K keeps getting lower, what can I do?

[Guest guest]

I just re-read the Evolution of PA article, and I still don't completely understand why as time goes on my K keeps getting lower and I have to keep adding more K pills. I did well on just one 20 MEQ tab per day for a couple of years... then it went up to two earlier this year, and now I'm up to four. The pills are starting to upset my stomach - I can tolerate three a day just fine, but the fourth one is starting to cause problems, which I think will just be counterproductive.Before anyone cries out anything about eating too much salt - I eat the same thing every day (and have done so all year long), all made by myself, with no added sodium. According to Fitday, my sodium does not exceed 880mg/day.The article notes that "hypokalemia might be precipitated by a low potassium intake, diuretic use, or extrarenal loss of potassium in sweat, vomit, or stool" - none of these apply at present other than the same low dietary K intake I've had all my life thanks to fructose intolerance.So - from reading the article, the only explanation I could glean was that as the tumor grows, the aldo production increases, the renin decreases, and the K decreases. Am I understanding correctly? Just wondering if there are any measures I can take to keep it from dropping lower? Increasing dietary K is out since I have hereditary fructose intolerance.--msmith1928Nulliparous

female, 46, 5'3", 120 lbs, polymenorrhea, hyperinsulinemia, hereditary fructose intolerance, lactose intolerance, probable gluten intolerance. Current meds are K 20 MEQ 4x/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

[Guest guest]

I just went to look up your K question and saw a table discussing electrolyte

disorders. They list something called " Hypernatremia " which as I understabd it

is water deprivation. I'll quote two sentences, " Hypernatremia occurs most

often as a result of water deprivation.... The presence of hypernatremia,

particularly when accompanied by hypokalemic alkalosis, should alert the

physcian to the possibility of primary aldosteronism. "

As you know, I am not a doctor but this may be the answer you are looking for,

it may not be too much NA but too little H2O to flush it from your system!

Since I had to look hypokalemic alkalosis up, here is what I found:

Hypokalemic alkalosis is caused by the kidneys' response to an extreme lack or

loss of potassium, which can occur when people take certain diuretic

medications.

Compensated alkalosis occurs when the body returns the acid - base balance to

normal in cases of alkalosis, but bicarbonate and carbon dioxide levels remain

abnormal.

Symptoms

•Confusion (can progress to stupor or coma)

•Hand tremor

•Lightheadedness

•Muscle twitching

•Nausea, vomiting

•Numbness or tingling in the face or extremities

•Prolonged muscle spasms (tetany)

Don't know if it applies but may be worth looking into as you wait for your AVS!

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(last week ave): 123/71

Other Issues/Opportunities: COPD w/ft Oxygen, OSA w Bi-Pap settings 13/19, DM2.

and PTSD

Meds: Duloxetine hcl 80 MG, Mirtazapine 15 MG, Metoprolol Tartrate 200 MG,

81mg asprin, Metformin 2000MG and Spironolactone 75 MG.

>

> I just re-read the Evolution of PA article, and I still don't completely

> understand why as time goes on my K keeps getting lower and I have to

> keep adding more K pills. I did well on just one 20 MEQ tab per day for

> a couple of years... then it went up to two earlier this year, and now

> I'm up to four. The pills are starting to upset my stomach - I can

> tolerate three a day just fine, but the fourth one is starting to cause

> problems, which I think will just be counterproductive.

>

> Before anyone cries out anything about eating too much salt - I eat the

> same thing every day (and have done so all year long), all made by

> myself, with no added sodium. According to Fitday, my sodium does not

> exceed 880mg/day.

>

> The article notes that " hypokalemia might be precipitated by a low

> potassium intake, diuretic use, or extrarenal loss of potassium in

> sweat, vomit, or stool " - none of these apply at present other than the

> same low dietary K intake I've had all my life thanks to fructose

> intolerance.

>

> So - from reading the article, the only explanation I could glean was

> that as the tumor grows, the aldo production increases, the renin

> decreases, and the K decreases. Am I understanding correctly?

>

> Just wondering if there are any measures I can take to keep it from

> dropping lower? Increasing dietary K is out since I have hereditary

> fructose intolerance.

>

>

> --msmith1928

> Nulliparous female, 46, 5'3 " , 120 lbs, polymenorrhea,

> hyperinsulinemia, hereditary fructose intolerance, lactose intolerance,

> probable gluten intolerance. Current meds are K 20 MEQ 4x/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

>

[Guest guest]

I'm 46, but estrogen loss hasn't happened yet. Mine's higher than normal, which

is why my docs think I have such a hard time with spiro.

The low birth weight bit is intriguing - I was 4 weeks early and one ounce away

from being placed in the ICU at birth. And I've been sensitive to salt my entire

life. Definitely going to do some reading about this and ask the nephrologist.

Now get out there and mow that lawn

> > > >

> > > > I just re-read the Evolution of PA article, and I still don't completely

> > > > understand why as time goes on my K keeps getting lower and I have to

> > > > keep adding more K pills. I did well on just one 20 MEQ tab per day for

> > > > a couple of years... then it went up to two earlier this year, and now

> > > > I'm up to four. The pills are starting to upset my stomach - I can

> > > > tolerate three a day just fine, but the fourth one is starting to cause

> > > > problems, which I think will just be counterproductive.

> > > >

> > > > Before anyone cries out anything about eating too much salt - I eat the

> > > > same thing every day (and have done so all year long), all made by

> > > > myself, with no added sodium. According to Fitday, my sodium does not

> > > > exceed 880mg/day.

> > > >

> > > > The article notes that " hypokalemia might be precipitated by a low

> > > > potassium intake, diuretic use, or extrarenal loss of potassium in

> > > > sweat, vomit, or stool " - none of these apply at present other than the

> > > > same low dietary K intake I've had all my life thanks to fructose

> > > > intolerance.

> > > >

> > > > So - from reading the article, the only explanation I could glean was

> > > > that as the tumor grows, the aldo production increases, the renin

> > > > decreases, and the K decreases. Am I understanding correctly?

> > > >

> > > > Just wondering if there are any measures I can take to keep it from

> > > > dropping lower? Increasing dietary K is out since I have hereditary

> > > > fructose intolerance.

> > > >

> > > >

> > > > --msmith1928

> > > > Nulliparous female, 46, 5'3 " , 120 lbs, polymenorrhea,

> > > > hyperinsulinemia, hereditary fructose intolerance, lactose intolerance,

> > > > probable gluten intolerance. Current meds are K 20 MEQ 4x/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

> > > >

> > >

> >

>

[Guest guest]

Believe you have this right but could be more to it.

from reading the article, the only explanation I could glean was

that as the tumor grows, the aldo production increases, the renin

decreases, and the K decreases. Am I understanding correctly?

