Jump to content
RemedySpot.com

Re: Anyone pregnant with PA?

Rate this topic

Guest guest

By Guest guest
in Health, Medicine and Natural Healing 11

 Share

Recommended Posts

Guest guest

Guest guest

Posted
Posted

First what problem is the adrenal bump causing?Immediately stop any ACEs or ARBs you are taking (if any) as they may cause serious problems with your baby.Call you doctor immediately in the morning and ask what you should do as well.If you have PA, you did not provide a thumbnail so I don't recall who you are among the other 550 others here. At least one is also pregnant now. PA commonly gets better during pregnancy as the increased progesterone is an aldo blocker.Please send details so we can help.CE Grim MD So I just found out I am pregnant (and you all are finding out before my mom). A total surprise (we gave up last year after a year of fertility treatments) and I just had my CT scan last week so not so great. They found a adrenal adenoma and the doc was researching finding a surgeon to take it out. Has anyone been in this boat????? Would love to get some input on what other people have done. Thanks!

Link to comment
Share on other sites
Guest guest

Guest guest

Posted
Posted

Congratations!!!!! And best of luck to you

So I just found out I am pregnant (and you all are finding out before my mom). A total surprise (we gave up last year after a year of fertility treatments) and I just had my CT scan last week so not so great. They found a adrenal adenoma and the doc was researching finding a surgeon to take it out. Has anyone been in this boat????? Would love to get some input on what other people have done.

Thanks!

Link to comment
Share on other sites
Guest guest

Guest guest

Posted
Posted

Dr. Grim,

Thanks for your email. I have a summary of my story up on the yahoo site.

I have high blood pressure and low potassium from the adrenal bump.

I found out on Monday that I was pregnant and went to my doc immediately. She

conferred with my Nephrologist and they took me off Lisinopril and potassium

chloride and switched me over to 25 mg Eperenone.

For the pregnancy, I have low progesterone so I am starting 200 mg capsules

tonight. Sounds like I should be monitoring my blood pressure really closely if

this could affect my PA.

I met with the Nephrologist today and he gave me the names of two surgeons at

University of Colorado Hospital and suggested that I make the appointment with

them as the next step to see what they would recommend. I also have a call into

my endocrinologist. He is recommending surgery after I am 12 weeks along.

So good to hear about PA getting better during pregnancy.

This is all way way too overwhelming.

Cheers,

Bradley

Re: Anyone pregnant with PA?

Posted by: " Clarence Grim " lowerbp2@... lowerbp2

Tue May 24, 2011 10:57 pm (PDT)

First what problem is the adrenal bump causing?

Immediately stop any ACEs or ARBs you are taking (if any) as they may

cause serious problems with your baby.

Call you doctor immediately in the morning and ask what you should do

as well.

If you have PA, you did not provide a thumbnail so I don't recall who

you are among the other 550 others here. At least one is also

pregnant now.

PA commonly gets better during pregnancy as the increased progesterone

is an aldo blocker.

Please send details so we can help.

CE Grim MD

> So I just found out I am pregnant (and you all are finding out

> before my mom). A total surprise (we gave up last year after a year

> of fertility treatments) and I just had my CT scan last week so not

> so great. They found a adrenal adenoma and the doc was researching

> finding a surgeon to take it out. Has anyone been in this boat?????

> Would love to get some input on what other people have done.

>

> Thanks!

>

>

>

Link to comment
Share on other sites
Guest guest

Guest guest

Posted
Posted

We think the improvement in BP in PA is related to the marked increase in progesterone that occurs during pregnancy.The treatment of PA during pregnancy has not been well studied. Were you PG when 24 urine aldo done?Any renin or blood aldo numbers?What is your family Hx of HTN and stroke esp in young men. See item 5 below. Happy to share my knowledge and expertise on a consulting basis with you and team on this issue.My 1 year consulting charge is $500. This gives you and team unlimited access to my expertise by email, tele, or Skype.CEGrim 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 had a long standing interest is Primary Aldosteronism since medical school days when I saw my first patient with Primary Aldosteronism in 1963 as a 4th year medical student. I did a Nephrology Fellowship at Duke and an Endocrinology and Metabolism Fellowship with Dr. Conn (1969-70). I have been on the faculty of the University of MO, Indiana Univ, UCLA/ R. Drew, and the Medical College of Wisconsin in Divisions of Nephrology, Endocrinology, Hypertension, Cardiology and Epidemiology. I have published over 240 papers and book chapters in most areas of the broad discipline of High Blood Pressure. My CV is in our files for details. The GOAL of our group is to teach you and your health care team about the ins and outs of the causes, diagnosis and control of the many forms of hyperaldosteronism. The steps below will introduce you into the fascinating world of high blood pressure, salt and potassium and the role of the adrenal hormone aldosterone in health and disease. Doing these in sequence will save you time and effort in getting up to speed in taking control of you health and educating your own health care team. While we can’t make you a doctor we will make you into a pretty good BP doctor-a skill that you will have for life. 1. Overview: Read my article in our files on the evolution of PA (Evolution_of_PA-Grim.pdf ) and take to all members of health care team. Tell us what stage you believe you are in. This is a brief review of most causes of hyperaldosteronism, high blood pressure, low potassium (K). Be certain that you and your health care team understand the key role of excess diet salt in HTN and especially in PA. Go to: http://www.worldactiononsalt.com/evidence/treatment_trials.htm For a state of the art and science discussion of salt and health. 2. Other patients with hyperaldosteronism (Conn’s syndrome). Read our Conn's stories in our files and then give us your own in as much detail as you can. Dr. Conn was the first to describe this disease process and the syndrome is named after him. To see others' stories, on the Hyperaldosteronism home page, go to Files/Conn’s Stories. You'll find instructions in "A - How to put your story here.doc "Then send us your story in an email and then we will likely ask more questions and make suggestions before you upload it to our files. 3. Hyperaldosteronism and Salt: The deadly Duo. Eating Plan to control high blood pressure due to hyperaldosteronism and most others with high blood pressure. This will reduce your need for medications and in many will get your BP and K to goal without meds.. Get the DASH diet book by T. et al, read it and use it: $8 in paperback at your local bookstore. If they don’t have it ask them to order it for you. Learning to eat the DASH way will play a major role in your road to good BP and K control and, in many of our folks here, will revolutionize your life. Go to chapter 9 and do the 14 day challenge. Tell your Dr you are doing this as your BP may plummet if you are on other meds in only 2-3 days. or go to http://www.nhlbi.nih.gov/health/public/heart/hbp/dash/new_dash.pdf download this 64 page booklet free and do the Week on the DASH Diet for 2 weeks. If you are on BP meds be prepared for a large fall in BP and let your Dr. know you are doing this. Or go to (but costs money) DASH Diet for Health ProgramThe DASH Diet for Health Program is designed to help you improve your eating and exercise habits. Twice each week we will provide you with information on our website about food, food preparation, eating out, losing weight, getting fit and much more. In addition to providing new information each week on our website, we create a web page specially for you where you can track progress in areas such as your weight, blood pressure, and exercise.http://www.dashforhealth.com/ I strongly recommend you get the book and read it now! 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. Your life is in the hands of those who measure your BP. 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. There is a brief discussion of this in my Evolution Article. 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 high salt diet for 2 weeks-at least 4000 mg of Na a day.2. No BP meds in last 4-12 weeks depending on meds and Drs advice.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 1-4 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. I call this Dr. Grim’s “Quick Pee Test” for PA. Our PA Registry: If you have been Dxed with PA already and are on Rx or have had surgery please go to http://www.kwiksurveys.com/online-survey.php?surveyID=HIJIO_f2685379 and complete our survey with as much information as you know. If there is some information you don't know ask us and we will help. If you need to update this as you journey thru the diagnostic/treatment process you can add another entry but label it as Nameyymmdd. For example today 4/20/11 for me would be Grim110420. This way of writing the date is an ever increasing number and will allow us and you to sort your multiple entries into a dated order. We are working on a more extensive database. 8. Learn the language: If you are new to medical lingo then download the acroyms from http://health.groups.yahoo.com/group/bloodpressureline/message/291869. Salt and high blood pressure: To learn the state of the science of salt and blood pressure please spend some time looking at http://www.worldactiononsalt.com/evidence/treatment_trials.htm10. Become a HBP expert consumer: Expect that it will take at least several weeks to get all this digested and to learn the new language of high blood pressure health care. As most doctors and nurses in practice have had very little training in high blood pressure you must become an expert yourself. For example most have never had anyone listen with them with a double stethoscope to verify that they can hear BP sounds. We cannot make you a doctor but we will make you a pretty good BP doctor.11. How High Blood Pressure should be managed: Go to nih.gov and download and read the Joint National Commission (JNC) Report 7 to get an overview on current guidelines. I ask all my secretaries to read this so they can communicate the importance of high blood pressure to my patients. JNC 8 will be out soon.Then: get (and study) the Hypertension Primer from americanheart.org. This is the most up-to-date compendium of what is known about high blood pressure and what every Dr. should know when they graduate from Medical School. Every chapter is only 2-3 pages. Read one chapter every week-night and you will finish it in about a year. I am working on a reading guide for lay people for the Primer. Stay tuned.12. Ask us questions: Ask any questions about high blood pressure you want answered. That is what we are here for.13. One-on-one Consulting: I can provide individual consulting if you do not want to go public. If you want individual one-on-one consulting for you and your Doctor contract me directly at lowerbp2@....May your pressure be low!Clarence E. Grim BS, MS, MD, FACP, FACCBoard Certified in Internal Medicine, Geriatrics, and High Blood Pressure Specializing in Primary Aldosteronism and Difficult to Control High Blood Pressure. Dr. Grim,Thanks for your email. I have a summary of my story up on the yahoo site. I have high blood pressure and low potassium from the adrenal bump.I found out on Monday that I was pregnant and went to my doc immediately. She conferred with my Nephrologist and they took me off Lisinopril and potassium chloride and switched me over to 25 mg Eperenone. For the pregnancy, I have low progesterone so I am starting 200 mg capsules tonight. Sounds like I should be monitoring my blood pressure really closely if this could affect my PA. I met with the Nephrologist today and he gave me the names of two surgeons at University of Colorado Hospital and suggested that I make the appointment with them as the next step to see what they would recommend. I also have a call into my endocrinologist. He is recommending surgery after I am 12 weeks along. So good to hear about PA getting better during pregnancy. This is all way way too overwhelming. Cheers, BradleyRe: Anyone pregnant with PA?Posted by: "Clarence Grim" lowerbp2@... lowerbp2Tue May 24, 2011 10:57 pm (PDT)First what problem is the adrenal bump causing?Immediately stop any ACEs or ARBs you are taking (if any) as they may cause serious problems with your baby.Call you doctor immediately in the morning and ask what you should do as well.If you have PA, you did not provide a thumbnail so I don't recall who you are among the other 550 others here. At least one is also pregnant now.PA commonly gets better during pregnancy as the increased progesterone is an aldo blocker.Please send details so we can help.CE Grim MD> So I just found out I am pregnant (and you all are finding out > before my mom). A total surprise (we gave up last year after a year > of fertility treatments) and I just had my CT scan last week so not > so great. They found a adrenal adenoma and the doc was researching > finding a surgeon to take it out. Has anyone been in this boat????? > Would love to get some input on what other people have done.>> Thanks!> >>

