Re: Medical Opinions vs Facts

[Guest guest]

Dr Grim is not saying one should not be screened for Aldo renin. Just the ratio

system isn't the best way to determine who may have PA.

Some studies are showing high Aldo is related to psych problems. Some day they

may treat psych problems with Sprio.

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

> > > > > > > > > > > > > I find both opinions, and facts to be of value.

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

> > > > > > > > > > > > > For example - the research articles will probably

> > > > never, ever mention that spiro's estrogenic properties can

> > > > exacerbate menstrual irregularities, or can cause gynecomastia in

> > > > women. They will also never mention that the estrogenic properties

> > > > may cause weight gain (plenty of anecdotal evidence of that if you

> > > > look hard enough), yet in the three weeks I was on it, my weight

> > > > (which under normal circumstances only fluctuates by a pound either

> > > > way) went up five pounds. So my *opinion* that this drug's side

> > > > effects outweigh it's benefits *may* be of value to some newbie who

> > > > comes here down the line.

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

> > > > > > > > > > > > > However. My HTN doctor's *opinion* that I could

> > > > have skipped AVS and gone straight to surgery, even though I'm a bit

> > > > past 40, was not supported by any of the " facts " in the research

> > > > articles. So I was able to choose to ignore his opinion, and follow

> > > > the guidance I got via the *facts* presented in research articles.

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

> > > > > > > > > > > > > --- In

> > > > >

> > > >

> > > >

> > >

> >

>

[Guest guest]

I think it's a very important comment. Although I have PA according to Dr. Grim, but my aldo is not high, and I wondered all the time about brain fog and psych problems. I don't have them, probably because of normal aldo, but I have all other symptoms of PA. All of them!!!!Natalia To: hyperaldosteronism Sent: Monday, October 17, 2011 6:04 PMSubject: Re: Medical Opinions vs Facts

Dr Grim is not saying one should not be screened for Aldo renin. Just the ratio system isn't the best way to determine who may have PA.

Some studies are showing high Aldo is related to psych problems. Some day they may treat psych problems with Sprio.

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

> > > > > > > > > > > > > I find both opinions, and facts to be of value.

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

> > > > > > > > > > > > > For example - the research articles will probably

> > > > never, ever mention that spiro's estrogenic properties can

> > > > exacerbate menstrual irregularities, or can cause gynecomastia in

> > > > women. They will also never mention that the estrogenic properties

> > > > may cause weight gain (plenty of anecdotal evidence of that if you

> > > > look hard enough), yet in the three weeks I was on it, my weight

> > > > (which under normal circumstances only fluctuates by a pound either

> > > > way) went up five pounds. So my *opinion* that this drug's side

> > > > effects outweigh it's benefits *may* be of value to some newbie who

> > > > comes here down the line.

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

> > > > > > > > > > > > > However. My HTN doctor's *opinion* that I could

> > > > have skipped AVS and gone straight to surgery, even though I'm a bit

> > > > past 40, was not supported by any of the "facts" in the research

> > > > articles. So I was able to choose to ignore his opinion, and follow

> > > > the guidance I got via the *facts* presented in research articles.

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

> > > > > > > > > > > > > --- In

> > > > >

> > > >

> > > >

> > >

> >

>

[Guest guest]

LETS KEEP AT THEM.CE Grim MDOn Oct 17, 2011, at 12:52 PM, Francis Bill SUSPECTED PA wrote: You have told me this before that you think I have PA based on Information I have posted. This is the first time you have given your thoughts on the A/R ratio Something I was trying to get an answer in past posting on this. You have hinted to this before. If only could get main line medical system to accept this. Many would be spared needless suffering. > > > > > > > > > > > > > > > > > > > > > > I find both opinions, and facts to be of value. > > > > > > > > > > > > > > > > > > > > > > For example - the research articles will probably > > never, ever mention that spiro's estrogenic properties can > > exacerbate menstrual irregularities, or can cause gynecomastia in > > women. They will also never mention that the estrogenic properties > > may cause weight gain (plenty of anecdotal evidence of that if you > > look hard enough), yet in the three weeks I was on it, my weight > > (which under normal circumstances only fluctuates by a pound either > > way) went up five pounds. So my *opinion* that this drug's side > > effects outweigh it's benefits *may* be of value to some newbie who > > comes here down the line. > > > > > > > > > > > > > > > > > > > > > > However. My HTN doctor's *opinion* that I could > > have skipped AVS and gone straight to surgery, even though I'm a bit > > past 40, was not supported by any of the "facts" in the research > > articles. So I was able to choose to ignore his opinion, and follow > > the guidance I got via the *facts* presented in research articles. > > > > > > > > > > > > > > > > > > > > > > --- In > > > > > > > >

[Guest guest]

I prefer to take a good history first then do a good medical exam.CE Grim MD Disordered Aldo:Renin ratio good place to start surely? As a screening test? I dream of a world where every patient who is sent to a pscyhologist for their non existent psych problems due to undiagnosed PA is offered this first... > > > > > > > > > > > > > > > > > > > > > > > > I find both opinions, and facts to be of value. > > > > > > > > > > > > > > > > > > > > > > > > For example - the research articles will probably > > > never, ever mention that spiro's estrogenic properties can > > > exacerbate menstrual irregularities, or can cause gynecomastia in > > > women. They will also never mention that the estrogenic properties > > > may cause weight gain (plenty of anecdotal evidence of that if you > > > look hard enough), yet in the three weeks I was on it, my weight > > > (which under normal circumstances only fluctuates by a pound either > > > way) went up five pounds. So my *opinion* that this drug's side > > > effects outweigh it's benefits *may* be of value to some newbie who > > > comes here down the line. > > > > > > > > > > > > > > > > > > > > > > > > However. My HTN doctor's *opinion* that I could > > > have skipped AVS and gone straight to surgery, even though I'm a bit > > > past 40, was not supported by any of the "facts" in the research > > > articles. So I was able to choose to ignore his opinion, and follow > > > the guidance I got via the *facts* presented in research articles. > > > > > > > > > > > > > > > > > > > > > > > > --- In > > > > > > > > > > > > >

[Guest guest]

I believe when you first posted your Aldo Renin Dr Grim thought you may have

Liddle's Syndrome or Apparent Mineralocorticoid. Have they been ruled out?