I would asy your Dr if other forms of K might work better for you.

> > > > >

> > > > > I just re-read the Evolution of PA article, and I still don't

completely

> > > > > understand why as time goes on my K keeps getting lower and I have to

> > > > > keep adding more K pills. I did well on just one 20 MEQ tab per day

for

> > > > > a couple of years... then it went up to two earlier this year, and now

> > > > > I'm up to four. The pills are starting to upset my stomach - I can

> > > > > tolerate three a day just fine, but the fourth one is starting to

cause

> > > > > problems, which I think will just be counterproductive.

> > > > >

> > > > > Before anyone cries out anything about eating too much salt - I eat

the

> > > > > same thing every day (and have done so all year long), all made by

> > > > > myself, with no added sodium. According to Fitday, my sodium does not

> > > > > exceed 880mg/day.

> > > > >

> > > > > The article notes that " hypokalemia might be precipitated by a low

> > > > > potassium intake, diuretic use, or extrarenal loss of potassium in

> > > > > sweat, vomit, or stool " - none of these apply at present other than

the

> > > > > same low dietary K intake I've had all my life thanks to fructose

> > > > > intolerance.

> > > > >

> > > > > So - from reading the article, the only explanation I could glean was

> > > > > that as the tumor grows, the aldo production increases, the renin

> > > > > decreases, and the K decreases. Am I understanding correctly?

> > > > >

> > > > > Just wondering if there are any measures I can take to keep it from

> > > > > dropping lower? Increasing dietary K is out since I have hereditary

> > > > > fructose intolerance.

> > > > >

> > > > >

> > > > > --msmith1928

> > > > > Nulliparous female, 46, 5'3 " , 120 lbs, polymenorrhea,

> > > > > hyperinsulinemia, hereditary fructose intolerance, lactose

intolerance,

> > > > > probable gluten intolerance. Current meds are K 20 MEQ 4x/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

> > > > >

> > > >

> > >

> >

>

[Guest guest]

I drink none at all. I have hereditary fructose intolerance, which I clearly stated in my post. Tomatoes, the main ingredient in V8, are chock-full of fructose, and would make me vomit so much that I would lose even more K.> > > > > > >> > > > > > > I just re-read the Evolution of PA article, and I still don't completely> > > > > > > understand why as time goes on my K keeps getting lower and I have to> > > > > > > keep adding more K pills. I did well on just one 20 MEQ tab per day for> > > > > > > a couple of years... then it went up to two earlier this year, and now> > > > > > > I'm up to four. The pills are starting to upset my stomach - I can> > > > > > > tolerate three a day just fine, but the fourth one is starting to cause> > > > > > > problems, which I think will just be counterproductive.> > > > > > > > > > > > > > Before anyone cries out anything about eating too much salt - I eat the> > > > > > > same thing every day (and have done so all year long), all made by> > > > > > > myself, with no added sodium. According to Fitday, my sodium does not> > > > > > > exceed 880mg/day.> > > > > > > > > > > > > > The article notes that "hypokalemia might be precipitated by a low> > > > > > > potassium intake, diuretic use, or extrarenal loss of potassium in> > > > > > > sweat, vomit, or stool" - none of these apply at present other than the> > > > > > > same low dietary K intake I've had all my life thanks to fructose> > > > > > > intolerance.> > > > > > > > > > > > > > So - from reading the article, the only explanation I could glean was> > > > > > > that as the tumor grows, the aldo production increases, the renin> > > > > > > decreases, and the K decreases. Am I understanding correctly?> > > > > > > > > > > > > > Just wondering if there are any measures I can take to keep it from> > > > > > > dropping lower? Increasing dietary K is out since I have hereditary> > > > > > > fructose intolerance.> > > > > > > > > > > > > > > > > > > > > --msmith1928> > > > > > > Nulliparous female, 46, 5'3", 120 lbs, polymenorrhea,> > > > > > > hyperinsulinemia, hereditary fructose intolerance, lactose intolerance,> > > > > > > probable gluten intolerance. Current meds are K 20 MEQ 4x/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> > > > > > >> > > > > >> > > > >> > > >> > >> > > >>

[Guest guest]

You are correct. As the tumor enlarges it may mKe more Aldo. The best wAy to measure this would be with sequential 24 hr Urines for Aldo Na and K size and production are not very well correlated but not well studied in individuals Tiped sad Send form miiPhone ;-)May your pressure be low!CE Grim MDSpecializing in DifficultHypertension

I just re-read the Evolution of PA article, and I still don't completely understand why as time goes on my K keeps getting lower and I have to keep adding more K pills. I did well on just one 20 MEQ tab per day for a couple of years... then it went up to two earlier this year, and now I'm up to four. The pills are starting to upset my stomach - I can tolerate three a day just fine, but the fourth one is starting to cause problems, which I think will just be counterproductive.Before anyone cries out anything about eating too much salt - I eat the same thing every day (and have done so all year long), all made by myself, with no added sodium. According to Fitday, my sodium does not exceed 880mg/day.The article notes that "hypokalemia might be precipitated by a low potassium intake, diuretic use, or extrarenal loss of potassium in sweat, vomit, or stool" - none of these apply at present other than the same low dietary K intake I've had all my life thanks to fructose intolerance.So - from reading the article, the only explanation I could glean was that as the tumor grows, the aldo production increases, the renin decreases, and the K decreases. Am I understanding correctly? Just wondering if there are any measures I can take to keep it from dropping lower? Increasing dietary K is out since I have hereditary fructose intolerance.--msmith1928Nulliparous

female, 46, 5'3", 120 lbs, polymenorrhea, hyperinsulinemia, hereditary fructose intolerance, lactose intolerance, probable gluten intolerance. Current meds are K 20 MEQ 4x/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

[Guest guest]

I would also think as we age our metabolism slows down thus making us hold on to

aldo longer. Would seem both can happen tumor grows making more aldo and ageing

causes us to hold on to aldo.

>

> > I just re-read the Evolution of PA article, and I still don't completely

understand why as time goes on my K keeps getting lower and I have to keep

adding more K pills. I did well on just one 20 MEQ tab per day for a couple of

years... then it went up to two earlier this year, and now I'm up to four. The

pills are starting to upset my stomach - I can tolerate three a day just fine,

but the fourth one is starting to cause problems, which I think will just be

counterproductive.

> >

> > Before anyone cries out anything about eating too much salt - I eat the same

thing every day (and have done so all year long), all made by myself, with no

added sodium. According to Fitday, my sodium does not exceed 880mg/day.

