Re: Suspect PA but no Dx

[Guest guest]

Wow, your history, your bad response to HCTZ, the positive result to spiro, and the no result to lisinopril scream PA.

Surgery has not been proven undeniably to be better then medication, though we have some anecdotal stories that people have done very well. Dr G has said he suspects some on here did well and some didn't after surgery but didn't always relay their experiences.

So what did your doc do that made you mad? Looks like they researched it, looks like they found it, looks like they wanted to do what is safest first (more people die in routine surgery then from taking spiro and DASHing), and the average patient is afraid of having surgery anyway, I am one of those considering how dangerously and critically high my BP used to be, so maybe they were trying to be nice and avoid everything that goes with surgery first.

Actually it sounds as if you were pretty damn lucky. Read through some of the stories on here about some being misdagnosed for years and years. A BP of 150 /90 is way too high, but not uncommon for someone over 50. There are many on here who were in and out of hospitals with BP's of 180's and higher over 120's and higher for years and years who were in their 30's and 40's before they finally found it. I bet some aren't around to tell their story.

Be grateful you had an alert doc. Sounds like they on the ball. Discuss your options with them as all they have to do is refer you to a surgeon to discuss it more. It's no harm to your doc to do so.

Subject: Suspect PA but no DxTo: hyperaldosteronism Date: Saturday, October 29, 2011, 9:59 AM

I've been reading your messages for a while and really learning a lot. I am a 58 yr. old woman with hypertension diagnosed about a year ago. I probably had high BP for the last 5 years but don't go to the doctor unless I absolutely have to, so I'm not sure. My Gyno recorded BPs of 150s/90s the last couple of years and insisted that I find a PCP and deal with it before she would give me another Rx for HRT. The last PCP I had that I could work with died in a car crash about 7 years ago and I've been frustrated in trying to find a good doc since then.Anyway, I saw a doctor recently who picked up on the probable PA (I had never even heard of hyperaldosteronism!) because I had a bad reaction to Lisinopril (went to the ER with heart attack symptoms - BP 140/100). The ER doc suggested HCT might be a better BP med and the PCP prescribed it. My BP immediately got better and I thought I was home free. Not so. When I had some lab work done as a follow

up a month or two later my K was 3.2 and the PCP called and told me to pick up a Rx for 20Meq and take for 1 month, then come see him again and have more labs. At that visit he told me we should try Spironolactone because of the low K and that it was a probable Dx of PA but that surgery was not really a better predictor of survival (!). When I asked about all the other symptoms in addition to the HBP he told me that a lot of his patients are much sicker than I am and since my BP is good with the Spiro I should not consider expensive tests/surgery – or wait until I'm on Medicare!!! Needless to say I am once again in the market for a PCP. I have an appointment (in January!) to see a woman who comes highly recommended but of course, I'll have to start all over trying to convince her.In the meantime I'm going to start DASHing and wonder if I can stop the Spiro if my BP gets too low. (It's been in the 110s/70s most of the time since starting

Spiro.) If so, do I have to taper off? Should I still pursue the tests for an adenoma? If I feel good by DASHing does it matter?Honestly, many days I feel so horrible that I can barely function. Yesterday I could barely raise my arms or put one foot in front of the other. Not too long ago I woke in the night with terrible chest pain and my heart flopping around in my chest like a fish out of water. I was so exhausted that I just rolled over and thought how nice it would be to just die of a heart attack and not have to continue the way I've been feeling. On my good days (which are few and far between) I know better. Thanks for all the knowledge!!! Lyndap.s. last lab work showed K at 3.6 and the PCP is OK with that

[Guest guest]

The PCP who picked up the PA sounds excellent tome and I would not abandon him as he likely saved you years of more suffering as uWill note in many stories here. We just need to fine tune his expertise. Take him my evolution article remind him I trainDr Conn. Ask him to listen to you and not be satisfied until u are feeling normal. How many times a night do u get up to pee ? Do u eat licorice every day. I would work harder on DASHing and have PCP check your urine Na K till u get the ration less than one. May your pressure be low!CE Grim MDSpecializing in DifficultHypertension

I've been reading your messages for a while and really learning a lot. I am a 58 yr. old woman with hypertension diagnosed about a year ago. I probably had high BP for the last 5 years but don't go to the doctor unless I absolutely have to, so I'm not sure. My Gyno recorded BPs of 150s/90s the last couple of years and insisted that I find a PCP and deal with it before she would give me another Rx for HRT. The last PCP I had that I could work with died in a car crash about 7 years ago and I've been frustrated in trying to find a good doc since then.

Anyway, I saw a doctor recently who picked up on the probable PA (I had never even heard of hyperaldosteronism!) because I had a bad reaction to Lisinopril (went to the ER with heart attack symptoms - BP 140/100). The ER doc suggested HCT might be a better BP med and the PCP prescribed it. My BP immediately got better and I thought I was home free. Not so. When I had some lab work done as a follow up a month or two later my K was 3.2 and the PCP called and told me to pick up a Rx for 20Meq and take for 1 month, then come see him again and have more labs. At that visit he told me we should try Spironolactone because of the low K and that it was a probable Dx of PA but that surgery was not really a better predictor of survival (!). When I asked about all the other symptoms in addition to the HBP he told me that a lot of his patients are much sicker than I am and since my BP is good with the Spiro I should not consider expensive tests/surgery – or wait until I'm on Medicare!!! Needless to say I am once again in the market for a PCP. I have an appointment (in January!) to see a woman who comes highly recommended but of course, I'll have to start all over trying to convince her.

