Re: Controlled BP with Unusual SIde Effect

[Guest guest]

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

Yep, I've tried to wean off twice and felt like my heart was going to explode. I tried 25 mg 2x day and that was bearable. When I cut down to 25 mg once/day my heart rate was back up in the 100's. I hate that feeling of heart pounding & feeling like I've just run a mile. After 3 days it hadn't gotten any better and I went back on the 50 daily. My thinking has been slowing down for years, I'd like to blame it on the BB but don't think I can ;-)

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]

Well if you believe that you are alloted a certain number of heart beats and when that is up you are down (under). So if you are a believer BB will make you last longer as will not exercising (which uses up many beats), or working too hard or maybe even sitting in a hot tub.CE Yep, I've tried to wean off twice and felt like my heart was going to explode. I tried 25 mg 2x day and that was bearable. When I cut down to 25 mg once/day my heart rate was back up in the 100's. I hate that feeling of heart pounding & feeling like I've just run a mile. After 3 days it hadn't gotten any better and I went back on the 50 daily. My thinking has been slowing down for years, I'd like to blame it on the BB but don't think I can ;-) 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]

Ive been on BB a long time and the tachycardia only started after i started

the spiro. unless the hyperthyroidism is back. a few weeks ago I was told

it (TSH) was normal

>Have you tried weaning off the BB. Esp since you are on spiro now.

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>My guess is that you may be able to slowly back off.

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>But if feeling OK might just set tight.

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>BB can slow down ones thinking as well as the heart.

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>CE Grim MD

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>> 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.

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>> a

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>>> I belive he is taking inspra not Spiro.

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>>> >

>>> > > 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?

>>> > >

>>> > >

>>> >

>>>

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>>

>>

>>

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[Guest guest]

Again if your BP is lower that it was before spiro then the BP control systems send out a signal that the BP is falling, the BP is falling. Heart! You need to speed up to keep the BP from following. Small blood vessels you need to constrict to keep the BP from falling. After a while they decide the threat is not too bad and slow down and eventually stop yelling at the heart etc.Recommend you get the Hypertension Primer from the AHA if you want to understand this. Or get a copy of Guyton's Medical Physiology used and study the regulation of the the body fluid volume.Ive been on BB a long time and the tachycardia only started after i started the spiro. unless the hyperthyroidism is back. a few weeks ago I was told it (TSH) was normal>Have you tried weaning off the BB. Esp since you are on spiro now.>>My guess is that you may be able to slowly back off.>>But if feeling OK might just set tight.>>BB can slow down ones thinking as well as the heart.>>CE Grim MD>>>> >> 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]

I don't know if anyone has

answered this.  Your 50 mg of eplerenone

is equal to about 25 mg of spironolactone. 

In other words, it takes approximately 2x the milligrams of Inspra than

of spironolactone.  For PA in general, 50

mg of Inspra or 25 mg of spironolactone is not much.

Val

From:

hyperaldosteronism

[mailto:hyperaldosteronism ] On Behalf Of Bingham

:

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

From:

Valarie

Your 50 mg eplerenone is equal to about 25

mg of spironolactone. With more eplerenone 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.

[Guest guest]

diet trumps exercise in my experience.CE Grim MDI don't know if anyone has answered this. Your 50 mg of eplerenone is equal to about 25 mg of spironolactone. In other words, it takes approximately 2x the milligrams of Inspra than of spironolactone. For PA in general, 50 mg of Inspra or 25 mg of spironolactone is not much. Val From: hyperaldosteronism [mailto:hyperaldosteronism ] On Behalf Of Bingham: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 Your 50 mg eplerenone is equal to about 25 mg of spironolactone. With more eplerenone 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.

[Guest guest]

Val,It has taken me awhile to respond to you. Actually, I did not accurately describe my dosage. I take 50mg Inspra times 3, for a total of 150 mg daily. I also take 8 meq of Klor con X 4, for a total of 32 meq of K. I find it interesting in your earlier post that massive dosages of spiro or Inspra can benefit patients by blocking Aldosterone almost completely, thus negating the need for K, if following DASH principles. I will approach my physician with this prospect. I am in the process of retrieving my old medical records so that I may chronicle my experience with PA...........Rod To: hyperaldosteronism Sent: Tue, November 30, 2010 3:34:16 PMSubject: RE: Re: Controlled BP with Unusual SIde Effect

I don't know if anyone has

answered this. Your 50 mg of eplerenone

is equal to about 25 mg of spironolactone.