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

> > > > > > > > > > > > > > I find both opinions, and facts to be of value.

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

> > > > > > > > > > > > > > For example - the research articles will probably

> > > > > never, ever mention that spiro's estrogenic properties can

> > > > > exacerbate menstrual irregularities, or can cause gynecomastia in

> > > > > women. They will also never mention that the estrogenic properties

> > > > > may cause weight gain (plenty of anecdotal evidence of that if you

> > > > > look hard enough), yet in the three weeks I was on it, my weight

> > > > > (which under normal circumstances only fluctuates by a pound either

> > > > > way) went up five pounds. So my *opinion* that this drug's side

> > > > > effects outweigh it's benefits *may* be of value to some newbie who

> > > > > comes here down the line.

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

> > > > > > > > > > > > > > However. My HTN doctor's *opinion* that I could

> > > > > have skipped AVS and gone straight to surgery, even though I'm a bit

> > > > > past 40, was not supported by any of the " facts " in the research

> > > > > articles. So I was able to choose to ignore his opinion, and follow

> > > > > the guidance I got via the *facts* presented in research articles.

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

> > > > > > > > > > > > > > --- In

> > > > > >

> > > > >

> > > > >

> > > >

> > >

> >

>

[Guest guest]

Hang on are you saying you don't have psych problems or you don't have PA?

I have been told I *may* have a range of pscyh problems inc anxiety, panic

attacks, asperger's syndrome, psychogenic polydipsia based on various

psychologist opinions when previous drs gave up, I rejected all these and yet

when I pursued PA they wanted to give me another psych diagnosis - Munchausen's!

But then PA turned out to be right!

But I had to really push them to get this far and I am not even there yet so

that makes me think that there may be others out there who are too ill or weak

or just too fed up to push their drs anymore so they accept a pscyh diagnosis of

anxiety etc and go undiagnosed.

Interestingly there is research which is showing that various types of 'anxiety'

have physcial causes that push the body into imbalance and cause it to secrete

adrenaline, noradrenaline etc which makes you feel anxious e.g. mitral valve

prolapse, POTS, diabetes, dehydration etc and so is physical not emotional. But

if you don't have it diagnosed and some one is telling you it's in your head and

to calm down all the time then maybe you will start to believe you have an

anxiety disorder.

Point I'm making is: what if spiro doesn't help in psych problems - what if

those 'psych problems' ARE undiagnosed PA??

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

> > > > > > > > > > > > > > I find both opinions, and facts to be of value.

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

> > > > > > > > > > > > > > For example - the research articles will probably

> > > > > never, ever mention that spiro's estrogenic properties can

> > > > > exacerbate menstrual irregularities, or can cause gynecomastia in

> > > > > women. They will also never mention that the estrogenic properties

> > > > > may cause weight gain (plenty of anecdotal evidence of that if you

> > > > > look hard enough), yet in the three weeks I was on it, my weight

> > > > > (which under normal circumstances only fluctuates by a pound either

> > > > > way) went up five pounds. So my *opinion* that this drug's side

> > > > > effects outweigh it's benefits *may* be of value to some newbie who

> > > > > comes here down the line.

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

> > > > > > > > > > > > > > However. My HTN doctor's *opinion* that I could

> > > > > have skipped AVS and gone straight to surgery, even though I'm a bit

> > > > > past 40, was not supported by any of the " facts " in the research

> > > > > articles. So I was able to choose to ignore his opinion, and follow

> > > > > the guidance I got via the *facts* presented in research articles.

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

> > > > > > > > > > > > > > --- In

> > > > > >

> > > > >

> > > > >

> > > >

> > >

> >

>

[Guest guest]

I don't believe I have pscyh problems I also don't have DX of PA only that from

what I posed leads Dr Grim to think I have PA.

It is suspected that high Aldo causes some pscyh problems. Studies on this are

so what new as I haven't seen any before 2005. It will probably take more

studies before it gets to treating stage.

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

> > > > > > > > > > > > > > > I find both opinions, and facts to be of value.

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

> > > > > > > > > > > > > > > For example - the research articles will probably

> > > > > > never, ever mention that spiro's estrogenic properties can

> > > > > > exacerbate menstrual irregularities, or can cause gynecomastia in

> > > > > > women. They will also never mention that the estrogenic properties

> > > > > > may cause weight gain (plenty of anecdotal evidence of that if you

> > > > > > look hard enough), yet in the three weeks I was on it, my weight

> > > > > > (which under normal circumstances only fluctuates by a pound either

> > > > > > way) went up five pounds. So my *opinion* that this drug's side

> > > > > > effects outweigh it's benefits *may* be of value to some newbie who

> > > > > > comes here down the line.

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

> > > > > > > > > > > > > > > However. My HTN doctor's *opinion* that I could

> > > > > > have skipped AVS and gone straight to surgery, even though I'm a bit

> > > > > > past 40, was not supported by any of the " facts " in the research

> > > > > > articles. So I was able to choose to ignore his opinion, and follow

> > > > > > the guidance I got via the *facts* presented in research articles.

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

> > > > > > > > > > > > > > > --- In

> > > > > > >

> > > > > >

> > > > > >

> > > > >

> > > >

> > >

> >

>

[Guest guest]

IIRC many of us here have erroneously been tagged with psych problems in the

early stages of our diagnosis. I certainly was - my first low K/palpitations ER

visit was written off as an " anxiety attack " (which my insurance didn't pay

since it didn't cover psych and I was stuck with a giant bill!) and I was

treated incorrectly for the next 3 or 4 years with various psych meds. I somehow

knew instinctively that this wasn't right, and eventually began refusing

treatment.