Link to comment
Share on other sites
Guest guest

Guest guest

Posted
Posted

Dr Grim:If the increase in progesterone causes improvements in PA in pregnancy, then should women take progesterone be at along with a lower dose of Spiro--or could progesterone alone be used as an treatment?Just a thought! Farah

We think the improvement in BP in PA is related to the marked increase in progesterone that occurs during pregnancy.The treatment of PA during pregnancy has not been well studied. Were you PG when 24 urine aldo done?Any renin or blood aldo numbers?What is your family Hx of HTN and stroke esp in young men. See item 5 below. Happy to share my knowledge and expertise on a consulting basis with you and team on this issue.My 1 year consulting charge is $500. This gives you and team unlimited access to my expertise by email, tele, or Skype.CEGrim 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 had a long standing interest is Primary Aldosteronism since medical school days when I saw my first patient with Primary Aldosteronism in 1963 as a 4th year medical student. I did a Nephrology Fellowship at Duke and an Endocrinology and Metabolism Fellowship with Dr. Conn (1969-70). I have been on the faculty of the University of MO, Indiana Univ, UCLA/ R. Drew, and the Medical College of Wisconsin in Divisions of Nephrology, Endocrinology, Hypertension, Cardiology and Epidemiology. I have published over 240 papers and book chapters in most areas of the broad discipline of High Blood Pressure. My CV is in our files for details. The GOAL of our group is to teach you and your health care team about the ins and outs of the causes, diagnosis and control of the many forms of hyperaldosteronism. The steps below will introduce you into the fascinating world of high blood pressure, salt and potassium and the role of the adrenal hormone aldosterone in health and disease. Doing these in sequence will save you time and effort in getting up to speed in taking control of you health and educating your own health care team. While we can’t make you a doctor we will make you into a pretty good BP doctor-a skill that you will have for life. 1. Overview: Read my article in our files on the evolution of PA (Evolution_of_PA-Grim.pdf ) and take to all members of health care team. Tell us what stage you believe you are in. This is a brief review of most causes of hyperaldosteronism, high blood pressure, low potassium (K). Be certain that you and your health care team understand the key role of excess diet salt in HTN and especially in PA. Go to: http://www.worldactiononsalt.com/evidence/treatment_trials.htm For a state of the art and science discussion of salt and health. 2. Other patients with hyperaldosteronism (Conn’s syndrome). Read our Conn's stories in our files and then give us your own in as much detail as you can. Dr. Conn was the first to describe this disease process and the syndrome is named after him. To see others' stories, on the Hyperaldosteronism home page, go to Files/Conn’s Stories. You'll find instructions in "A - How to put your story here.doc "Then send us your story in an email and then we will likely ask more questions and make suggestions before you upload it to our files. 3. Hyperaldosteronism and Salt: The deadly Duo. Eating Plan to control high blood pressure due to hyperaldosteronism and most others with high blood pressure. This will reduce your need for medications and in many will get your BP and K to goal without meds.. Get the DASH diet book by T. et al, read it and use it: $8 in paperback at your local bookstore. If they don’t have it ask them to order it for you. Learning to eat the DASH way will play a major role in your road to good BP and K control and, in many of our folks here, will revolutionize your life. Go to chapter 9 and do the 14 day challenge. Tell your Dr you are doing this as your BP may plummet if you are on other meds in only 2-3 days. or go to http://www.nhlbi.nih.gov/health/public/heart/hbp/dash/new_dash.pdf download this 64 page booklet free and do the Week on the DASH Diet for 2 weeks. If you are on BP meds be prepared for a large fall in BP and let your Dr. know you are doing this. Or go to (but costs money) DASH Diet for Health ProgramThe DASH Diet for Health Program is designed to help you improve your eating and exercise habits. Twice each week we will provide you with information on our website about food, food preparation, eating out, losing weight, getting fit and much more. In addition to providing new information each week on our website, we create a web page specially for you where you can track progress in areas such as your weight, blood pressure, and exercise.http://www.dashforhealth.com/ I strongly recommend you get the book and read it now! 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. Your life is in the hands of those who measure your BP. 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. There is a brief discussion of this in my Evolution Article. 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 high salt diet for 2 weeks-at least 4000 mg of Na a day.2. No BP meds in last 4-12 weeks depending on meds and Drs advice.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 1-4 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. I call this Dr. Grim’s “Quick Pee Test†for PA. Our PA Registry: If you have been Dxed with PA already and are on Rx or have had surgery please go to http://www.kwiksurveys.com/online-survey.php?surveyID=HIJIO_f2685379 and complete our survey with as much information as you know. If there is some information you don't know ask us and we will help. If you need to update this as you journey thru the diagnostic/treatment process you can add another entry but label it as Nameyymmdd. For example today 4/20/11 for me would be Grim110420. This way of writing the date is an ever increasing number and will allow us and you to sort your multiple entries into a dated order. We are working on a more extensive database. 8. Learn the language: If you are new to medical lingo then download the acroyms from http://health.groups.yahoo.com/group/bloodpressureline/message/291869. Salt and high blood pressure: To learn the state of the science of salt and blood pressure please spend some time looking at http://www.worldactiononsalt.com/evidence/treatment_trials.htm10. Become a HBP expert consumer: Expect that it will take at least several weeks to get all this digested and to learn the new language of high blood pressure health care. As most doctors and nurses in practice have had very little training in high blood pressure you must become an expert yourself. For example most have never had anyone listen with them with a double stethoscope to verify that they can hear BP sounds. We cannot make you a doctor but we will make you a pretty good BP doctor.11. How High Blood Pressure should be managed: Go to nih.gov and download and read the Joint National Commission (JNC) Report 7 to get an overview on current guidelines. I ask all my secretaries to read this so they can communicate the importance of high blood pressure to my patients. JNC 8 will be out soon.Then: get (and study) the Hypertension Primer from americanheart.org. This is the most up-to-date compendium of what is known about high blood pressure and what every Dr. should know when they graduate from Medical School. Every chapter is only 2-3 pages. Read one chapter every week-night and you will finish it in about a year. I am working on a reading guide for lay people for the Primer. Stay tuned.12. Ask us questions: Ask any questions about high blood pressure you want answered. That is what we are here for.13. One-on-one Consulting: I can provide individual consulting if you do not want to go public. If you want individual one-on-one consulting for you and your Doctor contract me directly at lowerbp2@....May your pressure be low!Clarence E. Grim BS, MS, MD, FACP, FACCBoard Certified in Internal Medicine, Geriatrics, and High Blood Pressure Specializing in Primary Aldosteronism and Difficult to Control High Blood Pressure. Dr. Grim,Thanks for your email. I have a summary of my story up on the yahoo site. I have high blood pressure and low potassium from the adrenal bump.I found out on Monday that I was pregnant and went to my doc immediately. She conferred with my Nephrologist and they took me off Lisinopril and potassium chloride and switched me over to 25 mg Eperenone. For the pregnancy, I have low progesterone so I am starting 200 mg capsules tonight. Sounds like I should be monitoring my blood pressure really closely if this could affect my PA. I met with the Nephrologist today and he gave me the names of two surgeons at University of Colorado Hospital and suggested that I make the appointment with them as the next step to see what they would recommend. I also have a call into my endocrinologist. He is recommending surgery after I am 12 weeks along. So good to hear about PA getting better during pregnancy. This is all way way too overwhelming. Cheers, BradleyRe: Anyone pregnant with PA?Posted by: "Clarence Grim" lowerbp2@... lowerbp2Tue May 24, 2011 10:57 pm (PDT)First what problem is the adrenal bump causing?Immediately stop any ACEs or ARBs you are taking (if any) as they may cause serious problems with your baby.Call you doctor immediately in the morning and ask what you should do as well.If you have PA, you did not provide a thumbnail so I don't recall who you are among the other 550 others here. At least one is also pregnant now.PA commonly gets better during pregnancy as the increased progesterone is an aldo blocker.Please send details so we can help.CE Grim MD> So I just found out I am pregnant (and you all are finding out > before my mom). A total surprise (we gave up last year after a year > of fertility treatments) and I just had my CT scan last week so not > so great. They found a adrenal adenoma and the doc was researching > finding a surgeon to take it out. Has anyone been in this boat????? > Would love to get some input on what other people have done.>> Thanks!> >>