In the meantime I'm going to start DASHing and wonder if I can stop the Spiro if my BP gets too low. (It's been in the 110s/70s most of the time since starting Spiro.) If so, do I have to taper off? Should I still pursue the tests for an adenoma? If I feel good by DASHing does it matter?

Honestly, many days I feel so horrible that I can barely function. Yesterday I could barely raise my arms or put one foot in front of the other. Not too long ago I woke in the night with terrible chest pain and my heart flopping around in my chest like a fish out of water. I was so exhausted that I just rolled over and thought how nice it would be to just die of a heart attack and not have to continue the way I've been feeling. On my good days (which are few and far between) I know better.

Thanks for all the knowledge!!! Lynda

p.s. last lab work showed K at 3.6 and the PCP is OK with that

[Guest guest]

Just to correct there is. I study that has proven that surgery is better than MCB DASH approach. If that fails then consider further testing. May your pressure be low!CE Grim MDSpecializing in DifficultHypertension

Wow, your history, your bad response to HCTZ, the positive result to spiro, and the no result to lisinopril scream PA.

Surgery has not been proven undeniably to be better then medication, though we have some anecdotal stories that people have done very well. Dr G has said he suspects some on here did well and some didn't after surgery but didn't always relay their experiences.

So what did your doc do that made you mad? Looks like they researched it, looks like they found it, looks like they wanted to do what is safest first (more people die in routine surgery then from taking spiro and DASHing), and the average patient is afraid of having surgery anyway, I am one of those considering how dangerously and critically high my BP used to be, so maybe they were trying to be nice and avoid everything that goes with surgery first.

Actually it sounds as if you were pretty damn lucky. Read through some of the stories on here about some being misdagnosed for years and years. A BP of 150 /90 is way too high, but not uncommon for someone over 50. There are many on here who were in and out of hospitals with BP's of 180's and higher over 120's and higher for years and years who were in their 30's and 40's before they finally found it. I bet some aren't around to tell their story.

Be grateful you had an alert doc. Sounds like they on the ball. Discuss your options with them as all they have to do is refer you to a surgeon to discuss it more. It's no harm to your doc to do so.

Subject: Suspect PA but no DxTo: hyperaldosteronism Date: Saturday, October 29, 2011, 9:59 AM

I've been reading your messages for a while and really learning a lot. I am a 58 yr. old woman with hypertension diagnosed about a year ago. I probably had high BP for the last 5 years but don't go to the doctor unless I absolutely have to, so I'm not sure. My Gyno recorded BPs of 150s/90s the last couple of years and insisted that I find a PCP and deal with it before she would give me another Rx for HRT. The last PCP I had that I could work with died in a car crash about 7 years ago and I've been frustrated in trying to find a good doc since then.Anyway, I saw a doctor recently who picked up on the probable PA (I had never even heard of hyperaldosteronism!) because I had a bad reaction to Lisinopril (went to the ER with heart attack symptoms - BP 140/100). The ER doc suggested HCT might be a better BP med and the PCP prescribed it. My BP immediately got better and I thought I was home free. Not so. When I had some lab work done as a follow

up a month or two later my K was 3.2 and the PCP called and told me to pick up a Rx for 20Meq and take for 1 month, then come see him again and have more labs. At that visit he told me we should try Spironolactone because of the low K and that it was a probable Dx of PA but that surgery was not really a better predictor of survival (!). When I asked about all the other symptoms in addition to the HBP he told me that a lot of his patients are much sicker than I am and since my BP is good with the Spiro I should not consider expensive tests/surgery – or wait until I'm on Medicare!!! Needless to say I am once again in the market for a PCP. I have an appointment (in January!) to see a woman who comes highly recommended but of course, I'll have to start all over trying to convince her.In the meantime I'm going to start DASHing and wonder if I can stop the Spiro if my BP gets too low. (It's been in the 110s/70s most of the time since starting

Spiro.) If so, do I have to taper off? Should I still pursue the tests for an adenoma? If I feel good by DASHing does it matter?Honestly, many days I feel so horrible that I can barely function. Yesterday I could barely raise my arms or put one foot in front of the other. Not too long ago I woke in the night with terrible chest pain and my heart flopping around in my chest like a fish out of water. I was so exhausted that I just rolled over and thought how nice it would be to just die of a heart attack and not have to continue the way I've been feeling. On my good days (which are few and far between) I know better. Thanks for all the knowledge!!! Lyndap.s. last lab work showed K at 3.6 and the PCP is OK with that

[Guest guest]

Dr Grim did I read that right - you know of one study that shows an advantage of

surgery over meds? Any chance you have a link or citation? I'd love to pass a

copy of that along to my medical team. Thanks.

> >

> >

> > Subject: Suspect PA but no Dx

> > To: hyperaldosteronism

> > Date: Saturday, October 29, 2011, 9:59 AM

> >

> >

> > I've been reading your messages for a while and really learning a lot. I am

a 58 yr. old woman with hypertension diagnosed about a year ago. I probably had

high BP for the last 5 years but don't go to the doctor unless I absolutely have

to, so I'm not sure. My Gyno recorded BPs of 150s/90s the last couple of years

and insisted that I find a PCP and deal with it before she would give me another

Rx for HRT. The last PCP I had that I could work with died in a car crash about

7 years ago and I've been frustrated in trying to find a good doc since then.

