RE: Potassium levels while on Spiro

[Guest guest]

, my K rose from 3.5 to 4.8 after two weeks of spiro. After that, my

endo didn't want to test it anymore. She said I would excrete any excess K.

Val

From: hyperaldosteronism

[mailto:hyperaldosteronism ] On Behalf Of em5704

I'd like some input from people who are on spiro about what their K

levels are like, and are K levels dosage dependent on the spiro? Has

anyone had K rise to danger levels while on spiro? Thanks,

[Guest guest]

Goal is to get BP and K controlled with as few meds as possible.

DASHing seems to be a very good way to do this. So that rather than

decrease K in diet I would recommend decreasing meds.

You did not mention what your BP is doing.

Can you give us your AVS story sometime. Thanks

Be sure to tell you health care team everything you are doing as they

know your total picture better than we do.

Also ask to have plasma K done as it is less variable.

Be sure they are following all the steps to get the most accurate

blood K level. See our files.

Clarence Grim BS, MS, MD

Clinical Professor of Medicine

Medical College of Wisconsin

Senior Consultant to Shared Care Research and Education Consulting, Inc.

Specializing in Difficult to control high blood pressure.

On Dec 29, 2008, at 10:52 AM, em5704 wrote:

> Hello, haven't posted in a bit. To refresh, I have been through all

> testing short of AVS and have been diagnosed with PA due to left

> adrenal tumor. I had low K (3.3) before spiro. I started spiro -- 100

> mg daily -- last June, and at July labs, my K had increased to 4.4,

> with my sodium and chloride being slightly low. I just had labs taken

> again in December, and my K has increased again to 4.9. The cutoff

> for normal K at my lab is 5.1. All my other measures (glucose, CO2,

> calcium etc) were good, sodium once again was slightly low. I feel

> good.

>

> My question is -- I am concerned that my K is going up. I am reducing

> the spiro to 50 mg a day and will monitor BP to see how I do on the

> lower maintenance dose.

>

> I have stopped eating high K foods, like bananas, raisins and

> oranges. But I am used to eating healthily and fruits and vegetables

> are what I like to eat.

>

> My endo didn't seem concerned that my K had risen from 4.4 to 4.9

> within 5 mos. He has ordered labs for 6 mos from now -- shouldnt I be

> monitored more often that that? He made no suggestions about reducing

> spiro dosage, so I'm reducing it on my own. I feel like I;m really

> directing my own care.

>

> I'd like some input from people who are on spiro about what their K

> levels are like, and are K levels dosage dependent on the spiro? Has

> anyone had K rise to danger levels while on spiro? Thanks,

>

>

>

[Guest guest]

I did the same thing. Reduced Spiro to 75mg/day. My diet includes a high

amount of potassium fruits and vegetables. Initially I was adding more salt

to my foods to bring the sodium up but I learned that I could just reduce

spiro and continue with dashing and it has worked for me. I notice when my

sodium is low, I tend to feel very tired and exhausted. I am mainly on 75mgs

spiro with occasional times when I reduce it to 50 and so far it has worked

for me. Also, if I know I have a stressful situation coming my way, I take

an additional 12.5 mgs before I face the world.

Farah

On Mon, Dec 29, 2008 at 11:42 AM, Clarence Grim <lowerbp2@...> wrote:

> Goal is to get BP and K controlled with as few meds as possible.

>

> DASHing seems to be a very good way to do this. So that rather than

> decrease K in diet I would recommend decreasing meds.

>

> You did not mention what your BP is doing.

>

> Can you give us your AVS story sometime. Thanks

>

> Be sure to tell you health care team everything you are doing as they

> know your total picture better than we do.

>

> Also ask to have plasma K done as it is less variable.

>

> Be sure they are following all the steps to get the most accurate

> blood K level. See our files.

>

> Clarence Grim BS, MS, MD

>

> Clinical Professor of Medicine

> Medical College of Wisconsin

> Senior Consultant to Shared Care Research and Education Consulting, Inc.

>

> Specializing in Difficult to control high blood pressure.