I think in the U.S. this gets especially complicated as psych meds are among the

top-selling, most profitable drugs out there. Seems like any and every doctor

can write a 'script for them and is more than willing to do so.

Even my primary care doctor, who I trust and who got my PA diagnosis in motion

in the first place, isn't immune to this. A few weeks before my surgery, I was

having a bit of trouble coping, and he said " You know, there are meds for that. "

I just told him point blank, " The tumor is in my adrenal, not my brain. I don't

think it makes sense to take meds that treat my brain. "

He couldn't exactly argue with my logic

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

> > > > > > > > > > > > > > > I find both opinions, and facts to be of value.

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

> > > > > > > > > > > > > > > For example - the research articles will probably

> > > > > > never, ever mention that spiro's estrogenic properties can

> > > > > > exacerbate menstrual irregularities, or can cause gynecomastia in

> > > > > > women. They will also never mention that the estrogenic properties

> > > > > > may cause weight gain (plenty of anecdotal evidence of that if you

> > > > > > look hard enough), yet in the three weeks I was on it, my weight

> > > > > > (which under normal circumstances only fluctuates by a pound either

> > > > > > way) went up five pounds. So my *opinion* that this drug's side

> > > > > > effects outweigh it's benefits *may* be of value to some newbie who

> > > > > > comes here down the line.

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

> > > > > > > > > > > > > > > However. My HTN doctor's *opinion* that I could

> > > > > > have skipped AVS and gone straight to surgery, even though I'm a bit

> > > > > > past 40, was not supported by any of the " facts " in the research

> > > > > > articles. So I was able to choose to ignore his opinion, and follow

> > > > > > the guidance I got via the *facts* presented in research articles.

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

> > > > > > > > > > > > > > > --- In

> > > > > > >

> > > > > >

> > > > > >

> > > > >

> > > >

> > >

> >

>

[Guest guest]

Or that psych problems lead to high aldo. Studies seem to lean that aldo is a factor in psych issues more than psych causes the high aldo, but they weren't always conclusive. Many studies were done in the late '60's it appeared but not too much these days. Wonder why the interest in the 60's

Subject: Re: Medical Opinions vs FactsTo: hyperaldosteronism Date: Tuesday, October 18, 2011, 7:24 PM

I don't believe I have pscyh problems I also don't have DX of PA only that from what I posed leads Dr Grim to think I have PA. It is suspected that high Aldo causes some pscyh problems. Studies on this are so what new as I haven't seen any before 2005. It will probably take more studies before it gets to treating stage. > > > > > > > > > > > > > > >> > > > > > > > > > > > > > > I

find both opinions, and facts to be of value.> > > > > > > > > > > > > > >> > > > > > > > > > > > > > > For example - the research articles will probably > > > > > > never, ever mention that spiro's estrogenic properties can > > > > > > exacerbate menstrual irregularities, or can cause gynecomastia in > > > > > > women. They will also never mention that the estrogenic properties > > > > > > may cause weight gain (plenty of anecdotal evidence of that if you > > > > > > look hard enough), yet in the three weeks I was on it, my weight > > > > > > (which under normal circumstances only fluctuates by a pound either > > > > > > way) went up five pounds. So my *opinion* that this drug's side > > >

> > > effects outweigh it's benefits *may* be of value to some newbie who > > > > > > comes here down the line.> > > > > > > > > > > > > > >> > > > > > > > > > > > > > > However. My HTN doctor's *opinion* that I could > > > > > > have skipped AVS and gone straight to surgery, even though I'm a bit > > > > > > past 40, was not supported by any of the "facts" in the research > > > > > > articles. So I was able to choose to ignore his opinion, and follow > > > > > > the guidance I got via the *facts* presented in research articles.> > > > > > > > > > > > > > >> > > > > > > > > > > > > > > --- In> > > > > > >> >

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

[Guest guest]

As I recall she has gotten better with eplerenone. So these questions are moot now. Her aldo was measureable as well. Liddle's and AME and licorice tend to have VERY low aldos. Lower than lower limit generally.CE Grim MDOn Oct 18, 2011, at 8:29 AM, Francis Bill SUSPECTED PA wrote: I believe when you first posted your Aldo Renin Dr Grim thought you may have Liddle's Syndrome or Apparent Mineralocorticoid. Have they been ruled out? > > > > > > > > > > > > > > > > > > > > > > > > > > > > I find both opinions, and facts to be of value. > > > > > > > > > > > > > > > > > > > > > > > > > > > > For example - the research articles will probably > > > > > never, ever mention that spiro's estrogenic properties can > > > > > exacerbate menstrual irregularities, or can cause gynecomastia in > > > > > women. They will also never mention that the estrogenic properties > > > > > may cause weight gain (plenty of anecdotal evidence of that if you > > > > > look hard enough), yet in the three weeks I was on it, my weight > > > > > (which under normal circumstances only fluctuates by a pound either > > > > > way) went up five pounds. So my *opinion* that this drug's side > > > > > effects outweigh it's benefits *may* be of value to some newbie who > > > > > comes here down the line. > > > > > > > > > > > > > > > > > > > > > > > > > > > > However. My HTN doctor's *opinion* that I could > > > > > have skipped AVS and gone straight to surgery, even though I'm a bit > > > > > past 40, was not supported by any of the "facts" in the research > > > > > articles. So I was able to choose to ignore his opinion, and follow > > > > > the guidance I got via the *facts* presented in research articles. > > > > > > > > > > > > > > > > > > > > > > > > > > > > --- In > > > > > > > > > > > > > > > > > > > > > > > > > >

[Guest guest]

