For those who have had Ca problems with PA. Some new data to explain. If your medical team is working on Ca problems please ask them to download and read this article before going after the PHA as Treating PA may will eliminate the PHA.

[Guest guest]

J Clin Endocrinol Metab. 2011 Oct 19. [Epub ahead of print]Hyperparathyroidism in Patients with Primary Aldosteronism: Cross-Sectional and Interventional Data from the GECOH Study.Pilz S, Kienreich K, Drechsler C, Ritz E, Fahrleitner-Pammer A, Gaksch M, Meinitzer A, März W, Pieber TR, Tomaschitz A.SourceDepartment of Internal Medicine (S.P., K.K., A.F.-P., M.G., T.R.P., A.T.), Division of Endocrinology and Metabolism, and Clinical Institute of Medical and Chemical Laboratory Diagnostics (A.M., W.M.), Medical University of Graz, 8036 Graz, Austria; Department of Epidemiology and Biostatistics and EMGO Institute for Health and Care Research (S.P.), VU University Medical Center, 1081 BT Amsterdam, The Netherlands; Department of Medicine (C.D.), Division of Nephrology, University of Würzburg, 97070 Würzburg, Germany; Department of Medicine (E.R.), Division of Nephrology, University Hospital Heidelberg, 69115 Heidelberg, Germany; Synlab-Academy (W.M.), Synlab Services LLC, 69214 Eppelheim, Germany; and Mannheim Institute of Public Health (W.M.), Medical Faculty Mannheim, Ruperto Carola University Heidelberg, 68167 Mannheim, Germany.AbstractContext:Experimental studies suggest that aldosterone induces hypercalciuria and might contribute to hyperparathyroidism.Objective:We aimed to test for differences in PTH levels and parameters of calcium and vitamin D metabolism in patients with primary aldosteronism (PA) compared with patients with essential hypertension (EH) and to evaluate the impact of PA treatment on these laboratory values.Design, Setting, and Participants:The Graz Endocrine Causes of Hypertension study includes hypertensive patients referred for screening for endocrine hypertension at a tertiary care center in Graz, Austria.Main Outcome Measures:Differences in PTH levels between patients with PA and EH.Results:Among 192 patients, we identified 10 patients with PA and 182 with EH. PTH levels (mean ± sd in picograms per milliliter) were significantly higher in PA patients compared with EH (67.8 ± 26.9 vs. 46.5 ± 20.9; P = 0.002). After treatment of PA with either adrenal surgery (n = 5) or mineralocorticoid receptor antagonists (n = 5), PTH concentrations decreased to 43.9 ± 14.9 (P = 0.023). Serum 25-hydroxyvitamin D concentrations were similar in both groups. Compared with EH, serum calcium concentrations were significantly lower (2.35 ± 0.10 vs. 2.26 ± 0.10 mmol/liter; P = 0.013), and there was a nonsignificant trend toward an increased spot urine calcium to creatinine ratio in PA [median (interquartile range) 0.19 (0.11-0.31) vs. 0.33 (0.12-0.53); P = 0.094].Conclusions:Our results suggest that PA contributes to secondary hyperparathyroidism. Further studies are warranted to evaluate whether PTH has implications for PA diagnostics and whether mineralocorticoid receptor antagonists have a general impact on PTH and calcium metabolism.

[Guest guest]

This is so interesting, I have had problems metabolizing Calcium and

Vitamin D. Foods high in those vitamins would give me severe bone

pain

and muscle pain. I would get so sick even though my vitamin d is

low. I am able to now eat these foods in moderation. The doctors

told me I had an autoimmune disease called Sarcoidosis.

I left his office and never went back.

Phyllis

44yo AA female, 15 year hx HTN 220/120, possible PA? previous 6 bp

meds now 2 pills, Inspra 50mg daily and Benicar 10mg daily. Trying

to Dash hard

LVH, Cardiomyopathy, insulin resistance, hx of CHF, TIA's, Renal

insufficiency

J Clin Endocrinol Metab. 2011 Oct 19.

[Epub ahead of print]

Hyperparathyroidism

in Patients with Primary Aldosteronism:

Cross-Sectional and Interventional Data from the GECOH

Study.

Pilz S, Kienreich K, Drechsler C, Ritz E, Fahrleitner-Pammer

A, Gaksch M, Meinitzer A, März W, Pieber TR, Tomaschitz A.