>

>

> On Dec 29, 2008, at 10:52 AM, em5704 wrote:

>

> > Hello, haven't posted in a bit. To refresh, I have been through all

> > testing short of AVS and have been diagnosed with PA due to left

> > adrenal tumor. I had low K (3.3) before spiro. I started spiro -- 100

> > mg daily -- last June, and at July labs, my K had increased to 4.4,

> > with my sodium and chloride being slightly low. I just had labs taken

> > again in December, and my K has increased again to 4.9. The cutoff

> > for normal K at my lab is 5.1. All my other measures (glucose, CO2,

> > calcium etc) were good, sodium once again was slightly low. I feel

> > good.

> >

> > My question is -- I am concerned that my K is going up. I am reducing

> > the spiro to 50 mg a day and will monitor BP to see how I do on the

> > lower maintenance dose.

> >

> > I have stopped eating high K foods, like bananas, raisins and

> > oranges. But I am used to eating healthily and fruits and vegetables

> > are what I like to eat.

> >

> > My endo didn't seem concerned that my K had risen from 4.4 to 4.9

> > within 5 mos. He has ordered labs for 6 mos from now -- shouldnt I be

> > monitored more often that that? He made no suggestions about reducing

> > spiro dosage, so I'm reducing it on my own. I feel like I;m really

> > directing my own care.

> >

> > I'd like some input from people who are on spiro about what their K

> > levels are like, and are K levels dosage dependent on the spiro? Has

> > anyone had K rise to danger levels while on spiro? Thanks,

> >

> >

> >

>

>

[Guest guest]

I have not had AVS.

My BP on 100 mg spiro daily was around 120/80 or below UNLESS I was

having a lot of stressful emotions and then it would creep up to

140/90. So I began adding 5 mg of Norvasc as needed. On 50 mg of

spiro daily + the Norvasc, it seems to be OK, but it's too soon to

tell, only a couple of days.

I always make sure not to clench my fist now when I have blood taken,

because I know that artificially raises K.

I am DASHing and have been since June.

I would rather decrease the spiro than the K in my diet -- Dr. Grim,

will taking a lower dose of spiro decrease the serum K? And what is

a serum K goal to aim for? The lab normal parameters for K are 3.5-

5.1. I'm at 4.9 now, but is that too high?

>

> > Hello, haven't posted in a bit. To refresh, I have been through

all

> > testing short of AVS and have been diagnosed with PA due to left

> > adrenal tumor. I had low K (3.3) before spiro. I started spiro --

100

> > mg daily -- last June, and at July labs, my K had increased to

4.4,

> > with my sodium and chloride being slightly low. I just had labs

taken

> > again in December, and my K has increased again to 4.9. The cutoff

> > for normal K at my lab is 5.1. All my other measures (glucose,

CO2,

> > calcium etc) were good, sodium once again was slightly low. I feel

> > good.

> >

> > My question is -- I am concerned that my K is going up. I am

reducing

> > the spiro to 50 mg a day and will monitor BP to see how I do on

the

> > lower maintenance dose.

> >

> > I have stopped eating high K foods, like bananas, raisins and

> > oranges. But I am used to eating healthily and fruits and

vegetables

> > are what I like to eat.

> >

> > My endo didn't seem concerned that my K had risen from 4.4 to 4.9

> > within 5 mos. He has ordered labs for 6 mos from now -- shouldnt

I be

> > monitored more often that that? He made no suggestions about

reducing

> > spiro dosage, so I'm reducing it on my own. I feel like I;m really

> > directing my own care.

> >

> > I'd like some input from people who are on spiro about what their

K

> > levels are like, and are K levels dosage dependent on the spiro?

Has

> > anyone had K rise to danger levels while on spiro? Thanks,

> >

> >

> >

>

>

>

>

[Guest guest]

clenching fist just before venipuncture raises K?????

where is it written?

On Dec 29, 2008, at 7:30 PM, em5704 wrote:

> I have not had AVS.

>

> My BP on 100 mg spiro daily was around 120/80 or below UNLESS I was

> having a lot of stressful emotions and then it would creep up to

> 140/90. So I began adding 5 mg of Norvasc as needed. On 50 mg of

> spiro daily + the Norvasc, it seems to be OK, but it's too soon to

> tell, only a couple of days.

>

> I always make sure not to clench my fist now when I have blood taken,

> because I know that artificially raises K.

>

> I am DASHing and have been since June.

