Re: please help; do I have PA?_symptoms

[Guest guest]

I do have high BP, usually in the evening (145ish) but my BP is normal in the

morning when I usually have my dr. appointments. The odd thing is that my BP

spikes overnight while I am sleeping.

Last month I ended up in the ER at 2AM with BP 181/112 and a HR ~130.

The typical crisis starts with palpitations, tachycardia and shortness of breath

which wakes me up. After I pee 2-3 times and do deep breathing to slow my HR &

BP goes back down and my HR goes back to normal-high (usually within 1 hour). ER

doctors tested me for heart attack (negative) and released me in the morning to

" follow up with your physician " . The DX was panic/anxiety attack ;-)

That ER night my CPK was high 277 (<175 u/L) but CKMB was normal; and I had

severe thigh cramps the day before (low K?) but blood K was normal at 3.9 while

in the ER.

I have almost permanent muscle twitching and cramps (arms, legs, rib muscle,

neck and shoulder muscle, etc). In the evening I do have severe pain in the back

of my neck, with dizziness and lightheadedness, intolerance to noise, general

tiredness, legs pain (as if I ran a marathon), startling very easy and a general

bad mood feeling. I am feeling depressed and moody although there is not a lot

of stress in my day to day life.

Sometimes I do have tachycardia during the day. My heart starts racing for no

reason (even when I sit down) without any trigger. I then feel SOB, dizzy and

confused. After 15 min. into a crisis my muscle twitching becomes tremors and I

usually have to sit or lay down to let it pass (pre-syncope). All my muscle will

then randomly contract (like jerking) and I cannot control it for another 15

min.

The days I have a crisis I cannot concentrate, my short term memory is gone and

I usually have to go to sleep to recover. Always an overnight sleep will resolve

all symptoms.

I have had good and bad days. But my energy levels are way down and I am

generally much weaker. The only symptom which stays even in the good days is

muscle twitching but I've learned to live with it.

The other thing is that I sweat A LOT overnight but not every day. I know that I

am very salt sensitive. If I eat out I usually have more profound perspiration.

I guess my body is releasing H2O to regulate BP.

Sometimes I walk and after exercise I feel like I am drunk, have a hard time

walking straight and I feel like my inner muscles are trembling. I usually have

profuse sweating after walking (especially face & neck) and I guess K+ goes out

hence the " inner tremors " .

After even light exercise my HR goes up to ~120.

I do have a lot of systemic symptoms and I might have missed some. I call them

" rush of adrenaline crisis " ;-). Feel free to ask any question and I will reply.

tiu

>

> What are your symptoms? Do you have high blood pressure?

>

[Guest guest]

Yes, head and neck/shoulder pains with spells.

I've lost almost 20 lbs in the last 6 months.

My lowest blood K was 3.7 in may (last 12mo).

I do pee 2-3 times/night and sweat a lot while sleeping.

My K was <4.1 for the last 12 mo and my latest K was 3.8.

I am semi-DASHing and I do take K supplements (as well as Mg/Ca)

and eat a K reach diet. BTW, I am mostly vegetarian and eat a low Na diet when I

can.

Thank you for your reply.

tiu

>

> Headaches with spells? WT loss or gain recently? Has K ever been low? How many

times a night do you get up to pee?

> How often has blood K been low? Get the DASH BOOK and start tonight. You will

likely begin to feel better in a few days. Add 1 cup of low sodium V-8 a day

now.

>

> Tiped sad Send form mi

> iPhone ;-)

>

> May your pressure be low!

>

> CE Grim MD

> Specializing in Difficult

> Hypertension

[Guest guest]

You mentioned in previous msg that your heart rate goes up over 120 after a

short time exercising (I'm assuming you're exercising stood up not sat down)

which is consistent with postural orthostatic tachycardia syndrome (POTS) -

which I have as well as PA and I suspect they are linked so they may be in you

too. What happens to your bp when stood up/exercising - does it rise or fall

significantly? Ask your drs for a tilt table test and a measurement of your

epinephrine/norephinephrine levels.

Or might be Cushings syndrome + POTS since you mention evening/night

hyperactivity and I know this is sometimes found in Cushings. Have you had 24hr

saliva cortisol measurement that shows if your cortisol level is rising rather

than falling during the day? You can have this done privately if your drs wont

agree to it.

