RE: spiro

[Guest guest]

Watch this veido to know more about sprio

>

> From what I've been researching online, ppl with hyperaldo can take anywhere

from 100-400mg of spiro a day..... WOW! That just seems like alot to be on a

diuretic especially if it depletes your potassium. How can a person take so much

spiro and feel well and if it depletes your potassium how much potassium supp

would be needed. Just curious in case the dr's decide to increase my spiro

dosage.

>

[Guest guest]

Spiro blocks also thus decreasing Na retention and potassium excretion. It is not a diuretic in the usual sense of the term. Did you rad my evolution. Article yet?May your pressure be low!CE Grim MS, MDSpecializing in DifficultHypertension

From what I've been researching online, ppl with hyperaldo can take anywhere from 100-400mg of spiro a day..... WOW! That just seems like alot to be on a diuretic especially if it depletes your potassium. How can a person take so much spiro and feel well and if it depletes your potassium how much potassium supp would be needed. Just curious in case the dr's decide to increase my spiro dosage.

[Guest guest]

No I access the group from mobile device and am only on mailing list, unable to

open files until I get to a computer.

Re: spiro

Spiro blocks also thus decreasing Na retention and potassium excretion. It is

not a diuretic in the usual sense of the term. Did you rad my evolution. Article

yet?

May your pressure be low!

CE Grim MS, MD

Specializing in Difficult

Hypertension

On Nov 18, 2011, at 10:13, " adifferentme@... "

wrote:

> From what I've been researching online, ppl with hyperaldo can take anywhere

from 100-400mg of spiro a day..... WOW! That just seems like alot to be on a

diuretic especially if it depletes your potassium. How can a person take so much

spiro and feel well and if it depletes your potassium how much potassium supp

would be needed. Just curious in case the dr's decide to increase my spiro

dosage.

>

>

[Guest guest]

You said lebetalol is not good for hyperaldo but it seems to work for me but

only for a short while so I take 3 times per day. What meds are good besides

spiro? I will need to ask this endo dr on Monday.

Re: spiro

Spiro blocks also thus decreasing Na retention and potassium excretion. It is

not a diuretic in the usual sense of the term. Did you rad my evolution. Article

yet?

May your pressure be low!

CE Grim MS, MD

Specializing in Difficult

Hypertension

On Nov 18, 2011, at 10:13, " adifferentme@... "

wrote:

> From what I've been researching online, ppl with hyperaldo can take anywhere

from 100-400mg of spiro a day..... WOW! That just seems like alot to be on a

diuretic especially if it depletes your potassium. How can a person take so much

spiro and feel well and if it depletes your potassium how much potassium supp

would be needed. Just curious in case the dr's decide to increase my spiro

dosage.

>

>

[Guest guest]