>

> I would rather decrease the spiro than the K in my diet -- Dr. Grim,

> will taking a lower dose of spiro decrease the serum K? And what is

> a serum K goal to aim for? The lab normal parameters for K are 3.5-

> 5.1. I'm at 4.9 now, but is that too high?

>

>

> >

> > > Hello, haven't posted in a bit. To refresh, I have been through

> all

> > > testing short of AVS and have been diagnosed with PA due to left

> > > adrenal tumor. I had low K (3.3) before spiro. I started spiro --

> 100

> > > mg daily -- last June, and at July labs, my K had increased to

> 4.4,

> > > with my sodium and chloride being slightly low. I just had labs

> taken

> > > again in December, and my K has increased again to 4.9. The cutoff

> > > for normal K at my lab is 5.1. All my other measures (glucose,

> CO2,

> > > calcium etc) were good, sodium once again was slightly low. I feel

> > > good.

> > >

> > > My question is -- I am concerned that my K is going up. I am

> reducing

> > > the spiro to 50 mg a day and will monitor BP to see how I do on

> the

> > > lower maintenance dose.

> > >

> > > I have stopped eating high K foods, like bananas, raisins and

> > > oranges. But I am used to eating healthily and fruits and

> vegetables

> > > are what I like to eat.

> > >

> > > My endo didn't seem concerned that my K had risen from 4.4 to 4.9

> > > within 5 mos. He has ordered labs for 6 mos from now -- shouldnt

> I be

> > > monitored more often that that? He made no suggestions about

> reducing

> > > spiro dosage, so I'm reducing it on my own. I feel like I;m really

> > > directing my own care.

> > >

> > > I'd like some input from people who are on spiro about what their

> K

> > > levels are like, and are K levels dosage dependent on the spiro?

> Has

> > > anyone had K rise to danger levels while on spiro? Thanks,

> > >

> > >

> > >

> >

> >

> >

> >

[Guest guest]

Grim's Guide to True Blood K

1. Best to ask for a plasma K as when blood clots the platelets rupture and

the serum K goes up.

2. Don't squeeze you hand or pump it this will increase it up to 2.

3. Don't hyperventilate-this will falsely lower it. in 30 seconds

4. Don't let them draw blood with the tourniquet on as this will falsely

increase it.

5. Tell them to process blood immediately as letting it sit will increase

the K in the tube but is low in the blood in your body.

6. Eating before blood is drawn can increase it. Depending on what you eat.

7. Don't get acute leukemia with very high wbc counts and let blood sit. The

will take up the K and give a pseudo hypokalemia.

8. Don't measure right after taking too much insulin-it will be low.

May have left some out. Others can fill in.

Also see:

http://www.merck.com/mmpe/sec12/ch156/ch156f.html#sec12-ch156-ch156f-777

for disorders of K concentration.

http://f1.grp.fs.com/v1/kHJZSWrCyAUERbIZ5DrlDb_kvXiR2PVrQN3pVsfdc39gJSh

RYxJoJWAssK8W54DtBD21zd_lqxol3Y5qV8eMbDFC6wxj/Grims%20Guide%20to%20True%20Bl

ood%20K.doc

Val

From: hyperaldosteronism

[mailto:hyperaldosteronism ] On Behalf Of arthur springer

clenching fist just before venipuncture raises K?????

where is it written?

[Guest guest]

and good luck trying to explain to the technician when he/she is taking your

blood.

Without a tourniquet no blood will be drawn in the syringe. So, make sure to

tell the technician to first take the blood for other tests if any, before

taking the tube of blood for K. Then as soon as your blood comes loosen the

tourniquet. The tech will insist that you make a fist, but make sure to keep

your fist loosened while they are drawing blood.

Cheers,

Farah

On Mon, Dec 29, 2008 at 8:03 PM, Valarie <val@...> wrote:

>

> Grim's Guide to True Blood K

>

> 1. Best to ask for a plasma K as when blood clots the platelets rupture and

> the serum K goes up.

> 2. Don't squeeze you hand or pump it this will increase it up to 2.

> 3. Don't hyperventilate-this will falsely lower it. in 30 seconds

> 4. Don't let them draw blood with the tourniquet on as this will falsely

> increase it.

> 5. Tell them to process blood immediately as letting it sit will increase

> the K in the tube but is low in the blood in your body.

