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dietary sodium after adrenalectomy?

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Dr Grim (or others who know more than I do), I've gotten conflicting

advice with regard to dietary sodium after adrenalectomy and was

wondering if you could comment.

My surgeon said " don't worry about sodium any more " when I was given my

discharge instructions. I asked my HTN specialist about this, and he

said it was more like " don't go out and eat a bag of potato chips, but

don't drive yourself crazy counting every single gram any more. "

I have, however, heard that others have been advised to actually eat

*high* sodium post-ADX to " get the other adrenal to wake up. "

I'm still not adding sodium to my food, but have loosened up about

prepared foods (from the Whole Foods takeout counter, which as prepared

foods go are pretty low-sodium compared to a typical restaurant) and

haven't had any BP spikes or water/salt weight gain.

In fact - I've noticed consistently that the lowest BP readings I've

gotten are about an hour after eating something prepared by someone

else, thus with higher sodium than I normally would eat. Still not as

low as I'd like to be seeing, but high 120s/mid-80s. (The rest of the

day it's still jumping all over the place, and averaging high 130s/high

80s.)

Can someone set me straight as to what the right thing to do is?

Thanks as always :)

-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.

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Ir you only have PA you should be able to eat what you want. if you had PA and essential HTN (FH of HTN) then a lowered sodium diet is always be good.The other adrenal issue is usually over by 2 weeks and can be told by what your post op renin and aldo are. My experience in those in whom I have followed who had both adrenals out for PA is that they remain very salt sensitive.I do not understand why you want lower BPs. We do not begin drugs until it raises to above 135/85 at home. The lower you salt intake the lower your home BP should be. There is some concern about getting BP too low as increasing risk or vascular problems. but not studied in PA. If you feel faint when you stand up your BP is too low is my adage. Check your standing BP and post exercise BP just to see what that is doing. CE Grim MD Dr Grim (or others who know more than I do), I've gotten conflicting advice with regard to dietary sodium after adrenalectomy and was wondering if you could comment. My surgeon said "don't worry about sodium any more" when I was given my discharge instructions. I asked my HTN specialist about this, and he said it was more like "don't go out and eat a bag of potato chips, but don't drive yourself crazy counting every single gram any more." I have, however, heard that others have been advised to actually eat *high* sodium post-ADX to "get the other adrenal to wake up." I'm still not adding sodium to my food, but have loosened up about prepared foods (from the Whole Foods takeout counter, which as prepared foods go are pretty low-sodium compared to a typical restaurant) and haven't had any BP spikes or water/salt weight gain. In fact - I've noticed consistently that the lowest BP readings I've gotten are about an hour after eating something prepared by someone else, thus with higher sodium than I normally would eat. Still not as low as I'd like to be seeing, but high 120s/mid-80s. (The rest of the day it's still jumping all over the place, and averaging high 130s/high 80s.) Can someone set me straight as to what the right thing to do is? Thanks as always :) -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.

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Thanks Dr Grim! So 130s/80s is fine? I was hoping to see something closer to

what I used to see before I had PA, which was always 110s/70s - of course, I was

a lot younger then.

How soon after surgery should renin and aldo be tested? I'm seeing my HTN

specialist tomorrow and will remind him if he doesn't bring it up :)

>

> > Dr Grim (or others who know more than I do), I've gotten conflicting

> > advice with regard to dietary sodium after adrenalectomy and was

> > wondering if you could comment.

> >

> > My surgeon said " don't worry about sodium any more " when I was given

> > my

> > discharge instructions. I asked my HTN specialist about this, and he

> > said it was more like " don't go out and eat a bag of potato chips, but

> > don't drive yourself crazy counting every single gram any more. "

> >

> > I have, however, heard that others have been advised to actually eat

> > *high* sodium post-ADX to " get the other adrenal to wake up. "

> >

> > I'm still not adding sodium to my food, but have loosened up about

> > prepared foods (from the Whole Foods takeout counter, which as

> > prepared

> > foods go are pretty low-sodium compared to a typical restaurant) and

> > haven't had any BP spikes or water/salt weight gain.

> >

> > In fact - I've noticed consistently that the lowest BP readings I've

> > gotten are about an hour after eating something prepared by someone

> > else, thus with higher sodium than I normally would eat. Still not as

> > low as I'd like to be seeing, but high 120s/mid-80s. (The rest of the

> > day it's still jumping all over the place, and averaging high 130s/

> > high

> > 80s.)

> >

> > Can someone set me straight as to what the right thing to do is?

> >

> > Thanks as always :)

> >

> > -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.

> >

> >

>

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