Hey read my evolution article it is all in there.CE Grim MD Welcome to the exciting world of Hyperaldosteronism You are in the right place! I am Dr. CE Grim a retired Professor of Medicine and Endocrinology. I have had a long standing interest is Primary Aldosteronism since medical school days when I saw my first patient with Primary Aldosteronism in 1963 as a 4th year medical student. I did a Nephrology Fellowship at Duke and an Endocrinology and Metabolism Fellowship with Dr. Conn (1969-70). I have been on the faculty of the University of MO, Indiana Univ, UCLA/ R. Drew, and the Medical College of Wisconsin in Divisions of Nephrology, Endocrinology, Hypertension, Cardiology and Epidemiology. I have published over 240 papers and book chapters in most areas of the broad discipline of High Blood Pressure. My CV is in our files for details. The GOAL of our group is to teach you and your health care team about the ins and outs of the causes, diagnosis and control of the many forms of hyperaldosteronism. The steps below will introduce you into the fascinating world of high blood pressure, salt and potassium and the role of the adrenal hormone aldosterone in health and disease. Doing these in sequence will save you time and effort in getting up to speed in taking control of you health and educating your own health care team. While we can’t make you a doctor we will make you into a pretty good BP doctor-a skill that you will have for life. 1. Overview: Read my article in our files on the evolution of PA (Evolution_of_PA-Grim.pdf ) and take to all members of health care team. Tell us what stage you believe you are in. This is a brief review of most causes of hyperaldosteronism, high blood pressure, low potassium (K). Be certain that you and your health care team understand the key role of excess diet salt in HTN and especially in PA. Go to: http://www.worldactiononsalt.com/evidence/treatment_trials.htm For a state of the art and science discussion of salt and health. 2. Other patients with hyperaldosteronism (Conn’s syndrome). Read our Conn's stories in our files and then give us your own in as much detail as you can. Dr. Conn was the first to describe this disease process and the syndrome is named after him. To see others' stories, on the Hyperaldosteronism home page, go to Files/Conn’s Stories. You'll find instructions in "A - How to put your story here.doc "Then send us your story in an email and then we will likely ask more questions and make suggestions before you upload it to our files. 3. Hyperaldosteronism and Salt: The deadly Duo. Eating Plan to control high blood pressure due to hyperaldosteronism and most others with high blood pressure. This will reduce your need for medications and in many will get your BP and K to goal without meds.. Get the DASH diet book by T. et al, read it and use it: $8 in paperback at your local bookstore. If they don’t have it ask them to order it for you. Learning to eat the DASH way will play a major role in your road to good BP and K control and, in many of our folks here, will revolutionize your life. Go to chapter 9 and do the 14 day challenge. Tell your Dr you are doing this as your BP may plummet if you are on other meds in only 2-3 days. or go to http://www.nhlbi.nih.gov/health/public/heart/hbp/dash/new_dash.pdf download this 64 page booklet free and do the Week on the DASH Diet for 2 weeks. If you are on BP meds be prepared for a large fall in BP and let your Dr. know you are doing this. Or go to (but costs money) DASH Diet for Health ProgramThe DASH Diet for Health Program is designed to help you improve your eating and exercise habits. Twice each week we will provide you with information on our website about food, food preparation, eating out, losing weight, getting fit and much more. In addition to providing new information each week on our website, we create a web page specially for you where you can track progress in areas such as your weight, blood pressure, and exercise.http://www.dashforhealth.com/ I strongly recommend you get the book and read it now! 4. Measure your BP: Measure your BP daily so you can see if it is getting better. If you are taking meds be sure to tell your health care team you are doing this as your BP may plummet to normal quickly. We recommend you use a device you listen to and will help you learn how to do this. If this is not something you want to do we can teach a significant other how to do it. See sharedcareinc.com or email to sharedcare@... to order a video on how to do this. If you already have one we will teach you how to teach your health care team how to validate your device. Your life and health depends on accurate BP measurements. Go to the amricanheart.org and download the Guidelines for Human Blood Pressure Measurement. Insist the your health care team do BP the AHA way. Your life is in the hands of those who measure your BP. Never trust your life to an automatic BP machine unless you know it is accurate on YOU. 5. Genetics and your BP: Go to familyhistory.hhs.gov and do your detailed family medical history so we can review with you to help Dx familial causes of high blood pressure and heart disease. If BP runs in your family you may save lives in your family by checking their BP yourself. There is a brief discussion of this in my Evolution Article. 6. How to DX and treat PA: Go to our file/Conn's Articles of Note/Medications/Bravo spir 1973.pdf and read this article and take to your health care team. It is old but still one of the best in the medical management of PA. Also see our file from the Endocrine Society Guidelines on PA. Dr. Grim's Perfect Primary Aldosteronism Blood and Urine Testing to diagnose PA in one day. 1. Eat a high salt diet for 2 weeks-at least 4000 mg of Na a day.2. No BP meds in last 4-12 weeks depending on meds and Drs advice.3. Collect 24 hr urine for Na, K and creatinine and aldosterone. Do not lose a drop of this liquid gold. It is impossible to interpret the renin and aldo without this.4. The morning you finish the 24 hr urine have fasting blood drawn for renin, aldo and K using our guidelines to get an accurate K. Try to get this done about 1-4 hours after you have been out of bed.5. Send us the results with the normal values for your lab.6. If you ever have a salt (saline) infusion test for PA be certain to ask them to measure how much you pee during the 4 hours of the infusion. If it is 1-1.5 liter of urine it strongly suggests that you may have PA. If more tha 1.5 L you almost certainly have PA. I call this Dr. Grim’s “Quick Pee Test” for PA. Our PA Registry: If you have been Dxed with PA already and are on Rx or have had surgery please go to http://www.kwiksurveys.com/online-survey.php?surveyID=HIJIO_f2685379 and complete our survey with as much information as you know. If there is some information you don't know ask us and we will help. If you need to update this as you journey thru the diagnostic/treatment process you can add another entry but label it as Nameyymmdd. For example today 4/20/11 for me would be Grim110420. This way of writing the date is an ever increasing number and will allow us and you to sort your multiple entries into a dated order. We are working on a more extensive database. 8. Learn the language: If you are new to medical lingo then download the acroyms from http://health.groups.yahoo.com/group/bloodpressureline/message/291869. Salt and high blood pressure: To learn the state of the science of salt and blood pressure please spend some time looking at http://www.worldactiononsalt.com/evidence/treatment_trials.htm10. Become a HBP expert consumer: Expect that it will take at least several weeks to get all this digested and to learn the new language of high blood pressure health care. As most doctors and nurses in practice have had very little training in high blood pressure you must become an expert yourself. For example most have never had anyone listen with them with a double stethoscope to verify that they can hear BP sounds. We cannot make you a doctor but we will make you a pretty good BP doctor.11. How High Blood Pressure should be managed: Go to nih.gov and download and read the Joint National Commission (JNC) Report 7 to get an overview on current guidelines. I ask all my secretaries to read this so they can communicate the importance of high blood pressure to my patients. JNC 8 will be out soon.Then: get (and study) the Hypertension Primer from americanheart.org. This is the most up-to-date compendium of what is known about high blood pressure and what every Dr. should know when they graduate from Medical School. Every chapter is only 2-3 pages. Read one chapter every week-night and you will finish it in about a year. I am working on a reading guide for lay people for the Primer. Stay tuned.12. Ask us questions: Ask any questions about high blood pressure you want answered. That is what we are here for.13. One-on-one Consulting: I can provide individual consulting if you do not want to go public. If you want individual one-on-one consulting for you and your Doctor contract me directly at lowerbp2@....May your pressure be low!Clarence E. Grim BS, MS, MD, FACP, FACCBoard Certified in Internal Medicine, Geriatrics, and High Blood Pressure Specializing in Primary Aldosteronism and Difficult to Control High Blood Pressure. You said lebetalol is not good for hyperaldo but it seems to work for me but only for a short while so I take 3 times per day. What meds are good besides spiro? I will need to ask this endo dr on Monday. Re: spiro Spiro blocks also thus decreasing Na retention and potassium excretion. It is not a diuretic in the usual sense of the term. Did you rad my evolution. Article yet? May your pressure be low! CE Grim MS, MD Specializing in Difficult Hypertension > From what I've been researching online, ppl with hyperaldo can take anywhere from 100-400mg of spiro a day..... WOW! That just seems like alot to be on a diuretic especially if it depletes your potassium. How can a person take so much spiro and feel well and if it depletes your potassium how much potassium supp would be needed. Just curious in case the dr's decide to increase my spiro dosage. > >

