RE: So here is something that is bugging me a bit

[Guest guest]

It sounds like getting tested, in and of itself, is the problem for some people

- their docs refuse to order the tests.

When I showed up at my last (now fired) doctor's office asking him to order the

blood test for the ARR, he refused. I was incredibly fortunate in that I was

able to go doctor-shopping until I found one who would order the tests; some

people here, depending on the type of insurance they have, do not have this

freedom.

And that's a crying shame.

-msmith1928

Nulliparous female, 46, 5'3 " , 115 lbs, CT showed 1cm left adrenal nodule, AVS

determined disease is unilateral, had left laparoscopic adrenalectomy on

10/13/2011. Low sodium, fructose- and grain-free diet due to hereditary fructose

intolerance, lactose intolerance, gluten intolerance (probable celiac).

>

> Many people on here seem to argue with each other regarding whether or not

they actually have PA. It occurred to me today that all the mystery is taken

out of diagnosis with simple confirmation tests. There seem to be plenty of

tests such as salt loading etc. that could either diagnose or rule out PA. I

know when I was diagnosed the salt loading test confirmed my PA. My endo was a

skeptic at Mayo until the salt loading results. There is now no doubt that I

have PA. Why wouldn't one get confirmation testing of some sort. I know that

salt loading can be torturous, but there are other tests that are easier on the

body. I guess I just don't get all of the arguing over something that seems

like it would be so simple. Get tested and you either have PA or you don't.

>

> What am I missing?

>

[Guest guest]

It is a shame! Personally I would call every doctor allowed in my network and

ask their office point blank if they are willing to test me for PA if I was in

their shoes.

I know how challenging it can be. My doc at Mayo told me he would be shocked if

I had PA. He agreed to test me to get me to shut up about it for the most part.

My upfront test was borderline, but the salt loading test left no doubt.

Couldn't someone ask a doctor to do a confirmation test of some sort?

> >

> > Many people on here seem to argue with each other regarding whether or not

they actually have PA. It occurred to me today that all the mystery is taken

out of diagnosis with simple confirmation tests. There seem to be plenty of

tests such as salt loading etc. that could either diagnose or rule out PA. I

know when I was diagnosed the salt loading test confirmed my PA. My endo was a

skeptic at Mayo until the salt loading results. There is now no doubt that I

have PA. Why wouldn't one get confirmation testing of some sort. I know that

salt loading can be torturous, but there are other tests that are easier on the

body. I guess I just don't get all of the arguing over something that seems

like it would be so simple. Get tested and you either have PA or you don't.

> >

> > What am I missing?

> >

>

[Guest guest]

All these tests are not conclusive, unfortunately. The most conclusive test is going on spiro or Inspra and check your BP and ho do you feel. Most people here started to feel the difference after 2 - 3 tablets (!!!!!) Considering that all of them had a long terrible history of high BP and feeling like going through the hell, it sounds like a miracle! Natalia Kamneva 67 Russian F with 2 cm left adrenal adenoma, recently diagnosed with PA; diabetic; on 100 mg eplerenone, 80 mg Micardis, 2000 mg metformin, 60 mg Dexilant and 2 mg Lorazepam; Dashing; still have some occasional problems with BP, K and Na; on private consultation with Dr Grim.To: hyperaldosteronism Sent: Thursday, November 3, 2011 6:45 PMSubject: So here is something that is bugging me a bit

Many people on here seem to argue with each other regarding whether or not they actually have PA. It occurred to me today that all the mystery is taken out of diagnosis with simple confirmation tests. There seem to be plenty of tests such as salt loading etc. that could either diagnose or rule out PA. I know when I was diagnosed the salt loading test confirmed my PA. My endo was a skeptic at Mayo until the salt loading results. There is now no doubt that I have PA. Why wouldn't one get confirmation testing of some sort. I know that salt loading can be torturous, but there are other tests that are easier on the body. I guess I just don't get all of the arguing over something that seems like it would be so simple. Get tested and you either have PA or you don't.

What am I missing?