Good judgment as usual. Anxiety is a normal part of living.CE Grim MD IIRC many of us here have erroneously been tagged with psych problems in the early stages of our diagnosis. I certainly was - my first low K/palpitations ER visit was written off as an "anxiety attack" (which my insurance didn't pay since it didn't cover psych and I was stuck with a giant bill!) and I was treated incorrectly for the next 3 or 4 years with various psych meds. I somehow knew instinctively that this wasn't right, and eventually began refusing treatment. I think in the U.S. this gets especially complicated as psych meds are among the top-selling, most profitable drugs out there. Seems like any and every doctor can write a 'script for them and is more than willing to do so. Even my primary care doctor, who I trust and who got my PA diagnosis in motion in the first place, isn't immune to this. A few weeks before my surgery, I was having a bit of trouble coping, and he said "You know, there are meds for that." I just told him point blank, "The tumor is in my adrenal, not my brain. I don't think it makes sense to take meds that treat my brain." He couldn't exactly argue with my logic > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > I find both opinions, and facts to be of value. > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > For example - the research articles will probably > > > > > > never, ever mention that spiro's estrogenic properties can > > > > > > exacerbate menstrual irregularities, or can cause gynecomastia in > > > > > > women. They will also never mention that the estrogenic properties > > > > > > may cause weight gain (plenty of anecdotal evidence of that if you > > > > > > look hard enough), yet in the three weeks I was on it, my weight > > > > > > (which under normal circumstances only fluctuates by a pound either > > > > > > way) went up five pounds. So my *opinion* that this drug's side > > > > > > effects outweigh it's benefits *may* be of value to some newbie who > > > > > > comes here down the line. > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > However. My HTN doctor's *opinion* that I could > > > > > > have skipped AVS and gone straight to surgery, even though I'm a bit > > > > > > past 40, was not supported by any of the "facts" in the research > > > > > > articles. So I was able to choose to ignore his opinion, and follow > > > > > > the guidance I got via the *facts* presented in research articles. > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > --- In > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > >

[Guest guest]

No, they were never checked. But Dr Grim now suggests that I have early stage of PA, although I have very high uncontrolled BP for 30 years and nocturia for 18 years. Nevertheless I didn't have any other symptoms until last year. 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.From:

Francis Bill SUSPECTED PA To: hyperaldosteronism Sent: Tuesday, October 18, 2011 8:29 AMSubject: Re: Medical Opinions vs Facts

I believe when you first posted your Aldo Renin Dr Grim thought you may have Liddle's Syndrome or Apparent Mineralocorticoid. Have they been ruled out?

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

> > > > > > > > > > > > > > I find both opinions, and facts to be of value.

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

> > > > > > > > > > > > > > For example - the research articles will probably

> > > > > never, ever mention that spiro's estrogenic properties can

> > > > > exacerbate menstrual irregularities, or can cause gynecomastia in

> > > > > women. They will also never mention that the estrogenic properties

> > > > > may cause weight gain (plenty of anecdotal evidence of that if you

> > > > > look hard enough), yet in the three weeks I was on it, my weight

> > > > > (which under normal circumstances only fluctuates by a pound either

> > > > > way) went up five pounds. So my *opinion* that this drug's side

> > > > > effects outweigh it's benefits *may* be of value to some newbie who

> > > > > comes here down the line.

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

> > > > > > > > > > > > > > However. My HTN doctor's *opinion* that I could

> > > > > have skipped AVS and gone straight to surgery, even though I'm a bit

> > > > > past 40, was not supported by any of the "facts" in the research

> > > > > articles. So I was able to choose to ignore his opinion, and follow

> > > > > the guidance I got via the *facts* presented in research articles.

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

> > > > > > > > > > > > > > --- In

> > > > > >

> > > > >

> > > > >

> > > >

> > >

> >

>

[Guest guest]

Natalia,Dr Grim so many times mentioned that A2RBs would be useless in PA…how come you are still on Micardis? I suspect it might reduce effectiveness of Epler. Have you tried to quit it for 6-8 weeks to see if Epler works better in normalizing your BP keeping it steady? Max.62M L adenoma by NP59 scan. High aldos not low renin. med combo #76={Spiro=100, Amlo=10, Indap=2.5, Ramip=5, Metf=1000, Crestor=20, Feno=67, K.Cl=120 mEq}{K=4.7}{not DASHing but low-salt diet, heat intolerance} Natalia KamnevaNo, they were never checked. But Dr Grim now suggests that I have early stage of PA, although I have very high uncontrolled BP for 30 years and nocturia for 18 years. Nevertheless I didn't have any other symptoms until last year. 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.

[Guest guest]

All one needs to be think about Conn's is HTN, Nocturia without other causes is a very important clue as well. Not she has problems getting an accurate blood K due to blood drawing problems as I recall. CE Grim MD No, they were never checked. But Dr Grim now suggests that I have early stage of PA, although I have very high uncontrolled BP for 30 years and nocturia for 18 years. Nevertheless I didn't have any other symptoms until last year. 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: Tuesday, October 18, 2011 8:29 AMSubject: Re: Medical Opinions vs Facts I believe when you first posted your Aldo Renin Dr Grim thought you may have Liddle's Syndrome or Apparent Mineralocorticoid. Have they been ruled out? > > > > > > > > > > > > > > > > > > > > > > > > > > > > I find both opinions, and facts to be of value. > > > > > > > > > > > > > > > > > > > > > > > > > > > > For example - the research articles will probably > > > > > never, ever mention that spiro's estrogenic properties can > > > > > exacerbate menstrual irregularities, or can cause gynecomastia in > > > > > women. They will also never mention that the estrogenic properties > > > > > may cause weight gain (plenty of anecdotal evidence of that if you > > > > > look hard enough), yet in the three weeks I was on it, my weight > > > > > (which under normal circumstances only fluctuates by a pound either > > > > > way) went up five pounds. So my *opinion* that this drug's side > > > > > effects outweigh it's benefits *may* be of value to some newbie who > > > > > comes here down the line. > > > > > > > > > > > > > > > > > > > > > > > > > > > > However. My HTN doctor's *opinion* that I could > > > > > have skipped AVS and gone straight to surgery, even though I'm a bit > > > > > past 40, was not supported by any of the "facts" in the research > > > > > articles. So I was able to choose to ignore his opinion, and follow > > > > > the guidance I got via the *facts* presented in research articles. > > > > > > > > > > > > > > > > > > > > > > > > > > > > --- In > > > > > > > > > > > > > > > > > > > > > > > > > >

[Guest guest]

Which is better Inspra or Spiro? One is 150.00 and one is 4.00 per

month.