In other words, it takes approximately 2x the milligrams of Inspra than

of spironolactone. For PA in general, 50

mg of Inspra or 25 mg of spironolactone is not much. Val

From:

hyperaldosteronism

[mailto:hyperaldosteronism ] On Behalf Of Bingham

:

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

From:

Valarie

Your 50 mg eplerenone is equal to about 25

mg of spironolactone. With more eplerenone 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.

[Guest guest]

They are going to do some confirmatory tests for PA. I should stay on my regular diet (normal salt - I don't use much anyway) for now right until confirmation, right?

I don't know if anyone has answered this. Your 50 mg of eplerenone is equal to about 25 mg of spironolactone. In other words, it takes approximately 2x the milligrams of Inspra than of spironolactone. For PA in general, 50 mg of Inspra or 25 mg of spironolactone is not much.

Val

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

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

Your 50 mg eplerenone is equal to about 25 mg of spironolactone. With more eplerenone 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.

[Guest guest]

Well that depends on what YOUR normal diet is.Give us an estimate of you average sodium intake in mgs of sodium. Some recommend upping salt intake to 200 mM/day before testing. That is 200 x 23 mg of sodium a day. Ask your lab that is doing the testing: what was the diet you did when you set up your normal values and how did you docuement that your normals were eating this amount?CE Grim MDThey are going to do some confirmatory tests for PA. I should stay on my regular diet (normal salt - I don't use much anyway) for now right until confirmation, right? I don't know if anyone has answered this. Your 50 mg of eplerenone is equal to about 25 mg of spironolactone. In other words, it takes approximately 2x the milligrams of Inspra than of spironolactone. For PA in general, 50 mg of Inspra or 25 mg of spironolactone is not much. Val From: hyperaldosteronism [mailto:hyperaldosteronism ] On Behalf Of Bingham: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 Your 50 mg eplerenone is equal to about 25 mg of spironolactone. With more eplerenone 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.

[Guest guest]

You may mwant to look at the meds lists at this link.

http://health.groups.yahoo.com/group/hyperaldosteronism/files/Meds%20and%20Tests\

%20for%20PA/

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> I don't know if anyone has answered this.  Your 50 mg of eplerenone is equal

to about 25 mg of spironolactone.  In other words, it takes approximately 2x

the milligrams of Inspra than of spironolactone.  For PA in general, 50 mg of

Inspra or 25 mg of spironolactone is not much.

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> Val

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From: hyperaldosteronism  [mailto:hyperaldosteronism@yahoogroup\

s.com] On Behalf Of  Bingham

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> 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 

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> From: Valarie

> Your 50 mg eplerenone is equal to about 25 mg of spironolactone.  With more

eplerenone 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.

>  

>

[Guest guest]

LOL!!

RE: Re: Controlled BP with Unusual SIde Effect

I don't know if anyone has answered this. Your 50 mg of eplerenone is equal to about 25 mg of spironolactone. In other words, it takes approximately 2x the milligrams of Inspra than of spironolactone. For PA in general, 50 mg of Inspra or 25 mg of spironolactone is not much.

Val

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

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

Your 50 mg eplerenone is equal to about 25 mg of spironolactone. With more eplerenone 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.

[Guest guest]

You have to be off Inspra and

spiro (6 weeks) for the tests to be valid. 

You should have a 24-hour urine turned in on the morning of your

aldo/renin tests.  Aldo and renin can

only be accurately interpreted with knowledge of your sodium ingestion.

Val

From:

hyperaldosteronism [mailto:hyperaldosteronism ] On

Behalf Of Bingham

They

are going to do some confirmatory tests for PA. I should stay on my regular

diet (normal salt - I don't use much anyway) for now right until

confirmation, right?