Link to comment
Share on other sites
Guest guest

Guest guest

Posted
Posted

I believe progesterone has other long term effects that are not desirable. But not my area of expertise. Good thinking. The levels in preg are many times higher than what we give for other problems. Tiped sad Send form miiPhone ;-)May your pressure be low!CE Grim MDSpecializing in DifficultHypertension

Dr Grim:If the increase in progesterone causes improvements in PA in pregnancy, then should women take progesterone be at along with a lower dose of Spiro--or could progesterone alone be used as an treatment?Just a thought! Farah

We think the improvement in BP in PA is related to the marked increase in progesterone that occurs during pregnancy.The treatment of PA during pregnancy has not been well studied. Were you PG when 24 urine aldo done?Any renin or blood aldo numbers?What is your family Hx of HTN and stroke esp in young men. See item 5 below. Happy to share my knowledge and expertise on a consulting basis with you and team on this issue.My 1 year consulting charge is $500. This gives you and team unlimited access to my expertise by email, tele, or Skype.CEGrim 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 had a long standing interest is Primary Aldosteronism since medical school days when I saw my first patient with Primary Aldosteronism in 1963 as a 4th year medical student. I did a Nephrology Fellowship at Duke and an Endocrinology and Metabolism Fellowship with Dr. Conn (1969-70). I have been on the faculty of the University of MO, Indiana Univ, UCLA/ R. Drew, and the Medical College of Wisconsin in Divisions of Nephrology, Endocrinology, Hypertension, Cardiology and Epidemiology. I have published over 240 papers and book chapters in most areas of the broad discipline of High Blood Pressure. My CV is in our files for details. The GOAL of our group is to teach you and your health care team about the ins and outs of the causes, diagnosis and control of the many forms of hyperaldosteronism. The steps below will introduce you into the fascinating world of high blood pressure, salt and potassium and the role of the adrenal hormone aldosterone in health and disease. Doing these in sequence will save you time and effort in getting up to speed in taking control of you health and educating your own health care team. While we can’t make you a doctor we will make you into a pretty good BP doctor-a skill that you will have for life. 1. Overview: Read my article in our files on the evolution of PA (Evolution_of_PA-Grim.pdf ) and take to all members of health care team. Tell us what stage you believe you are in. This is a brief review of most causes of hyperaldosteronism, high blood pressure, low potassium (K). Be certain that you and your health care team understand the key role of excess diet salt in HTN and especially in PA. Go to: http://www.worldactiononsalt.com/evidence/treatment_trials.htm For a state of the art and science discussion of salt and health. 2. Other patients with hyperaldosteronism (Conn’s syndrome). Read our Conn's stories in our files and then give us your own in as much detail as you can. Dr. Conn was the first to describe this disease process and the syndrome is named after him. To see others' stories, on the Hyperaldosteronism home page, go to Files/Conn’s Stories. You'll find instructions in "A - How to put your story here.doc "Then send us your story in an email and then we will likely ask more questions and make suggestions before you upload it to our files. 3. Hyperaldosteronism and Salt: The deadly Duo. Eating Plan to control high blood pressure due to hyperaldosteronism and most others with high blood pressure. This will reduce your need for medications and in many will get your BP and K to goal without meds.. Get the DASH diet book by T. et al, read it and use it: $8 in paperback at your local bookstore. If they don’t have it ask them to order it for you. Learning to eat the DASH way will play a major role in your road to good BP and K control and, in many of our folks here, will revolutionize your life. Go to chapter 9 and do the 14 day challenge. Tell your Dr you are doing this as your BP may plummet if you are on other meds in only 2-3 days. or go to http://www.nhlbi.nih.gov/health/public/heart/hbp/dash/new_dash.pdf download this 64 page booklet free and do the Week on the DASH Diet for 2 weeks. If you are on BP meds be prepared for a large fall in BP and let your Dr. know you are doing this. Or go to (but costs money) DASH Diet for Health ProgramThe DASH Diet for Health Program is designed to help you improve your eating and exercise habits. Twice each week we will provide you with information on our website about food, food preparation, eating out, losing weight, getting fit and much more. In addition to providing new information each week on our website, we create a web page specially for you where you can track progress in areas such as your weight, blood pressure, and exercise.http://www.dashforhealth.com/ I strongly recommend you get the book and read it now! 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. Your life is in the hands of those who measure your BP. 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. There is a brief discussion of this in my Evolution Article. 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 high salt diet for 2 weeks-at least 4000 mg of Na a day.2. No BP meds in last 4-12 weeks depending on meds and Drs advice.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 1-4 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. I call this Dr. Grim’s “Quick Pee Test†for PA. Our PA Registr

Link to comment
Share on other sites
Guest guest

Guest guest

Posted
Posted

I asked the pharmacist this very question in the topic of spiro side effects

and he stated that the other side effects and risks would outweigh it

>Dr Grim:

>If the increase in progesterone causes improvements in PA in pregnancy, then

should women take progesterone be at along with a lower dose of Spiro--or could

progesterone alone be used as an treatment?

>

>Just a thought!

>

>Farah

>

>

>

>

>> We think the improvement in BP in PA is related to the marked increase in

progesterone that occurs during pregnancy.

>>

>>

>> The treatment of PA during pregnancy has not been well studied.

>>

>> Were you PG when 24 urine aldo done?

>>

>> Any renin or blood aldo numbers?

>>

>> What is your family Hx of HTN and stroke esp in young men. See item 5 below.

>> Happy to share my knowledge and expertise on a consulting basis with you and

team on this issue.

>>

>> My 1 year consulting charge is $500. This gives you and team unlimited access

to my expertise by email, tele, or Skype.

>>

>> CEGrim 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 had a long standing interest is Primary Aldosteronism since medical

school days when I saw my first patient with Primary Aldosteronism in 1963 as a

4th year medical student. I did a Nephrology Fellowship at Duke and an

Endocrinology and Metabolism Fellowship with Dr. Conn (1969-70). I have been on

the faculty of the University of MO, Indiana Univ, UCLA/ R. Drew, and the

Medical College of Wisconsin in Divisions of Nephrology, Endocrinology,

Hypertension, Cardiology and Epidemiology.

>>

>> I have published over 240 papers and book chapters in most areas of the broad

discipline of High Blood Pressure. My CV is in our files for details.

>>

>> The GOAL of our group is to teach you and your health care team about the ins

and outs of the causes, diagnosis and control of the many forms of

hyperaldosteronism.

>>

>> The steps below will introduce you into the fascinating world of high blood

pressure, salt and potassium and the role of the adrenal hormone aldosterone in

health and disease. Doing these in sequence will save you time and effort in

getting up to speed in taking control of you health and educating your own

health care team.

>>

>> While we can’t make you a doctor we will make you into a pretty good BP

doctor-a skill that you will have for life.

>>

>> 1. Overview: Read my article in our files on the evolution of PA

(Evolution_of_PA-Grim.pdf ) and take to all members of health care team. Tell

us what stage you believe you are in. This is a brief review of most causes of

hyperaldosteronism, high blood pressure, low potassium (K).

>>

>> Be certain that you and your health care team understand the key role of

excess diet salt in HTN and especially in PA.

>>

>> Go to: http://www.worldactiononsalt.com/evidence/treatment_trials.htm

>>

>> For a state of the art and science discussion of salt and health.

>>

>> 2. Other patients with hyperaldosteronism (Conn’s syndrome). Read our

Conn's stories in our files and then give us your own in as much detail as you

can. Dr. Conn was the first to describe this disease process and the syndrome is

named after him. To see others' stories, on the Hyperaldosteronism home page, go

to Files/Conn’s Stories. You'll find instructions in " A - How to put your

story here.doc "

>> Then send us your story in an email and then we will likely ask more

questions and make suggestions before you upload it to our files.

>>

>> 3. Hyperaldosteronism and Salt: The deadly Duo.