> >

> > Anyway, I saw a doctor recently who picked up on the probable PA (I had

never even heard of hyperaldosteronism!) because I had a bad reaction to

Lisinopril (went to the ER with heart attack symptoms - BP 140/100). The ER doc

suggested HCT might be a better BP med and the PCP prescribed it. My BP

immediately got better and I thought I was home free. Not so. When I had some

lab work done as a follow up a month or two later my K was 3.2 and the PCP

called and told me to pick up a Rx for 20Meq and take for 1 month, then come see

him again and have more labs. At that visit he told me we should try

Spironolactone because of the low K and that it was a probable Dx of PA but that

surgery was not really a better predictor of survival (!). When I asked about

all the other symptoms in addition to the HBP he told me that a lot of his

patients are much sicker than I am and since my BP is good with the Spiro I

should not consider expensive tests/surgery †" or wait until I'm on Medicare!!!

Needless to say I am once again in the market for a PCP. I have an appointment

(in January!) to see a woman who comes highly recommended but of course, I'll

have to start all over trying to convince her.

> >

> > In the meantime I'm going to start DASHing and wonder if I can stop the

Spiro if my BP gets too low. (It's been in the 110s/70s most of the time since

starting Spiro.) If so, do I have to taper off? Should I still pursue the tests

for an adenoma? If I feel good by DASHing does it matter?

> >

> > Honestly, many days I feel so horrible that I can barely function. Yesterday

I could barely raise my arms or put one foot in front of the other. Not too long

ago I woke in the night with terrible chest pain and my heart flopping around in

my chest like a fish out of water. I was so exhausted that I just rolled over

and thought how nice it would be to just die of a heart attack and not have to

continue the way I've been feeling. On my good days (which are few and far

between) I know better.

> >

> > Thanks for all the knowledge!!! Lynda

> > p.s. last lab work showed K at 3.6 and the PCP is OK with that

> >

> >

>

[Guest guest]

I agree with . Don't change he doctor. It's very, very rare that PCP could figured out PA. He is not a bad doctor. Nevertheless K=3.2 is not goof enough. Dash!!!!! 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: Saturday, October 29, 2011 12:48 PMSubject: Re: Suspect PA but no Dx

Wow, your history, your bad response to HCTZ, the positive result to spiro, and the no result to lisinopril scream PA.

Surgery has not been proven undeniably to be better then medication, though we have some anecdotal stories that people have done very well. Dr G has said he suspects some on here did well and some didn't after surgery but didn't always relay their experiences.

So what did your doc do that made you mad? Looks like they researched it, looks like they found it, looks like they wanted to do what is safest first (more people die in routine surgery then from taking spiro and DASHing), and the average patient is afraid of having surgery anyway, I am one of those considering how dangerously and critically high my BP used to be, so maybe they were trying to be nice and avoid everything that goes with surgery first.

Actually it sounds as if you were pretty damn lucky. Read through some of the stories on here about some being misdagnosed for years and years. A BP of 150 /90 is way too high, but not uncommon for someone over 50. There are many on here who were in and out of hospitals with BP's of 180's and higher over 120's and higher for years and years who were in their 30's and 40's before they finally found it. I bet some aren't around to tell their story.

Be grateful you had an alert doc. Sounds like they on the ball. Discuss your options with them as all they have to do is refer you to a surgeon to discuss it more. It's no harm to your doc to do so.

Subject: Suspect PA but no DxTo: hyperaldosteronism Date: Saturday, October 29, 2011, 9:59 AM

I've been reading your messages for a while and really learning a lot. I am a 58 yr. old woman with hypertension diagnosed about a year ago. I probably had high BP for the last 5 years but don't go to the doctor unless I absolutely have to, so I'm not sure. My Gyno recorded BPs of 150s/90s the last couple of years and insisted that I find a PCP and deal with it before she would give me another Rx for HRT. The last PCP I had that I could work with died in a car crash about 7 years ago and I've been frustrated in trying to find a good doc since then.Anyway, I saw a doctor recently who picked up on the probable PA (I had never even heard of hyperaldosteronism!) because I had a bad reaction to Lisinopril (went to the ER with heart attack symptoms - BP 140/100). The ER doc suggested HCT might be a better BP med and the PCP prescribed it. My BP immediately got better and I thought I was home free. Not so. When I had some lab work done as a follow

up a month or two later my K was 3.2 and the PCP called and told me to pick up a Rx for 20Meq and take for 1 month, then come see him again and have more labs. At that visit he told me we should try Spironolactone because of the low K and that it was a probable Dx of PA but that surgery was not really a better predictor of survival (!). When I asked about all the other symptoms in addition to the HBP he told me that a lot of his patients are much sicker than I am and since my BP is good with the Spiro I should not consider expensive tests/surgery – or wait until I'm on Medicare!!! Needless to say I am once again in the market for a PCP. I have an appointment (in January!) to see a woman who comes highly recommended but of course, I'll have to start all over trying to convince her.In the meantime I'm going to start DASHing and wonder if I can stop the Spiro if my BP gets too low. (It's been in the 110s/70s most of the time since starting

Spiro.) If so, do I have to taper off? Should I still pursue the tests for an adenoma? If I feel good by DASHing does it matter?Honestly, many days I feel so horrible that I can barely function. Yesterday I could barely raise my arms or put one foot in front of the other. Not too long ago I woke in the night with terrible chest pain and my heart flopping around in my chest like a fish out of water. I was so exhausted that I just rolled over and thought how nice it would be to just die of a heart attack and not have to continue the way I've been feeling. On my good days (which are few and far between) I know better. Thanks for all the knowledge!!! Lyndap.s. last lab work showed K at 3.6 and the PCP is OK with that

[Guest guest]

Oh, BTW, for all of us. I just found out that many herbal teas contain licorice. Guys, be careful with herbal tea, especially exotic and expensive one :-) 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 " <hyperaldosteronism >Sent: Saturday, October 29, 2011 1:15 PMSubject: Re: Suspect PA but no Dx