> >

> > The article notes that " hypokalemia might be precipitated by a low potassium

intake, diuretic use, or extrarenal loss of potassium in sweat, vomit, or stool "

- none of these apply at present other than the same low dietary K intake I've

had all my life thanks to fructose intolerance.

> >

> > So - from reading the article, the only explanation I could glean was that

as the tumor grows, the aldo production increases, the renin decreases, and the

K decreases. Am I understanding correctly?

> >

> > Just wondering if there are any measures I can take to keep it from dropping

lower? Increasing dietary K is out since I have hereditary fructose intolerance.

> >

> >

> > --msmith1928

> > Nulliparous female, 46, 5'3 " , 120 lbs, polymenorrhea, hyperinsulinemia,

hereditary fructose intolerance, lactose intolerance, probable gluten

intolerance. Current meds are K 20 MEQ 4x/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

> >

> >

>

[Guest guest]

Dr. Grim, Re:msmith, she is preparing for an AVS so she is off Spiro! Did you

see my post re: salt-sensitivity? In the HTN Primer (Table A49.1) I see things

such as: " Delayed, half-life for urine sodium excretion; Dietary, Increased

prevalence in Nutritional potassium deficiency; Disproportionate rate of LVH

(which she mentioned in 2001).

I know this is hard to DX but is this a possibility and do you know of a way to

test? (If you tell me it is check NA in the urine and she tells me she is

consuming no more than 800mg of NA/day on a static diet we gain nothing!)

Thanks.

- 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(last week ave): 124/61

Other Issues/Opportunities: COPD w/ft Oxygen, OSA w Bi-Pap settings 13/19, DM2.

and PTSD

Meds: Duloxetine hcl 80 MG, Mirtazapine 15 MG, Metoprolol Tartrate 200 MG,

81mg asprin, Metformin 2000MG and Spironolactone 75 MG.

> > > > > > > > >

> > > > > > > > > I just re-read the Evolution of PA article, and I still don't

completely

> > > > > > > > > understand why as time goes on my K keeps getting lower and I

have to

> > > > > > > > > keep adding more K pills. I did well on just one 20 MEQ tab

per day for

> > > > > > > > > a couple of years... then it went up to two earlier this year,

and now

> > > > > > > > > I'm up to four. The pills are starting to upset my stomach - I

can

> > > > > > > > > tolerate three a day just fine, but the fourth one is starting

to cause

> > > > > > > > > problems, which I think will just be counterproductive.

> > > > > > > > >

> > > > > > > > > Before anyone cries out anything about eating too much salt -

I eat the

> > > > > > > > > same thing every day (and have done so all year long), all

made by

> > > > > > > > > myself, with no added sodium. According to Fitday, my sodium

does not

> > > > > > > > > exceed 880mg/day.

> > > > > > > > >

> > > > > > > > > The article notes that " hypokalemia might be precipitated by a

low

> > > > > > > > > potassium intake, diuretic use, or extrarenal loss of

potassium in

> > > > > > > > > sweat, vomit, or stool " - none of these apply at present other

than the

> > > > > > > > > same low dietary K intake I've had all my life thanks to

fructose

> > > > > > > > > intolerance.

> > > > > > > > >

> > > > > > > > > So - from reading the article, the only explanation I could

glean was

> > > > > > > > > that as the tumor grows, the aldo production increases, the

renin

> > > > > > > > > decreases, and the K decreases. Am I understanding correctly?

> > > > > > > > >

> > > > > > > > > Just wondering if there are any measures I can take to keep it

from

> > > > > > > > > dropping lower? Increasing dietary K is out since I have

hereditary

> > > > > > > > > fructose intolerance.

> > > > > > > > >

> > > > > > > > >

> > > > > > > > > --msmith1928

> > > > > > > > > Nulliparous female, 46, 5'3 " , 120 lbs, polymenorrhea,

> > > > > > > > > hyperinsulinemia, hereditary fructose intolerance, lactose

intolerance,

> > > > > > > > > probable gluten intolerance. Current meds are K 20 MEQ 4x/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

> > > > > > > > >

> > > > > > > >

> > > > > > >

> > > > > >

> > > > >

> > > >

> > > >

> > >

> >

>

[Guest guest]

Thanks , your memory is downright impressive! My doctors don't see the point of testing urine for dietary Na at this time since, as you pointed out, I don't exceed 800mg a day and I always eat the same thing. They know I'm not lying, and they know I'm intelligent enough to not be overlooking hidden sources of sodium. And they know that "drink some V8!" isn't going to be the answer for me.I'm trying to get my AVS scheduled for 8/19. If that falls through, it's not going to happen until early September since the IR is going on vacation. Meanwhile I'm probably worrying too much as my symptoms seem to have suddenly gotten worse since my short-lived spiro experiment.-msmith1928Nulliparous female, 46, 5'3", 120 lbs, polymenorrhea, hyperinsulinemia, hereditary fructose intolerance,

lactose intolerance, probable gluten intolerance. Current meds are K 20

MEQ 4x/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); spiro caused gynecomastia and polymenorrhea> > > > > > > > > >> > > > > > > > > > I just re-read the Evolution of PA article, and I still don't completely> > > > > > > > > > understand why as time goes on my K keeps getting lower and I have to> > > > > > > > > > keep adding more K pills. I did well on just one 20 MEQ tab per day for> > > > > > > > > > a couple of years... then it went up to two earlier this year, and now> > > > > > > > > > I'm up to four. The pills are starting to upset my stomach - I can> > > > > > > > > > tolerate three a day just fine, but the fourth one is starting to cause> > > > > > > > > > problems, which I think will just be counterproductive.> > > > > > > > > > > > > > > > > > > > Before anyone cries out anything about eating too much salt - I eat the> > > > > > > > > > same thing every day (and have done so all year long), all made by> > > > > > > > > > myself, with no added sodium. According to Fitday, my sodium does not> > > > > > > > > > exceed 880mg/day.> > > > > > > > > > > > > > > > > > > > The article notes that "hypokalemia might be precipitated by a low> > > > > > > > > > potassium intake, diuretic use, or extrarenal loss of potassium in> > > > > > > > > > sweat, vomit, or stool" - none of these apply at present other than the> > > > > > > > > > same low dietary K intake I've had all my life thanks to fructose> > > > > > > > > > intolerance.> > > > > > > > > > > > > > > > > > > > So - from reading the article, the only explanation I could glean was> > > > > > > > > > that as the tumor grows, the aldo production increases, the renin> > > > > > > > > > decreases, and the K decreases. Am I understanding correctly?> > > > > > > > > > > > > > > > > > > > Just wondering if there are any measures I can take to keep it from> > > > > > > > > > dropping lower? Increasing dietary K is out since I have hereditary> > > > > > > > > > fructose intolerance.> > > > > > > > > > > > > > > > > > > > > > > > > > > > > > --msmith1928> > > > > > > > > > Nulliparous female, 46, 5'3", 120 lbs, polymenorrhea,> > > > > > > > > > hyperinsulinemia, hereditary fructose intolerance, lactose intolerance,> > > > > > > > > > probable gluten intolerance. Current meds are K 20 MEQ 4x/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> > > > > > > > > >> > > > > > > > >> > > > > > > >> > > > > > >> > > > > >> > > > > > > > > >> > > >> > >> >>

[Guest guest]

It's not necessarily my memory, I can read with comprehension, I went to files

and read your very complete story and compared your history to some of the items

in the SS chapter of the HTN Primer. As for the AVS, I remember a conversation

we had in another group and your unique situation has kept my attention.