>>

>>

>> Eating Plan to control high blood pressure due to hyperaldosteronism and most

others with high blood pressure. This will reduce your need for medications

and in many will get your BP and K to goal without meds.. Get the DASH diet book

by T. et al, read it and use it: $8 in paperback at your local bookstore.

If they don’t have it ask them to order it for you. Learning to eat the DASH

way will play a major role in your road to good BP and K control and, in many of

our folks here, will revolutionize your life.

>>

>> Go to chapter 9 and do the 14 day challenge. Tell your Dr you are doing this

as your BP may plummet if you are on other meds in only 2-3 days.

>>

>> or

>>

>> go to http://www.nhlbi.nih.gov/health/public/heart/hbp/dash/new_dash.pdf

>>

>> download this 64 page booklet free and do the Week on the DASH Diet for 2

weeks. If you are on BP meds be prepared for a large fall in BP and let your

Dr. know you are doing this.

>>

>> Or go to (but costs money)

>>

>> DASH Diet for Health Program

>> The DASH Diet for Health Program is designed to help you improve your eating

and exercise habits. Twice each week we will provide you with information on our

website about food, food preparation, eating out, losing weight, getting fit and

much more. In addition to providing new information each week on our website, we

create a web page specially for you where you can track progress in areas such

as your weight, blood pressure, and exercise.

>> http://www.dashforhealth.com/

>>

>> I strongly recommend you get the book and read it now!

>>

>> 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. Your

life is in the hands of those who measure your BP. 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. There is a brief discussion

of this in my Evolution Article.

>>

>> 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 high salt diet for 2 weeks-at least 4000 mg of Na a day.

>> 2. No BP meds in last 4-12 weeks depending on meds and Drs advice.

>> 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 1-4 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. I call this Dr. Grim’s “Quick Pee Testâ€

for PA.

>>

>> Our PA Registry: If you have been Dxed with PA already and are on Rx or have

had surgery please go

>>

>> to http://www.kwiksurveys.com/online-survey.php?surveyID=HIJIO_f2685379

>>

>> and complete our survey with as much information as you know. If there is

some information you don't know ask us and we will help. If you need to update

this as you journey thru the diagnostic/treatment process you can add another

entry but label it as Nameyymmdd. For example today 4/20/11 for me would be

Grim110420. This way of writing the date is an ever increasing number and will

allow us and you to sort your multiple entries into a dated order. We are

working on a more extensive database.

>>

>> 8. Learn the language: If you are new to medical lingo then download the

acroyms from

>>

>> http://health.groups.yahoo.com/group/bloodpressureline/message/29186

>> 9. Salt and high blood pressure: To learn the state of the science of salt

and blood pressure please spend some time looking at

>> http://www.worldactiononsalt.com/evidence/treatment_trials.htm

>> 10. Become a HBP expert consumer: Expect that it will take at least several

weeks to get all this digested and to learn the new language of high blood

pressure health care. As most doctors and nurses in practice have had very

little training in high blood pressure you must become an expert yourself. For

example most have never had anyone listen with them with a double stethoscope to

verify that they can hear BP sounds.

>>

>> We cannot make you a doctor but we will make you a pretty good BP doctor.

>> 11. How High Blood Pressure should be managed:

>> Go to nih.gov and download and read the Joint National Commission (JNC)

Report 7 to get an overview on current guidelines. I ask all my secretaries to

read this so they can communicate the importance of high blood pressure to my

patients. JNC 8 will be out soon.

>> Then: get (and study) the Hypertension Primer from americanheart.org. This

is the most up-to-date compendium of what is known about high blood pressure and

what every Dr. should know when they graduate from Medical School. Every

chapter is only 2-3 pages. Read one chapter every week-night and you will

finish it in about a year. I am working on a reading guide for lay people for

the Primer. Stay tuned.

>> 12. Ask us questions: Ask any questions about high blood pressure you

want answered. That is what we are here for.

>> 13. One-on-one Consulting: I can provide individual consulting if you do

not want to go public. If you want individual one-on-one consulting for you and

your Doctor contract me directly at lowerbp2@....

>> May your pressure be low!

>> Clarence E. Grim BS, MS, MD, FACP, FACC

>> Board Certified in Internal Medicine, Geriatrics, and High Blood Pressure

>>

>> Specializing in Primary Aldosteronism and Difficult to Control High Blood

Pressure.

>>

>>

>>

>>

>>

>>> Dr. Grim,

>>>

>>> Thanks for your email. I have a summary of my story up on the yahoo site.

>>>

>>> I have high blood pressure and low potassium from the adrenal bump.

>>>

>>> I found out on Monday that I was pregnant and went to my doc immediately.

She conferred with my Nephrologist and they took me off Lisinopril and potassium

chloride and switched me over to 25 mg Eperenone.

>>>

>>> For the pregnancy, I have low progesterone so I am starting 200 mg capsules

tonight. Sounds like I should be monitoring my blood pressure really closely if

this could affect my PA.

>>>

>>> I met with the Nephrologist today and he gave me the names of two surgeons

at University of Colorado Hospital and suggested that I make the appointment

with them as the next step to see what they would recommend. I also have a call

into my endocrinologist. He is recommending surgery after I am 12 weeks along.

>>>

>>> So good to hear about PA getting better during pregnancy.

>>>

>>> This is all way way too overwhelming.

>>>

>>> Cheers,

>>> Bradley

>>>

>>> Re: Anyone pregnant with PA?

>>> Posted by: " Clarence Grim " lowerbp2@... lowerbp2

>>> Tue May 24, 2011 10:57 pm (PDT)

>>>

>>> First what problem is the adrenal bump causing?

>>>

>>> Immediately stop any ACEs or ARBs you are taking (if any) as they may

>>> cause serious problems with your baby.

>>>

>>> Call you doctor immediately in the morning and ask what you should do

>>> as well.

>>>

>>> If you have PA, you did not provide a thumbnail so I don't recall who

>>> you are among the other 550 others here. At least one is also

>>> pregnant now.

>>>

>>> PA commonly gets better during pregnancy as the increased progesterone

>>> is an aldo blocker.

>>>

>>> Please send details so we can help.

>>>

>>> CE Grim MD

>>>

>>>

>>> > So I just found out I am pregnant (and you all are finding out

>>> > before my mom). A total surprise (we gave up last year after a year

>>> > of fertility treatments) and I just had my CT scan last week so not

>>> > so great. They found a adrenal adenoma and the doc was researching

>>> > finding a surgeon to take it out. Has anyone been in this boat?????

>>> > Would love to get some input on what other people have done.

>>> >

>>> > Thanks!

>>> >

>>> >

>>> >

>>>

>>

>>

Link to comment
Share on other sites
Guest guest

Guest guest

Posted
Posted

Do you

know what the " other side effects and risks " are?  Was he talking about progesterone or the

progestins?  I take 100 mg progesterone every day.

Val

From: hyperaldosteronism

[mailto:hyperaldosteronism ] On Behalf Of Bingham

Sent: Thursday, May 26, 2011 9:16 AM

To: hyperaldosteronism

Subject: Re: Re: Anyone pregnant with PA?

I asked the pharmacist this very question in

the topic of spiro side effects and he stated that the other side effects and

risks would outweigh it

>Dr Grim:

>If the increase in progesterone causes improvements in PA in pregnancy,

then should women take progesterone be at along with a lower dose of Spiro--or

could progesterone alone be used as an treatment?

>

>Just a thought!

>

>Farah

>

>

>

>

>> We think the improvement in BP in PA is related to the marked increase

in progesterone that occurs during pregnancy.

>>

>>

>> The treatment of PA during pregnancy has not been well studied.

>>

>> Were you PG when 24 urine aldo done?

>>

>> Any renin or blood aldo numbers?

>>

>> What is your family Hx of HTN and stroke esp in young men. See item 5

below.

>> Happy to share my knowledge and expertise on a consulting basis with

you and team on this issue.

>>

>> My 1 year consulting charge is $500. This gives you and team unlimited

access to my expertise by email, tele, or Skype.

>>

>> CEGrim 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 had a long standing interest is Primary Aldosteronism since

medical school days when I saw my first patient with Primary Aldosteronism in

1963 as a 4th year medical student. I did a Nephrology Fellowship at Duke and

an Endocrinology and Metabolism Fellowship with Dr. Conn (1969-70). I have been

on the faculty of the University of MO, Indiana Univ, UCLA/ R. Drew, and

the Medical College of Wisconsin in Divisions of Nephrology, Endocrinology,

Hypertension, Cardiology and Epidemiology.

>>

>> I have published over 240 papers and book chapters in most areas of

the broad discipline of High Blood Pressure. My CV is in our files for details.

>>

>> The GOAL of our group is to teach you and your health care team about

the ins and outs of the causes, diagnosis and control of the many forms of

hyperaldosteronism.

>>

>> The steps below will introduce you into the fascinating world of high

blood pressure, salt and potassium and the role of the adrenal hormone

aldosterone in health and disease. Doing these in sequence will save you time

and effort in getting up to speed in taking control of you health and educating

your own health care team.

>>

>> While we can’t make you a doctor we will make you into a pretty good

BP doctor-a skill that you will have for life.

>>

>> 1. Overview: Read my article in our files on the evolution of PA

(Evolution_of_PA-Grim.pdf ) and take to all members of health care team. Tell

us what stage you believe you are in. This is a brief review of most causes of

hyperaldosteronism, high blood pressure, low potassium (K).

