Re: My Father Has Low Potassium!

[Guest guest]

Pam, I recently did a little family history digging and learned that while nobody in my family talks about being diagnosed with low K or HTN, both my aunt and grandmother have/had CHF and problems with water retention. They both take/took diurectics and potassium. Furthermore, I learned that when my great grandmother lived with my grandmother, my grandma cooked everything from scratch with no salt specifically in response to a medical condition my great grandma had. I tried getting medical records on my grandma and great grandma, but was told they aren't available any more. My aunt, however, says that all three of them developed their problems when they were in their sixties. I still found it interesting...

My Father Has Low Potassium!

Hi, AllDr. Grim, I thought you might be particularlyinterested in this. My father has never mentioned anyinstances of low potassium; however, I attended two ofhis recent doctor visits and I knew he was tested forK last time. This time I specifically asked what hispotassium was. His doctor responded, "3.5". He wasnot going to say anything about it until I asked! Perhaps he thought this level was too "borderline" tobe of any significance.But it really got my attention!My father started having high blood pressure when hewas 25. Strokes run in his family, on his mother'sside. She was disabled by a stroke in her early 50s. My father has had multiple repeated strokes, leadingto vascular parkinsonism.My son was diagnosed with hypertension at age 15. Hehas LVH. His doctor has not ever tried to work him upfor PA.My DNA was analyzed by the Yale group. No known formof hereditary aldosteronism was discovered.I convinced my father's doctor to let him tryspironolactone, since he had stopped taking hiscurrent BP medication anyway due to side effects.I will let you know if he sees any improvement in hisblood pressure.Warmly,Pam"I'd rather learn from one bird how to sing, than to teach ten thousand stars how not to dance."__________________________________________________

[Guest guest]

they should all be tested for PA esp your son but I recall he is your step son?

May your pressure be low!

Clarence E. Grim, BS (Chem/Math), MS (Biochem), MD, FACP, FACC, FAHS

Clinical Professor of Medicine and Epidemiology

Director, Hypertension Diagnosis and Treatment Center

Board Certified in Internal Medicine, Geriatrics and Hypertension

Published over 220 scientific papers, book chapters and 220 abstracts in the area of high blood pressure epidemiology, physiology, endocrinology measurement, treatment and how to detect curable causes.

Listed in Best Doctors in America

Specializing in Difficult to Control High Blood Pressure and the History and Physiology of High Blood pressure in the African Diaspora

[Guest guest]

Sorry, not sure if you're responding to Pam or me, but of the three family members I mentioned, 2 passed away (one over 10 years ago, one much more than that). The third promised she'd ask about it at her next physical. I have both a step son and a biological son. Both have suffered from leg cramps, but not until puberty in my step son's case. My bio son is 4, however, and complains of them on occasion. He's due for a physical so I'll bring it up to his pediatrician.

Re: My Father Has Low Potassium!

they should all be tested for PA esp your son but I recall he is your step son?May your pressure be low!Clarence E. Grim, BS (Chem/Math), MS (Biochem), MD, FACP, FACC, FAHSClinical Professor of Medicine and EpidemiologyDirector, Hypertension Diagnosis and Treatment CenterBoard Certified in Internal Medicine, Geriatrics and HypertensionPublished over 220 scientific papers, book chapters and 220 abstracts in the area of high blood pressure epidemiology, physiology, endocrinology measurement, treatment and how to detect curable causes.Listed in Best Doctors in AmericaSpecializing in Difficult to Control High Blood Pressure and the History and Physiology of High Blood pressure in the African Diaspora

[Guest guest]

Hi, Dr. Grim

No, he is my biological son. They do not suspect PA

because he is overweight. However, I know of a lot of

kids who are overweight who do not have hypertension

at age 15 with LVH.

Unfortuately, his doctor will not test him for PA.

Her suspicion is not high enough, I gather.

Warmly,

Pam

--- lowerbp2@... wrote:

> they should all be tested for PA esp your son but I

> recall he is your step

> son?

>

>

>

> May your pressure be low!