> >

> > Headaches with spells? WT loss or gain recently? Has K ever been low? How

many times a night do you get up to pee?

> > How often has blood K been low? Get the DASH BOOK and start tonight. You

will likely begin to feel better in a few days. Add 1 cup of low sodium V-8 a

day now.

> >

> > Tiped sad Send form mi

> > iPhone ;-)

> >

> > May your pressure be low!

> >

> > CE Grim MD

> > Specializing in Difficult

> > Hypertension

>

[Guest guest]

Dr Grim, is there such a tumor where the release of the extra hormone either

Aldo or Cortisol is done in a paroxystic fashion? Like the tumor is not active

some days and then it activates in other days?

I mean to say that the lab tests need to be done on the days when the tumor is

producing hormone otherwise the results will be normal.

I do not have the typical Cushing's body, but my blood Cortisol and urine

17-OHCS and 17KS were abnormal.

Can you have Cushing's but not the " moon face " ? Like if the tumor is producing

hormone only 1 day in a month (for example) maybe you don't get the " moon face "

and weight gain?

Have you seen or heard such a PTN in your entire practice?

Thank you for all your insights!

L

PS. I am 5'10 " and weight 180.

>

> I would get the PA Dx confirmed first as Cushing's is much rarer than PA.

>

> Do a google images for Cushing's and if you don't look like any of

> them I would put it on the back burner for now.

>

> Esp if thin.

>

> CE Grim MD

[Guest guest]

I know that not everyone is the same, but my cortisol was very high during

diagnosis. My dex test was very definitive that I did not have Cushings. What

I did have was severe anxiety until diagnosis and starting Spiro! My doc at

Mayo explained that stress and anxiety can cause high cortisol. This is why a

dex test can help determine if the cortisol is from Cushings or from

anxiety/stress.

Keep pursuing the PA diagnosis. No matter what the results, knowing if you have

it or not will cause stress to go down. Spiro helps anxiety because the Aldo

can be blocked. This is just my 2 cents. BTW, I had to practically beg Mayo to

do a full blown diagnostic screening for PA. The doctors found that I had PA

and my anxiety is now almost completely gone.

Not saying that you have an anxiety disorder, only that stress of any kind can

raise cortisol production.

> >

> > I would get the PA Dx confirmed first as Cushing's is much rarer than PA.

> >

> > Do a google images for Cushing's and if you don't look like any of

> > them I would put it on the back burner for now.

> >

> > Esp if thin.

> >

> > CE Grim MD

>

[Guest guest]

I was also tested for a pheo and know what you are going through. The good news,

now that I am on Spiro and DASHing.......no more labile hypertension! I haven't

had an adrenaline rush where my heart jumps suddenly to 100 MPH and blood

pressure is over 150/110. No ER visits since April except for one when I had

severe diarehea and my PCP wanted me to go get fluids and K to prevent problems.

Hang in there and have hope!

> >

> > You mentioned in previous msg that your heart rate goes up over 120 after a

short time exercising (I'm assuming you're exercising stood up not sat down)

which is consistent with postural orthostatic tachycardia syndrome (POTS) -

which I have as well as PA and I suspect they are linked so they may be in you

too. What happens to your bp when stood up/exercising - does it rise or fall

significantly? Ask your drs for a tilt table test and a measurement of your

epinephrine/norephinephrine levels.

> >

> > Or might be Cushings syndrome + POTS since you mention evening/night

hyperactivity and I know this is sometimes found in Cushings. Have you had 24hr

saliva cortisol measurement that shows if your cortisol level is rising rather

than falling during the day? You can have this done privately if your drs wont

agree to it.

>

[Guest guest]

Prednisone is the same as Cortisol. It is used to treat inflammatory diseases

sometimes in very high doses. In some it increases your need to eat.

My brother was on it gained about 50 LB with him it became a quest to find

something to eat of drink even would drink pickle juice. Others will tell you it

does not affect them like this.

Maybe the same is true if you have Cushing's.

> > >

> > > I would get the PA Dx confirmed first as Cushing's is much rarer than PA.

> > >

> > > Do a google images for Cushing's and if you don't look like any of

> > > them I would put it on the back burner for now.

> > >

> > > Esp if thin.

> > >

> > > CE Grim MD

> >

> >

>