>>

>> Be certain that you and your health care team understand the key role

of excess diet salt in HTN and especially in PA.

>>

>> Go to: http://www.worldactiononsalt.com/evidence/treatment_trials.htm

>>

>> For a state of the art and science discussion of salt and health.

>>

>> 2. Other patients with hyperaldosteronism (Conn’s syndrome). Read our

Conn's stories in our files and then give us your own in as much detail as you

can. Dr. Conn was the first to describe this disease process and the syndrome

is named after him. To see others' stories, on the Hyperaldosteronism home

page, go to Files/Conn’s Stories. You'll find instructions in " A - How to

put your story here.doc "

>> Then send us your story in an email and then we will likely ask more

questions and make suggestions before you upload it to our files.

>>

>> 3. Hyperaldosteronism and Salt: The deadly Duo.

>>

>>

>> Eating Plan to control high blood pressure due to hyperaldosteronism

and most others with high blood pressure. This will reduce your need for

medications and in many will get your BP and K to goal without meds.. Get the

DASH diet book by T. et al, read it and use it: $8 in paperback at your

local bookstore. If they don’t have it ask them to order it for you. Learning

to eat the DASH way will play a major role in your road to good BP and K

control and, in many of our folks here, will revolutionize your life.

>>

>> Go to chapter 9 and do the 14 day challenge. Tell your Dr you are

doing this as your BP may plummet if you are on other meds in only 2-3 days.

>>

>> or

>>

>> go to http://www.nhlbi.nih.gov/health/public/heart/hbp/dash/new_dash.pdf

>>

>> download this 64 page booklet free and do the Week on the DASH Diet

for 2 weeks. If you are on BP meds be prepared for a large fall in BP and let

your Dr. know you are doing this.

>>

>> Or go to (but costs money)

>>

>> DASH Diet for Health Program

>> The DASH Diet for Health Program is designed to help you improve your

eating and exercise habits. Twice each week we will provide you with

information on our website about food, food preparation, eating out, losing

weight, getting fit and much more. In addition to providing new information

each week on our website, we create a web page specially for you where you can

track progress in areas such as your weight, blood pressure, and exercise.

>> http://www.dashforhealth.com/

>>

>> I strongly recommend you get the book and read it now!

>>

>> 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. Your

life is in the hands of those who measure your BP. 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. There is a brief

discussion of this in my Evolution Article.

>>

>> 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 high salt diet for 2 weeks-at least 4000 mg of Na a day.

>> 2. No BP meds in last 4-12 weeks depending on meds and Drs advice.

>> 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 1-4 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. I call this Dr. Grim’s “Quick Pee Test†for

PA.

>>

>> Our PA Registry: If you have been Dxed with PA already and are on Rx or

have had surgery please go

>>

>> to http://www.kwiksurveys.com/online-survey.php?surveyID=HIJIO_f2685379

>>

>> and complete our survey with as much information as you know. If there

is some information you don't know ask us and we will help. If you need to

update this as you journey thru the diagnostic/treatment process you can add

another entry but label it as Nameyymmdd. For example today 4/20/11 for me

would be Grim110420. This way of writing the date is an ever increasing number

and will allow us and you to sort your multiple entries into a dated order. We

are working on a more extensive database.

>>

>> 8. Learn the language: If you are new to medical lingo then download

the acroyms from

>>

>> http://health.groups.yahoo.com/group/bloodpressureline/message/29186

>> 9. Salt and high blood pressure: To learn the state of the science of

salt and blood pressure please spend some time looking at

>> http://www.worldactiononsalt.com/evidence/treatment_trials.htm

>> 10. Become a HBP expert consumer: Expect that it will take at least

several weeks to get all this digested and to learn the new language of high

blood pressure health care. As most doctors and nurses in practice have had

very little training in high blood pressure you must become an expert yourself.

For example most have never had anyone listen with them with a double

stethoscope to verify that they can hear BP sounds.

>>

>> We cannot make you a doctor but we will make you a pretty good BP

doctor.

>> 11. How High Blood Pressure should be managed:

>> Go to nih.gov and download and read the Joint National Commission

(JNC) Report 7 to get an overview on current guidelines. I ask all my

secretaries to read this so they can communicate the importance of high blood

pressure to my patients. JNC 8 will be out soon.

>> Then: get (and study) the Hypertension Primer from americanheart.org.

This is the most up-to-date compendium of what is known about high blood

pressure and what every Dr. should know when they graduate from Medical School.

Every chapter is only 2-3 pages. Read one chapter every week-night and you will

finish it in about a year. I am working on a reading guide for lay people for

the Primer. Stay tuned.

>> 12. Ask us questions: Ask any questions about high blood pressure you

want answered. That is what we are here for.

>> 13. One-on-one Consulting: I can provide individual consulting if you

do not want to go public. If you want individual one-on-one consulting for you

and your Doctor contract me directly at lowerbp2@....

>> May your pressure be low!

>> Clarence E. Grim BS, MS, MD, FACP, FACC

>> Board Certified in Internal Medicine, Geriatrics, and High Blood

Pressure

>>

>> Specializing in Primary Aldosteronism and Difficult to Control High

Blood Pressure.

>>

>>

>>

>>

>>

>>> Dr. Grim,

>>>

>>> Thanks for your email. I have a summary of my story up on the

yahoo site.

>>>

>>> I have high blood pressure and low potassium from the adrenal

bump.

>>>

>>> I found out on Monday that I was pregnant and went to my doc

immediately. She conferred with my Nephrologist and they took me off Lisinopril

and potassium chloride and switched me over to 25 mg Eperenone.

>>>

>>> For the pregnancy, I have low progesterone so I am starting 200 mg

capsules tonight. Sounds like I should be monitoring my blood pressure really

closely if this could affect my PA.

>>>

>>> I met with the Nephrologist today and he gave me the names of two

surgeons at University of Colorado Hospital and suggested that I make the

appointment with them as the next step to see what they would recommend. I also

have a call into my endocrinologist. He is recommending surgery after I am 12

weeks along.

>>>

>>> So good to hear about PA getting better during pregnancy.

>>>

>>> This is all way way too overwhelming.

>>>

>>> Cheers,

>>> Bradley

>>>

>>> Re: Anyone pregnant with PA?

>>> Posted by: " Clarence Grim " lowerbp2@... lowerbp2

>>> Tue May 24, 2011 10:57 pm (PDT)

>>>

>>> First what problem is the adrenal bump causing?

>>>

>>> Immediately stop any ACEs or ARBs you are taking (if any) as they

may

>>> cause serious problems with your baby.

>>>

>>> Call you doctor immediately in the morning and ask what you should

do

>>> as well.

>>>

>>> If you have PA, you did not provide a thumbnail so I don't recall

who

>>> you are among the other 550 others here. At least one is also

>>> pregnant now.

>>>

>>> PA commonly gets better during pregnancy as the increased

progesterone

>>> is an aldo blocker.

>>>

>>> Please send details so we can help.

>>>

>>> CE Grim MD

>>>

>>>

>>> > So I just found out I am pregnant (and you all are finding

out

>>> > before my mom). A total surprise (we gave up last year after

a year

>>> > of fertility treatments) and I just had my CT scan last week

so not

>>> > so great. They found a adrenal adenoma and the doc was

researching

>>> > finding a surgeon to take it out. Has anyone been in this

boat?????

>>> > Would love to get some input on what other people have done.

>>> >

>>> > Thanks!

>>> >

>>> >

>>> >

>>>

>>

>>

Link to comment
Share on other sites
Guest guest

Guest guest

Posted
Posted

The issue was the high dose one might need to mimic pregnancy and block the very high aldo seen in normal pregnancy. Tiped sad Send form miiPhone ;-)May your pressure be low!CE Grim MDSpecializing in DifficultHypertension

Do you

know what the "other side effects and risks" are? Was he talking about progesterone or the

progestins? I take 100 mg progesterone every day.

Val

From: hyperaldosteronism

[mailto:hyperaldosteronism ] On Behalf Of Bingham

Sent: Thursday, May 26, 2011 9:16 AM

To: hyperaldosteronism

Subject: Re: Re: Anyone pregnant with PA?

I asked the pharmacist this very question in

the topic of spiro side effects and he stated that the other side effects and

risks would outweigh it

>Dr Grim:

>If the increase in progesterone causes improvements in PA in pregnancy,

then should women take progesterone be at along with a lower dose of Spiro--or

could progesterone alone be used as an treatment?

>

>Just a thought!

>

>Farah

>

>

>

>

>> We think the improvement in BP in PA is related to the marked increase

in progesterone that occurs during pregnancy.

>>

>>

>> The treatment of PA during pregnancy has not been well studied.

>>

>> Were you PG when 24 urine aldo done?

>>

>> Any renin or blood aldo numbers?

>>

>> What is your family Hx of HTN and stroke esp in young men. See item 5

below.

>> Happy to share my knowledge and expertise on a consulting basis with

you and team on this issue.

>>

>> My 1 year consulting charge is $500. This gives you and team unlimited

access to my expertise by email, tele, or Skype.