>

> Clarence E. Grim, BS (Chem/Math), MS (Biochem), MD,

> FACP, FACC, FAHS

> Clinical Professor of Medicine and Epidemiology

> Director, Hypertension Diagnosis and Treatment

> Center

> Board Certified in Internal Medicine, Geriatrics and

> Hypertension

>

> Published over 220 scientific papers, book chapters

> and 220 abstracts in the

> area of high blood pressure epidemiology,

> physiology, endocrinology

> measurement, treatment and how to detect curable

> causes.

> Listed in Best Doctors in America

> Specializing in Difficult to Control High Blood

> Pressure and the History and

> Physiology of High Blood pressure in the African

> Diaspora

>

>

" I'd rather learn from one bird how to sing, than to teach ten thousand stars

how not to dance. "

__________________________________________________

[Guest guest]

Hi, Dr. Grim

There were a lot of posts yesterday, so I'm repeating

this one because it sort of fell to the bottom of a

pile. Dr. Grim, if you were responding to in a

previous post, oops! Sorry about that. I don't mean

to answer a question on behalf of .

Thanks, Dr. Grim!

Warmly,

Pam

* * * * * * * * * *

Hi, All

Dr. Grim, I thought you might be particularly

interested in this. My father has never mentioned any

instances of low potassium; however, I attended two of

his recent doctor visits and I knew he was tested for

K last time. This time I specifically asked what his

potassium was. His doctor responded, " 3.5 " . He was

not going to say anything about it until I asked!

Perhaps he thought this level was too " borderline " to

be of any significance.

But it really got my attention!

My father started having high blood pressure when he

was 25. Strokes run in his family, on his mother's

side. She was disabled by a stroke in her early 50s.

My father has had multiple repeated strokes, leading

to vascular parkinsonism.

My son was diagnosed with hypertension at age 15. He

has LVH. His doctor has not ever tried to work him up

for PA.

My DNA was analyzed by the Yale group. No known form

of hereditary aldosteronism was discovered.

I convinced my father's doctor to let him try

spironolactone, since he had stopped taking his

current BP medication anyway due to side effects.

I will let you know if he sees any improvement in his

blood pressure.

Warmly,

Pam

" I'd rather learn from one bird how to sing, than to teach ten thousand stars

how not to dance. "

__________________________________________________

[Guest guest]

I would never attribute HTN and LVH to overweight in a teen ager. You must insist that he be tested for PA.

The first PA family we saw with GRA had HTN and LVH at age 8 and 6. The oldest son stopped taking his meds in college and had a disabling stroke.

They always had normal Ks as well.

May your pressure be low!CE Grim MDClinical Professor of Internal MedicineProfessor of EpidemiologyBoard Certified in Internal Medicine, Geriatrics and Hypertension

Re: My Father Has Low Potassium!

Hi, Dr. Grim

No, he is my biological son. They do not suspect PA

because he is overweight. However, I know of a lot of

kids who are overweight who do not have hypertension

at age 15 with LVH.

Unfortuately, his doctor will not test him for PA. Her suspicion is not high enough, I gather.

Warmly,

Pam

--- lowerbp2@... wrote:

> they should all be tested for PA esp your son but I

> recall he is your step > son?

> > > > May your pressure be low!

> > Clarence E. Grim, BS (Chem/Math), MS (Biochem), MD,

> FACP, FACC, FAHS

> Clinical Professor of Medicine and Epidemiology

> Director, Hypertension Diagnosis and Treatment

> Center

> Board Certified in Internal Medicine, Geriatrics and

> Hypertension

> > Published over 220 scientific papers, book chapters

> and 220 abstracts in the > area of high blood pressure epidemiology,

> physiology, endocrinology > measurement, treatment and how to detect curable

> causes.

> Listed in Best Doctors in America

> Specializing in Difficult to Control High Blood

> Pressure and the History and > Physiology of High Blood pressure in the African

> Diaspora

> > "I'd rather learn from one bird how to sing, than to teach ten thousand stars how not to dance."