The PCP who picked up the PA sounds excellent tome and I would not abandon him as he likely saved you years of more suffering as uWill note in many stories here. We just need to fine tune his expertise. Take him my evolution article remind him I trainDr Conn. Ask him to listen to you and not be satisfied until u are feeling normal. How many times a night do u get up to pee ? Do u eat licorice every day. I would work harder on DASHing and have PCP check your urine Na K till u get the ration less than one. May your pressure be low!CE Grim MDSpecializing in DifficultHypertension

I've been reading your messages for a while and really learning a lot. I am a 58 yr. old woman with hypertension diagnosed about a year ago. I probably had high BP for the last 5 years but don't go to the doctor unless I absolutely have to, so I'm not sure. My Gyno recorded BPs of 150s/90s the last couple of years and insisted that I find a PCP and deal with it before she would give me another Rx for HRT. The last PCP I had that I could work with died in a car crash about 7 years ago and I've been frustrated in trying to find a good doc since then.

Anyway, I saw a doctor recently who picked up on the probable PA (I had never even heard of hyperaldosteronism!) because I had a bad reaction to Lisinopril (went to the ER with heart attack symptoms - BP 140/100). The ER doc suggested HCT might be a better BP med and the PCP prescribed it. My BP immediately got better and I thought I was home free. Not so. When I had some lab work done as a follow up a month or two later my K was 3.2 and the PCP called and told me to pick up a Rx for 20Meq and take for 1 month, then come see him again and have more labs. At that visit he told me we should try Spironolactone because of the low K and that it was a probable Dx of PA but that surgery was not really a better predictor of survival (!). When I asked about all the other symptoms in addition to the HBP he told me that a lot of his patients are much sicker than I am and since my BP is good with the Spiro I should not consider expensive tests/surgery – or

wait until I'm on Medicare!!! Needless to say I am once again in the market for a PCP. I have an appointment (in January!) to see a woman who comes highly recommended but of course, I'll have to start all over trying to convince her.

In the meantime I'm going to start DASHing and wonder if I can stop the Spiro if my BP gets too low. (It's been in the 110s/70s most of the time since starting Spiro.) If so, do I have to taper off? Should I still pursue the tests for an adenoma? If I feel good by DASHing does it matter?

Honestly, many days I feel so horrible that I can barely function. Yesterday I could barely raise my arms or put one foot in front of the other. Not too long ago I woke in the night with terrible chest pain and my heart flopping around in my chest like a fish out of water. I was so exhausted that I just rolled over and thought how nice it would be to just die of a heart attack and not have to continue the way I've been feeling. On my good days (which are few and far between) I know better.

Thanks for all the knowledge!!! Lynda

p.s. last lab work showed K at 3.6 and the PCP is OK with that

[Guest guest]

Thanks so much for all the feedback. I do appreciate the fact that my PCP

recognized PA. I just feel so horrible and his response is " many of my patients

are much sicker than you. " And he doesn't appreciate how drastic the other

symptoms are even though I have my BP under control. He gives me the impression

that he thinks I'm just a drama queen and nothing could be further from the

truth.

He's right that I'm not nearly as sick as some people - I don't have a myriad of

diagnoses as so many on this list seem to. That doesn't change the fact that I

don't feel well enough most days to do anything other than go to work and come

home and collapse. I support my son who is a quadriplegic for the last 13+

years and I can't just stop working or go on disability.

I can't accept that as a 58 yr. old woman who is otherwise healthy I can only

hope to get through my days. I would truly rather be dead. Then at least my

children would have my life insurance! Don't misunderstand - I'm NOT suicidal.

I just want to feel better and I want a doctor who will work with me and respect

my desire to be healthy.

I'm 5'3 " and 138 pounds. I don't smoke, drink, or do drugs. I avoid medication

in general if at all possible. I'm just trying to figure out if I should

seriously pursue surgery or try to manage this condition with diet and exercise.

I am open to any and all suggestions. Thanks so much for your quick responses!

Lynda

[Guest guest]

No - I almost never eat licorice or anything that contains it. I do not use

herbal teas.

[Guest guest]

I see a potential issue where your body is not agreeing with your doctor and lab

ranges! you reported K of 3.6 and many here have experienced low K problems

when their K got below 3.8. I have never had low K but your SX is what others

report.

Many have what they call " brain fog " which is very real to us but some doctors

think we are psyco or " middle age women's syndrome " ! Makes you want to zap them

with a dose of either (or both!) I would remind my doctor exactly how many PTNs

of his that you are worried about and to stick with treating that one!

I am treating my PA w/meds and Dash and it is working very well BUT it took me

10 months to get complete control! We charged the delay off to excess NA but I

have recently read where it may take some time to get the excess aldosterone out

of your system.

If you are on Spiro, remember you have to wash that out of your system, 6 weeks,

to pursue an AVS. If you haven't read the " Stowasser et/al " article in our

files it does a good job laying out pros and cons although it doesn't advocate

Meds and DASH as strong as Dr. Grim does.

- 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.

>

>

>

> Thanks so much for all the feedback. I do appreciate the fact that my PCP

recognized PA. I just feel so horrible and his response is " many of my patients

are much sicker than you. " And he doesn't appreciate how drastic the other

symptoms are even though I have my BP under control. He gives me the impression

that he thinks I'm just a drama queen and nothing could be further from the

truth.

>

> He's right that I'm not nearly as sick as some people - I don't have a myriad

of diagnoses as so many on this list seem to. That doesn't change the fact that

I don't feel well enough most days to do anything other than go to work and come

home and collapse. I support my son who is a quadriplegic for the last 13+

years and I can't just stop working or go on disability.