>>

>> CEGrim 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 had a long standing interest is Primary Aldosteronism since

medical school days when I saw my first patient with Primary Aldosteronism in

1963 as a 4th year medical student. I did a Nephrology Fellowship at Duke and

an Endocrinology and Metabolism Fellowship with Dr. Conn (1969-70). I have been

on the faculty of the University of MO, Indiana Univ, UCLA/ R. Drew, and

the Medical College of Wisconsin in Divisions of Nephrology, Endocrinology,

Hypertension, Cardiology and Epidemiology.

>>

>> I have published over 240 papers and book chapters in most areas of

the broad discipline of High Blood Pressure. My CV is in our files for details.

>>

>> The GOAL of our group is to teach you and your health care team about

the ins and outs of the causes, diagnosis and control of the many forms of

hyperaldosteronism.

>>

>> The steps below will introduce you into the fascinating world of high

blood pressure, salt and potassium and the role of the adrenal hormone

aldosterone in health and disease. Doing these in sequence will save you time

and effort in getting up to speed in taking control of you health and educating

your own health care team.

>>

>> While we can’t make you a doctor we will make you into a pretty good

BP doctor-a skill that you will have for life.

>>

>> 1. Overview: Read my article in our files on the evolution of PA

(Evolution_of_PA-Grim.pdf ) and take to all members of health care team. Tell

us what stage you believe you are in. This is a brief review of most causes of

hyperaldosteronism, high blood pressure, low potassium (K).

>>

>> Be certain that you and your health care team understand the key role

of excess diet salt in HTN and especially in PA.

>>

>> Go to: http://www.worldactiononsalt.com/evidence/treatment_trials.htm

>>

>> For a state of the art and science discussion of salt and health.

>>

>> 2. Other patients with hyperaldosteronism (Conn’s syndrome). Read our

Conn's stories in our files and then give us your own in as much detail as you

can. Dr. Conn was the first to describe this disease process and the syndrome

is named after him. To see others' stories, on the Hyperaldosteronism home

page, go to Files/Conn’s Stories. You'll find instructions in "A - How to

put your story here.doc "

>> Then send us your story in an email and then we will likely ask more

questions and make suggestions before you upload it to our files.

>>

>> 3. Hyperaldosteronism and Salt: The deadly Duo.

>>

>>

>> Eating Plan to control high blood pressure due to hyperaldosteronism

and most others with high blood pressure. This will reduce your need for

medications and in many will get your BP and K to goal without meds.. Get the

DASH diet book by T. et al, read it and use it: $8 in paperback at your

local bookstore. If they don’t have it ask them to order it for you. Learning

to eat the DASH way will play a major role in your road to good BP and K

control and, in many of our folks here, will revolutionize your life.

>>

>> Go to chapter 9 and do the 14 day challenge. Tell your Dr you are

doing this as your BP may plummet if you are on other meds in only 2-3 days.

>>

>> or

>>

>> go to http://www.nhlbi.nih.gov/health/public/heart/hbp/dash/new_dash.pdf

>>

>> download this 64 page booklet free and do the Week on the DASH Diet

for 2 weeks. If you are on BP meds be prepared for a large fall in BP and let

your Dr. know you are doing this.

>>

>> Or go to (but costs money)

>>

>> DASH Diet for Health Program

>> The DASH Diet for Health Program is designed to help you improve your

eating and exercise habits. Twice each week we will provide you with

information on our website about food, food preparation, eating out, losing

weight, getting fit and much more. In addition to providing new information

each week on our website, we create a web page specially for you where you can

track progress in areas such as your weight, blood pressure, and exercise.

>> http://www.dashforhealth.com/

>>

>> I strongly recommend you get the book and read it now!

>>

>> 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. Your

life is in the hands of those who measure your BP. 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. There is a brief

discussion of this in my Evolution Article.

>>

>> 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 high salt diet for 2 weeks-at least 4000 mg of Na a day.

>> 2. No BP meds in last 4-12 weeks depending on meds and Drs advice.

>> 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 1-4 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. I call this Dr. Grim’s “Quick Pee Test†for

PA.

>>

>> Our PA Registry: If you have been Dxed with PA already and are on Rx or

have had surgery please go

>>

>> to http://www.kwiksurveys.com/online-survey.php?surveyID=HIJIO_f2685379

>>

>> and complete our survey with as much information as you know. If there

is some information you don't know ask us and we will help. If you need to

update this as you journey thru the diagnostic/treatment process you can add

another entry but label it as Nameyymmdd. For example today 4/20/11 for me

would be Grim110420. This way of writing the date is an ever increasing number

and will allow us and you to sort your multiple entries into a dated order. We

are working on a more extensive database.

>>

>> 8. Learn the language: If you are new to medical lingo then download

the acroyms from

>>

>> http://health.groups.yahoo.com/group/bloodpressureline/message/29186

>> 9. Salt and high blood pressure: To learn the state of the science of

salt and blood pressure please spend some time looking at

>> http://www.worldactiononsalt.com/evidence/treatment_trials.htm

>> 10. Become a HBP expert consumer: Expect that it will take at least

several weeks to get all this digested and to learn the new language of high

blood pressure health care. As most doctors and nurses in practice have had

very little training in high blood pressure you must become an expert yourself.

For example most have never had anyone listen with them with a double

stethoscope to verify that they can hear BP sounds.

>>

>> We cannot make you a doctor but we will make you a pretty good BP

doctor.

>> 11. How High Blood Pressure should be managed:

>> Go to nih.gov and download and read the Joint National Commission

(JNC) Report 7 to get an overview on current guidelines. I ask all my

secretaries to read this so they can communicate the importance of high blood

pressure to my patients. JNC 8 will be out soon.

>> Then: get (and study) the Hypertension Primer from americanheart.org.

This is the most up-to-date compendium of what is known about high blood

pressure and what every Dr. should know when they graduate from Medical School.

Every chapter is only 2-3 pages. Read one chapter every week-night and you will

finish it in about a year. I am working on a reading guide for lay people for

the Primer. Stay tuned.

>> 12. Ask us questions: Ask any questions about high blood pressure you

want answered. That is what we are here for.

>> 13. One-on-one Consulting: I can provide individual consulting if you

do not want to go public. If you want individual one-on-one consulting for you

and your Doctor contract me directly at lowerbp2@....

>> May your pressure be low!

>> Clarence E. Grim BS, MS, MD, FACP, FACC

>> Board Certified in Internal Medicine, Geriatrics, and High Blood

Pressure

>>

>> Specializing in Primary Aldosteronism and Difficult to Control High

Blood Pressure.

>>

>>

>>

>>

>>

>>> Dr. Grim,

>>>

>>> Thanks for your email. I have a summary of my story up on the

yahoo site.

>>>

>>> I have high blood pressure and low potassium from the adrenal

bump.

>>>

>>> I found out on Monday that I was pregnant and went to my doc

immediately. She conferred with my Nephrologist and they took me off Lisinopril

and potassium chloride and switched me over to 25 mg Eperenone.

>>>

>>> For the pregnancy, I have low progesterone so I am starting 200 mg

capsules tonight. Sounds like I should be monitoring my blood pressure really

closely if this could affect my PA.

>>>

>>> I met with the Nephrologist today and he gave me the names of two

surgeons at University of Colorado Hospital and suggested that I make the

appointment with them as the next step to see what they would recommend. I also

have a call into my endocrinologist. He is recommending surgery after I am 12

weeks along.

>>>

>>> So good to hear about PA getting better during pregnancy.

>>>

>>> This is all way way too ov

Link to comment
Share on other sites
Guest guest

Guest guest

Posted
Posted

Hi ,

I'm 8 weeks pregnant with PA. This is my 6th baby and I'm 39yrs old. I was

diagnosed w/ PA 4 yrs ago shortly after the birth of my last baby. My BP was

normal until delivery. I'm not on BP meds now but was on 200 mg of Spiro before

getting diet under control. I'm very nervous about my BP going up and the docs

pushing meds at me this time around.

>

> Dr. Grim,

>

> Thank you for your email. Unfortunately we don't have the funds to be able to

hire you for the year of consulting. We are having mounting medical bills as

you can imagine and now the unexpected baby. I, of course, just two weeks ago,

got rid of the very last of our baby things from our first child so we are

having to start all over again. Figures!!!

>

> Do you know if there are any studies out there on PA during pregnancy? I

would love to read up on what is out there.

>

> I was not PG when the 24 urine aldo was done.

>

> Blood ado was 19. Renin was less than 0.6 ng/mL/h. This was when my

potassium was around 3.0. It also has the following on the lab results

although I don't know what it means:

> (Peripheral vein specimen)

> Na-depleted, upright:

> Mean: 10.8

> Range - 2.9-24

> Na-replete, upright

> Mean 1.9

> Range less than or equal to 0.6-4.3

>

> Can you connect me with the other pregnant person in the group? I would love

to write her and ask about her situation.

>

> I should tell the surgeon that he should take on my case as a study and not

charge me! He is at a university hospital. Maybe I am a good freak of nature!

>

> Cheers,

>

>

>

>

>

>

>

>

>

> Re: Anyone pregnant with PA?

> Posted by: " Clarence Grim " lowerbp2@... lowerbp2

> Wed May 25, 2011 10:06 pm (PDT)

>

>

>

> We think the improvement in BP in PA is related to the marked increase

> in progesterone that occurs during pregnancy.