[Guest guest]

In my case the Neprologist used a 25mg of Spiro as his first test. (There was a

3 1/2 year old lab test of extremely low renin.) When BP dove down to normal he

was satisfied and labeled it PA. Another Neper ordered more tests to satisfy

himself that nothing else was going on because I was still considering surgery.

I never had salt loading or anything else because whatever you want to call it,

it responds very well to Spiro and DASH! the only thing I still need to

consider if the tumor is growing. It was " unchanged " at 3 1/2 years so I guess

I need to check again in 5 years, if I remember! :>)

- 65 yo super ob. male - 12mm X 13mm rt. a.adnoma with previous rt. flank

pain. Treating with Meds. And DASH. . Current BP(last week ave): 131/76 HR 60

Other Issues/Opportunities: OSA w Bi-Pap settings 13/19, DM2, and PTSD.

Meds: Duloxetine hcl 80 MG, Metoprolol Tartrate 200 MG, 81mg asprin, Metformin

2000MG and Spironolactone 50 MG.

>

> Many people on here seem to argue with each other regarding whether or not

they actually have PA. It occurred to me today that all the mystery is taken

out of diagnosis with simple confirmation tests. There seem to be plenty of

tests such as salt loading etc. that could either diagnose or rule out PA. I

know when I was diagnosed the salt loading test confirmed my PA. My endo was a

skeptic at Mayo until the salt loading results. There is now no doubt that I

have PA. Why wouldn't one get confirmation testing of some sort. I know that

salt loading can be torturous, but there are other tests that are easier on the

body. I guess I just don't get all of the arguing over something that seems

like it would be so simple. Get tested and you either have PA or you don't.

>

> What am I missing?

>

[Guest guest]

The issue is where do u do the cut off to say one has PA or not. If u reread my evolution article you can better understand this problem. Better than most Drs do is my bet. The.best confirmation for me is that the BP and K problems get better with DASH and or spironolactone. And if one feels normal on this they why worry. When there is also a bump on the adrenal this adds an additional question. Is the bump causing all the problem and will all return to normal by taking out the bump? And what are the risks and benefits of doing an AVS and then if it lateralizes what are the risks and be benefits of doing surgery as less than 50% are cured by surgery. May your pressure be low!CE Grim MS, MDSpecializing in DifficultHypertension

Many people on here seem to argue with each other regarding whether or not they actually have PA. It occurred to me today that all the mystery is taken out of diagnosis with simple confirmation tests. There seem to be plenty of tests such as salt loading etc. that could either diagnose or rule out PA. I know when I was diagnosed the salt loading test confirmed my PA. My endo was a skeptic at Mayo until the salt loading results. There is now no doubt that I have PA. Why wouldn't one get confirmation testing of some sort. I know that salt loading can be torturous, but there are other tests that are easier on the body. I guess I just don't get all of the arguing over something that seems like it would be so simple. Get tested and you either have PA or you don't.

What am I missing?

[Guest guest]

You forgot about DASH. One can easily out salt MCB. May your pressure be low!CE Grim MS, MDSpecializing in DifficultHypertension

All these tests are not conclusive, unfortunately. The most conclusive test is going on spiro or Inspra and check your BP and ho do you feel. Most people here started to feel the difference after 2 - 3 tablets (!!!!!) Considering that all of them had a long terrible history of high BP and feeling like going through the hell, it sounds like a miracle! Natalia Kamneva 67 Russian F with 2 cm left adrenal adenoma, recently diagnosed with PA; diabetic; on 100 mg eplerenone, 80 mg Micardis, 2000 mg metformin, 60 mg Dexilant and 2 mg Lorazepam; Dashing; still have some occasional problems with BP, K and Na; on private consultation with Dr Grim.To: hyperaldosteronism Sent: Thursday, November 3, 2011 6:45 PMSubject: So here is something that is bugging me a bit

Many people on here seem to argue with each other regarding whether or not they actually have PA. It occurred to me today that all the mystery is taken out of diagnosis with simple confirmation tests. There seem to be plenty of tests such as salt loading etc. that could either diagnose or rule out PA. I know when I was diagnosed the salt loading test confirmed my PA. My endo was a skeptic at Mayo until the salt loading results. There is now no doubt that I have PA. Why wouldn't one get confirmation testing of some sort. I know that salt loading can be torturous, but there are other tests that are easier on the body. I guess I just don't get all of the arguing over something that seems like it would be so simple. Get tested and you either have PA or you don't.

