHing, you shouldn't need K. Are you getting brand name or generic? I just finished a test of the two for about a month each. Systolic was 2 points higher on the generic but that is probably not significant since other things were not held constant.

Val

From: hyperaldosteronism [mailto:hyperaldosteronism ] On Behalf Of Rod

As an 18 year PA sufferer I can tell you that I experienced Gynomastia on Spironolactone. When I changed to Epleronone the Gynomastia problem was gone in 4 to 6 weeks. Hopefully you have an excellent drug insurance plan, because the Epleronone is expensive. Can anyone tell me if my regimen of 32 MEQ of Potassium (K) and 50 mg of Epleronone is a typical dosage? I am doing well on that dosage and since CT studies were inconclusive and Adrenal vein sampling attempts were a complete failure, I am content with simply taking the medication.

..........Rod

[Guest guest]

Excess aldo increases K loss in the sweat and saliva. So expect this to happen. Should get better with spiro and DASHing.100 mEq of K is a lot. DASHing will get it into you in a healthier and tastier form.Low sodium V8- 1 cups a day gets you 80 mEq.But without lowering Na in the diet it is very hard to eat or take enough K in many PAs to feel well.CE Grim MDI have been unable to do much of any kind of exercise for the last several years b/c my potassium tanks quickly when I sweat. For instance, we went to South Padre Island recently and I did a lot of walking around. When we got back and I got my weekly lab drawn, my potassium was down to 3.6 (been running 3.9 or 4.0 on 100 MEQ of effervescent K). On top of it I am extremely symptomatic when my K drops and it takes me a day or even two to recover. Anyone else experience this?To: hyperaldosteronism Sent: Sun, November 28, 2010 10:50:24 PMSubject: Re: Re: Controlled BP with Unusual SIde Effect Rod, Cardio excersise is obviously good for us as you said, but I have found that it also really helps me with my mood too. I am a pretty even keel type guy, but it sure gives me that "pick me up" just knowing I did something to help myself and gets those endorphins naturally flowing. I used to tell my patients to use the TV method that I use to excersise and I have done this for years now. I watch a show or two a week, plus mostly sports, but I try to take a one hour show at least a couple times a week (I personally like Psych, The Good Guys, and Lie to Me) and I take every commercial and do some excersise during that hour. I like to jump rope as I read that 10 minutes of jump roping is nearly equal to 1 hour of jogging! But I guess anything would help and I will do whatever idea comes to me and mix it up a little, but I try to work up a sweat and then enjoy my show when it comes back on. At least it helps me feel all around good. Subject: Re: Re: Controlled BP with Unusual SIde EffectTo: hyperaldosteronism Date: Sunday, November 28, 2010, 10:27 PM Thanks for your reply Val. I normally take Inspra (50mg), I recently ran out and now I am temporarily taking 100mg spiro until I get the Inspra Rx renewed. So It sounds like it is about an equal dosage between the two. I just got the DASH book and I will try the diet since Dr Grim, yourself, and many others report such good results on DASH. So far the best way I have found to keep BP in good range is simply cardiovascular exercise. I think many people would find a good cardio exercise program easier to stay on than a strict DASH diet, your thoughts?..........Rod To: hyperaldosteronism Sent: Sun, November 28, 2010 6:55:46 PMSubject: RE: Re: Controlled BP with Unusual SIde EffectYour 50 mg epleronone is equal to about 25 mg of spironolactone. With more epleronone and DASHing, you shouldn't need K. Are you getting brand name or generic? I just finished a test of the two for about a month each. Systolic was 2 points higher on the generic but that is probably not significant since other things were not held constant. Val From: hyperaldosteronism [mailto:hyperaldosteronism ] On Behalf Of Rod As an 18 year PA sufferer I can tell you that I experienced Gynomastia on Spironolactone. When I changed to Epleronone the Gynomastia problem was gone in 4 to 6 weeks. Hopefully you have an excellent drug insurance plan, because the Epleronone is expensive. Can anyone tell me if my regimen of 32 MEQ of Potassium (K) and 50 mg of Epleronone is a typical dosage? I am doing well on that dosage and since CT studies were inconclusive and Adrenal vein sampling attempts were a complete failure, I am content with simply taking the medication..........Rod