>

> The treatment of PA during pregnancy has not been well studied.

>

> Were you PG when 24 urine aldo done?

>

> Any renin or blood aldo numbers?

>

> What is your family Hx of HTN and stroke esp in young men. See item 5

> below.

> Happy to share my knowledge and expertise on a consulting basis with

> you and team on this issue.

>

> My 1 year consulting charge is $500. This gives you and team unlimited

> access to my expertise by email, tele, or Skype.

>

> CEGrim MD

>

Link to comment
Share on other sites
Guest guest

Guest guest

Posted
Posted

congrats on #6. We are having our 8th (this one broke through the barriers as my

wife was on birth control) and she is 42 and I am 44! We have 3 boys 3 girls and

# 7 was a little boy we lost at birth so we know already his one is a girl and

will make us 4 and 4 boys to girls. Nice and even. Older makes us wiser, but

hard physically for my wife.

>Hi ,

>

>I'm 8 weeks pregnant with PA. This is my 6th baby and I'm 39yrs old. I was

diagnosed w/ PA 4 yrs ago shortly after the birth of my last baby. My BP was

normal until delivery. I'm not on BP meds now but was on 200 mg of Spiro before

getting diet under control. I'm very nervous about my BP going up and the docs

pushing meds at me this time around.

>

>

>

>

>>

>> Dr. Grim,

>>

>> Thank you for your email. Unfortunately we don't have the funds to be able

to hire you for the year of consulting. We are having mounting medical bills as

you can imagine and now the unexpected baby. I, of course, just two weeks ago,

got rid of the very last of our baby things from our first child so we are

having to start all over again. Figures!!!

>>

>> Do you know if there are any studies out there on PA during pregnancy? I

would love to read up on what is out there.

>>

>> I was not PG when the 24 urine aldo was done.

>>

>> Blood ado was 19. Renin was less than 0.6 ng/mL/h. This was when my

potassium was around 3.0. It also has the following on the lab results

although I don't know what it means:

>> (Peripheral vein specimen)

>> Na-depleted, upright:

>> Mean: 10.8

>> Range - 2.9-24

>> Na-replete, upright

>> Mean 1.9

>> Range less than or equal to 0.6-4.3

>>

>> Can you connect me with the other pregnant person in the group? I would love

to write her and ask about her situation.

>>

>> I should tell the surgeon that he should take on my case as a study and not

charge me! He is at a university hospital. Maybe I am a good freak of nature!

>>

>> Cheers,

>>

>>

>>

>>

>>

>>

>>

>>

>>

>> Re: Anyone pregnant with PA?

>> Posted by: " Clarence Grim " lowerbp2@... lowerbp2

>> Wed May 25, 2011 10:06 pm (PDT)

>>

>>

>>

>> We think the improvement in BP in PA is related to the marked increase

>> in progesterone that occurs during pregnancy.

>>

>> The treatment of PA during pregnancy has not been well studied.

>>

>> Were you PG when 24 urine aldo done?

>>

>> Any renin or blood aldo numbers?

>>

>> What is your family Hx of HTN and stroke esp in young men. See item 5

>> below.

>> Happy to share my knowledge and expertise on a consulting basis with

>> you and team on this issue.

>>

>> My 1 year consulting charge is $500. This gives you and team unlimited

>> access to my expertise by email, tele, or Skype.

>>

>> CEGrim MD

>>

>

>

Link to comment
Share on other sites
Guest guest

Guest guest

Posted
Posted

Would work on DASHing but check with your team. CE Grim MDcongrats on #6. We are having our 8th (this one broke through the barriers as my wife was on birth control) and she is 42 and I am 44! We have 3 boys 3 girls and # 7 was a little boy we lost at birth so we know already his one is a girl and will make us 4 and 4 boys to girls. Nice and even. Older makes us wiser, but hard physically for my wife.>Hi ,>>I'm 8 weeks pregnant with PA. This is my 6th baby and I'm 39yrs old. I was diagnosed w/ PA 4 yrs ago shortly after the birth of my last baby. My BP was normal until delivery. I'm not on BP meds now but was on 200 mg of Spiro before getting diet under control. I'm very nervous about my BP going up and the docs pushing meds at me this time around.>> >>>>>> Dr. Grim,>> >> Thank you for your email. Unfortunately we don't have the funds to be able to hire you for the year of consulting. We are having mounting medical bills as you can imagine and now the unexpected baby. I, of course, just two weeks ago, got rid of the very last of our baby things from our first child so we are having to start all over again. Figures!!!>> >> Do you know if there are any studies out there on PA during pregnancy? I would love to read up on what is out there.>> >> I was not PG when the 24 urine aldo was done. >> >> Blood ado was 19. Renin was less than 0.6 ng/mL/h. This was when my potassium was around 3.0. It also has the following on the lab results although I don't know what it means:>> (Peripheral vein specimen)>> Na-depleted, upright:>> Mean: 10.8>> Range - 2.9-24>> Na-replete, upright>> Mean 1.9>> Range less than or equal to 0.6-4.3>> >> Can you connect me with the other pregnant person in the group? I would love to write her and ask about her situation. >> >> I should tell the surgeon that he should take on my case as a study and not charge me! He is at a university hospital. Maybe I am a good freak of nature!>> >> Cheers,>> >> >> >> >> >> >> >> >> >> Re: Anyone pregnant with PA?>> Posted by: "Clarence Grim" lowerbp2@... lowerbp2>> Wed May 25, 2011 10:06 pm (PDT)>> >> >> >> We think the improvement in BP in PA is related to the marked increase >> in progesterone that occurs during pregnancy.>> >> The treatment of PA during pregnancy has not been well studied.>> >> Were you PG when 24 urine aldo done?>> >> Any renin or blood aldo numbers?>> >> What is your family Hx of HTN and stroke esp in young men. See item 5 >> below.>> Happy to share my knowledge and expertise on a consulting basis with >> you and team on this issue.>> >> My 1 year consulting charge is $500. This gives you and team unlimited >> access to my expertise by email, tele, or Skype.>> >> CEGrim MD>>>>

Link to comment
Share on other sites
Guest guest

Guest guest

Posted
Posted

,

First of all, congratulations on your pregnancy!!

I am pretty sure I had PA during both of my pregnancies (it wasn't

diagnosed until afterwards). This is what I can tell you about my

pregnancies. I had a hard time getting pregnant for my first pregnancy,

but was finally able to get pregnant with fertility treatments. Once

pregnant, my blood pressure was ok until the second half of the

pregnancy. Then it started going up. I then ended up on bedrest and was

transferred to a perinatal doctor (ob that specializes in higher risk

pregnancies). They closely watched my blood pressure. I took labetalol

and methyldopa (regarded as the blood pressure meds to take during

pregnancy). I had a c-section at 38 weeks for my first pregnancy (due to

my daughter being small and my increasing blood pressure) and 39 weeks

for my second pregnancy. After pregnancy, I was diagnosed with high

blood pressure as it never returned to normal.

There was an article someone posted about PA during pregnancy that

should be in the database somewhere. In the article they treated the

blood pressure during pregnancy with meds and not surgery. What I can

tell you about my pregnancy is that while it was not fun, with my good

medical team and control of blood pressure with meds, I was able to go

full term. I would strongly suggest that you go to a perinatal doc as

they will constantly check fetal growth and closely monitor your blood

pressure. At the first sign of anything, they will do testing, etc to

ensure the best outcome for both you and the baby.

Some of the PA symptoms I had during pregnancy were very frequent heart

palpitations (probably due to low potassium), frequent nightime bathroom

trips, fatigue, and high blood pressure. As you can see, most of those

symptoms are consistant with a normal pregnancy, except for the heart

palpitations. I had a potassium test shortly after pregnancy and my

potassium was low and continued to be low. You are fortunate to have a

diagnosis before pregnancy so your medical team knows what to look for.

Is this your first pregnancy? My experience was that my second pregnancy

was somewhat easier than my first.

Please let me know if you have any questions. While I am not a doctor, I

hope that maybe I can at least be able to offer some answers or

reassurance to you.

polymac

>

> So I just found out I am pregnant (and you all are finding out before

my mom). A total surprise (we gave up last year after a year of

fertility treatments) and I just had my CT scan last week so not so

great. They found a adrenal adenoma and the doc was researching finding

a surgeon to take it out. Has anyone been in this boat????? Would love

to get some input on what other people have done.

>

> Thanks!

>

>

Link to comment
Share on other sites
Guest guest

Guest guest

Posted
Posted

Farah,

I am on a 200 mg progesterone nightly if that gives you an idea of the dosage

during pregnancy. I am not sure if that is the amount needed overall for

pregnancy or if this is just to get me up to the required level.

The list of potential side effects with the meds is pretty awful.

Cheers,

Re: Anyone pregnant with PA?

Posted by: " Clarence Grim " lowerbp2@... lowerbp2

Thu May 26, 2011 5:42 am (PDT)

I believe progesterone has other long term effects that are not desirable. But

not my area of expertise.

Good thinking. The levels in preg are many times higher than what we give for

other problems.

Tiped sad Send form mi

iPhone ;-)

May your pressure be low!