I dont have insurance.

Phyllis

 

Eplere is not approved for PA. It is approved for high

Blood pressure. 

Tiped sad Send form mi

iPhone ;-)

May your pressure be low!

CE Grim MD

Specializing in Difficult

Hypertension

On Oct 20, 2011, at 14:55, Francis Bill SUSPECTED PA

wrote:

 

I can not afford insurance. Right now my only

choice for health care is the VA. Since my PRA ratio

was less then 20 by there standards I don't have I

PA. So no need for eplerenone.

>

[Guest guest]

There's a label now for every emotion - and every emotion except happiness seems to be a "disorder" (and even happiness might be seen as mania or narcissistic personality disorder) depending on who one sees as their medical provider. What used to be personality is now some disorder.

Subject: Re: Re: Medical Opinions vs FactsTo: hyperaldosteronism Date: Thursday, October 20, 2011, 3:10 AM

I rarely give lorazapam for BP problems.

CE Grim MD

To: hyperaldosteronism Sent: Tuesday, October 18, 2011 6:34 PMSubject: Re: Medical Opinions vs Facts

Hang on are you saying you don't have psych problems or you don't have PA?I have been told I *may* have a range of pscyh problems inc anxiety, panic attacks, asperger's syndrome, psychogenic polydipsia based on various psychologist opinions when previous drs gave up, I rejected all these and yet when I pursued PA they wanted to give me another psych diagnosis - Munchausen's! But then PA turned out to be right!But I had to really push them to get this far and I am not even there yet so that makes me think that there may be others out there who are too ill or weak or just too fed up to push their drs anymore so they accept a pscyh diagnosis of anxiety etc and go undiagnosed.Interestingly there is research which is showing that various types of 'anxiety' have physcial causes that push the body into imbalance and cause it to secrete adrenaline, noradrenaline etc which makes you feel anxious e.g. mitral valve prolapse, POTS,

diabetes, dehydration etc and so is physical not emotional. But if you don't have it diagnosed and some one is telling you it's in your head and to calm down all the time then maybe you will start to believe you have an anxiety disorder.Point I'm making is: what if spiro doesn't help in psych problems - what if those 'psych problems' ARE undiagnosed PA??> > > > > > > > > > > > > >> > > > > > > > > > > > > > I find both opinions, and facts to be of value.> > > > > > > > > > > > > >> > > > > > > > > > > > > > For example - the research articles will probably > > > > > never, ever mention that spiro's estrogenic properties can > > > > > exacerbate menstrual irregularities, or can cause gynecomastia in > > > > > women. They will also never mention that the estrogenic properties > > > > > may cause weight gain (plenty of anecdotal evidence of that if you > > > >

> look hard enough), yet in the three weeks I was on it, my weight > > > > > (which under normal circumstances only fluctuates by a pound either > > > > > way) went up five pounds. So my *opinion* that this drug's side > > > > > effects outweigh it's benefits *may* be of value to some newbie who > > > > > comes here down the line.> > > > > > > > > > > > > >> > > > > > > > > > > > > > However. My HTN doctor's *opinion* that I could > > > > > have skipped AVS and gone straight to surgery, even though I'm a bit > > > > > past 40, was not supported by any of the "facts" in the research > > > > > articles. So I was able to choose to ignore his opinion, and follow > > > > > the guidance I got via the *facts*

presented in research articles.> > > > > > > > > > > > > >> > > > > > > > > > > > > > --- In> > > > > >> > > > >> > > > >> > > >> > >> >>

[Guest guest]

The coments are classic undiagnosed PA pathway in most of our histories. I heard everything from "stress" "depression' "lazy" and who knows what else over about 5 years.. We moved to AZ in '09 when I never wanted to leave Texas, but I was too tired and sick to argue. My "colleagues" I now understand would not stop whispering to wife that I was "stressed" and so she thought the change of scenery and moving closer to home (Cali) would help "cure" me of my stress and depression (because it always causes a BP of 170/130 daily and drops my potassium - sarcasm...) - which only got worse and worse and worse in AZ until 11/2010 when I finally started spiro.

I have told the story though that I walked out on a doc once in Texas who couldn't drop the depression tag. I told him over and over I wasn't depressed, but he didn't give a damn. The label was more important than the patient.

Subject: Re: Re: Medical Opinions vs FactsTo: "hyperaldosteronism " <hyperaldosteronism >Date: Thursday, October 20, 2011, 1:44 AM

What I am saying, I do have PA but I don't have psych problems and even didn't have them before being on eplerenone. I was prescribed lorazepam but I took it only when I had a terrible spikes in BP and now take it only at night time since I have insomnia. And BTW, in addition my cortisol is high and I am diabetic. I agree that a range of psych problems may be caused by underlying physical problems. Natalia

To: hyperaldosteronism Sent: Tuesday, October 18, 2011 6:34 PMSubject: Re: Medical Opinions vs Facts