What am I missing?

[Guest guest]

Spiro/DASH normalized my blood pressure but spiro had no positive impact on my myriad of other symptoms. Val From: hyperaldosteronism [mailto:hyperaldosteronism ] On Behalf Of Natalia Kamneva All these tests are not conclusive, unfortunately. The most conclusive test is going on spiro or Inspra and check your BP and ho do you feel. Most people here started to feel the difference after 2 - 3 tablets (!!!!!) Considering that all of them had a long terrible history of high BP and feeling like going through the hell, it sounds like a miracle!

[Guest guest]

I don't recall how high the Spiro was pushed. But seem to recall you could not tolerate it. And BTW you had had Lyme clinically DXED. And RxOf that helped symptoms. So not clear which s. got better with which rxMay your pressure be low!CE Grim MS, MDSpecializing in DifficultHypertension

Spiro/DASH normalized my blood pressure but spiro had no positive impact on my myriad of other symptoms. Val From: hyperaldosteronism [mailto:hyperaldosteronism ] On Behalf Of Natalia Kamneva All these tests are not conclusive, unfortunately. The most conclusive test is going on spiro or Inspra and check your BP and

ho do you feel. Most people here started to feel the difference after 2 - 3 tablets (!!!!!) Considering that all of them had a long terrible history of high BP and feeling like going through the hell, it sounds like a miracle!

[Guest guest]

After more than three years of below normal K in addition to HTN, my PCP

(finally) sent me to a nephrologist who immediately sent me to have my renin &

aldo tested. When my ARR was 466, she ordered a CT scan & sent me to an

endocrinologist, who ordered a saline suppression test. The CT scan showed a

6.7 mm tumor in my left adrenal gland. The saline suppression test was

inconclusive, so the endo ordered another renin & aldo test, which showed an ARR

of 233. Based on my symptoms, which were getting worse, the CT scan & the high

ARR, the endo recommended that I have an AVS, which showed that I had much

higher levels of aldo in my left adrenal vein.

Lucy Sage

Sent from my Verizon Wireless Phone

crzylnebkr wrote:

>Many people on here seem to argue with each other regarding whether or not they

actually have PA. It occurred to me today that all the mystery is taken out of

diagnosis with simple confirmation tests. There seem to be plenty of tests such

as salt loading etc. that could either diagnose or rule out PA. I know when I

was diagnosed the salt loading test confirmed my PA. My endo was a skeptic at

Mayo until the salt loading results. There is now no doubt that I have PA. Why

wouldn't one get confirmation testing of some sort. I know that salt loading

can be torturous, but there are other tests that are easier on the body. I

guess I just don't get all of the arguing over something that seems like it

would be so simple. Get tested and you either have PA or you don't.

>

>What am I missing?

>

[Guest guest]

And then what happened? Need thumbnail. May your pressure be low!CE Grim MS, MDSpecializing in DifficultHypertension

After more than three years of below normal K in addition to HTN, my PCP (finally) sent me to a nephrologist who immediately sent me to have my renin & aldo tested. When my ARR was 466, she ordered a CT scan & sent me to an endocrinologist, who ordered a saline suppression test. The CT scan showed a 6.7 mm tumor in my left adrenal gland. The saline suppression test was inconclusive, so the endo ordered another renin & aldo test, which showed an ARR of 233. Based on my symptoms, which were getting worse, the CT scan & the high ARR, the endo recommended that I have an AVS, which showed that I had much higher levels of aldo in my left adrenal vein.

Lucy Sage

Sent from my Verizon Wireless Phone

crzylnebkr wrote:

>Many people on here seem to argue with each other regarding whether or not they actually have PA. It occurred to me today that all the mystery is taken out of diagnosis with simple confirmation tests. There seem to be plenty of tests such as salt loading etc. that could either diagnose or rule out PA. I know when I was diagnosed the salt loading test confirmed my PA. My endo was a skeptic at Mayo until the salt loading results. There is now no doubt that I have PA. Why wouldn't one get confirmation testing of some sort. I know that salt loading can be torturous, but there are other tests that are easier on the body. I guess I just don't get all of the arguing over something that seems like it would be so simple. Get tested and you either have PA or you don't.