[Guest guest]

Spiro doesn't deplete your potassium, even opposite. It's called potassium-sparing-diuretic.Look at Wikipedia. Some side effect of spiro is high potassium, not low. Natalia To: hyperaldosteronism Sent: Friday, November 18, 2011 10:13 AMSubject:

spiro

From what I've been researching online, ppl with hyperaldo can take anywhere from 100-400mg of spiro a day..... WOW! That just seems like alot to be on a diuretic especially if it depletes your potassium. How can a person take so much spiro and feel well and if it depletes your potassium how much potassium supp would be needed. Just curious in case the dr's decide to increase my spiro dosage.

[Guest guest]

I think someone said here they still had to take potassium while on spiro and I

use to be on triamterene some time ago which is potassium sparing as well but

ended up with low potassium. I will know when my lab results come back but I

dont think potassium sparing always mean that.

spiro

 

From what I've been researching online, ppl with hyperaldo can take anywhere

from 100-400mg of spiro a day..... WOW! That just seems like alot to be on a

diuretic especially if it depletes your potassium. How can a person take so much

spiro and feel well and if it depletes your potassium how much potassium supp

would be needed. Just curious in case the dr's decide to increase my spiro

dosage.

[Guest guest]

Francis,What does he say in this video: he is using spiro in a combination with some other drug. What drug is it? Is it ACE? Is it verapamil? Many thanks, Natalia To: hyperaldosteronism Sent:

Friday, November 18, 2011 11:40 AMSubject: Re: spiro

Watch this veido to know more about sprio

>

> From what I've been researching online, ppl with hyperaldo can take anywhere from 100-400mg of spiro a day..... WOW! That just seems like alot to be on a diuretic especially if it depletes your potassium. How can a person take so much spiro and feel well and if it depletes your potassium how much potassium supp would be needed. Just curious in case the dr's decide to increase my spiro dosage.