> 6. Eating before blood is drawn can increase it. Depending on what you eat.

>

> 7. Don't get acute leukemia with very high wbc counts and let blood sit.

> The

> will take up the K and give a pseudo hypokalemia.

> 8. Don't measure right after taking too much insulin-it will be low.

>

> May have left some out. Others can fill in.

>

> Also see:

> http://www.merck.com/mmpe/sec12/ch156/ch156f.html#sec12-ch156-ch156f-777

>

> for disorders of K concentration.

>

>

> http://f1.grp.fs.com/v1/kHJZSWrCyAUERbIZ5DrlDb_kvXiR2PVrQN3pVsfdc39gJSh

>

> RYxJoJWAssK8W54DtBD21zd_lqxol3Y5qV8eMbDFC6wxj/Grims%20Guide%20to%20True%20Bl

> ood%20K.doc

>

>

> Val

>

> From: hyperaldosteronism <hyperaldosteronism%40>

>

[mailto:hyperaldosteronism <hyperaldosteronism%40>\

]

> On Behalf Of arthur springer

>

> clenching fist just before venipuncture raises K?????

> where is it written?

>

>

[Guest guest]

anywhere in normal range K is good. I usually dont follow it but

ever 6 months or a year if the pt feels well.

120/80 bp may be too low to feel good. I shoot for <135/<85. Lower

make make some feel week so each person is different.

Taking a single dose of spiro likely has no effect on BP as time

course of action is hours.

The effect of spiro on K is a function of your dietary intake of K

and Na and how much aldo you are making.

Clarence Grim BS, MS, MD

Clinical Professor of Medicine

Medical College of Wisconsin

Senior Consultant to Shared Care Research and Education Consulting, Inc.

Specializing in Difficult to control high blood pressure.

On Dec 29, 2008, at 4:30 PM, em5704 wrote:

> I have not had AVS.

>

> My BP on 100 mg spiro daily was around 120/80 or below UNLESS I was

> having a lot of stressful emotions and then it would creep up to

> 140/90. So I began adding 5 mg of Norvasc as needed. On 50 mg of

> spiro daily + the Norvasc, it seems to be OK, but it's too soon to

> tell, only a couple of days.

>

> I always make sure not to clench my fist now when I have blood taken,

> because I know that artificially raises K.

>

> I am DASHing and have been since June.

>

> I would rather decrease the spiro than the K in my diet -- Dr. Grim,

> will taking a lower dose of spiro decrease the serum K? And what is

> a serum K goal to aim for? The lab normal parameters for K are 3.5-

> 5.1. I'm at 4.9 now, but is that too high?

>

>

> >

> > > Hello, haven't posted in a bit. To refresh, I have been through

> all

> > > testing short of AVS and have been diagnosed with PA due to left

> > > adrenal tumor. I had low K (3.3) before spiro. I started spiro --

> 100

> > > mg daily -- last June, and at July labs, my K had increased to

> 4.4,

> > > with my sodium and chloride being slightly low. I just had labs

> taken

> > > again in December, and my K has increased again to 4.9. The cutoff

> > > for normal K at my lab is 5.1. All my other measures (glucose,

> CO2,

> > > calcium etc) were good, sodium once again was slightly low. I feel

> > > good.

> > >

> > > My question is -- I am concerned that my K is going up. I am

> reducing

> > > the spiro to 50 mg a day and will monitor BP to see how I do on

> the

> > > lower maintenance dose.

> > >

> > > I have stopped eating high K foods, like bananas, raisins and

> > > oranges. But I am used to eating healthily and fruits and

> vegetables

> > > are what I like to eat.

> > >

> > > My endo didn't seem concerned that my K had risen from 4.4 to 4.9

> > > within 5 mos. He has ordered labs for 6 mos from now -- shouldnt

> I be

> > > monitored more often that that? He made no suggestions about

> reducing

> > > spiro dosage, so I'm reducing it on my own. I feel like I;m really

> > > directing my own care.

> > >

> > > I'd like some input from people who are on spiro about what their

> K

> > > levels are like, and are K levels dosage dependent on the spiro?

> Has

> > > anyone had K rise to danger levels while on spiro? Thanks,

> > >

> > >

> > >

> >

> >

> >

> >

[Guest guest]

See our guidelines in our files.