>

>What am I missing?

>

[Guest guest]

I was on spiro (150 mg) for about 1.5 years before Lyme DX.  Spiro did not help with anything but HTN.  All the other symptoms persisted. Val _______________________________________________________________________________________________________Female, hypothyroidism, hyperparathyroidism, hyperaldosterone (all endocrine, BTW), and Lyme + HTN that have responded very well to IV antibiotics; breast cancer caught early and probably cured. From: hyperaldosteronism [mailto:hyperaldosteronism ] On Behalf Of Clarence Grim I don't recall how high the Spiro was pushed. But seem to recall you could not tolerate it. And BTW you had had Lyme clinically DXED. And RxOf that helped symptoms. So not clear which s. got better with which rx Spiro/DASH normalized my blood pressure but spiro had no positive impact on my myriad of other symptoms. From: hyperaldosteronism [mailto:hyperaldosteronism ] On Behalf Of Natalia Kamneva All these tests are not conclusive, unfortunately. The most conclusive test is going on spiro or Inspra and check your BP and ho do you feel. Most people here started to feel the difference after 2 - 3 tablets (!!!!!) Considering that all of them had a long terrible history of high BP and feeling like going through the hell, it sounds like a miracle!

[Guest guest]

And was your urine Na and K checked regularly to validate DASHing. I do recall you had the lowest Na Mayo has ever seen in a urine. Obviously they do not recommend reduced Na intake as part of the treatment plan.CE Grim MD I was on spiro (150 mg) for about 1.5 years before Lyme DX. Spiro did not help with anything but HTN. All the other symptoms persisted. Val _______________________________________________________________________________________________________Female, hypothyroidism, hyperparathyroidism, hyperaldosterone (all endocrine, BTW), and Lyme + HTN that have responded very well to IV antibiotics; breast cancer caught early and probably cured. From: hyperaldosteronism [mailto:hyperaldosteronism ] On Behalf Of Clarence Grim I don't recall how high the Spiro was pushed. But seem to recall you could not tolerate it. And BTW you had had Lyme clinically DXED. And RxOf that helped symptoms. So not clear which s. got better with which rx Spiro/DASH normalized my blood pressure but spiro had no positive impact on my myriad of other symptoms. From: hyperaldosteronism [mailto:hyperaldosteronism ] On Behalf Of Natalia Kamneva All these tests are not conclusive, unfortunately. The most conclusive test is going on spiro or Inspra and check your BP and ho do you feel. Most people here started to feel the difference after 2 - 3 tablets (!!!!!) Considering that all of them had a long terrible history of high BP and feeling like going through the hell, it sounds like a miracle!

[Guest guest]

The answer is simple, it keeps the PTN " pissed off " which raises the BP which

causes more BP meds to be dispensed which keeps the drug companies happy. If

totally effective it will cause Clinical Depression which keeps the " Psyco Docs "

employed and my Cymbalta costs $796/qtr which makes the drug companies really

happy! See, everybody is happy (well almost everyone!) IMHO

- 65 yo super ob. male - 12mm X 13mm rt. a.adnoma with previous rt. flank

pain. Treating with Meds. And DASH. . Current BP(last week ave): 131/76 HR 60

Other Issues/Opportunities: OSA w Bi-Pap settings 13/19, DM2, and PTSD.

Meds: Duloxetine hcl 80 MG, Metoprolol Tartrate 200 MG, 81mg asprin, Metformin

2000MG and Spironolactone 50 MG.

> >

> > Many people on here seem to argue with each other regarding whether or not

they actually have PA. It occurred to me today that all the mystery is taken out

of diagnosis with simple confirmation tests. There seem to be plenty of tests

such as salt loading etc. that could either diagnose or rule out PA. I know when

I was diagnosed the salt loading test confirmed my PA. My endo was a skeptic at

Mayo until the salt loading results. There is now no doubt that I have PA. Why

wouldn't one get confirmation testing of some sort. I know that salt loading can

be torturous, but there are other tests that are easier on the body. I guess I

just don't get all of the arguing over something that seems like it would be so

simple. Get tested and you either have PA or you don't.

