Re: What does supine mean with an aldo test

[Guest guest]

In my book supine means before getting our of bed. Upright can be

anytime after you get up. We have used 2-4 hours of standing in the

past. The key is to study a large number of normals under the same

conditions which is not normally done.

Here at MCW we have used 1 hr supine then 10 min up.

On Apr 12, 2008, at 6:57 PM, Valarie wrote:

> The lab ranges for upright vs supine are different. What is required

> to be

> tested " supine. " How many prior hours of being at rest?

>

> Does upright or supine matter with a renin test?

>

> Val

>

>

>

[Guest guest]

This is my friend's note to me. What say you all?

Hello Val:

Here were my numbers for both Aldo and Renin. I was sitting down,

but had been up for about 45 min or so. Supine technically means

laying down, but when I read Labcorps Patient Prep guidelines..the pt

is encouraged to be " ambulatory " for at least 30 min if physically

able....otherwise, they are " supine " ,so I am unclear..It's

conceivable that the lab tech (although she was a supervisor) made a

mistake..I think I'm going to have to get Dr. to double check

these numbers. If sitting down is " supine " , then my aldo is high and

my renin is normal; if sitting down is " upright " then renin is low

and aldo is normal..the first would mean a diagnosis of PA (except

cortisol is usually normal) and the second would mean a diagnosis of

Cushing's from my very new and limited understanding.

Cortisol might as well have been ascertained as " high " ; it was ~8:30A

and I was not feeling stressed in the least; value was 21.4 (range

3.1-22.4 ug/dl)

Renin, plasma - 1.22 upright 1.31-3.95; supine .15-2.33 ng/ml/hr

Aldosterone - 17.1 upright; supine 1.0 - 16.0

Again, LabCorps is supposed to note position and apparently they went

by recumbent or " supine " . Either way, something is off.

Val

[Guest guest]

Early stage? Comments?

More from my friend:

Val:

Potassium wasn't checked this time around, and yes, it appears that

LabCorps marked the sample as supine. Potassium has been " low

normal " in past, with sodium toward the upper end of the range...this

was true when racing/anxiety was much worse than it is now.

Yes, lab marked aldo as high..

And the polyuria is as you describe..worse at night. I used to go

all day and void maybe 2-3 times a day with good healthy

amounts..now, esp at night (which is when I eat my largest meal), I

have to void 4-6 times after eating and during the night..more than a

dribble comes out but not a lot..pressure or insistency is inconsistent with

amount.

BP's as I said in my earlier message are generally 95-100 over 65-80,

but higher when I race (sometimes 125/80)..high for me. Also, family

history of BP issues abound.

Val

[Guest guest]

See my comments on renin aldo results.

'

On Apr 12, 2008, at 8:37 PM, Valarie wrote:

> Early stage? Comments?

>

> More from my friend:

>

> Val:

> Potassium wasn't checked this time around, and yes, it appears that

> LabCorps marked the sample as supine. Potassium has been " low

> normal " in past, with sodium toward the upper end of the range...this

> was true when racing/anxiety was much worse than it is now.

> Yes, lab marked aldo as high..

> And the polyuria is as you describe..worse at night. I used to go

> all day and void maybe 2-3 times a day with good healthy

> amounts..now, esp at night (which is when I eat my largest meal), I

> have to void 4-6 times after eating and during the night..more than a

> dribble comes out but not a lot..pressure or insistency is

> inconsistent with

> amount.

> BP's as I said in my earlier message are generally 95-100 over 65-80,

> but higher when I race (sometimes 125/80)..high for me. Also, family

> history of BP issues abound.

>

> Val

>

>

[Guest guest]

And still more:

The plot certainly " sickens " here. Sometimes, (and I have a current

active EBV infection which some suppose cause left ventricular

dysfunction) I get what I call the " kicked in the chest " feeling..no

pain, but I feel like my heart is absolutely ready to STOP...very,

very weak and very, very tired..to the point of collapse. I DID have

an echo (stress) and it was pronounced " normal " ..but when I was being

reviewed, the attending doc said " I'm going to go ahead and

call 'that' normal " ..my BP at the time was 83 over something..and I

didn't push him..hmmm..maybe I should get my notes. (If you remember,

I had a SVT incident with heartrate exceeding 200 BPM's back in May

of '07).