__________________________________________________

[Guest guest]

In a message dated 4/27/05 2:06:07 AM, spirlhelix@... writes:

Hi, Dr. Grim

We know we don't have GRA or Liddel's because I tested

negative on the DNA test.

But with my father's hx of strokes and now low K, I'm

beginning to wonder . . . how would we find out if

this was a form of hereditary aldosteronism not

previously identified?

Warmly,

Pam

First you need to test everyone in the family with a PA/PRA test. Then if there is more than one with a high ratio, we could see if we could interest Dr. Lifton is studing the entire family. Would need several affected and nonaffected relatives the more the better. Maybe it really is PAM's syndrome.

Get all the family tree as far back as you can how old and what they died from and if they ever had low K etc. Then lets look at it.

CE Grim, MD

[Guest guest]

Hi, Dr. Grim

We know we don't have GRA or Liddel's because I tested

negative on the DNA test.

But with my father's hx of strokes and now low K, I'm

beginning to wonder . . . how would we find out if

this was a form of hereditary aldosteronism not

previously identified?

Warmly,

Pam

--- lowerbp2@... wrote:

> I would never attribute HTN and LVH to overweight in

> a teen ager. You must insist that he be tested for

> PA.

> The first PA family we saw with GRA had HTN and LVH

> at age 8 and 6. The oldest son stopped taking his

> meds in college and had a disabling stroke.

>

> They always had normal Ks as well.

>

>

>

>

> May your pressure be low!

>

> CE Grim MD

> Clinical Professor of Internal Medicine

> Professor of Epidemiology

>

> Board Certified in Internal Medicine, Geriatrics and

> Hypertension

>

>

> Re: My Father Has Low

> Potassium!

>

>

>

> Hi, Dr. Grim

>

> No, he is my biological son. They do not suspect PA

> because he is overweight. However, I know of a lot

> of

> kids who are overweight who do not have hypertension

> at age 15 with LVH.

>

> Unfortuately, his doctor will not test him for PA.

> Her suspicion is not high enough, I gather.

>

> Warmly,

>

> Pam

>

> --- lowerbp2@... wrote:

> > they should all be tested for PA esp your son but

> I

> > recall he is your step

> > son?

> >

> >

> >

> > May your pressure be low!

> >

> > Clarence E. Grim, BS (Chem/Math), MS (Biochem),

> MD,

> > FACP, FACC, FAHS

> > Clinical Professor of Medicine and Epidemiology

> > Director, Hypertension Diagnosis and Treatment

> > Center

> > Board Certified in Internal Medicine, Geriatrics

> and

> > Hypertension

> >

> > Published over 220 scientific papers, book

> chapters

> > and 220 abstracts in the

> > area of high blood pressure epidemiology,

> > physiology, endocrinology

> > measurement, treatment and how to detect curable

> > causes.

> > Listed in Best Doctors in America

> > Specializing in Difficult to Control High Blood

> > Pressure and the History and

> > Physiology of High Blood pressure in the African

> > Diaspora

> >

> >

>

> " I'd rather learn from one bird how to sing, than to

> teach ten thousand stars

> how not to dance. "

>

> __________________________________________________

>

[Guest guest]

Hi, Dr. Grim

Is there any way read a result for the PA/PRA test

while the patient is still on spironolactone?

They are afraid to take me off spiro to test me again

because my BP rises pretty dramatically when off

spironolactone.

Warmly,

Pam

--- lowerbp2@... wrote:

>

> In a message dated 4/27/05 2:06:07 AM,

> spirlhelix@... writes:

>

>

> > Hi, Dr. Grim

> >

> > We know we don't have GRA or Liddel's because I

> tested

> > negative on the DNA test.

> >

> > But with my father's hx of strokes and now low K,

> I'm

> > beginning to wonder . . . how would we find out if

> > this was a form of hereditary aldosteronism not

> > previously identified?

> >

> > Warmly,

> >

> > Pam

> >

> >

>

> First you need to test everyone in the family with a

> PA/PRA test. Then if

> there is more than one with a high ratio, we could

> see if we could interest Dr.