I know Dr. Grim has done some work on this, especially with African Americans so

I didn't try to go too far. Figure he can give us direction quite easily

although I haven't seen a good way to test for it.

- 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(last week ave): 124/61

Other Issues/Opportunities: COPD w/ft Oxygen, OSA w Bi-Pap settings 13/19, DM2.

and PTSD

Meds: Duloxetine hcl 80 MG, Mirtazapine 15 MG, Metoprolol Tartrate 200 MG,

81mg asprin, Metformin 2000MG and Spironolactone 75 MG.

> > > > > > > > > > >

> > > > > > > > > > > I just re-read the Evolution of PA article, and I

> still don't completely

> > > > > > > > > > > understand why as time goes on my K keeps getting

> lower and I have to

> > > > > > > > > > > keep adding more K pills. I did well on just one 20

> MEQ tab per day for

> > > > > > > > > > > a couple of years... then it went up to two earlier

> this year, and now

> > > > > > > > > > > I'm up to four. The pills are starting to upset my

> stomach - I can

> > > > > > > > > > > tolerate three a day just fine, but the fourth one

> is starting to cause

> > > > > > > > > > > problems, which I think will just be

> counterproductive.

> > > > > > > > > > >

> > > > > > > > > > > Before anyone cries out anything about eating too

> much salt - I eat the

> > > > > > > > > > > same thing every day (and have done so all year

> long), all made by

> > > > > > > > > > > myself, with no added sodium. According to Fitday,

> my sodium does not

> > > > > > > > > > > exceed 880mg/day.

> > > > > > > > > > >

> > > > > > > > > > > The article notes that " hypokalemia might be

> precipitated by a low

> > > > > > > > > > > potassium intake, diuretic use, or extrarenal loss

> of potassium in

> > > > > > > > > > > sweat, vomit, or stool " - none of these apply at

> present other than the

> > > > > > > > > > > same low dietary K intake I've had all my life

> thanks to fructose

> > > > > > > > > > > intolerance.

> > > > > > > > > > >

> > > > > > > > > > > So - from reading the article, the only explanation

> I could glean was

> > > > > > > > > > > that as the tumor grows, the aldo production

> increases, the renin

> > > > > > > > > > > decreases, and the K decreases. Am I understanding

> correctly?

> > > > > > > > > > >

> > > > > > > > > > > Just wondering if there are any measures I can take

> to keep it from

> > > > > > > > > > > dropping lower? Increasing dietary K is out since I

> have hereditary

> > > > > > > > > > > fructose intolerance.

> > > > > > > > > > >

> > > > > > > > > > >

> > > > > > > > > > > --msmith1928

> > > > > > > > > > > Nulliparous female, 46, 5'3 " , 120 lbs,

> polymenorrhea,

> > > > > > > > > > > hyperinsulinemia, hereditary fructose intolerance,

> lactose intolerance,

> > > > > > > > > > > probable gluten intolerance. Current meds are K 20

> MEQ 4x/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

> > > > > > > > > > >

> > > > > > > > > >

> > > > > > > > >

> > > > > > > >

> > > > > > >

> > > > > >

> > > > > >

> > > > >

> > > >

> > >

> >

>

[Guest guest]

As already stated:My doctors don't see the point of testing urine for dietary Na at this time.I'm just trying to understand why I was stable on a smaller dose of K for so long, and now it seems I have to keep increasing it, when nothing has changed other than three weeks on spiro.> > > > > > > > > > > >> > > > > > > > > > > > I just re-read the Evolution of PA article, and I still don't completely> > > > > > > > > > > > understand why as time goes on my K keeps getting lower and I have to> > > > > > > > > > > > keep adding more K pills. I did well on just one 20 MEQ tab per day for> > > > > > > > > > > > a couple of years... then it went up to two earlier this year, and now> > > > > > > > > > > > I'm up to four. The pills are starting to upset my stomach - I can> > > > > > > > > > > > tolerate three a day just fine, but the fourth one is starting to cause> > > > > > > > > > > > problems, which I think will just be counterproductive.> > > > > > > > > > > > > > > > > > > > > > > > Before anyone cries out anything about eating too much salt - I eat the> > > > > > > > > > > > same thing every day (and have done so all year long), all made by> > > > > > > > > > > > myself, with no added sodium. According to Fitday, my sodium does not> > > > > > > > > > > > exceed 880mg/day.> > > > > > > > > > > > > > > > > > > > > > > > The article notes that "hypokalemia might be precipitated by a low> > > > > > > > > > > > potassium intake, diuretic use, or extrarenal loss of potassium in> > > > > > > > > > > > sweat, vomit, or stool" - none of these apply at present other than the> > > > > > > > > > > > same low dietary K intake I've had all my life thanks to fructose> > > > > > > > > > > > intolerance.> > > > > > > > > > > > > > > > > > > > > > > > So - from reading the article, the only explanation I could glean was> > > > > > > > > > > > that as the tumor grows, the aldo pro>

[Guest guest]

Off - been off of it since July 13. Within a week of stopping it my K started

crashing.

> > > > > > > > > > > > > >

> > > > > > > > > > > > > > I just re-read the Evolution of PA article, and I

still don't completely

> > > > > > > > > > > > > > understand why as time goes on my K keeps getting

lower and I have to

> > > > > > > > > > > > > > keep adding more K pills. I did well on just one 20

MEQ tab per day for

> > > > > > > > > > > > > > a couple of years... then it went up to two earlier

this year, and now

> > > > > > > > > > > > > > I'm up to four. The pills are starting to upset my

stomach - I can

> > > > > > > > > > > > > > tolerate three a day just fine, but the fourth one

is starting to cause

> > > > > > > > > > > > > > problems, which I think will just be

counterproductive.