> >

> > What am I missing?

> >

>

[Guest guest]

Yes, you are right! And I was one of them :-) Natalia To: "hyperaldosteronism " <hyperaldosteronism >Sent: Thursday, November 3, 2011 8:28 PMSubject: Re: So here is something that is bugging me a bit

You forgot about DASH. One can easily out salt MCB. May your pressure be low!CE Grim MS, MDSpecializing in DifficultHypertension

All these tests are not conclusive, unfortunately. The most conclusive test is going on spiro or Inspra and check your BP and ho do you feel. Most people here started to feel the difference after 2 - 3 tablets (!!!!!) Considering that all of them had a long terrible history of high BP and feeling like going through the hell, it sounds like a miracle! Natalia Kamneva 67 Russian F with 2 cm left adrenal adenoma, recently diagnosed with PA; diabetic; on 100 mg eplerenone, 80 mg Micardis, 2000 mg metformin, 60 mg Dexilant and 2 mg Lorazepam; Dashing; still have some occasional problems with BP, K and Na; on private consultation with Dr Grim.To: hyperaldosteronism Sent: Thursday, November 3, 2011 6:45 PMSubject: So here is something that is bugging me a bit

Many people on here seem to argue with each other regarding whether or not they actually have PA. It occurred to me today that all the mystery is taken out of diagnosis with simple confirmation tests. There seem to be plenty of tests such as salt loading etc. that could either diagnose or rule out PA. I know when I was diagnosed the salt loading test confirmed my PA. My endo was a skeptic at Mayo until the salt loading results. There is now no doubt that I have PA. Why wouldn't one get confirmation testing of some sort. I know that salt loading can be torturous, but there are other tests that are easier on the body. I guess I just don't get all of the arguing over something that seems like it would be so simple. Get tested and you either have PA or you don't.

What am I missing?

[Guest guest]

I no longer check urine Na and K. I just eat mostly low salt and do a daily moving average on my blood pressure. I do have periodic K (and other) tests and it is always really good in the 4's. At Mayo, Dr. Young had never seen anyone's urinary Na so low. Even with Na that low, my BP was still in the 155 range. That told me that I was somewhat responsive to low salt but not entirely. My BP really dropped when I went on Lyme treatment, and oddly enough, the kind of antibiotic I'm on makes some difference on my BP. There is a Lyme cult that treats Lyme with very high doses of Vitamin C and salt. Many report positive results. I'm guessing Lyme does respond in some way to sodium. The international PA guidelines of which Dr. Young is one author do not mention DASHing. Perhaps the guidelines need revision? Val From: hyperaldosteronism [mailto:hyperaldosteronism ] On Behalf Of Clarence Grim And was your urine Na and K checked regularly to validate DASHing. I do recall you had the lowest Na Mayo has ever seen in a urine. Obviously they do not recommend reduced Na intake as part of the treatment plan. CE Grim MDI was on spiro (150 mg) for about 1.5 years before Lyme DX. Spiro did not help with anything but HTN. All the other symptoms persisted.Val _______________________________________________________________________________________________________Female, hypothyroidism, hyperparathyroidism, hyperaldosterone (all endocrine, BTW), and Lyme + HTN that have responded very well to IV antibiotics; breast cancer caught early and probably cured.From: hyperaldosteronism [mailto:hyperaldosteronism ] On Behalf Of Clarence Grim I don't recall how high the Spiro was pushed. But seem to recall you could not tolerate it. And BTW you had had Lyme clinically DXED. And RxOf that helped symptoms. So not clear which s. got better with which rx Spiro/DASH normalized my blood pressure but spiro had no positive impact on my myriad of other symptoms. From: hyperaldosteronism [mailto:hyperaldosteronism ] On Behalf Of Natalia Kamneva All these tests are not conclusive, unfortunately. The most conclusive test is going on spiro or Inspra and check your BP and ho do you feel. Most people here started to feel the difference after 2 - 3 tablets (!!!!!) Considering that all of them had a long terrible history of high BP and feeling like going through the hell, it sounds like a miracle! .