> Lifton is studing the entire family. Would need

> several affected and

> nonaffected relatives the more the better. Maybe

> it really is PAM's syndrome.

>

> Get all the family tree as far back as you can how

> old and what they died

> from and if they ever had low K etc. Then lets

> look at it.

>

>

>

> CE Grim, MD

>

" I'd rather learn from one bird how to sing, than to teach ten thousand stars

how not to dance. "

__________________________________________________

[Guest guest]

It may affect the reading but here is what I do. However if the ratio is high then I assume that is presumptive evidence of PA.

If you are doing well on Inspra or other Rx I would just sit tight and DASH.

CE Grim, MD

[Guest guest]

Hi, Dr. Grim

If I understand you correctly, I would go ahead and

get the testing done (ARR?) despite the fact that I am

on Spironolactone.

My blood pressure is very high lately (220/130) and I

have had to double the Spironolactone to 200 mg daily.

It is now in the 186/98 range after a week of this

increase. It is not controlled, obviously.

Does it still make sense to test now?

Warmly,

Pam

--- lowerbp2@... wrote:

> It may affect the reading but here is what I do.

> However if the ratio is

> high then I assume that is presumptive evidence of

> PA.

>

> If you are doing well on Inspra or other Rx I would

> just sit tight and DASH.

>

>

>

> CE Grim, MD

>

" I'd rather learn from one bird how to sing, than to teach ten thousand stars

how not to dance. "

__________________________________________________

[Guest guest]

Test both PA and PRA I mean.

May your pressure be low!CE Grim MDClinical Professor of Internal MedicineProfessor of EpidemiologyBoard Certified in Internal Medicine, Geriatrics and Hypertension

Re: My Father Has Low Potassium!

Hi, Dr. Grim

If I understand you correctly, I would go ahead and

get the testing done (ARR?) despite the fact that I am

on Spironolactone.

My blood pressure is very high lately (220/130) and I

have had to double the Spironolactone to 200 mg daily.

It is now in the 186/98 range after a week of this

increase. It is not controlled, obviously.

Does it still make sense to test now?

Warmly,

Pam

--- lowerbp2@... wrote:

> It may affect the reading but here is what I do. > However if the ratio is > high then I assume that is presumptive evidence of

> PA. > > If you are doing well on Inspra or other Rx I would

> just sit tight and DASH. > > > > CE Grim, MD

> "I'd rather learn from one bird how to sing, than to teach ten thousand stars how not to dance."

__________________________________________________

[Guest guest]

is that all u r on?

Thanks

Mark

Re: My Father Has Low Potassium!

Hi, Dr. GrimIf I understand you correctly, I would go ahead andget the testing done (ARR?) despite the fact that I amon Spironolactone.My blood pressure is very high lately (220/130) and Ihave had to double the Spironolactone to 200 mg daily.It is now in the 186/98 range after a week of thisincrease. It is not controlled, obviously.Does it still make sense to test now?Warmly,Pam--- lowerbp2@... wrote:> It may affect the reading but here is what I do. > However if the ratio is > high then I assume that is presumptive evidence of> PA. > > If you are doing well on Inspra or other Rx I would> just sit tight and DASH. > > > > CE Grim, MD> "I'd rather learn from one bird how to sing, than to teach ten thousand stars how not to dance."__________________________________________________

[Guest guest]

Hi, Mark

Yes, that is all I am on. For about a year, I took

100 mg of Spironolactone. I needed to increase it

recently.

Warmly,

Pam

--- THE HOUSE <thewhiningpplz@...> wrote:

> is that all u r on?

> Thanks

> Mark

" I'd rather learn from one bird how to sing, than to teach ten thousand stars

how not to dance. "

__________________________________________________

[Guest guest]

ok well my DR said to me once that he has never seen only spero or inspro with a pa person.

im on inspra 2 times a day 100 mgl and atenolol 25 mlg 2 times a day

Thanks

Mark

Re: My Father Has Low Potassium!