Hang on are you saying you don't have psych problems or you don't have PA?I have been told I *may* have a range of pscyh problems inc anxiety, panic attacks, asperger's syndrome, psychogenic polydipsia based on various psychologist opinions when previous drs gave up, I rejected all these and yet when I pursued PA they wanted to give me another psych diagnosis - Munchausen's! But then PA turned out to be right!But I had to really push them to get this far and I am not even there yet so that makes me think that there may be others out there who are too ill or weak or just too fed up to push their drs anymore so they accept a pscyh diagnosis of anxiety etc and go undiagnosed.Interestingly there is research which is showing that various types of 'anxiety' have physcial causes that push the body into imbalance and cause it to secrete adrenaline, noradrenaline etc which makes you feel anxious e.g. mitral valve prolapse, POTS,

diabetes, dehydration etc and so is physical not emotional. But if you don't have it diagnosed and some one is telling you it's in your head and to calm down all the time then maybe you will start to believe you have an anxiety disorder.Point I'm making is: what if spiro doesn't help in psych problems - what if those 'psych problems' ARE undiagnosed PA??> > > > > > > > > > > > > >> > > > > > > > > > > > > > I find both opinions, and facts to be of value.> > > > > > > > > > > > > >> > > > > > > > > > > > > > For example - the research articles will probably > > > > > never, ever mention that spiro's estrogenic properties can > > > > > exacerbate menstrual irregularities, or can cause gynecomastia in > > > > > women. They will also never mention that the estrogenic properties > > > > > may cause weight gain (plenty of anecdotal evidence of that if you > > > >

> look hard enough), yet in the three weeks I was on it, my weight > > > > > (which under normal circumstances only fluctuates by a pound either > > > > > way) went up five pounds. So my *opinion* that this drug's side > > > > > effects outweigh it's benefits *may* be of value to some newbie who > > > > > comes here down the line.> > > > > > > > > > > > > >> > > > > > > > > > > > > > However. My HTN doctor's *opinion* that I could > > > > > have skipped AVS and gone straight to surgery, even though I'm a bit > > > > > past 40, was not supported by any of the "facts" in the research > > > > > articles. So I was able to choose to ignore his opinion, and follow > > > > > the guidance I got via the *facts*

presented in research articles.> > > > > > > > > > > > > >> > > > > > > > > > > > > > --- In> > > > > >> > > > >> > > > >> > > >> > >> >>

[Guest guest]

I don't want this to become a diatribe and discussion on other medical professions, but if one sees a psychiatrist, psychologist, or a chiropractor they are 100% of 100% of the time leaving the office with a "problem" or diagnosis of something even if you went in soley for a checkup with no complaints.

Never does a chiro say "I don't see anything wrong you are doing great" and a psych can always find the quirk in one's personality and apply a label to it. So on one extreme we go misdiagnosed even when our symptoms are smacking them in the face - like in PA, and on another, we get tagged forever with a label in our charts because either WE had to have some validation for our physical or mental feelings and symptoms, or because the doc has to put something to get paid. And all the while the real problem may be right in front of them.

Subject: Re: Re: Medical Opinions vs FactsTo: hyperaldosteronism Date: Thursday, October 20, 2011, 3:10 AM

I rarely give lorazapam for BP problems.

CE Grim MD

To: hyperaldosteronism Sent: Tuesday, October 18, 2011 6:34 PMSubject: Re: Medical Opinions vs Facts

Hang on are you saying you don't have psych problems or you don't have PA?I have been told I *may* have a range of pscyh problems inc anxiety, panic attacks, asperger's syndrome, psychogenic polydipsia based on various psychologist opinions when previous drs gave up, I rejected all these and yet when I pursued PA they wanted to give me another psych diagnosis - Munchausen's! But then PA turned out to be right!But I had to really push them to get this far and I am not even there yet so that makes me think that there may be others out there who are too ill or weak or just too fed up to push their drs anymore so they accept a pscyh diagnosis of anxiety etc and go undiagnosed.Interestingly there is research which is showing that various types of 'anxiety' have physcial causes that push the body into imbalance and cause it to secrete adrenaline, noradrenaline etc which makes you feel anxious e.g. mitral valve prolapse, POTS,

diabetes, dehydration etc and so is physical not emotional. But if you don't have it diagnosed and some one is telling you it's in your head and to calm down all the time then maybe you will start to believe you have an anxiety disorder.Point I'm making is: what if spiro doesn't help in psych problems - what if those 'psych problems' ARE undiagnosed PA??> > > > > > > > > > > > > >> > > > > > > > > > > > > > I find both opinions, and facts to be of value.> > > > > > > > > > > > > >> > > > > > > > > > > > > > For example - the research articles will probably > > > > > never, ever mention that spiro's estrogenic properties can > > > > > exacerbate menstrual irregularities, or can cause gynecomastia in > > > > > women. They will also never mention that the estrogenic properties > > > > > may cause weight gain (plenty of anecdotal evidence of that if you > > > >

> look hard enough), yet in the three weeks I was on it, my weight > > > > > (which under normal circumstances only fluctuates by a pound either > > > > > way) went up five pounds. So my *opinion* that this drug's side > > > > > effects outweigh it's benefits *may* be of value to some newbie who > > > > > comes here down the line.> > > > > > > > > > > > > >> > > > > > > > > > > > > > However. My HTN doctor's *opinion* that I could > > > > > have skipped AVS and gone straight to surgery, even though I'm a bit > > > > > past 40, was not supported by any of the "facts" in the research > > > > > articles. So I was able to choose to ignore his opinion, and follow > > > > > the guidance I got via the *facts*

presented in research articles.> > > > > > > > > > > > > >> > > > > > > > > > > > > > --- In> > > > > >> > > > >> > > > >> > > >> > >> >>

[Guest guest]

So we see your wife believed them and treated that depression and stress " the

way God Intended " ! How's that little one doing? ;>)

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

> > > > > > > > > > > > > > > I find both opinions, and facts to be of value.