>

> I can't accept that as a 58 yr. old woman who is otherwise healthy I can only

hope to get through my days. I would truly rather be dead. Then at least my

children would have my life insurance! Don't misunderstand - I'm NOT suicidal.

I just want to feel better and I want a doctor who will work with me and respect

my desire to be healthy.

>

> I'm 5'3 " and 138 pounds. I don't smoke, drink, or do drugs. I avoid

medication in general if at all possible. I'm just trying to figure out if I

should seriously pursue surgery or try to manage this condition with diet and

exercise.

>

> I am open to any and all suggestions. Thanks so much for your quick

responses!

> Lynda

>

[Guest guest]

I don't have current lab results but this was early 2011 when I was feeling

horrible even though I had my BP under control with HCTZ:

Sodium 141 135 - 145 mmol/L

Potassium 3.2 3.5 - 5.2 mmol/L

CO2 26 19 - 31 mmol/L

Globulin 1.7 2.0 - 3.7 g/dL

Alb/Glob Ratio 2.6 1.00 - 2.0

Calcium 9.2 8.4 - 10.6 mg/dL

Hemoglobin 13.7 11.5 - 16.0 g/dL

Glucose 66 65 - 99 mg/dL

Urea Nitrogen 21 8 - 25 mg/dL

Creatinine .87 .60 - 1.40 mg/dL

GFR Estimated >60 >60 mL/min/l.73m2

Current Symptoms:

Cramping of my legs and feet (comes and goes)

Extreme (!) fatigue - probably my most bothersome symptom

Shortness of breath (comes and goes)

Palpitations/chest pain (comes and goes)

Sweating for no particular reason (comes and goes)

Headaches (frequent migraines)

Muscle aches - especially after I do any kind of manual labor (yard work,

housework)

Thirsty no matter how much water I drink

Frequent (!) urination all day - I would get up 3-4 times at night but I try not

to disturb the household

Blurred vision (comes and goes)

Brain Fog/Too many 'senior' moments

Tinnitus - extreme (but don't know if this is related to PA)

Current meds:

Evamist (1.53 mg Estradiol: HRT spray)

25mg Spironolactone

[Guest guest]

Hard to DX w/o current labs but if your potassium is not higher it would explain

most of your SX. Are you dashing? What is your BP and other vitals? Do you

have PA or the tests for it?

- 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.

>

>

>

>

>

>

> I don't have current lab results but this was early 2011 when I was feeling

horrible even though I had my BP under control with HCTZ:

> Sodium 141 135 - 145 mmol/L

> Potassium 3.2 3.5 - 5.2 mmol/L

> CO2 26 19 - 31 mmol/L

> Globulin 1.7 2.0 - 3.7 g/dL

> Alb/Glob Ratio 2.6 1.00 - 2.0

> Calcium 9.2 8.4 - 10.6 mg/dL

> Hemoglobin 13.7 11.5 - 16.0 g/dL

> Glucose 66 65 - 99 mg/dL

> Urea Nitrogen 21 8 - 25 mg/dL

> Creatinine .87 .60 - 1.40 mg/dL

> GFR Estimated >60 >60 mL/min/l.73m2

>

> Current Symptoms:

> Cramping of my legs and feet (comes and goes)

> Extreme (!) fatigue - probably my most bothersome symptom

> Shortness of breath (comes and goes)

> Palpitations/chest pain (comes and goes)

> Sweating for no particular reason (comes and goes)

> Headaches (frequent migraines)

> Muscle aches - especially after I do any kind of manual labor (yard work,

housework)

> Thirsty no matter how much water I drink

> Frequent (!) urination all day - I would get up 3-4 times at night but I try

not to disturb the household

> Blurred vision (comes and goes)

> Brain Fog/Too many 'senior' moments

> Tinnitus - extreme (but don't know if this is related to PA)

>

> Current meds:

> Evamist (1.53 mg Estradiol: HRT spray)

> 25mg Spironolactone

>

[Guest guest]

Your symptoms sound SO much like my low potassium symptoms before my

adrenalectomy! Even though I was taking K tabs I could rarely keep it over 3.9,

which I determined was the minimum level I needed to not have symptoms.

Since my adrenalectomy my K has remained steady between 4.4-4.5, and I have not

had a single symptom - and I have to say that I've felt better than I have in

YEARS even though I'm barely 2 weeks out of surgery! My energy levels have been

fantastic, despite the 4 holes in my side, and brain fog has been nonexistent.

I'm starting to think that the " normal " value most labs show of 3.5-5 is just

too low for most people with PA, especially as others have posted here that they

were still symptomatic with " normal " values between 3.5 and 4.

-msmith1928

Nulliparous female, 46, 5'3 " , 116 lbs, polymenorrhea, hyperinsulinemia,

hereditary fructose intolerance, lactose intolerance, gluten intolerance

(probable celiac). Current meds: singulair 10mg, norethindrone .35mg to regulate

polymenorrhea, fexofenadine 180mg as needed. Low sodium, fructose- and

grain-free diet. CT showed 1cm left adrenal nodule, AVS determined disease is

unilateral, had left laparoscopic adrenalectomy on 10/13/2011.