Source

Department of Internal Medicine (S.P., K.K., A.F.-P.,

M.G., T.R.P., A.T.), Division of Endocrinology and

Metabolism, and Clinical Institute of Medical and

Chemical Laboratory Diagnostics (A.M., W.M.), Medical

University of Graz, 8036 Graz, Austria; Department of

Epidemiology and Biostatistics and EMGO Institute for

Health and Care Research (S.P.), VU University Medical

Center, 1081 BT Amsterdam, The Netherlands; Department

of Medicine (C.D.), Division of Nephrology, University

of Würzburg, 97070 Würzburg, Germany; Department of

Medicine (E.R.), Division of Nephrology, University

Hospital Heidelberg, 69115 Heidelberg, Germany;

Synlab-Academy (W.M.), Synlab Services LLC, 69214

Eppelheim, Germany; and Mannheim Institute of Public

Health (W.M.), Medical Faculty Mannheim, Ruperto Carola

University Heidelberg, 68167 Mannheim, Germany.

Abstract

Context:Experimental studies suggest that aldosterone

induces hypercalciuria and might contribute to

hyperparathyroidism.Objective:We aimed to test for

differences in PTH levels and parameters of calcium and

vitamin D metabolism in patients with primary

aldosteronism (PA) compared with patients with

essential hypertension (EH) and to evaluate the impact

of PA treatment on these laboratory values.Design,

Setting, and Participants:The Graz Endocrine Causes of

Hypertension study includes hypertensive patients

referred for screening for endocrine hypertension at a

tertiary care center in Graz, Austria.Main Outcome

Measures:Differences in PTH levels between patients with

PA and EH.Results:Among 192 patients, we identified 10

patients with PA and 182 with EH. PTH levels (mean ± sd

in picograms per milliliter) were significantly higher

in PA patients compared with EH (67.8 ± 26.9 vs. 46.5 ±

20.9; P = 0.002). After treatment of PA with either

adrenal surgery (n = 5) or mineralocorticoid receptor

antagonists (n = 5), PTH concentrations decreased to

43.9 ± 14.9 (P = 0.023). Serum 25-hydroxyvitamin D

concentrations were similar in both groups. Compared

with EH, serum calcium concentrations were significantly

lower (2.35 ± 0.10 vs. 2.26 ± 0.10 mmol/liter; P =

0.013), and there was a nonsignificant trend toward an

increased spot urine calcium to creatinine ratio in PA

[median (interquartile range) 0.19 (0.11-0.31) vs. 0.33

(0.12-0.53); P = 0.094].Conclusions:Our results suggest

that PA contributes to secondary hyperparathyroidism.

Further studies are warranted to evaluate whether PTH

has implications for PA diagnostics and whether

mineralocorticoid receptor antagonists have a general

impact on PTH and calcium metabolism.

[Guest guest]

Dr. Grim:

I cannot thank you enough for posting this! I was sure I had some other dreaded

disease not related to PA when I was told my calcium was elevated this week. I

am going to take this along with me to my 2nd appointment next week.

We are so fortunate to have you as a source of endless information and hope.

>

> J Clin Endocrinol Metab. 2011 Oct 19. [Epub ahead of print]

> Hyperparathyroidism in Patients with Primary Aldosteronism: Cross-

> Sectional and Interventional Data from the GECOH Study.

> Pilz S, Kienreich K, Drechsler C, Ritz E, Fahrleitner-Pammer A, Gaksch

> M, Meinitzer A, März W, Pieber TR, Tomaschitz A.

> Source

> Department of Internal Medicine (S.P., K.K., A.F.-P., M.G., T.R.P.,

> A.T.), Division of Endocrinology and Metabolism, and Clinical

> Institute of Medical and Chemical Laboratory Diagnostics (A.M., W.M.),

> Medical University of Graz, 8036 Graz, Austria; Department of

> Epidemiology and Biostatistics and EMGO Institute for Health and Care

> Research (S.P.), VU University Medical Center, 1081 BT Amsterdam, The

> Netherlands; Department of Medicine (C.D.), Division of Nephrology,

> University of Würzburg, 97070 Würzburg, Germany; Department of

> Medicine (E.R.), Division of Nephrology, University Hospital

> Heidelberg, 69115 Heidelberg, Germany; Synlab-Academy (W.M.), Synlab

> Services LLC, 69214 Eppelheim, Germany; and Mannheim Institute of

> Public Health (W.M.), Medical Faculty Mannheim, Ruperto Carola

> University Heidelberg, 68167 Mannheim, Germany.