In the past, I was diagnosed as having MVP, but after thyroid meds,

no murmur was seen and the stress echo doc said no. Interestingly, when I

get the racing, my

BP's go up for me..but usually are lower end of normal..however, that

being said, I have a family history of VERY high BP on BOTH sides

(genetically, the deck appears to be somewhat stacked against me from

an endocrinological standpoint).

Val

From: hyperaldosteronism

[mailto:hyperaldosteronism ] On Behalf Of Valarie

Val:

Potassium wasn't checked this time around, and yes, it appears that

LabCorps marked the sample as supine. Potassium has been " low

normal " in past, with sodium toward the upper end of the range...this

was true when racing/anxiety was much worse than it is now.

Yes, lab marked aldo as high..

And the polyuria is as you describe..worse at night. I used to go

all day and void maybe 2-3 times a day with good healthy

amounts..now, esp at night (which is when I eat my largest meal), I

have to void 4-6 times after eating and during the night..more than a

dribble comes out but not a lot..pressure or insistency is inconsistent with

amount.

BP's as I said in my earlier message are generally 95-100 over 65-80,

but higher when I race (sometimes 125/80)..high for me. Also, family

history of BP issues abound.

Val

[Guest guest]

A group of five of us found each other on the Web. We've been on hormone

and thyroid forums and something clicked among us. We seem to all have

symptoms in common, namely thyroid med or hormone intolerance. Before long,

we were sending individual messages right and left until we finally formed a

private group so everyone got to hear everything. They are all bright,

well-studied women and we've been educating each other. Two are nurses and

one has a lab background. Here is another post to me tonight. We'd been

discussing heart irregularities. Now, they're asking me things I am not

qualified to answer.

I've already told her what tests to get. I'm going to swell our membership

here.

Val

<b53cjf@...> wrote:

Val,

What type of cardiac malfunction?

Something is very wrong with me. My heart is doing funny things, beating

faster than normal. I was eating pretzels today and my heart went wild, like

the salt was too much. I can tell I'm in for another sleepless night. I have

no appetite at all. Is it possible to have PA without a high BP? Meant to

add that things calmed down a bit after drinking low sodium V8.

BP is 129/72. The pounding heart is much worse when partially lying down and

lying down. I can feel it pulsing through my whole body. I just really

don't want to go to the ER. I'm so stressed about this.

[Guest guest]

She needs to go to her Dr and tell all.

On Apr 12, 2008, at 9:33 PM, Valarie wrote:

> A group of five of us found each other on the Web. We've been on

> hormone

> and thyroid forums and something clicked among us. We seem to all have

> symptoms in common, namely thyroid med or hormone intolerance. Before

> long,

> we were sending individual messages right and left until we finally

> formed a

> private group so everyone got to hear everything. They are all bright,

> well-studied women and we've been educating each other. Two are

> nurses and

> one has a lab background. Here is another post to me tonight. We'd

> been

> discussing heart irregularities. Now, they're asking me things I am

> not

> qualified to answer.

>

> I've already told her what tests to get. I'm going to swell our

> membership

> here.

>

> Val

>

> <b53cjf@...> wrote:

>

> Val,

>

> What type of cardiac malfunction?

>

> Something is very wrong with me. My heart is doing funny things,

> beating

> faster than normal. I was eating pretzels today and my heart went

> wild, like

> the salt was too much. I can tell I'm in for another sleepless night.

> I have

> no appetite at all. Is it possible to have PA without a high BP?

> Meant to

> add that things calmed down a bit after drinking low sodium V8.

>

> BP is 129/72. The pounding heart is much worse when partially lying

> down and

> lying down. I can feel it pulsing through my whole body. I just really

> don't want to go to the ER. I'm so stressed about this.

>

>