>

>

>

>

>

>

> I don't have current lab results but this was early 2011 when I was feeling

horrible even though I had my BP under control with HCTZ:

> Sodium 141 135 - 145 mmol/L

> Potassium 3.2 3.5 - 5.2 mmol/L

> CO2 26 19 - 31 mmol/L

> Globulin 1.7 2.0 - 3.7 g/dL

> Alb/Glob Ratio 2.6 1.00 - 2.0

> Calcium 9.2 8.4 - 10.6 mg/dL

> Hemoglobin 13.7 11.5 - 16.0 g/dL

> Glucose 66 65 - 99 mg/dL

> Urea Nitrogen 21 8 - 25 mg/dL

> Creatinine .87 .60 - 1.40 mg/dL

> GFR Estimated >60 >60 mL/min/l.73m2

>

> Current Symptoms:

> Cramping of my legs and feet (comes and goes)

> Extreme (!) fatigue - probably my most bothersome symptom

> Shortness of breath (comes and goes)

> Palpitations/chest pain (comes and goes)

> Sweating for no particular reason (comes and goes)

> Headaches (frequent migraines)

> Muscle aches - especially after I do any kind of manual labor (yard work,

housework)

> Thirsty no matter how much water I drink

> Frequent (!) urination all day - I would get up 3-4 times at night but I try

not to disturb the household

> Blurred vision (comes and goes)

> Brain Fog/Too many 'senior' moments

> Tinnitus - extreme (but don't know if this is related to PA)

>

> Current meds:

> Evamist (1.53 mg Estradiol: HRT spray)

> 25mg Spironolactone

>

[Guest guest]

Yes u have many Sx of PA DUE to low K. Any better when Spiro started?I recommend starting to DASH NOW AND START 1 cup low Na v-8 a day. At least. You may start to feel better in a few days. Read sodium content of everything u eat or drink. Goal is less thN 500 mg a day. May your pressure be low!CE Grim MS, MDSpecializing in DifficultHypertension

I don't have current lab results but this was early 2011 when I was feeling horrible even though I had my BP under control with HCTZ:

Sodium 141 135 - 145 mmol/L

Potassium 3.2 3.5 - 5.2 mmol/L

CO2 26 19 - 31 mmol/L

Globulin 1.7 2.0 - 3.7 g/dL

Alb/Glob Ratio 2.6 1.00 - 2.0

Calcium 9.2 8.4 - 10.6 mg/dL

Hemoglobin 13.7 11.5 - 16.0 g/dL

Glucose 66 65 - 99 mg/dL

Urea Nitrogen 21 8 - 25 mg/dL

Creatinine .87 .60 - 1.40 mg/dL

GFR Estimated >60 >60 mL/min/l.73m2

Current Symptoms:

Cramping of my legs and feet (comes and goes)

Extreme (!) fatigue - probably my most bothersome symptom

Shortness of breath (comes and goes)

Palpitations/chest pain (comes and goes)

Sweating for no particular reason (comes and goes)

Headaches (frequent migraines)

Muscle aches - especially after I do any kind of manual labor (yard work, housework)

Thirsty no matter how much water I drink

Frequent (!) urination all day - I would get up 3-4 times at night but I try not to disturb the household

Blurred vision (comes and goes)

Brain Fog/Too many 'senior' moments

Tinnitus - extreme (but don't know if this is related to PA)

Current meds:

Evamist (1.53 mg Estradiol: HRT spray)

25mg Spironolactone

[Guest guest]

I will definitely try the low-Na V8 juice. I had no idea that I would have to

try to get only 500mg of Na! That sounds like a real challenge. I have not

really improved much in terms of symptoms with the Spiro - other than BP being

OK.

That's why I was wondering about surgery - assuming it's an option.

Thanks,

Lynda

[Guest guest]

It is 1500 not 500 of NA.

>

> I will definitely try the low-Na V8 juice. I had no idea that I would have to

try to get only 500mg of Na! That sounds like a real challenge. I have not

really improved much in terms of symptoms with the Spiro - other than BP being

OK.

>

> That's why I was wondering about surgery - assuming it's an option.

>

> Thanks,

> Lynda

>

[Guest guest]

I believe 500mg of NA is a misprint, 1500mg is considered low.

25mg of spiro might be too low. 25mg resolved BP issues for me but I was on

25mg bid and low NA when everything corrected. I did not notice a gradual

change BTW, it was all one day, April 23, 2011, just like turning off a light

switch!

- 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.

>

> I will definitely try the low-Na V8 juice. I had no idea that I would have to

try to get only 500mg of Na! That sounds like a real challenge. I have not

really improved much in terms of symptoms with the Spiro - other than BP being

OK.

>

> That's why I was wondering about surgery - assuming it's an option.

>

> Thanks,

> Lynda

>

[Guest guest]

lyndahnaz, I have had all those symptoms and they did not resolve with spiro/eplerenone. I have Lyme disease, Babesia and Bartonella for which I am receiving treatment. I expect to now live. Two years ago, I was trying to write final letters to my children. Val From: hyperaldosteronism [mailto:hyperaldosteronism ] On Behalf Of lyndahnazCurrent Symptoms:Cramping of my legs and feet (comes and goes)Extreme (!) fatigue - probably my most bothersome symptomShortness of breath (comes and goes)Palpitations/chest pain (comes and goes)Sweating for no particular reason (comes and goes)Headaches (frequent migraines)Muscle aches - especially after I do any kind of manual labor (yard work, housework)Thirsty no matter how much water I drinkFrequent (!) urination all day - I would get up 3-4 times at night but I try not to disturb the householdBlurred vision (comes and goes)Brain Fog/Too many 'senior' momentsTinnitus - extreme (but don't know if this is related to PA)Current meds:Evamist (1.53 mg Estradiol: HRT spray)25mg Spironolactone

[Guest guest]

Lynda,I have all the same symptoms too. Could you try to take 2 tablets of spiro per day and see what happens? And DASH!!!!! Natalia To: hyperaldosteronism Sent: Sunday, October 30, 2011 1:04 PMSubject: Re: Suspect PA but no Dx

Your symptoms sound SO much like my low potassium symptoms before my adrenalectomy! Even though I was taking K tabs I could rarely keep it over 3.9, which I determined was the minimum level I needed to not have symptoms.

