Guest guest Posted June 27, 2011 Report Share Posted June 27, 2011 Probably need to up the potassium. I shouldnt, but i experiment with my doses to watch the relationship to symptoms. If it were me, I would take another 20 meq of potassium and check back in a few hours. I would bet your pressure will drop. My father-in-law started drinking some low Sodium V8, as i suggested, and he is amazed that his BP is now lower than it has been in years. Too bad you cant tolerate it. That is a good natural way to suppliment without having to rely on the pills. Although the pills are cheap, so no big deal to just take them. ============================================================================45-Male-Caucasian, 5'9"- 234lbs, PA Diagnosed 2007 Suspected Hyperplasia-No tumors on CT - No AVS.Meds: 100mg Spiro, 1800mg Calcium, 1000mg Magnesium, 100,000UI Vit D (weekly), 20mg OmeprazoleSide effects: Gynecomastia, stomach inflammationOther Diags: GERD, Hiatal Hernia, Metabolic Syndrome - PreDiabetic, Secondary Hyperparathyroidism caused by Renal calcium leak, Bone Cyct in left Femoral Head and Pelvis. Benign Lung Nodules, Fibromyalgia, Scarring on Right Kidney Lower Pole, Right Flank PainDASH: Started "sort of" DASHing 5/3/2011To: hyperaldosteronism Sent: Monday, June 27, 2011 1:06 PMSubject: Re: spiro, day 2 Thanks . I actually think my doc cut back the K too much too soon and will discuss this at my next appointment later this week. This is my 6th day of spiro and outside of that one 129/90 reading, my BP has remained higher than usual - average 150s/low 100s rather than my unmedicated 140s/low 90s. This has me a bit worried! wrote: > > Sounds like you are on the right track and hope it continues! (I don't envy you with everything else you have going on!) Your Dr. treated your K a little differently than mine, they put me on Siro and did frequent tests to watch the K only eliminating it when the K started to reach max! You may be getting a peak and valley effect instesd of a liner progression! Hope they are right and it smooths out - Good Luck! > > - 64 yo morb. ob. male - 12mm X 13mm rt. a.adnoma with previous rt. flank & testicle pain. I have decided against an adrenalectomy at this time since Meds. are working so well. Current BP being watched after Oral Surgery and associated dietary changes. > Other Issues/Opportunities: COPD w/ft Oxygen, OSA w Bi-Pap settings 13/19, Type II Diab. and PTSD > Meds: Duloxetine hcl 80 MG, Mirtazapine 15 MG, Methadone 10 MG(titrating off S-L-O-W-L-Y) , Metoprolol Tartrate 200 MG, Metformin 2000MG, Lisinopril 2.5MG and Spironolactone 75 MG. > > > > > > > > > > > > Happy to report that this morning, my second day of spiro, my BP was 129/90. Not great but considering that it was running high 160s/100s yesterday, I think I can stop worrying that I was getting a paradoxical reaction of *increased* BP (which happened to me on Diovan, Cardizem, etc. etc.) > > > > > > > > The bad news is after cutting my K down from 60 MEQ/day to only 20 MEQ/day, my left trapezius muscle spasm is back in full force already. > > > > > > > > --msmith1928 > > > > Nulliparous female, 46, 5'3", 120 lbs, polymenorrhea, hyperinsulinemia, hereditary fructose intolerance, lactose intolerance, probable gluten intolerance. Current meds are spiro 12.5mg/dday, potassium 20MEQ/day, singulair 10mg, norethindrone .35mg to regulate polymenorrhea, cyclobenzaprine 5-10mg when needed, fexofenadine 180mg as needed. Low sodium, fructose- and grain-free diet. Known drug allergies include PCN, sulfa, tetracycline. 1cm left adrenal nodule, supine aldosterone 28.5/renin 0.2, potassium <2.9 (when not taking supplements), 25mg spiro caused gynecomastia and polymenorrhea. AVS showed right adrenal overproduces aldo; unable to sample left; proceeding as if my hyperaldosteronism is bilateral. > > > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 27, 2011 Report Share Posted June 27, 2011 Did he check your u Na? you can out salt Spiro. Tiped sad Send form miiPhone ;-)May your pressure be low!CE Grim MDSpecializing in DifficultHypertension Thanks . I actually think my doc cut back the K too much too soon and will discuss this at my next appointment later this week. This is my 6th day of spiro and outside of that one 129/90 reading, my BP has remained higher than usual - average 150s/low 100s rather than my unmedicated 140s/low 90s. This has me a bit worried! wrote: > > Sounds like you are on the right track and hope it continues! (I don't envy you with everything else you have going on!) Your Dr. treated your K a little differently than mine, they put me on Siro and did frequent tests to watch the K only eliminating it when the K started to reach max! You may be getting a peak and valley effect instesd of a liner progression! Hope they are right and it smooths out - Good Luck! > > - 64 yo morb. ob. male - 12mm X 13mm rt. a.adnoma with previous rt. flank & testicle pain. I have decided against an adrenalectomy at this time since Meds. are working so well. Current BP being watched after Oral Surgery and associated dietary changes. > Other Issues/Opportunities: COPD w/ft Oxygen, OSA w Bi-Pap settings 13/19, Type II Diab. and PTSD > Meds: Duloxetine hcl 80 MG, Mirtazapine 15 MG, Methadone 10 MG(titrating off S-L-O-W-L-Y) , Metoprolol Tartrate 200 MG, Metformin 2000MG, Lisinopril 2.5MG and Spironolactone 75 MG. > > > > > > > > > > > > Happy to report that this morning, my second day of spiro, my BP was 129/90. Not great but considering that it was running high 160s/100s yesterday, I think I can stop worrying that I was getting a paradoxical reaction of *increased* BP (which happened to me on Diovan, Cardizem, etc. etc.) > > > > > > > > The bad news is after cutting my K down from 60 MEQ/day to only 20 MEQ/day, my left trapezius muscle spasm is back in full force already. > > > > > > > > --msmith1928 > > > > Nulliparous female, 46, 5'3", 120 lbs, polymenorrhea, hyperinsulinemia, hereditary fructose intolerance, lactose intolerance, probable gluten intolerance. Current meds are spiro 12.5mg/dday, potassium 20MEQ/day, singulair 10mg, norethindrone .35mg to regulate polymenorrhea, cyclobenzaprine 5-10mg when needed, fexofenadine 180mg as needed. Low sodium, fructose- and grain-free diet. Known drug allergies include PCN, sulfa, tetracycline. 1cm left adrenal nodule, supine aldosterone 28.5/renin 0.2, potassium <2.9 (when not taking supplements), 25mg spiro caused gynecomastia and polymenorrhea. AVS showed right adrenal overproduces aldo; unable to sample left; proceeding as if my hyperaldosteronism is bilateral. > > > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 27, 2011 Report Share Posted June 27, 2011 I generally will cut K in half when first starting if it has been a problem in the past. Esp if K has been very low like yours.But then he knows you better. He may not know PA better. CE Grim MDSince spiro is supposed to normalize K pretty rapidly, my doctor told me to lower it. He said that usually when starting spiro, K is discontinued entirely, but since I get little K in my diet due to food intolerances he's keeping me on it but at a low dose.> >> > Happy to report that this morning, my second day of spiro, my BP was 129/90. Not great but considering that it was running high 160s/100s yesterday, I think I can stop worrying that I was getting a paradoxical reaction of *increased* BP (which happened to me on Diovan, Cardizem, etc. etc.)> > > > The bad news is after cutting my K down from 60 MEQ/day to only 20 MEQ/day, my left trapezius muscle spasm is back in full force already. > > > > --msmith1928> > Nulliparous female, 46, 5'3", 120 lbs, polymenorrhea, hyperinsulinemia, hereditary fructose intolerance, lactose intolerance, probable gluten intolerance. Current meds are spiro 12.5mg/dday, potassium 20MEQ/day, singulair 10mg, norethindrone .35mg to regulate polymenorrhea, cyclobenzaprine 5-10mg when needed, fexofenadine 180mg as needed. Low sodium, fructose- and grain-free diet. Known drug allergies include PCN, sulfa, tetracycline. 1cm left adrenal nodule, supine aldosterone 28.5/renin 0.2, potassium <2.9 (when not taking supplements), 25mg spiro caused gynecomastia and polymenorrhea. AVS showed right adrenal overproduces aldo; unable to sample left; proceeding as if my hyperaldosteronism is bilateral.> >> Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 27, 2011 Report Share Posted June 27, 2011 Being from MO and doing this for 45 years I like to see what's in the urine. Can sneak in many ways.Easy to check.Also only way to document Na and K intake and to see if K is higher than Na in urine-goal of DASH.CE Grim MDI average about 800mg of salt a day - doubtful this is an issue, as I never add salt to any food and do not eat anything prepared or processed. The only salt in my diet is what occurs naturally.> > > > > >> > > > > > Happy to report that this morning, my second day of spiro, my BP was 129/90. Not great but considering that it was running high 160s/100s yesterday, I think I can stop worrying that I was getting a paradoxical reaction of *increased* BP (which happened to me on Diovan, Cardizem, etc. etc.)> > > > > > > > > > > > The bad news is after cutting my K down from 60 MEQ/day to only 20 MEQ/day, my left trapezius muscle spasm is back in full force already. > > > > > > > > > > > > --msmith1928> > > > > > Nulliparous female, 46, 5'3", 120 lbs, polymenorrhea, hyperinsulinemia, hereditary fructose intolerance, lactose intolerance, probable gluten intolerance. Current meds are spiro 12.5mg/dday, potassium 20MEQ/day, singulair 10mg, norethindrone .35mg to regulate polymenorrhea, cyclobenzaprine 5-10mg when needed, fexofenadine 180mg as needed. Low sodium, fructose- and grain-free diet. Known drug allergies include PCN, sulfa, tetracycline. 