[Guest guest]

I reported the elimination of Mirtazpine a few weeks ago. struggled a little

with that one and decided to hold tight on the Cymbalta for now. PTSD claim is

coming to a close with physical scheduled for Monday. Then starting a

" Cognitive Processing Therapy " session later this month. Also, since it is used

for DM neuropathy so need to figure out how that fits in. Probably not the

right time to make too many changes until I find out how I handle some of this!

- 65 yo super ob. male - 12mm X 13mm rt. a.adnoma with previous rt. flank

pain. Treating with Meds. And DASH. . Current BP(last week ave): 131/76 HR 60

Other Issues/Opportunities: OSA w Bi-Pap settings 13/19, DM2, and PTSD.

Meds: Duloxetine hcl 80 MG, Metoprolol Tartrate 200 MG, 81mg asprin, Metformin

2000MG and Spironolactone 50 MG.

> > > >

> > > > Many people on here seem to argue with each other regarding whether or

not they actually have PA. It occurred to me today that all the mystery is taken

out of diagnosis with simple confirmation tests. There seem to be plenty of

tests such as salt loading etc. that could either diagnose or rule out PA. I

know when I was diagnosed the salt loading test confirmed my PA. My endo was a

skeptic at Mayo until the salt loading results. There is now no doubt that I

have PA. Why wouldn't one get confirmation testing of some sort. I know that

salt loading can be torturous, but there are other tests that are easier on the

body. I guess I just don't get all of the arguing over something that seems like

it would be so simple. Get tested and you either have PA or you don't.

> > > >

> > > > What am I missing?

> > > >

> > >

> >

> >

>

[Guest guest]

They did a urine test but apparently missed the request for for Na and K so I

didn't get those numbers. Plasma K was 4.6 (3.5-5.0) if that makes any

difference. (It's usually 4.8.) I have NEVER had any indication of Low K.

- 65 yo super ob. male - 12mm X 13mm rt. a.adnoma with previous rt. flank

pain. Treating with Meds. And DASH. . Current BP(last week ave): 131/76 HR 60

Other Issues/Opportunities: OSA w Bi-Pap settings 13/19, DM2, and PTSD.

Meds: Duloxetine hcl 80 MG, Metoprolol Tartrate 200 MG, 81mg asprin, Metformin

2000MG and Spironolactone 50 MG.

> > > > > >

> > > > > > Many people on here seem to argue with each other regarding whether

or not they actually have PA. It occurred to me today that all the mystery is

taken out of diagnosis with simple confirmation tests. There seem to be plenty

of tests such as salt loading etc. that could either diagnose or rule out PA. I

know when I was diagnosed the salt loading test confirmed my PA. My endo was a

skeptic at Mayo until the salt loading results. There is now no doubt that I

have PA. Why wouldn't one get confirmation testing of some sort. I know that

salt loading can be torturous, but there are other tests that are easier on the

body. I guess I just don't get all of the arguing over something that seems like

it would be so simple. Get tested and you either have PA or you don't.

> > > > > >

> > > > > > What am I missing?

> > > > > >

> > > > >

> > > >

> > > >

> > >

> >

> >

>

[Guest guest]

Sorry for the late post on this, but ego isn't the only reason docs refuse to

order tests. Many are compensated by our insurance under a method called

capitation. They get paid a flat fee per patient per month every month as long

as they are your PCP. If they order tests or refer you to a specilaist it cuts

into their payment. So, if they want to keep high income, they need to order

nothing they think won't yield results.

Even if physicians do not get paid on capitation and say they are on salary,

they often get bonusus based on utilization. If they order too many test more

than the doc next door, they get no bonus.