> Abstract

> Context:Experimental studies suggest that aldosterone induces

> hypercalciuria and might contribute to

> hyperparathyroidism.Objective:We aimed to test for differences in PTH

> levels and parameters of calcium and vitamin D metabolism in patients

> with primary aldosteronism (PA) compared with patients with essential

> hypertension (EH) and to evaluate the impact of PA treatment on these

> laboratory values.Design, Setting, and Participants:The Graz Endocrine

> Causes of Hypertension study includes hypertensive patients referred

> for screening for endocrine hypertension at a tertiary care center in

> Graz, Austria.Main Outcome Measures:Differences in PTH levels between

> patients with PA and EH.Results:Among 192 patients, we identified 10

> patients with PA and 182 with EH. PTH levels (mean ± sd in picograms

> per milliliter) were significantly higher in PA patients compared with

> EH (67.8 ± 26.9 vs. 46.5 ± 20.9; P = 0.002). After treatment of PA

> with either adrenal surgery (n = 5) or mineralocorticoid receptor

> antagonists (n = 5), PTH concentrations decreased to 43.9 ± 14.9 (P =

> 0.023). Serum 25-hydroxyvitamin D concentrations were similar in both

> groups. Compared with EH, serum calcium concentrations were

> significantly lower (2.35 ± 0.10 vs. 2.26 ± 0.10 mmol/liter; P =

> 0.013), and there was a nonsignificant trend toward an increased spot

> urine calcium to creatinine ratio in PA [median (interquartile range)

> 0.19 (0.11-0.31) vs. 0.33 (0.12-0.53); P = 0.094].Conclusions:Our

> results suggest that PA contributes to secondary hyperparathyroidism.

> Further studies are warranted to evaluate whether PTH has implications

> for PA diagnostics and whether mineralocorticoid receptor antagonists

> have a general impact on PTH and calcium metabolism.

>

[Guest guest]

But sarcoid can cause Ca problems and is more common in AA. May your pressure be low!CE Grim MDSpecializing in DifficultHypertension

This is so interesting, I have had problems metabolizing Calcium and

Vitamin D. Foods high in those vitamins would give me severe bone

pain

and muscle pain. I would get so sick even though my vitamin d is

low. I am able to now eat these foods in moderation. The doctors

told me I had an autoimmune disease called Sarcoidosis.

I left his office and never went back.

Phyllis

44yo AA female, 15 year hx HTN 220/120, possible PA? previous 6 bp

meds now 2 pills, Inspra 50mg daily and Benicar 10mg daily. Trying

to Dash hard

LVH, Cardiomyopathy, insulin resistance, hx of CHF, TIA's, Renal

insufficiency

J Clin Endocrinol Metab. 2011 Oct 19.

[Epub ahead of print]

Hyperparathyroidism

in Patients with Primary Aldosteronism:

Cross-Sectional and Interventional Data from the GECOH

Study.

Pilz S, Kienreich K, Drechsler C, Ritz E, Fahrleitner-Pammer

A, Gaksch M, Meinitzer A, März W, Pieber TR, Tomaschitz A.

Source

Department of Internal Medicine (S.P., K.K., A.F.-P.,

M.G., T.R.P., A.T.), Division of Endocrinology and

Metabolism, and Clinical Institute of Medical and

Chemical Laboratory Diagnostics (A.M., W.M.), Medical

University of Graz, 8036 Graz, Austria; Department of

Epidemiology and Biostatistics and EMGO Institute for

Health and Care Research (S.P.), VU University Medical

Center, 1081 BT Amsterdam, The Netherlands; Department

of Medicine (C.D.), Division of Nephrology, University

of Würzburg, 97070 Würzburg, Germany; Department of

Medicine (E.R.), Division of Nephrology, University

Hospital Heidelberg, 69115 Heidelberg, Germany;

Synlab-Academy (W.M.), Synlab Services LLC, 69214

Eppelheim, Germany; and Mannheim Institute of Public

Health (W.M.), Medical Faculty Mannheim, Ruperto Carola

University Heidelberg, 68167 Mannheim, Germany.

Abstract

Context:Experimental studies suggest that aldosterone

induces hypercalciuria and might contribute to

hyperparathyroidism.Objective:We aimed to test for

differences in PTH levels and parameters of calcium and

vitamin D metabolism in patients with primary

aldosteronism (PA) compared with patients with

essential hypertension (EH) and to evaluate the impact

of PA treatment on these laboratory values.Design,

Setting, and Participants:The Graz Endocrine Causes of

Hypertension study includes hypertensive patients

referred for screening for endocrine hypertension at a

tertiary care center in Graz, Austria.Main Outcome

Measures:Differences in PTH levels between patients with

PA and EH.Results:Among 192 patients, we identified 10

patients with PA and 182 with EH. PTH levels (mean ± sd

in picograms per milliliter) were significantly higher

in PA patients compared with EH (67.8 ± 26.9 vs. 46.5 ±

20.9; P = 0.002). After treatment of PA with either

adrenal surgery (n = 5) or mineralocorticoid receptor

antagonists (n = 5), PTH concentrations decreased to

43.9 ± 14.9 (P = 0.023). Serum 25-hydroxyvitamin D

concentrations were similar in both groups. Compared

with EH, serum calcium concentrations were significantly

lower (2.35 ± 0.10 vs. 2.26 ± 0.10 mmol/liter; P =

0.013), and there was a nonsignificant trend toward an

increased spot urine calcium to creatinine ratio in PA

[median (interquartile range) 0.19 (0.11-0.31) vs. 0.33

(0.12-0.53); P = 0.094].Conclusions:Our results suggest

that PA contributes to secondary hyperparathyroidism.