> > > > > > > > > > > > > >

> > > > > > > > > > > > > > Before anyone cries out anything about eating too

much salt - I eat the

> > > > > > > > > > > > > > same thing every day (and have done so all year

long), all made by

> > > > > > > > > > > > > > myself, with no added sodium. According to Fitday,

my sodium does not

> > > > > > > > > > > > > > exceed 880mg/day.

> > > > > > > > > > > > > >

> > > > > > > > > > > > > > The article notes that " hypokalemia might be

precipitated by a low

> > > > > > > > > > > > > > potassium intake, diuretic use, or extrarenal loss

of potassium in

> > > > > > > > > > > > > > sweat, vomit, or stool " - none of these apply at

present other than the

> > > > > > > > > > > > > > same low dietary K intake I've had all my life

thanks to fructose

> > > > > > > > > > > > > > intolerance.

> > > > > > > > > > > > > >

> > > > > > > > > > > > > > So - from reading the article, the only explanation

I could glean was

> > > > > > > > > > > > > > that as the tumor grows, the aldo pro

> > >

> >

>

[Guest guest]

My nephrologist DOES recommend low sodium diets - DASH, in fact.

BUT, he actually LISTENS to his patients too and treats them as

individuals rather than offering a one-size-fits-all, take-it-or-leave

it answer.

He is fully aware that due to the fructose intolerance, most high K

foods make me vomit, and that the headaches I get from ingesting excess

sodium are enough to guarantee compliance.

> > > > > > > > > > > > > >

> > > > > > > > > > > > > > I just re-read the Evolution of PA article,

and I still don't completely

> > > > > > > > > > > > > > understand why as time goes on my K keeps

getting lower and I have to

> > > > > > > > > > > > > > keep adding more K pills. I did well on just

one 20 MEQ tab per day for

> > > > > > > > > > > > > > a couple of years... then it went up to two

earlier this year, and now

> > > > > > > > > > > > > > I'm up to four. The pills are starting to

upset my stomach - I can

> > > > > > > > > > > > > > tolerate three a day just fine, but the

fourth one is starting to cause

> > > > > > > > > > > > > > problems, which I think will just be

counterproductive.

> > > > > > > > > > > > > >

> > > > > > > > > > > > > > Before anyone cries out anything about

eating too much salt - I eat the

> > > > > > > > > > > > > > same thing every day (and have done so all

year long), all made by

> > > > > > > > > > > > > > myself, with no added sodium. According to

Fitday, my sodium does not

> > > > > > > > > > > > > > exceed 880mg/day.

> > > > > > > > > > > > > >

> > > > > > > > > > > > > > The article notes that " hypokalemia might be

precipitated by a low

> > > > > > > > > > > > > > potassium intake, diuretic use, or

extrarenal loss of potassium in

> > > > > > > > > > > > > > sweat, vomit, or stool " - none of these

apply at present other than the

> > > > > > > > > > > > > > same low dietary K intake I've had all my

life thanks to fructose

> > > > > > > > > > > > > > intolerance.

> > > > > > > > > > > > > >

> > > > > > > > > > > > > > So - from reading the article, the only

explanation I could glean was

> > > > > > > > > > > > > > that as the tumor grows, the aldo pro

> > >

> >

>

[Guest guest]

Thanks, I hope you understand that telling me to drink V8 is like telling

someone with a peanut allergy to eat peanut butter - in other words, it is NEVER

going to happen, so no need to waste your time typing out that canned response!

My concern is that post-spiro, I'm having to take more K tabs than I ever had to

pre-spiro just to keep the level around 4.0. I'm convinced that darned drug has

done me more harm than good.

> > > > > > > > > > > > > > > >

> > > > > > > > > > > > > > > > I just re-read the Evolution of PA article,

> > and I still don't completely

> > > > > > > > > > > > > > > > understand why as time goes on my K keeps

> > getting lower and I have to

> > > > > > > > > > > > > > > > keep adding more K pills. I did well on just

> > one 20 MEQ tab per day for

> > > > > > > > > > > > > > > > a couple of years... then it went up to two

> > earlier this year, and now

> > > > > > > > > > > > > > > > I'm up to four. The pills are starting to

> > upset my stomach - I can

> > > > > > > > > > > > > > > > tolerate three a day just fine, but the

> > fourth one is starting to cause

> > > > > > > > > > > > > > > > problems, which I think will just be

> > counterproductive.

> > > > > > > > > > > > > > > >

> > > > > > > > > > > > > > > > Before anyone cries out anything about

> > eating too much salt - I eat the

> > > > > > > > > > > > > > > > same thing every day (and have done so all

> > year long), all made by

> > > > > > > > > > > > > > > > myself, with no added sodium. According to

> > Fitday, my sodium does not

> > > > > > > > > > > > > > > > exceed 880mg/day.

> > > > > > > > > > > > > > > >

> > > > > > > > > > > > > > > > The article notes that " hypokalemia might be

> > precipitated by a low

> > > > > > > > > > > > > > > > potassium intake, diuretic use, or

> > extrarenal loss of potassium in

> > > > > > > > > > > > > > > > sweat, vomit, or stool " - none of these

> > apply at present other than the

> > > > > > > > > > > > > > > > same low dietary K intake I've had all my

> > life thanks to fructose

> > > > > > > > > > > > > > > > intolerance.

> > > > > > > > > > > > > > > >

> > > > > > > > > > > > > > > > So - from reading the article, the only

> > explanation I could glean was

> > > > > > > > > > > > > > > > that as the tumor grows, the aldo pro

> > > > >

> > > >

> > >

> >

> >

>

[Guest guest]

Who knows, I might! I'm having alot of fun researching and am finding DXing is

alot like troubleshooting a computer, just follow the steps and don't make any

assumptions! If they only taught doctors to read with comprehension,a trait I

have already mastered, I would have been DXed 3 1/2 years earlier!

- 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(last week ave): 124/61

Other Issues/Opportunities: COPD w/ft Oxygen, OSA w Bi-Pap settings 13/19, DM2.

and PTSD

Meds: Duloxetine hcl 80 MG, Mirtazapine 15 MG, Metoprolol Tartrate 200 MG,

81mg asprin, Metformin 2000MG and Spironolactone 75 MG.

> > > > >

> > > > > I just re-read the Evolution of PA article, and I still don't

completely

> > > > > understand why as time goes on my K keeps getting lower and I have to

> > > > > keep adding more K pills. I did well on just one 20 MEQ tab per day

for

> > > > > a couple of years... then it went up to two earlier this year, and now

> > > > > I'm up to four. The pills are starting to upset my stomach - I can

> > > > > tolerate three a day just fine, but the fourth one is starting to

cause

> > > > > problems, which I think will just be counterproductive.