> > > > > > >

> > > > > > > Many people on here seem to argue with each other regarding

whether or not they actually have PA. It occurred to me today that all the

mystery is taken out of diagnosis with simple confirmation tests. There seem to

be plenty of tests such as salt loading etc. that could either diagnose or rule

out PA. I know when I was diagnosed the salt loading test confirmed my PA. My

endo was a skeptic at Mayo until the salt loading results. There is now no doubt

that I have PA. Why wouldn't one get confirmation testing of some sort. I know

that salt loading can be torturous, but there are other tests that are easier on

the body. I guess I just don't get all of the arguing over something that seems

like it would be so simple. Get tested and you either have PA or you don't.

> > > > > > >

> > > > > > > What am I missing?

> > > > > > >

> > > > > >

> > > > >

> > > > >

> > > >

> > >

> > >

> >

>

[Guest guest]

I have been urging this for about 5 years. I am working on an abstract to go to the Amer Soc of HTN meeting in May 12 that would be a collection of results good and bad in patients here with PA who have tried the DASH plan. So if anyone here has an experience to relate please let us know and place you story in our DASH stories file- I think we have one. And let the rest of us know that you as well.The title will be something like: The use of the DASH Diet in Primary Aldosteronism-the ideal treatment for the human form of Aldosterone/Salt hypertension. Background: Since 19XX the classic models of mineralocorticoid (MC) hypertension (DOCA/Salt, ALDO/salt) have shown that the manifestations of excess MC require an excess of dietary sodium (Na) intake to produce HTN, low K, vascular, cardiac and renal fibrosis. Early studies in primary aldosteronism (PA) reported the reversal of the symptoms and signs of PA with low Na diet and also permitted the reduction of MC blockers in the management of PA. We have been recommending the DASH diet as an adjunct to PA treatment for XX years and now report our findings. We recommend testing urine Na/K ratio (mM/mM in spot urine) as as a way on monitoring compliance. If not less than one then not likely DASHing. Number of patients with PA who tried DASHAverage age was XX range was ....Average BP before starting DASH was XXX/XXXAverage BP when on DASH for XX months XXX/XXX.% of pts with PA who reported improvement in: BP, K, nocturia, fatigue, cramps etc.% who were able to reduce their MBs and other BP meds If not improvement was reported the number who had urine K/Na ratio determined to document DASHing. I am assuming we will have more who got better than did not.The deadline for the abstract is Dec 5 2011.Lets get on this.All can contribute so we can get the word out.Maybe we should also do an abstract on Missed PA in the practice of medicine: why does it happen?This would tabulate the reasons PA has been missedCE Grim MD I no longer check urine Na and K. I just eat mostly low salt and do a daily moving average on my blood pressure. I do have periodic K (and other) tests and it is always really good in the 4's. At Mayo, Dr. Young had never seen anyone's urinary Na so low. Even with Na that low, my BP was still in the 155 range. That told me that I was somewhat responsive to low salt but not entirely. My BP really dropped when I went on Lyme treatment, and oddly enough, the kind of antibiotic I'm on makes some difference on my BP. There is a Lyme cult that treats Lyme with very high doses of Vitamin C and salt. Many report positive results. I'm guessing Lyme does respond in some way to sodium. The international PA guidelines of which Dr. Young is one author do not mention DASHing. Perhaps the guidelines need revision? Val From: hyperaldosteronism [mailto:hyperaldosteronism ] On Behalf Of Clarence Grim And was your urine Na and K checked regularly to validate DASHing. I do recall you had the lowest Na Mayo has ever seen in a urine. Obviously they do not recommend reduced Na intake as part of the treatment plan. CE Grim MDI was on spiro (150 mg) for about 1.5 years before Lyme DX. Spiro did not help with anything but HTN. All the other symptoms persisted.Val _______________________________________________________________________________________________________Female, hypothyroidism, hyperparathyroidism, hyperaldosterone (all endocrine, BTW), and Lyme + HTN that have responded very well to IV antibiotics; breast cancer caught early and probably cured.From: hyperaldosteronism [mailto:hyperaldosteronism ] On Behalf Of Clarence Grim I don't recall how high the Spiro was pushed. But seem to recall you could not tolerate it. And BTW you had had Lyme clinically DXED. And RxOf that helped symptoms. So not clear which s. got better with which rx Spiro/DASH normalized my blood pressure but spiro had no positive impact on my myriad of other symptoms. From: hyperaldosteronism [mailto:hyperaldosteronism ] On Behalf Of Natalia Kamneva All these tests are not conclusive, unfortunately. The most conclusive test is going on spiro or Inspra and check your BP and ho do you feel. Most people here started to feel the difference after 2 - 3 tablets (!!!!!) Considering that all of them had a long terrible history of high BP and feeling like going through the hell, it sounds like a miracle! .