Further studies are warranted to evaluate whether PTH

has implications for PA diagnostics and whether

mineralocorticoid receptor antagonists have a general

impact on PTH and calcium metabolism.

[Guest guest]

Phyllis do u live in LA? Used to have a research assistant by that name?May your pressure be low!CE Grim MDSpecializing in DifficultHypertension

This is so interesting, I have had problems metabolizing Calcium and

Vitamin D. Foods high in those vitamins would give me severe bone

pain

and muscle pain. I would get so sick even though my vitamin d is

low. I am able to now eat these foods in moderation. The doctors

told me I had an autoimmune disease called Sarcoidosis.

I left his office and never went back.

Phyllis

44yo AA female, 15 year hx HTN 220/120, possible PA? previous 6 bp

meds now 2 pills, Inspra 50mg daily and Benicar 10mg daily. Trying

to Dash hard

LVH, Cardiomyopathy, insulin resistance, hx of CHF, TIA's, Renal

insufficiency

J Clin Endocrinol Metab. 2011 Oct 19.

[Epub ahead of print]

Hyperparathyroidism

in Patients with Primary Aldosteronism:

Cross-Sectional and Interventional Data from the GECOH

Study.

Pilz S, Kienreich K, Drechsler C, Ritz E, Fahrleitner-Pammer

A, Gaksch M, Meinitzer A, März W, Pieber TR, Tomaschitz A.

Source

Department of Internal Medicine (S.P., K.K., A.F.-P.,

M.G., T.R.P., A.T.), Division of Endocrinology and

Metabolism, and Clinical Institute of Medical and

Chemical Laboratory Diagnostics (A.M., W.M.), Medical

University of Graz, 8036 Graz, Austria; Department of

Epidemiology and Biostatistics and EMGO Institute for

Health and Care Research (S.P.), VU University Medical

Center, 1081 BT Amsterdam, The Netherlands; Department

of Medicine (C.D.), Division of Nephrology, University

of Würzburg, 97070 Würzburg, Germany; Department of

Medicine (E.R.), Division of Nephrology, University

Hospital Heidelberg, 69115 Heidelberg, Germany;

Synlab-Academy (W.M.), Synlab Services LLC, 69214

Eppelheim, Germany; and Mannheim Institute of Public

Health (W.M.), Medical Faculty Mannheim, Ruperto Carola

University Heidelberg, 68167 Mannheim, Germany.

Abstract

Context:Experimental studies suggest that aldosterone

induces hypercalciuria and might contribute to

hyperparathyroidism.Objective:We aimed to test for

differences in PTH levels and parameters of calcium and

vitamin D metabolism in patients with primary

aldosteronism (PA) compared with patients with

essential hypertension (EH) and to evaluate the impact

of PA treatment on these laboratory values.Design,

Setting, and Participants:The Graz Endocrine Causes of

Hypertension study includes hypertensive patients

referred for screening for endocrine hypertension at a

tertiary care center in Graz, Austria.Main Outcome

Measures:Differences in PTH levels between patients with

PA and EH.Results:Among 192 patients, we identified 10

patients with PA and 182 with EH. PTH levels (mean ± sd

in picograms per milliliter) were significantly higher

in PA patients compared with EH (67.8 ± 26.9 vs. 46.5 ±

20.9; P = 0.002). After treatment of PA with either

adrenal surgery (n = 5) or mineralocorticoid receptor

antagonists (n = 5), PTH concentrations decreased to

43.9 ± 14.9 (P = 0.023). Serum 25-hydroxyvitamin D

concentrations were similar in both groups. Compared

with EH, serum calcium concentrations were significantly

lower (2.35 ± 0.10 vs. 2.26 ± 0.10 mmol/liter; P =

0.013), and there was a nonsignificant trend toward an

increased spot urine calcium to creatinine ratio in PA

[median (interquartile range) 0.19 (0.11-0.31) vs. 0.33

(0.12-0.53); P = 0.094].Conclusions:Our results suggest

that PA contributes to secondary hyperparathyroidism.

Further studies are warranted to evaluate whether PTH

has implications for PA diagnostics and whether

mineralocorticoid receptor antagonists have a general

impact on PTH and calcium metabolism.