> > > > >

> > > > > Before anyone cries out anything about eating too much salt - I eat

the

> > > > > same thing every day (and have done so all year long), all made by

> > > > > myself, with no added sodium. According to Fitday, my sodium does not

> > > > > exceed 880mg/day.

> > > > >

> > > > > The article notes that " hypokalemia might be precipitated by a low

> > > > > potassium intake, diuretic use, or extrarenal loss of potassium in

> > > > > sweat, vomit, or stool " - none of these apply at present other than

the

> > > > > same low dietary K intake I've had all my life thanks to fructose

> > > > > intolerance.

> > > > >

> > > > > So - from reading the article, the only explanation I could glean was

> > > > > that as the tumor grows, the aldo production increases, the renin

> > > > > decreases, and the K decreases. Am I understanding correctly?

> > > > >

> > > > > Just wondering if there are any measures I can take to keep it from

> > > > > dropping lower? Increasing dietary K is out since I have hereditary

> > > > > fructose intolerance.

> > > > >

> > > > >

> > > > > --msmith1928

> > > > > Nulliparous female, 46, 5'3 " , 120 lbs, polymenorrhea,

> > > > > hyperinsulinemia, hereditary fructose intolerance, lactose

intolerance,

> > > > > probable gluten intolerance. Current meds are K 20 MEQ 4x/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

> > > > >

> > > >

> > >

> >

> >

>

[Guest guest]

"don't make any assumptions" - if they taught this in med school, my diagnosis might not have taken 10 years.> > > > > >> > > > > > I just re-read the Evolution of PA article, and I still don't completely> > > > > > understand why as time goes on my K keeps getting lower and I have to> > > > > > keep adding more K pills. I did well on just one 20 MEQ tab per day for> > > > > > a couple of years... then it went up to two earlier this year, and now> > > > > > I'm up to four. The pills are starting to upset my stomach - I can> > > > > > tolerate three a day just fine, but the fourth one is starting to cause> > > > > > problems, which I think will just be counterproductive.> > > > > > > > > > > > Before anyone cries out anything about eating too much salt - I eat the> > > > > > same thing every day (and have done so all year long), all made by> > > > > > myself, with no added sodium. According to Fitday, my sodium does not> > > > > > exceed 880mg/day.> > > > > > > > > > > > The article notes that "hypokalemia might be precipitated by a low> > > > > > potassium intake, diuretic use, or extrarenal loss of potassium in> > > > > > sweat, vomit, or stool" - none of these apply at present other than the> > > > > > same low dietary K intake I've had all my life thanks to fructose> > > > > > intolerance.> > > > > > > > > > > > So - from reading the article, the only explanation I could glean was> > > > > > that as the tumor grows, the aldo production increases, the renin> > > > > > decreases, and the K decreases. Am I understanding correctly?> > > > > > > > > > > > Just wondering if there are any measures I can take to keep it from> > > > > > dropping lower? Increasing dietary K is out since I have hereditary> > > > > > fructose intolerance.> > > > > > > > > > > > > > > > > > --msmith1928> > > > > > Nulliparous female, 46, 5'3", 120 lbs, polymenorrhea,> > > > > > hyperinsulinemia, hereditary fructose intolerance, lactose intolerance,> > > > > > probable gluten intolerance. Current meds are K 20 MEQ 4x/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> > > > > >> > > > >> > > >> > > > > >> >>

[Guest guest]

Now I feel like I'm talking to my kids when they were teenagers! Let me see if

I can be more specific. I know there is a term " salt sensitivity " and when you

are deemed to have this condition certain system and bodily functions behave

differently. When I see " Delayed half-life for urine sodium excretion " I

presume that means your body retains some of the sodium that would normally have

been expelled. That retained NA would then mix with new sodium that you injest

which in turn could cause a sodium overload. (If I carry this forward for each

" sodium excretion cycle " it could build each little bit by each little bit and

after say 46 years you could have a lot of little bits!) I presume this could

be a reason to have too much NA for K to increase, correct?

With that being said, my question was, is there any medical tests that you are

aware of to test for this condition?

I did some looking and found this:

" The Grim-Weinberger saline/furosemide protocol was used to identify SSH: Mean

arterial blood pressure (MAP, taken by a Spacelabs 2007) decreased by at least

10 mm Hg from the end of a 4hr saline infusion (500ml/hr saline) compared to the

MAP at the end of 24 hrs of salt depletion induced by 1 day of a 20 mM Na diet

and furosemide at 10 am, 2 pm and 6 pm. SSH was present in 61 (59%) of all

subjects. In H-C SSH was detected in 80%, in AA in 66% and in C in 34%. Baseline

neurohormones [mean ± SD (N)] are tabulated (See Table) "

I also saw mention od " The Grim Protocol and a " " modified Grim Protocol which I

tried to look up but I was locked 0ut.

Can you shed any light on this? thanks

- 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(last week ave): 124/61

Other Issues/Opportunities: COPD w/ft Oxygen, OSA w Bi-Pap settings 13/19, DM2.

and PTSD

Meds: Duloxetine hcl 80 MG, Mirtazapine 15 MG, Metoprolol Tartrate 200 MG,

81mg asprin, Metformin 2000MG and Spironolactone 75 MG.

> > > > > > > > > > > > >

> > > > > > > > > > > > > I just re-read the Evolution of PA article, and I

> > > still don't completely

> > > > > > > > > > > > > understand why as time goes on my K keeps getting

> > > lower and I have to

> > > > > > > > > > > > > keep adding more K pills. I did well on just one 20

> > > MEQ tab per day for

> > > > > > > > > > > > > a couple of years... then it went up to two earlier

> > > this year, and now

> > > > > > > > > > > > > I'm up to four. The pills are starting to upset my

> > > stomach - I can

> > > > > > > > > > > > > tolerate three a day just fine, but the fourth one

> > > is starting to cause

> > > > > > > > > > > > > problems, which I think will just be

> > > counterproductive.

> > > > > > > > > > > > >

> > > > > > > > > > > > > Before anyone cries out anything about eating too

> > > much salt - I eat the

> > > > > > > > > > > > > same thing every day (and have done so all year

> > > long), all made by

> > > > > > > > > > > > > myself, with no added sodium. According to Fitday,

> > > my sodium does not

> > > > > > > > > > > > > exceed 880mg/day.

> > > > > > > > > > > > >

> > > > > > > > > > > > > The article notes that " hypokalemia might be

> > > precipitated by a low

> > > > > > > > > > > > > potassium intake, diuretic use, or extrarenal loss

> > > of potassium in

> > > > > > > > > > > > > sweat, vomit, or stool " - none of these apply at

> > > present other than the

> > > > > > > > > > > > > same low dietary K intake I've had all my life

> > > thanks to fructose

> > > > > > > > > > > > > intolerance.