[Guest guest]

I would suggest we need long term follow up on the Vit c salt Rx cult. Keep us posted. May your pressure be low!CE Grim MS, MDSpecializing in DifficultHypertension

I no longer check urine Na and K. I just eat mostly low salt and do a daily moving average on my blood pressure. I do have periodic K (and other) tests and it is always really good in the 4's. At Mayo, Dr. Young had never seen anyone's urinary Na so low. Even with Na that low, my BP was still in the 155 range. That told me that I was somewhat responsive to low salt but not entirely. My BP really dropped when I went on Lyme treatment, and oddly enough, the kind of antibiotic I'm on makes some difference on my BP. There is a Lyme cult that treats Lyme with very high doses of Vitamin C

and salt. Many report positive results. I'm guessing Lyme does respond in some way to sodium. The international PA guidelines of which Dr. Young is one author do not mention DASHing. Perhaps the guidelines need revision? Val From: hyperaldosteronism [mailto:hyperaldosteronism ] On Behalf Of Clarence Grim And was your urine Na and K checked regularly to validate DASHing. I do recall you had the lowest Na Mayo has ever seen in a urine. Obviously they do not recommend reduced Na intake as part of the treatment plan. CE Grim MDI was on spiro (150 mg) for about 1.5 years before Lyme DX. Spiro did not help with anything but HTN. All the other symptoms persisted.Val _______________________________________________________________________________________________________Female, hypothyroidism, hyperparathyroidism, hyperaldosterone (all endocrine, BTW), and Lyme + HTN that have responded very well to IV antibiotics; breast cancer caught early and probably cured.From: hyperaldosteronism [mailto:hyperaldosteronism ] On Behalf Of Clarence Grim I don't recall how high the Spiro was pushed. But seem to recall you could not tolerate it. And BTW you had had

Lyme clinically DXED. And RxOf that helped symptoms. So not clear which s. got better with which rx Spiro/DASH normalized my blood pressure but spiro had no positive impact on my myriad of other symptoms. From: hyperaldosteronism [mailto:hyperaldosteronism ] On Behalf Of Natalia Kamneva

All these tests are not conclusive, unfortunately. The most conclusive test is going on spiro or Inspra and check your BP and ho do you feel. Most people here started to feel the difference after 2 - 3 tablets (!!!!!) Considering that all of them had a long terrible history of high BP and feeling like going through the hell, it sounds like a miracle! .

[Guest guest]

Salt/ - vitamin C for Lyme treatment is Internet " wisdom. "   There is virtually no supporting research. Val From: hyperaldosteronism [mailto:hyperaldosteronism ] On Behalf Of Clarence Grim I would suggest we need long term follow up on the Vit c salt Rx cult. Keep us posted. There is a Lyme cult that treats Lyme with very high doses of Vitamin C and salt. Many report positive results. I'm guessing Lyme does respond in some way to sodium. The international PA guidelines of which Dr. Young is one author do not mention DASHing. Perhaps the guidelines need revision?

[Guest guest]

Sounds logical. May your pressure be low!CE Grim MS, MDSpecializing in DifficultHypertension

Salt/ - vitamin C for Lyme treatment is Internet "wisdom." There is virtually no supporting research. Val From: hyperaldosteronism [mailto:hyperaldosteronism ] On Behalf Of Clarence Grim I would suggest we need long term follow up on the Vit c salt Rx cult. Keep us posted. There is a Lyme cult that treats Lyme with very high doses of Vitamin C and salt. Many report positive results. I'm guessing Lyme does respond in some way to sodium. The international PA guidelines of which Dr. Young is one author do not mention DASHing. Perhaps the guidelines need revision?