Since my adrenalectomy my K has remained steady between 4.4-4.5, and I have not had a single symptom - and I have to say that I've felt better than I have in YEARS even though I'm barely 2 weeks out of surgery! My energy levels have been fantastic, despite the 4 holes in my side, and brain fog has been nonexistent.

I'm starting to think that the "normal" value most labs show of 3.5-5 is just too low for most people with PA, especially as others have posted here that they were still symptomatic with "normal" values between 3.5 and 4.

-msmith1928

Nulliparous female, 46, 5'3", 116 lbs, polymenorrhea, hyperinsulinemia, hereditary fructose intolerance, lactose intolerance, gluten intolerance (probable celiac). Current meds: singulair 10mg, norethindrone .35mg to regulate polymenorrhea, fexofenadine 180mg as needed. Low sodium, fructose- and grain-free diet. CT showed 1cm left adrenal nodule, AVS determined disease is unilateral, had left laparoscopic adrenalectomy on 10/13/2011.

>

>

>

>

>

>

> I don't have current lab results but this was early 2011 when I was feeling horrible even though I had my BP under control with HCTZ:

> Sodium 141 135 - 145 mmol/L

> Potassium 3.2 3.5 - 5.2 mmol/L

> CO2 26 19 - 31 mmol/L

> Globulin 1.7 2.0 - 3.7 g/dL

> Alb/Glob Ratio 2.6 1.00 - 2.0

> Calcium 9.2 8.4 - 10.6 mg/dL

> Hemoglobin 13.7 11.5 - 16.0 g/dL

> Glucose 66 65 - 99 mg/dL

> Urea Nitrogen 21 8 - 25 mg/dL

> Creatinine .87 .60 - 1.40 mg/dL

> GFR Estimated >60 >60 mL/min/l.73m2

>

> Current Symptoms:

> Cramping of my legs and feet (comes and goes)

> Extreme (!) fatigue - probably my most bothersome symptom

> Shortness of breath (comes and goes)

> Palpitations/chest pain (comes and goes)

> Sweating for no particular reason (comes and goes)

> Headaches (frequent migraines)

> Muscle aches - especially after I do any kind of manual labor (yard work, housework)

> Thirsty no matter how much water I drink

> Frequent (!) urination all day - I would get up 3-4 times at night but I try not to disturb the household

> Blurred vision (comes and goes)

> Brain Fog/Too many 'senior' moments

> Tinnitus - extreme (but don't know if this is related to PA)

>

> Current meds:

> Evamist (1.53 mg Estradiol: HRT spray)

> 25mg Spironolactone

>

[Guest guest]

Sorry it is 1500 mg. Good pick up. But if that does not get BP to goal then need to step it down to at least the rice diet which is 250 mg. A week or two at a time.CE Grim MD Dr Grim, I thought the goal was 1500mg not 500mg? Phyllis Yes u have many Sx of PA DUE to low K. Any better when Spiro started? I recommend starting to DASH NOW AND START 1 cup low Na v-8 a day. At least. You may start to feel better in a few days. Read sodium content of everything u eat or drink. Goal is less thN 500 mg a day. May your pressure be low! CE Grim MS, MD Specializing in Difficult Hypertension I don't have current lab results but this was early 2011 when I was feeling horrible even though I had my BP under control with HCTZ: Sodium 141 135 - 145 mmol/L Potassium 3.2 3.5 - 5.2 mmol/L CO2 26 19 - 31 mmol/L Globulin 1.7 2.0 - 3.7 g/dL Alb/Glob Ratio 2.6 1.00 - 2.0 Calcium 9.2 8.4 - 10.6 mg/dL Hemoglobin 13.7 11.5 - 16.0 g/dL Glucose 66 65 - 99 mg/dL Urea Nitrogen 21 8 - 25 mg/dL Creatinine .87 .60 - 1.40 mg/dL GFR Estimated >60 >60 mL/min/l.73m2 Current Symptoms: Cramping of my legs and feet (comes and goes) Extreme (!) fatigue - probably my most bothersome symptom Shortness of breath (comes and goes) Palpitations/chest pain (comes and goes) Sweating for no particular reason (comes and goes) Headaches (frequent migraines) Muscle aches - especially after I do any kind of manual labor (yard work, housework) Thirsty no matter how much water I drink Frequent (!) urination all day - I would get up 3-4 times at night but I try not to disturb the household Blurred vision (comes and goes) Brain Fog/Too many 'senior' moments Tinnitus - extreme (but don't know if this is related to PA) Current meds: Evamist (1.53 mg Estradiol: HRT spray) 25mg Spironolactone

[Guest guest]

et al you are correct should be 1500 mg or less. Not 500.CE Grim MD I believe 500mg of NA is a misprint, 1500mg is considered low. 25mg of spiro might be too low. 25mg resolved BP issues for me but I was on 25mg bid and low NA when everything corrected. I did not notice a gradual change BTW, it was all one day, April 23, 2011, just like turning off a light switch! - 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. > > I will definitely try the low-Na V8 juice. I had no idea that I would have to try to get only 500mg of Na! That sounds like a real challenge. I have not really improved much in terms of symptoms with the Spiro - other than BP being OK. > > That's why I was wondering about surgery - assuming it's an option. > > Thanks, > Lynda >

[Guest guest]