> > > > > > > > > > > > >

> > > > > > > > > > > > > So - from reading the article, the only explanation

> > > I could glean was

> > > > > > > > > > > > > that as the tumor grows, the aldo production

> > > increases, the renin

> > > > > > > > > > > > > decreases, and the K decreases. Am I understanding

> > > correctly?

> > > > > > > > > > > > >

> > > > > > > > > > > > > Just wondering if there are any measures I can take

> > > to keep it from

> > > > > > > > > > > > > dropping lower? Increasing dietary K is out since I

> > > have hereditary

> > > > > > > > > > > > > fructose intolerance.

> > > > > > > > > > > > >

> > > > > > > > > > > > >

> > > > > > > > > > > > > --msmith1928

> > > > > > > > > > > > > Nulliparous female, 46, 5'3 " , 120 lbs,

> > > polymenorrhea,

> > > > > > > > > > > > > hyperinsulinemia, hereditary fructose intolerance,

> > > lactose intolerance,

> > > > > > > > > > > > > probable gluten intolerance. Current meds are K 20

> > > MEQ 4x/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

> > > > > > > > > > > > >

> > > > > > > > > > > >

> > > > > > > > > > >

> > > > > > > > > >

> > > > > > > > >

> > > > > > > >

> > > > > > > >

> > > > > > >

> > > > > >

> > > > >

> > > >

> > >

> >

> >

>

[Guest guest]

, I always look forward to your post because you bring a fresh perspective.

Don't critize until you walk a mile in my shoes is certainly good advice!

How 'bout walking in my shoes for 3 1/2 minutes: The year is 2005 and a fat 59

yo male comes to your office looking for a 2nd opinion for rt. flank pain

radiating to his rt. testis. You ask him to point to the area and he points to

his rt. kidney. At this point do you DX his head? Wouldn't you cosider that

possibly it might have something to do with the kidney, especially when you

remember from 9th grade Biology that the testis starts in the area of the kidney

and drops down before birth, hopefully! (first hint)

He shows the first opinion including two ct-scans and a Nepherologists' report

that has two kidney stone in the right kidney that are nonobstructive in his

opinion. You of course would radiate a little more in case the Nepherologist

was blind, shit add a little contrast to it - that might take care of the

problem! NOT! I know you better than that and you know there can be problems

with the Kidney other than stones so you order up a Urine Test. When you get

the test back and really don't know what to look for where do you start?

Wouldn't it be prudent to scan for " out of range indicators " , you know, the lab

marks them with an H or L! (I know I would, especially if I only ad 20

min/PTN!)

HOLY CRAP, WHAT IS THIS " RENIN = 0.1 L " (hint 2) Would you say, " Shit, I don't

remember that from school, maybe if I put him on Methadone and Oxicodone he

won't remember! " or would you scratch your head or whatever and continue reading

and see that " Quest Labs " , where this test was performed, says the range should

be 0.65-5.0. Scratch again as the eyes wander; and he exclaims, " What the heck

is this! " as he spots the lab comment 5 (five) lines down, " Primary

aldosteronsim possible: <0.65 " . Oh this must not apply, they told us it was

real rare, couldn't be happening to me, this isn't what I went to school for,

maybe if I ignore it for 3 1/2 years nobody will notice, " WHAT, WHAT IN HE_ _ DO

YOU MEAN VETS CAN NOW ORDER THEIR ENTIRE RECORDS? " , Including labs?! Must be

time to polish the Resume!

Thanks for letting me wander down memory lane with you but it caused a problem

and it is all your fault so I expect you to help me figure it out!

What is a SERUM CRP-HI test for and why didn't they do a csCRP instead? On

6/27/6006 they got a result of 8.37 H the lab suggested retesting in 2 weeks

which they did and they got 11.10 H (Guess the lab only said to do it twice so

we can ignore it now, right? That's what they did!)

> > > > > >

> > > > > > I just re-read the Evolution of PA article, and I still don't

completely

> > > > > > understand why as time goes on my K keeps getting lower and I have

to

> > > > > > keep adding more K pills. I did well on just one 20 MEQ tab per day

for

> > > > > > a couple of years... then it went up to two earlier this year, and

now

> > > > > > I'm up to four. The pills are starting to upset my stomach - I can

> > > > > > tolerate three a day just fine, but the fourth one is starting to

cause

> > > > > > problems, which I think will just be counterproductive.

> > > > > >

> > > > > > Before anyone cries out anything about eating too much salt - I eat

the

> > > > > > same thing every day (and have done so all year long), all made by

> > > > > > myself, with no added sodium. According to Fitday, my sodium does

not

> > > > > > exceed 880mg/day.

> > > > > >

> > > > > > The article notes that " hypokalemia might be precipitated by a low

> > > > > > potassium intake, diuretic use, or extrarenal loss of potassium in

> > > > > > sweat, vomit, or stool " - none of these apply at present other than

the

> > > > > > same low dietary K intake I've had all my life thanks to fructose

> > > > > > intolerance.

> > > > > >

> > > > > > So - from reading the article, the only explanation I could glean

was

> > > > > > that as the tumor grows, the aldo production increases, the renin

> > > > > > decreases, and the K decreases. Am I understanding correctly?

> > > > > >

> > > > > > Just wondering if there are any measures I can take to keep it from

> > > > > > dropping lower? Increasing dietary K is out since I have hereditary

> > > > > > fructose intolerance.

> > > > > >

> > > > > >

> > > > > > --msmith1928

> > > > > > Nulliparous female, 46, 5'3 " , 120 lbs, polymenorrhea,

> > > > > > hyperinsulinemia, hereditary fructose intolerance, lactose

intolerance,

> > > > > > probable gluten intolerance. Current meds are K 20 MEQ 4x/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

> > > > > >

> > > > >

> > > >

> > >

> > >

> >

>

[Guest guest]

msmith, we may be having trouble id'ing SS because it looks like there isn't

agreement in the medical community! Thare is a Dr.Myron H. Weinberger who has

done a lot of research and authored a few articles. I found one " Salt

Sensitivity of Blood Pressure in Humans " at:

http://hyper.ahajournals.org/content/27/3/481.full?sid=0c7a403f-cd10-4de4-85d8-a\

5ca18676704#R15 (check out the first 16 or so credits, you might recognize a

name or two!). This one may give a good introduction so you can discuss the

possibility with your doctor!