Hi, MarkYes, that is all I am on. For about a year, I took100 mg of Spironolactone. I needed to increase itrecently.Warmly,Pam--- THE HOUSE <thewhiningpplz@...> wrote:> is that all u r on?> Thanks> Mark"I'd rather learn from one bird how to sing, than to teach ten thousand stars how not to dance."__________________________________________________

[Guest guest]

Hi, Mark

If I was back on Atenolol, I would be dead about now!

That is one that makes me insanely depressed and

unable to function. I was lying in bed for five or

six weeks, not sure if I was awake or asleep, or what

day it was. I had some very vivid dreams, though.

When I started functioning more, all I could think

about was how to kill myself.

Needless to say, Atenolol is now on my " Do Not Take "

list.

If I understood Dr. Grim correctly, I need to increase

the spironolactone slowly to 400 mg.; after that, we

will see if I'll need more medication for

hypertension.

Thanks for sharing!

Warmly,

Pam

--- THE HOUSE <thewhiningpplz@...> wrote:

> ok well my DR said to me once that he has never seen

> only spero or inspro with a pa person.

> im on inspra 2 times a day 100 mgl and atenolol 25

> mlg 2 times a day

> Thanks

> Mark

>

> Re: My Father Has

> Low Potassium!

>

" I'd rather learn from one bird how to sing, than to teach ten thousand stars

how not to dance. "

__________________________________________________

[Guest guest]

ok well that's what toperol did to me so ill tell u i know where u r with that.

are u swelling from water weight also like me im going to ask my neff for a water pill to see what it will do hopefully i can drop the atenolol if the water pill helps.

when i was on spero i did have this prob and come to find out the inspra dont have a diuretic in it.

Thanks

Mark

Re: My Father Has> Low Potassium!> "I'd rather learn from one bird how to sing, than to teach ten thousand stars how not to dance."__________________________________________________

[Guest guest]

In a message dated 4/28/05 9:17:46 AM, thewhiningpplz@... writes:

If I understood Dr. Grim correctly, I need to increase

the spironolactone slowly to 400 mg.; after that, we

will see if I'll need more medication for

hypertension.

Because the BP is so high now I would double the Spiro now and see what happens. By usual plan is to get up to a dose that controls BP fairly quickly then taper other drugs or add other drugs as needed. If BP can be controllled with Spiro then go for 3-6 months and begin to back down.

CE Grim, MD

[Guest guest]

In a message dated 4/28/05 9:17:46 AM, thewhiningpplz@... writes:

come to find out the inspra dont have a diuretic in it.

Neither spiro or Inspra are "diuretics" if you mean the get rid of water from the body or make you pee more. They do get rid of excess sodium if the cause of the Na retention is aldo or other mineralocorticoid. Indeed the most common effect I see with ABs (aldo blockers) is that the need to urinate goes back to normal.

CE Grim, MD

[Guest guest]

In a message dated 4/28/05 5:57:31 PM, spirlhelix@... writes:

Hi, Mike

No, I don't have much swelling in my hands just now.

Sometimes I get that, but nothing just at the present.

The shins and ankles are fine, too, so I don't think a

diuretic would help much at this time.

I got some pretty significant edema from nifedipine (I

didn't realize this was the cause at the time), then

they put me on diuretics, which really zapped my

potassium, so naturally they had to give me those K

horse pills.  Sheesh!

If you do go on a diuretic, do be careful of your

potassium level!  I don't know if Inspra will protect

you from the effect, but when I was on a diuretic

(before spironolactone) it was a constant battle to

keep the potassium level anywhere near normal.

The best possible good health to you!

Warmly,

Pam

HCTZ and Inspra might be a very good combo. For spiro its called Aldactazide but it is expensive or was.

CE Grim, MD

[Guest guest]

In a message dated 4/28/05 3:51:30 PM, spirlhelix@... writes:

Hi, Dr. Grim

Yes, I did double the Spironolactone a week ago to 100

mg twice a day.  I guess the slow part is waiting to

see what happens once it takes effect!