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

> > > > > > > > > > > > > > > For example - the research articles will probably

> > > > > > never, ever mention that spiro's estrogenic properties can

> > > > > > exacerbate menstrual irregularities, or can cause gynecomastia in

> > > > > > women. They will also never mention that the estrogenic properties

> > > > > > may cause weight gain (plenty of anecdotal evidence of that if you

> > > > > > look hard enough), yet in the three weeks I was on it, my weight

> > > > > > (which under normal circumstances only fluctuates by a pound either

> > > > > > way) went up five pounds. So my *opinion* that this drug's side

> > > > > > effects outweigh it's benefits *may* be of value to some newbie who

> > > > > > comes here down the line.

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

> > > > > > > > > > > > > > > However. My HTN doctor's *opinion* that I could

> > > > > > have skipped AVS and gone straight to surgery, even though I'm a bit

> > > > > > past 40, was not supported by any of the " facts " in the research

> > > > > > articles. So I was able to choose to ignore his opinion, and follow

> > > > > > the guidance I got via the *facts* presented in research articles.

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

> > > > > > > > > > > > > > > --- In

> > > > > > >

> > > > > >

> > > > > >

> > > > >

> > > >

> > >

> >

>

[Guest guest]

Since you mentioned it I have to share. When I saw my psychiatrist a week or so

ago I thought she was going to get me off the psyco drugs. When I mentioned it

she stopped and asked me exactly what I wanted. When I responded, " I want to

get off all drugs! " she panicked and I thought we were going to have to get the

mop! She finally agreed to let my cut the mirtazapine in half! I told her I

" would humor " her for a week or so and ended it last night. I told her I would

discuss the Cymbalta with my PCP next Monday since it is used dual purpose for

diabetic neuropathy (there may be better drugs for that)! I couldn't believe

she was so shocked, am I headed the wrong way or just weird?

- 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, Mirtazapine 7.5 MG, Metoprolol Tartrate 200 MG,

81mg asprin, Metformin 2000MG and Spironolactone 50 MG.

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

> > > > > > > > > > > > > > > I find both opinions, and facts to be of value.

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

> > > > > > > > > > > > > > > For example - the research articles will probably

> > > > > > never, ever mention that spiro's estrogenic properties can

> > > > > > exacerbate menstrual irregularities, or can cause gynecomastia in

> > > > > > women. They will also never mention that the estrogenic properties

> > > > > > may cause weight gain (plenty of anecdotal evidence of that if you

> > > > > > look hard enough), yet in the three weeks I was on it, my weight

> > > > > > (which under normal circumstances only fluctuates by a pound either

> > > > > > way) went up five pounds. So my *opinion* that this drug's side

> > > > > > effects outweigh it's benefits *may* be of value to some newbie who

> > > > > > comes here down the line.

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

> > > > > > > > > > > > > > > However. My HTN doctor's *opinion* that I could

> > > > > > have skipped AVS and gone straight to surgery, even though I'm a bit

> > > > > > past 40, was not supported by any of the " facts " in the research

> > > > > > articles. So I was able to choose to ignore his opinion, and follow

> > > > > > the guidance I got via the *facts* presented in research articles.

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

> > > > > > > > > > > > > > > --- In

> > > > > > >

> > > > > >

> > > > > >

> > > > >

> > > >

> > >

> >

>

[Guest guest]

Little one is theiving and bringing lots of joy and dirty diapers and I thnk was just desperate. She's a housewife with no medical background. She spent 10 years of our marriagewith me as a paramedic never bringing the job home to me suddenly...over about 5 years...seemingly unable to leave it behind and with the PA my symptoms, especially the low K I now know, so broad and affecting so many body systems I couldn't adequately explain to anyone all the things I was feelingSent from my Palm Pre on the Now Network from Sprint

So we see your wife believed them and treated that depression and stress "the way God Intended"! How's that little one doing? ;>)

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

> > > > > > > > > > > > > > > I find both opinions, and facts to be of value.

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

> > > > > > > > > > > > > > > For example - the research articles will probably

> > > > > > never, ever mention that spiro's estrogenic properties can

> > > > > > exacerbate menstrual irregularities, or can cause gynecomastia in

> > > > > > women. They will also never mention that the estrogenic properties

> > > > > > may cause weight gain (plenty of anecdotal evidence of that if you

> > > > > > look hard enough), yet in the three weeks I was on it, my weight

> > > > > > (which under normal circumstances only fluctuates by a pound either

> > > > > > way) went up five pounds. So my *opinion* that this drug's side

> > > > > > effects outweigh it's benefits *may* be of value to some newbie who

> > > > > > comes here down the line.

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

> > > > > > > > > > > > > > > However. My HTN doctor's *opinion* that I could

> > > > > > have skipped AVS and gone straight to surgery, even though I'm a bit

> > > > > > past 40, was not supported by any of the "facts" in the research

> > > > > > articles. So I was able to choose to ignore his opinion, and follow

> > > > > > the guidance I got via the *facts* presented in research articles.

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

> > > > > > > > > > > > > > > --- In

> > > > > > >

> > > > > >

> > > > > >

> > > > >

> > > >

> > >

> >

>

[Guest guest]

Thriving! It's the older ones theivingSent from my Palm Pre on the Now Network from Sprint

Little one is theiving and bringing lots of joy and dirty diapers and I thnk was just desperate. She's a housewife with no medical background. She spent 10 years of our marriagewith me as a paramedic never bringing the job home to me suddenly...over about 5 years...seemingly unable to leave it behind and with the PA my symptoms, especially the low K I now know, so broad and affecting so many body systems I couldn't adequately explain to anyone all the things I was feelingSent from my Palm Pre on the Now Network from Sprint

So we see your wife believed them and treated that depression and stress "the way God Intended"! How's that little one doing? ;>)

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

> > > > > > > > > > > > > > > I find both opinions, and facts to be of value.