If you want to persue the birth weight issue you might start with this

editorial: Expand+Editorial Commentaries

Salt Sensitivity

It Is Not Always in the Genes

W.

at:http://hyper.ahajournals.org/content/51/4/823.full#ref-12

He raises some good issues and I followed one of his credits (12) and they gave

some of the why in the development of the renal area in low birth weight

individuals. (I may have to look into this further for my wife. She is one of

twins and they both have HTN, maybe I'll suggest her PCP check out Furosemide

since it advertises that " it causes the kidneys to get rid of unneeded water and

salt from the body into the urine. " ) My Nephrologist put me on this and Spiro

when he DXed me, I have since stopped it since me endema has resolved.

That should keep you busy for a couple minutes! If nothing else maybe your

Nephrologist can tell us how it all works. I have selfish reasons to understand

how the kidneys work!

- 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(last week ave): 124/61

Other Issues/Opportunities: COPD w/ft Oxygen, OSA w Bi-Pap settings 13/19, DM2.

and PTSD

Meds: Duloxetine hcl 80 MG, Mirtazapine 15 MG, Metoprolol Tartrate 200 MG,

81mg asprin, Metformin 2000MG and Spironolactone 75 MG.

> > > > > > > > > > > > > >

> > > > > > > > > > > > > > I just re-read the Evolution of PA article, and I

> > > > still don't completely

> > > > > > > > > > > > > > understand why as time goes on my K keeps getting

> > > > lower and I have to

> > > > > > > > > > > > > > keep adding more K pills. I did well on just one 20

> > > > MEQ tab per day for

> > > > > > > > > > > > > > a couple of years... then it went up to two earlier

> > > > this year, and now

> > > > > > > > > > > > > > I'm up to four. The pills are starting to upset my

> > > > stomach - I can

> > > > > > > > > > > > > > tolerate three a day just fine, but the fourth one

> > > > is starting to cause

> > > > > > > > > > > > > > problems, which I think will just be

> > > > counterproductive.

> > > > > > > > > > > > > >

> > > > > > > > > > > > > > Before anyone cries out anything about eating too

> > > > much salt - I eat the

> > > > > > > > > > > > > > same thing every day (and have done so all year

> > > > long), all made by

> > > > > > > > > > > > > > myself, with no added sodium. According to Fitday,

> > > > my sodium does not

> > > > > > > > > > > > > > exceed 880mg/day.

> > > > > > > > > > > > > >

> > > > > > > > > > > > > > The article notes that " hypokalemia might be

> > > > precipitated by a low

> > > > > > > > > > > > > > potassium intake, diuretic use, or extrarenal loss

> > > > of potassium in

> > > > > > > > > > > > > > sweat, vomit, or stool " - none of these apply at

> > > > present other than the

> > > > > > > > > > > > > > same low dietary K intake I've had all my life

> > > > thanks to fructose

> > > > > > > > > > > > > > intolerance.

> > > > > > > > > > > > > >

> > > > > > > > > > > > > > So - from reading the article, the only explanation

> > > > I could glean was

> > > > > > > > > > > > > > that as the tumor grows, the aldo production

> > > > increases, the renin

> > > > > > > > > > > > > > decreases, and the K decreases. Am I understanding

> > > > correctly?

> > > > > > > > > > > > > >

> > > > > > > > > > > > > > Just wondering if there are any measures I can take

> > > > to keep it from

> > > > > > > > > > > > > > dropping lower? Increasing dietary K is out since I

> > > > have hereditary

> > > > > > > > > > > > > > fructose intolerance.

> > > > > > > > > > > > > >

> > > > > > > > > > > > > >

> > > > > > > > > > > > > > --msmith1928

> > > > > > > > > > > > > > Nulliparous female, 46, 5'3 " , 120 lbs,

> > > > polymenorrhea,

> > > > > > > > > > > > > > hyperinsulinemia, hereditary fructose intolerance,

> > > > lactose intolerance,

> > > > > > > > > > > > > > probable gluten intolerance. Current meds are K 20

> > > > MEQ 4x/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

> > > > > > > > > > > > > >

> > > > > > > > > > > > >

> > > > > > > > > > > >

> > > > > > > > > > >

> > > > > > > > > >

> > > > > > > > >

> > > > > > > > >

> > > > > > > >

> > > > > > >

> > > > > >

> > > > >

> > > >

> > >

> > >

> >

>

[Guest guest]

msmith, I now qualify as a doctor! I was closing out some sessions, preparing

to shutdown and this word jumped out at me, " hyperinsulinemia " . I need to add

another item to that list I quoted re. SS individuals: under Biochemical

" commonly but not always insulin resistence " !

That's only 4 but who's counting! (Would possibly be more if I understood some

of those big words, can you wait 7 yrs while I go to school?) ;>)

- 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(last week ave): 124/61

Other Issues/Opportunities: COPD w/ft Oxygen, OSA w Bi-Pap settings 13/19, DM2.

and PTSD

Meds: Duloxetine hcl 80 MG, Mirtazapine 15 MG, Metoprolol Tartrate 200 MG,

81mg asprin, Metformin 2000MG and Spironolactone 75 MG.

> > > > >

> > > > > I just re-read the Evolution of PA article, and I still don't

completely

> > > > > understand why as time goes on my K keeps getting lower and I have to

> > > > > keep adding more K pills. I did well on just one 20 MEQ tab per day

for

> > > > > a couple of years... then it went up to two earlier this year, and now

> > > > > I'm up to four. The pills are starting to upset my stomach - I can

> > > > > tolerate three a day just fine, but the fourth one is starting to

cause

> > > > > problems, which I think will just be counterproductive.

> > > > >

> > > > > Before anyone cries out anything about eating too much salt - I eat

the

> > > > > same thing every day (and have done so all year long), all made by

> > > > > myself, with no added sodium. According to Fitday, my sodium does not

> > > > > exceed 880mg/day.

> > > > >

> > > > > The article notes that " hypokalemia might be precipitated by a low

> > > > > potassium intake, diuretic use, or extrarenal loss of potassium in

> > > > > sweat, vomit, or stool " - none of these apply at present other than

the

> > > > > same low dietary K intake I've had all my life thanks to fructose

> > > > > intolerance.

> > > > >

> > > > > So - from reading the article, the only explanation I could glean was

> > > > > that as the tumor grows, the aldo production increases, the renin

> > > > > decreases, and the K decreases. Am I understanding correctly?

> > > > >

> > > > > Just wondering if there are any measures I can take to keep it from

> > > > > dropping lower? Increasing dietary K is out since I have hereditary

> > > > > fructose intolerance.

> > > > >

> > > > >

> > > > > --msmith1928

> > > > > Nulliparous female, 46, 5'3 " , 120 lbs, polymenorrhea,

> > > > > hyperinsulinemia, hereditary fructose intolerance, lactose

intolerance,

> > > > > probable gluten intolerance. Current meds are K 20 MEQ 4x/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

> > > > >

> > > >

> > >

> >

> >

>