So far, my blood pressure is in the 167/87-193/116

ranges, (BPs taken in the last 24 hours) after

increasing the Spironolactone.  Those are home

readings, so I would have to assume they would be

higher at the doctor's office where a week and a half

ago they were 224/131.

Warmly,

Pam

Looks like you are making some progress-keep us posted.

CE Grim, MD

[Guest guest]

In a message dated 4/28/05 8:09:29 AM, thewhiningpplz@... writes:

ok well my DR said to me once that he has never seen only spero or inspro with a pa person.

im on inspra 2 times a day 100 mgl and atenolol 25 mlg 2 times a day

Thanks

Mark

Guess he hasn't seen many-probably recongnized even fewrer.

CE Grim, MD

[Guest guest]

well i am retaining alot of water but b\p seems to hold well i just dont like the swelling of the hands and feet

spero never let this happen to me and no im not peeing wright like once or twice aday.

kidny funtion is good just not geting rid of the extra water.

Thanks

Mark

Re: My Father Has Low Potassium!

In a message dated 4/28/05 9:17:46 AM, thewhiningpplz@... writes:

come to find out the inspra dont have a diuretic in it.Neither spiro or Inspra are "diuretics" if you mean the get rid of water from the body or make you pee more. They do get rid of excess sodium if the cause of the Na retention is aldo or other mineralocorticoid. Indeed the most common effect I see with ABs (aldo blockers) is that the need to urinate goes back to normal. CE Grim, MD

[Guest guest]

Hi, Dr. Grim

Yes, I did double the Spironolactone a week ago to 100

mg twice a day. I guess the slow part is waiting to

see what happens once it takes effect!

So far, my blood pressure is in the 167/87-193/116

ranges, (BPs taken in the last 24 hours) after

increasing the Spironolactone. Those are home

readings, so I would have to assume they would be

higher at the doctor's office where a week and a half

ago they were 224/131.

Warmly,

Pam

--- lowerbp2@... wrote:

>

> In a message dated 4/28/05 9:17:46 AM,

> thewhiningpplz@... writes:

>

>

> > If I understood Dr. Grim correctly, I need to

> increase

> > the spironolactone slowly to 400 mg.; after that,

> we

> > will see if I'll need more medication for

> > hypertension.

> >

> >

>

> Because the BP is so high now I would double the

> Spiro now and see what

> happens. By usual plan is to get up to a dose that

> controls BP fairly quickly

> then taper other drugs or add other drugs as needed.

> If BP can be controllled

> with Spiro then go for 3-6 months and begin to back

> down.

>

>

>

> CE Grim, MD

>

" I'd rather learn from one bird how to sing, than to teach ten thousand stars

how not to dance. "

__________________________________________________

[Guest guest]

Hi, Mike

No, I don't have much swelling in my hands just now.

Sometimes I get that, but nothing just at the present.

The shins and ankles are fine, too, so I don't think a

diuretic would help much at this time.

I got some pretty significant edema from nifedipine (I

didn't realize this was the cause at the time), then

they put me on diuretics, which really zapped my

potassium, so naturally they had to give me those K

horse pills. Sheesh!

If you do go on a diuretic, do be careful of your

potassium level! I don't know if Inspra will protect

you from the effect, but when I was on a diuretic

(before spironolactone) it was a constant battle to

keep the potassium level anywhere near normal.

The best possible good health to you!

Warmly,

Pam

--- THE HOUSE <thewhiningpplz@...> wrote:

> ok well that's what toperol did to me so ill tell u

> i know where u r with that.

> are u swelling from water weight also like me im

> going to ask my neff for a water pill to see what it

> will do hopefully i can drop the atenolol if the

> water pill helps.

> when i was on spero i did have this prob and come to

> find out the inspra dont have a diuretic in it.

> Thanks

> Mark

> Re: My Father

> Has

> > Low Potassium!

> >

>

>

> " I'd rather learn from one bird how to sing, than

> to teach ten thousand stars how not to dance. "

>

> __________________________________________________

>