>

[Guest guest]

I used to take Triamterene combined with HCTZ for > 3 years and my analysis

indicated that Triam potency in sparing K was ~50% that of Spiro.

Max.

|

|I think someone said here they still had to take potassium while on spiro

and I

|use to be on triamterene some time ago which is potassium sparing as well

but

|ended up with low potassium. I will know when my lab results come back but

I

|dont think potassium sparing always mean that.

|

|

[Guest guest]

oh ok

RE: spiro

I used to take Triamterene combined with HCTZ for > 3 years and my analysis

indicated that Triam potency in sparing K was ~50% that of Spiro.

Max.

|

|I think someone said here they still had to take potassium while on spiro

and I

|use to be on triamterene some time ago which is potassium sparing as well

but

|ended up with low potassium. I will know when my lab results come back but

I

|dont think potassium sparing always mean that.

|

|

[Guest guest]

Yes, it is true. In some people it does, in some it doesn't. You have to learn to recognize your symptoms and regulate the dosage of potassium. Dr. Grim's advice is to drink low sodium V8 instead of potassium supplement. It works excellent for me. I even don't drink it every day, only, when I start to feel worse and when I have cramps. BTW, usually my headache disappears after one cup of V8 and a dosage of eplerenone. Your lab test probably will not say too much. For example, my K blood is always high, one time I was hospitalized with K=6.6, but what is it in reality it's difficult to say, since I am very difficult to draw blood. You better try to understand your symptoms and eat high K and low Na food. Natalia

To: hyperaldosteronism Sent: Friday, November 18, 2011 5:48 PMSubject: Re: spiro

I think someone said here they still had to take potassium while on spiro and I use to be on triamterene some time ago which is potassium sparing as well but ended up with low potassium. I will know when my lab results come back but I dont think potassium sparing always mean that.

spiro

From what I've been researching online, ppl with hyperaldo can take anywhere from 100-400mg of spiro a day..... WOW! That just seems like alot to be on a diuretic especially if it depletes your potassium. How can a person take so much spiro and feel well and if it depletes your potassium how much potassium supp would be needed. Just curious in case the dr's decide to increase my spiro dosage.

[Guest guest]

So does anyone here take are took potassium suppl with spiro?

RE: spiro

I used to take Triamterene combined with HCTZ for > 3 years and my analysis

indicated that Triam potency in sparing K was ~50% that of Spiro.

Max.

|

|I think someone said here they still had to take potassium while on spiro

and I

|use to be on triamterene some time ago which is potassium sparing as well

but

|ended up with low potassium. I will know when my lab results come back but

I

|dont think potassium sparing always mean that.

|

|

[Guest guest]

I know my symptoms of low potassium as I have had it a few times before and was

hospitalized with it being 2.5 once.

Re: spiro

 

I think someone said here they still had to take pota

[Guest guest]

Spiro=100 mg/d

KCl = 120 mEq/d

Max.

|

|So does anyone here take are took potassium suppl with spiro?

|

|

[Guest guest]

Eplerenon 100 mg;K supplements - very occasionally. Natalia To: hyperaldosteronism Sent: Friday, November 18, 2011 6:41 PMSubject: RE: spiro

Spiro=100 mg/d

KCl = 120 mEq/d

Max.

|

|So does anyone here take are took potassium suppl with spiro?

|

|

[Guest guest]

@Max, 120meq sure does seem like alot. The most I've ever taken is 20.

@ Natalia, Is Eplerehon an expensive medicine and is it a diuretic?

RE: spiro

 

Spiro=100 mg/d

KCl = 120 mEq/d

Max.

|

|So does anyone here take are took potassium suppl with spiro?

|

|

[Guest guest]

Take more, enjoy the life!

Max.

|@Max, 120meq sure does seem like alot. The most I've ever taken is 20.

|

[Guest guest]

Sprio blocks aldo triamterene does not.

>

> I think someone said here they still had to take potassium while on spiro and

I use to be on triamterene some time ago which is potassium sparing as well but

ended up with low potassium. I will know when my lab results come back but I

dont think potassium sparing always mean that.