Val so have you been able to stop spiro and no longer DASH and BP and K are at goal with Lyme Rx?CE Grim MD lyndahnaz, I have had all those symptoms and they did not resolve with spiro/eplerenone. I have Lyme disease, Babesia and Bartonella for which I am receiving treatment. I expect to now live. Two years ago, I was trying to write final letters to my children. Val From: hyperaldosteronism [mailto:hyperaldosteronism ] On Behalf Of lyndahnazCurrent Symptoms:Cramping of my legs and feet (comes and goes)Extreme (!) fatigue - probably my most bothersome symptomShortness of breath (comes and goes)Palpitations/chest pain (comes and goes)Sweating for no particular reason (comes and goes)Headaches (frequent migraines)Muscle aches - especially after I do any kind of manual labor (yard work, housework)Thirsty no matter how much water I drinkFrequent (!) urination all day - I would get up 3-4 times at night but I try not to disturb the householdBlurred vision (comes and goes)Brain Fog/Too many 'senior' momentsTinnitus - extreme (but don't know if this is related to PA)Current meds:Evamist (1.53 mg Estradiol: HRT spray)25mg Spironolactone

[Guest guest]

I am still on 75 mg eperlenone (compared to 150 mg spiro before I started Lyme treatment). My cortisol is also high so I imagine my aldosterone is still high as well. My BP is running 124/71 (down from 210/120). My K is about 4.2. I eat low salt but don't keep a record and don't do strict control like I used to do. I cannot stand the taste of much salt anymore but if I do eat some, like Chinese, I don't stress about it and my BP stays fine. After trying every weight loss program ever invented, I have lost 40 pounds since on Lyme treatment. BTW, for you DASHers, when I was at Mayo Clnic in 2008, my urine sodium was " too low to quantitate. " Young MD said he'd never seen sodium so low. 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 GrimVal so have you been able to stop spiro and no longer DASH and BP and K are at goal with Lyme Rx?CE Grim MD lyndahnaz, I have had all those symptoms and they did not resolve with spiro/eplerenone. I have Lyme disease, Babesia and Bartonella for which I am receiving treatment. I expect to now live. Two years ago, I was trying to write final letters to my children.Val From: hyperaldosteronism [mailto:hyperaldosteronism ] On Behalf Of lyndahnazCurrent Symptoms:Cramping of my legs and feet (comes and goes)Extreme (!) fatigue - probably my most bothersome symptomShortness of breath (comes and goes)Palpitations/chest pain (comes and goes)Sweating for no particular reason (comes and goes)Headaches (frequent migraines)Muscle aches - especially after I do any kind of manual labor (yard work, housework)Thirsty no matter how much water I drinkFrequent (!) urination all day - I would get up 3-4 times a t night but I try not to disturb the householdBlurred vision (comes and goes)Brain Fog/Too many 'senior' momentsTinnitus - extreme (but don't know if this is related to PA)Current meds:Evamist (1.53 mg Estradiol: HRT spray)25mg Spironolactone

[Guest guest]

mssmith - so glad to hear of your good results! It gives me hope.

Natlia - if I have my BP under control with 25mg spiro, would the other symptoms

(maybe) improve with an increase to 50mg? It never occurred to me to take more.

Thanks everyone,

Lynda

[Guest guest]

When I increased spiro the only result I got was diarreha. Went back to 25mg

bid and found the solution by lowering my salt (NA).

- 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.

>

> mssmith - so glad to hear of your good results! It gives me hope.

>

> Natlia - if I have my BP under control with 25mg spiro, would the other

symptoms (maybe) improve with an increase to 50mg? It never occurred to me to

take more.

>

> Thanks everyone,

> Lynda

>

[Guest guest]

Excellent the goal is to find the right combo an to master it so u sont have to think about it every day and it looks like you have. Keep up the good work.I have had pts lose 70 lbs on DASH. May your pressure be low!CE Grim MS, MDSpecializing in DifficultHypertension

I am still on 75 mg eperlenone (compared to 150 mg spiro before I started Lyme treatment). My cortisol is also high so I imagine my aldosterone is still high as well. My BP is running 124/71 (down from 210/120). My K is about 4.2. I eat low salt but don't keep a record and don't do strict control like I used to do. I cannot stand the taste of much salt anymore but if I do eat some, like Chinese, I don't stress about it and my BP stays fine. After trying every weight loss program ever invented, I have lost 40 pounds since on Lyme treatment. BTW, for you DASHers, when I was at Mayo Clnic in 2008, my urine sodium was "too low to

quantitate." Young MD said he'd never seen sodium so low. 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 GrimVal so have you been able to stop spiro and no longer DASH and BP and K are at goal with Lyme Rx?CE Grim MD lyndahnaz, I have had all those symptoms and they did not resolve with spiro/eplerenone. I have Lyme disease, Babesia and Bartonella for which I am receiving treatment. I expect to now live. Two years ago, I was trying to write final letters to my

children.Val From: hyperaldosteronism [mailto:hyperaldosteronism ] On Behalf Of lyndahnazCurrent Symptoms:Cramping of my legs and feet (comes and goes)Extreme (!) fatigue - probably my most bothersome symptomShortness of breath (comes and goes)Palpitations/chest pain (comes and goes)Sweating for no particular reason (comes and goes)Headaches (frequent migraines)Muscle aches - especially after I do any kind of manual labor (yard work, housework)Thirsty no matter how much water I drinkFrequent (!) urination all day - I would get up 3-4 times a t night but I try

not to disturb the householdBlurred vision (comes and goes)Brain Fog/Too many 'senior' momentsTinnitus - extreme (but don't know if this is related to PA)Current meds:Evamist (1.53 mg Estradiol: HRT spray)25mg Spironolactone