CE Grim MD

Specializing in Difficult

Hypertension

> Dr Grim:

> If the increase in progesterone causes improvements in PA in pregnancy, then

should women take progesterone be at along with a lower dose of Spiro--or could

progesterone alone be used as an treatment?

>

> Just a thought!

>

> Farah

>

Link to comment
Share on other sites
Guest guest

Guest guest

Posted
Posted

Val,

I am on 200 mg prometrium (taken vaginally). The list of side effects includes;

" nausea, bloating, breast tenderness, headache, change in vaginal discharge,

mood swings, blurred vision, dizziness, or drowsiness may occur. Others:

unusual vaginal bleeding, mental.mood changes (depression, memory loss),

swelling of hands/feet, persistent nausea/vomiting, dark urine, unusual

tiredness. This medication may rarely cause very serous (possibly fatal)

problems from blood clots (heart attach, stroke, blood clots in the lungs or

legs, blindness). Seek immediate medical attention if you experience any of the

following: chest/jaw/left arm pain, weakness on one side of the body, slurred

speech, difficulty walking, sudden vision changes, confusion, sudden severe

headache, severe dizziness, fainting, trouble breathing, coughing up blood,

pain/redness/weakness of thswellinge arms/legs, calf pain/swelling that is warm

to the touch. A very serious reaction to this drug is rare. Symptoms include:

rash, itching/swelling,, severe dizziness, trouble breathing. This is not a

complete list of possible side effects......... "

Cheers,

Re: Anyone pregnant with PA?

Posted by: " Valarie " val@... val1198

Thu May 26, 2011 10:25 am (PDT)

Do you know what the " other side effects and risks " are? Was he talking about

progesterone or the progestins? I take 100 mg progesterone every day.

Val

From: hyperaldosteronism

[mailto:hyperaldosteronism ] On Behalf Of Bingham

Sent: Thursday, May 26, 2011 9:16 AM

To: hyperaldosteronism

Subject: Re: Re: Anyone pregnant with PA?

I asked the pharmacist this very question in the topic of spiro side effects and

he stated that the other side effects and risks would outweigh it

>Dr Grim:

>If the increase in progesterone causes improvements in PA in pregnancy, then

should women take progesterone be at along with a lower dose of Spiro--or could

progesterone alone be used as an treatment?

>

>Just a thought!

>

>Farah

Link to comment
Share on other sites
Guest guest

Guest guest

Posted
Posted

Thanks for the story. Can you start a file in our Conn's stories file entitled Pregnancy stories.Thanks,CE Grim MD,First of all, congratulations on your pregnancy!!I am pretty sure I had PA during both of my pregnancies (it wasn'tdiagnosed until afterwards). This is what I can tell you about mypregnancies. I had a hard time getting pregnant for my first pregnancy,but was finally able to get pregnant with fertility treatments. Oncepregnant, my blood pressure was ok until the second half of thepregnancy. Then it started going up. I then ended up on bedrest and wastransferred to a perinatal doctor (ob that specializes in higher riskpregnancies). They closely watched my blood pressure. I took labetaloland methyldopa (regarded as the blood pressure meds to take duringpregnancy). I had a c-section at 38 weeks for my first pregnancy (due tomy daughter being small and my increasing blood pressure) and 39 weeksfor my second pregnancy. After pregnancy, I was diagnosed with highblood pressure as it never returned to normal.There was an article someone posted about PA during pregnancy thatshould be in the database somewhere. In the article they treated theblood pressure during pregnancy with meds and not surgery. What I cantell you about my pregnancy is that while it was not fun, with my goodmedical team and control of blood pressure with meds, I was able to gofull term. I would strongly suggest that you go to a perinatal doc asthey will constantly check fetal growth and closely monitor your bloodpressure. At the first sign of anything, they will do testing, etc toensure the best outcome for both you and the baby.Some of the PA symptoms I had during pregnancy were very frequent heartpalpitations (probably due to low potassium), frequent nightime bathroomtrips, fatigue, and high blood pressure. As you can see, most of thosesymptoms are consistant with a normal pregnancy, except for the heartpalpitations. I had a potassium test shortly after pregnancy and mypotassium was low and continued to be low. You are fortunate to have adiagnosis before pregnancy so your medical team knows what to look for.Is this your first pregnancy? My experience was that my second pregnancywas somewhat easier than my first.Please let me know if you have any questions. While I am not a doctor, Ihope that maybe I can at least be able to offer some answers orreassurance to you.polymac>> So I just found out I am pregnant (and you all are finding out beforemy mom). A total surprise (we gave up last year after a year offertility treatments) and I just had my CT scan last week so not sogreat. They found a adrenal adenoma and the doc was researching findinga surgeon to take it out. Has anyone been in this boat????? Would loveto get some input on what other people have done.>> Thanks!> >

Link to comment
Share on other sites
Guest guest

Guest guest

Posted
Posted

Not my area of expertise. CE Grim MDFarah,I am on a 200 mg progesterone nightly if that gives you an idea of the dosage during pregnancy. I am not sure if that is the amount needed overall for pregnancy or if this is just to get me up to the required level.The list of potential side effects with the meds is pretty awful. Cheers,Re: Anyone pregnant with PA?Posted by: "Clarence Grim" lowerbp2@... lowerbp2Thu May 26, 2011 5:42 am (PDT)I believe progesterone has other long term effects that are not desirable. But not my area of expertise. Good thinking. The levels in preg are many times higher than what we give for other problems. Tiped sad Send form miiPhone ;-)May your pressure be low!CE Grim MDSpecializing in DifficultHypertension> Dr Grim:> If the increase in progesterone causes improvements in PA in pregnancy, then should women take progesterone be at along with a lower dose of Spiro--or could progesterone alone be used as an treatment?> > Just a thought! > > Farah >

Link to comment
Share on other sites
Guest guest

Guest guest

Posted
Posted

Be sure to read if it is recommended or approved for use during pregnancy.CE Grim MDVal,I am on 200 mg prometrium (taken vaginally). The list of side effects includes;"nausea, bloating, breast tenderness, headache, change in vaginal discharge, mood swings, blurred vision, dizziness, or drowsiness may occur. Others: unusual vaginal bleeding, mental.mood changes (depression, memory loss), swelling of hands/feet, persistent nausea/vomiting, dark urine, unusual tiredness. This medication may rarely cause very serous (possibly fatal) problems from blood clots (heart attach, stroke, blood clots in the lungs or legs, blindness). Seek immediate medical attention if you experience any of the following: chest/jaw/left arm pain, weakness on one side of the body, slurred speech, difficulty walking, sudden vision changes, confusion, sudden severe headache, severe dizziness, fainting, trouble breathing, coughing up blood, pain/redness/weakness of thswellinge arms/legs, calf pain/swelling that is warm to the touch. A very serious reaction to this drug is rare. Symptoms include: rash, itching/swelling,, severe dizziness, trouble breathing. This is not a complete list of possible side effects........."Cheers,Re: Anyone pregnant with PA?Posted by: "Valarie " val@... val1198Thu May 26, 2011 10:25 am (PDT)Do you know what the "other side effects and risks" are? Was he talking about progesterone or the progestins? I take 100 mg progesterone every day.ValFrom: hyperaldosteronism [mailto:hyperaldosteronism ] On Behalf Of BinghamSent: Thursday, May 26, 2011 9:16 AMTo: hyperaldosteronism Subject: Re: Re: Anyone pregnant with PA?I asked the pharmacist this very question in the topic of spiro side effects and he stated that the other side effects and risks would outweigh it>Dr Grim:>If the increase in progesterone causes improvements in PA in pregnancy, then should women take progesterone be at along with a lower dose of Spiro--or could progesterone alone be used as an treatment?>>Just a thought! >>Farah

Link to comment
Share on other sites
Guest guest

Guest guest

Posted
Posted

Have had two successful pregnancies after HTN diagnosis, one after PA diagnosis though I think I had PAf rom the start. BP is always great in pregnancy. Have had uncomplicated pregnancies though the last one did have some pretty uncomfortable varicose veins - think that was more age and the fact that it was pregnancy #6. Will be happy to share anything that may help you. Congratulations on your new little one!,40 yo WF, 5 kids, Marine Corps wife, diagnosed PA 2007To: hyperaldosteronism Sent: Wed, May 25, 2011 12:06:52 AMSubject: Anyone pregnant with PA?

So I just found out I am pregnant (and you all are finding out before my mom). A total surprise (we gave up last year after a year of fertility treatments) and I just had my CT scan last week so not so great. They found a adrenal adenoma and the doc was researching finding a surgeon to take it out. Has anyone been in this boat????? Would love to get some input on what other people have done.

Thanks!

Link to comment
Share on other sites

Join the conversation

You are posting as a guest. If you have an account, sign in now to post with your account.
Note: Your post will require moderator approval before it will be visible.

Guest
Reply to this topic...

×   Pasted as rich text.   Paste as plain text instead

  Only 75 emoji are allowed.

×   Your link has been automatically embedded.   Display as a link instead

×   Your previous content has been restored.   Clear editor

×   You cannot paste images directly. Upload or insert images from URL.

Loading...
×
 Share
Go to topic listing
×
×
  • Create New...