1cm left adrenal nodule, supine aldosterone 28.5/renin 0.2, potassium <2.9 (when not taking supplements), 25mg spiro caused gynecomastia and polymenorrhea. AVS showed right adrenal overproduces aldo; unable to sample left; proceeding as if my hyperaldosteronism is bilateral.> > > > > >> > > > >> > > >> > >> > > >> Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 27, 2011 Report Share Posted June 27, 2011 Spiro usually reaches max at in 7-10 days as I recall. CE Grim MD Thanks for the input Dr Grim. I'm seeing him Wednesday and will be having the usual bloodwork done - if my K is below 4 I'm definitely going to tell him I think I need a higher dose. Also planning to ask if there's any immediate danger in keeping the dose higher for a few weeks until the spiro kicks in, since he's monitoring me weekly for the next month or so.> > > >> > > > Happy to report that this morning, my second day of spiro, my BP > > was 129/90. Not great but considering that it was running high 160s/ > > 100s yesterday, I think I can stop worrying that I was getting a > > paradoxical reaction of *increased* BP (which happened to me on > > Diovan, Cardizem, etc. etc.)> > > >> > > > The bad news is after cutting my K down from 60 MEQ/day to only > > 20 MEQ/day, my left trapezius muscle spasm is back in full force > > already.> > > >> > > > --msmith1928> > > > Nulliparous female, 46, 5'3", 120 lbs, polymenorrhea, > > hyperinsulinemia, hereditary fructose intolerance, lactose > > intolerance, probable gluten intolerance. Current meds are spiro > > 12.5mg/dday, potassium 20MEQ/day, singulair 10mg, norethindrone . > > 35mg to regulate polymenorrhea, cyclobenzaprine 5-10mg when needed, > > fexofenadine 180mg as needed. Low sodium, fructose- and grain-free > > diet. Known drug allergies include PCN, sulfa, tetracycline. 1cm > > left adrenal nodule, supine aldosterone 28.5/renin 0.2, potassium > > <2.9 (when not taking supplements), 25mg spiro caused gynecomastia > > and polymenorrhea. AVS showed right adrenal overproduces aldo; > > unable to sample left; proceeding as if my hyperaldosteronism is > > bilateral.> > > >> > >> >> >> >> Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 28, 2011 Report Share Posted June 28, 2011 What you want is a timed urine specimen. So figure out about when you wi be at dr if possible. If in AM I recommend u pee when When u get up to stay and record the time. Try not to before u go to dr if u can. When you get to dr office tell them u need to pee and want to collect the whole urine volume so it can be measured and then measure Na K and creatine in the urine. This can be converted to 24 hr estimates of your intake. Tiped sad Send form miiPhone ;-)May your pressure be low!CE Grim MDSpecializing in DifficultHypertension I'll ask the doc to do a pee test Wednesday. Wanted to make sure I've got this straight: are you saying that the K in urine should be higher than the NA? If it's not, then does that indicate that K supplements should be increased? (Assuming that salt intake can't be increased since I'm not adding salt to food and I'm not overeating or anything - there's no need for calorie cutting.) > > > > > > > > > > > > > > > > Happy to report that this morning, my second day of > > spiro, my BP was 129/90. Not great but considering that it was > > running high 160s/100s yesterday, I think I can stop worrying that I > > was getting a paradoxical reaction of *increased* BP (which happened > > to me on Diovan, Cardizem, etc. etc.) > > > > > > > > > > > > > > > > The bad news is after cutting my K down from 60 MEQ/day > > to only 20 MEQ/day, my left trapezius muscle spasm is back in full > > force already. > > > > > > > > > > > > > > > > --msmith1928 > > > > > > > > Nulliparous female, 46, 5'3", 120 lbs, polymenorrhea, > > hyperinsulinemia, hereditary fructose intolerance, lactose > > intolerance, probable gluten intolerance. Current meds are spiro > > 12.5mg/dday, potassium 20MEQ/day, singulair 10mg, norethindrone . > > 35mg to regulate polymenorrhea, cyclobenzaprine 5-10mg when needed, > > fexofenadine 180mg as needed. Low sodium, fructose- and grain-free > > diet. Known drug allergies include PCN, sulfa, tetracycline. 1cm > > left adrenal nodule, supine aldosterone 28.5/renin 0.2, potassium > > <2.9 (when not taking supplements), 25mg spiro caused gynecomastia > > and polymenorrhea. AVS showed right adrenal overproduces aldo; > > unable to sample left; proceeding as if my hyperaldosteronism is > > bilateral. > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > Quote Link to comment Share on other sites More sharing options...
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