>

>

> spiro

>

>

>  

> From what I've been researching online, ppl with hyperaldo can take anywhere

from 100-400mg of spiro a day..... WOW! That just seems like alot to be on a

diuretic especially if it depletes your potassium. How can a person take so much

spiro and feel well and if it depletes your potassium how much potassium supp

would be needed. Just curious in case the dr's decide to increase my spiro

dosage.

>

[Guest guest]

It is always a balance. Between how much K u eat and pee out. May your pressure be low!CE Grim MS, MDSpecializing in DifficultHypertension

I think someone said here they still had to take potassium while on spiro and I use to be on triamterene some time ago which is potassium sparing as well but ended up with low potassium. I will know when my lab results come back but I dont think potassium sparing always mean that.

spiro

From what I've been researching online, ppl with hyperaldo can take anywhere from 100-400mg of spiro a day..... WOW! That just seems like alot to be on a diuretic especially if it depletes your potassium. How can a person take so much spiro and feel well and if it depletes your potassium how much potassium supp would be needed. Just curious in case the dr's decide to increase my spiro dosage.

[Guest guest]

Quien Sabe?May your pressure be low!CE Grim MS, MDSpecializing in DifficultHypertension

Francis,What does he say in this video: he is using spiro in a combination with some other drug. What drug is it? Is it ACE? Is it verapamil? Many thanks, Natalia To: hyperaldosteronism Sent:

Friday, November 18, 2011 11:40 AMSubject: Re: spiro

Watch this veido to know more about sprio

>

> From what I've been researching online, ppl with hyperaldo can take anywhere from 100-400mg of spiro a day..... WOW! That just seems like alot to be on a diuretic especially if it depletes your potassium. How can a person take so much spiro and feel well and if it depletes your potassium how much potassium supp would be needed. Just curious in case the dr's decide to increase my spiro dosage.

>

[Guest guest]

Again does not spare just less out less but sparing is more marketable. May your pressure be low!CE Grim MS, MDSpecializing in DifficultHypertension

I used to take Triamterene combined with HCTZ for > 3 years and my analysis

indicated that Triam potency in sparing K was ~50% that of Spiro.

Max.

|

|I think someone said here they still had to take potassium while on spiro

and I

|use to be on triamterene some time ago which is potassium sparing as well

but

|ended up with low potassium. I will know when my lab results come back but

I

|dont think potassium sparing always mean that.

|

|

[Guest guest]

Many here do both or DASH which is the same as taking many K pills depending on which pills u r on. So DASH goal is 4700 mg K. A common K pil has about 400 mg (10 mM). Most OTC STUFF has a very small amt of KMay your pressure be low!CE Grim MS, MDSpecializing in DifficultHypertension

So does anyone here take are took potassium suppl with spiro?

RE: spiro

I used to take Triamterene combined with HCTZ for > 3 years and my analysis

indicated that Triam potency in sparing K was ~50% that of Spiro.

Max.

|

|I think someone said here they still had to take potassium while on spiro

and I

|use to be on triamterene some time ago which is potassium sparing as well

but

|ended up with low potassium. I will know when my lab results come back but

I

|dont think potassium sparing always mean that.

|

|

[Guest guest]

And a lot of salt as I recall. ;-)May your pressure be low!CE Grim MS, MDSpecializing in DifficultHypertension

Spiro=100 mg/d

KCl = 120 mEq/d

Max.

|

|So does anyone here take are took potassium suppl with spiro?

|

|

[Guest guest]

But he eats a lot more aSalt as I recall. May your pressure be low!CE Grim MS, MDSpecializing in DifficultHypertension

Take more, enjoy the life!

Max.

|@Max, 120meq sure does seem like alot. The most I've ever taken is 20.

|

[Guest guest]

Tri acts on ENac channels that let Na diffuse into renal tub cells. May your pressure be low!CE Grim MS, MDSpecializing in DifficultHypertension

Sprio blocks aldo triamterene does not.

>

> I think someone said here they still had to take potassium while on spiro and I use to be on triamterene some time ago which is potassium sparing as well but ended up with low potassium. I will know when my lab results come back but I dont think potassium sparing always mean that.

>

>

> spiro

>

>

>

> From what I've been researching online, ppl with hyperaldo can take anywhere from 100-400mg of spiro a day..... WOW! That just seems like alot to be on a diuretic especially if it depletes your potassium. How can a person take so much spiro and feel well and if it depletes your potassium how much potassium supp would be needed. Just curious in case the dr's decide to increase my spiro dosage.

>