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

> > > > > > > > > > > > > > > For example - the research articles will probably

> > > > > > never, ever mention that spiro's estrogenic properties can

> > > > > > exacerbate menstrual irregularities, or can cause gynecomastia in

> > > > > > women. They will also never mention that the estrogenic properties

> > > > > > may cause weight gain (plenty of anecdotal evidence of that if you

> > > > > > look hard enough), yet in the three weeks I was on it, my weight

> > > > > > (which under normal circumstances only fluctuates by a pound either

> > > > > > way) went up five pounds. So my *opinion* that this drug's side

> > > > > > effects outweigh it's benefits *may* be of value to some newbie who

> > > > > > comes here down the line.

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

> > > > > > > > > > > > > > > However. My HTN doctor's *opinion* that I could

> > > > > > have skipped AVS and gone straight to surgery, even though I'm a bit

> > > > > > past 40, was not supported by any of the "facts" in the research

> > > > > > articles. So I was able to choose to ignore his opinion, and follow

> > > > > > the guidance I got via the *facts* presented in research articles.

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

> > > > > > > > > > > > > > > --- In

> > > > > > >

> > > > > >

> > > > > >

> > > > >

> > > >

> > >

> >

>

[Guest guest]

I know, I know. I tried to taper Micardis for many times and always had a spike in BP. Dr. Grim recommends to do it again and I will try again. BTW, my BP is very steady about 125/75 on this combination:-) I read the article here sometime ago "Efficacy of low-dose spironolactone in subjects with resistant hypertension". For subjects with and without PA they added 12.5 to 25 mg/d of spiro to ACE or ARB. That's why I added eplerenone to Micardis a year ago. Note, I never was officially diagnosed with PA. My aldo is not high enough. What convinced me, that ACE and ARB are the only two groups of medications (before eplerenon) that definitely worked for me. All other groups just killed me. Thank you.Natalia To: hyperaldosteronism Sent: Tuesday, October 18, 2011 11:06 PMSubject: RE: Re: Medical Opinions vs Facts

Natalia,Dr Grim so many times mentioned that A2RBs would be useless in PA…how come you are still on Micardis? I suspect it might reduce effectiveness of Epler. Have you tried to quit it for 6-8 weeks to see if Epler works better in normalizing your BP keeping it steady? Max.62M L adenoma by NP59 scan. High aldos not low renin. med combo #76={Spiro=100, Amlo=10, Indap=2.5, Ramip=5,

Metf=1000, Crestor=20, Feno=67, K.Cl=120 mEq}{K=4.7}{not DASHing but low-salt diet, heat intolerance} Natalia KamnevaNo, they were never checked. But Dr Grim now suggests that I have early stage of PA, although I have very high uncontrolled BP for 30 years and nocturia for 18 years. Nevertheless I didn't have any other symptoms until

last year. 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.

[Guest guest]

I can not afford insurance. Right now my only choice for health care is the VA.

Since my PRA ratio was less then 20 by there standards I don't have I PA. So no

need for eplerenone.

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

> > > > > > > > > > > > > > > > I find both opinions, and facts to be of value.

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

> > > > > > > > > > > > > > > > For example - the research articles will

probably

> > > > > > > never, ever mention that spiro's estrogenic properties can

> > > > > > > exacerbate menstrual irregularities, or can cause gynecomastia in

> > > > > > > women. They will also never mention that the estrogenic properties

> > > > > > > may cause weight gain (plenty of anecdotal evidence of that if you

> > > > > > > look hard enough), yet in the three weeks I was on it, my weight

> > > > > > > (which under normal circumstances only fluctuates by a pound

either

> > > > > > > way) went up five pounds. So my *opinion* that this drug's side

> > > > > > > effects outweigh it's benefits *may* be of value to some newbie

who

> > > > > > > comes here down the line.

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

> > > > > > > > > > > > > > > > However. My HTN doctor's *opinion* that I could

> > > > > > > have skipped AVS and gone straight to surgery, even though I'm a

bit

> > > > > > > past 40, was not supported by any of the " facts " in the research

> > > > > > > articles. So I was able to choose to ignore his opinion, and

follow

> > > > > > > the guidance I got via the *facts* presented in research articles.

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

> > > > > > > > > > > > > > > > --- In

> > > > > > > >

> > > > > > >

> > > > > > >

> > > > > >

> > > > >

> > > >

> > >

> >

>

[Guest guest]

In that study the pts were already on ace and were still HTN. SUGGESTS ACE WAS not working well but we dont know pre ace BP Tiped sad Send form miiPhone ;-)May your pressure be low!CE Grim MDSpecializing in DifficultHypertension

I know, I know. I tried to taper Micardis for many times and always had a spike in BP. Dr. Grim recommends to do it again and I will try again. BTW, my BP is very steady about 125/75 on this combination:-) I read the article here sometime ago "Efficacy of low-dose spironolactone in subjects with resistant hypertension". For subjects with and without PA they added 12.5 to 25 mg/d of spiro to ACE or ARB. That's why I added eplerenone to Micardis a year ago. Note, I never was officially diagnosed with PA. My aldo is not high enough. What convinced me, that ACE and ARB are the only two groups of medications (before eplerenon) that definitely worked for me. All other groups just killed me. Thank you.Natalia To: hyperaldosteronism Sent: Tuesday, October 18, 2011 11:06 PMSubject: RE: Re: Medical Opinions vs Facts

Natalia,Dr Grim so many times mentioned that A2RBs would be useless in PA…how come you are still on Micardis? I suspect it might reduce effectiveness of Epler. Have you tried to quit it for 6-8 weeks to see if Epler works better in normalizing your BP keeping it steady? Max.62M L adenoma by NP59 scan. High aldos not low renin. med combo #76={Spiro=100, Amlo=10, Indap=2.5, Ramip=5,

Metf=1000, Crestor=20, Feno=67, K.Cl=120 mEq}{K=4.7}{not DASHing but low-salt diet, heat intolerance} Natalia KamnevaNo, they were never checked. But Dr Grim now suggests that I have early stage of PA, although I have very high uncontrolled BP for 30 years and nocturia for 18 years. Nevertheless I didn't have any other symptoms until

last year. 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.