I think we also have a paper in our files by the group from Glasgow.

If not I will try to find.

Clarence Grim

lowerbp2@...

On Dec 29, 2008, at 4:42 PM, arthur springer wrote:

> clenching fist just before venipuncture raises K?????

> where is it written?

>

> On Dec 29, 2008, at 7:30 PM, em5704 wrote:

>

> > I have not had AVS.

> >

> > My BP on 100 mg spiro daily was around 120/80 or below UNLESS I was

> > having a lot of stressful emotions and then it would creep up to

> > 140/90. So I began adding 5 mg of Norvasc as needed. On 50 mg of

> > spiro daily + the Norvasc, it seems to be OK, but it's too soon to

> > tell, only a couple of days.

> >

> > I always make sure not to clench my fist now when I have blood

> taken,

> > because I know that artificially raises K.

> >

> > I am DASHing and have been since June.

> >

> > I would rather decrease the spiro than the K in my diet -- Dr. Grim,

> > will taking a lower dose of spiro decrease the serum K? And what is

> > a serum K goal to aim for? The lab normal parameters for K are 3.5-

> > 5.1. I'm at 4.9 now, but is that too high?

> >

> >

> > >

> > > > Hello, haven't posted in a bit. To refresh, I have been through

> > all

> > > > testing short of AVS and have been diagnosed with PA due to left

> > > > adrenal tumor. I had low K (3.3) before spiro. I started

> spiro --

> > 100

> > > > mg daily -- last June, and at July labs, my K had increased to

> > 4.4,

> > > > with my sodium and chloride being slightly low. I just had labs

> > taken

> > > > again in December, and my K has increased again to 4.9. The

> cutoff

> > > > for normal K at my lab is 5.1. All my other measures (glucose,

> > CO2,

> > > > calcium etc) were good, sodium once again was slightly low. I

> feel

> > > > good.

> > > >

> > > > My question is -- I am concerned that my K is going up. I am

> > reducing

> > > > the spiro to 50 mg a day and will monitor BP to see how I do on

> > the

> > > > lower maintenance dose.

> > > >

> > > > I have stopped eating high K foods, like bananas, raisins and

> > > > oranges. But I am used to eating healthily and fruits and

> > vegetables

> > > > are what I like to eat.

> > > >

> > > > My endo didn't seem concerned that my K had risen from 4.4 to

> 4.9

> > > > within 5 mos. He has ordered labs for 6 mos from now -- shouldnt

> > I be

> > > > monitored more often that that? He made no suggestions about

> > reducing

> > > > spiro dosage, so I'm reducing it on my own. I feel like I;m

> really

> > > > directing my own care.

> > > >

> > > > I'd like some input from people who are on spiro about what

> their

> > K

> > > > levels are like, and are K levels dosage dependent on the spiro?

> > Has

> > > > anyone had K rise to danger levels while on spiro? Thanks,

> > > >

> > > >

> > > >

> > >

> > >

> > >

> > >

[Guest guest]

Also note that under stress normal subjects can go to over 300 mm

Hg. So in almost everyone it will be above 140/90 sometimes.

Clarence Grim

lowerbp2@...

On Dec 29, 2008, at 4:30 PM, em5704 wrote:

> I have not had AVS.

>

> My BP on 100 mg spiro daily was around 120/80 or below UNLESS I was

> having a lot of stressful emotions and then it would creep up to

> 140/90. So I began adding 5 mg of Norvasc as needed. On 50 mg of

> spiro daily + the Norvasc, it seems to be OK, but it's too soon to

> tell, only a couple of days.

>

> I always make sure not to clench my fist now when I have blood taken,

> because I know that artificially raises K.

>

> I am DASHing and have been since June.

>

> I would rather decrease the spiro than the K in my diet -- Dr. Grim,

> will taking a lower dose of spiro decrease the serum K? And what is

> a serum K goal to aim for? The lab normal parameters for K are 3.5-

> 5.1. I'm at 4.9 now, but is that too high?

>

>

> >

> > > Hello, haven't posted in a bit. To refresh, I have been through

> all

> > > testing short of AVS and have been diagnosed with PA due to left

> > > adrenal tumor. I had low K (3.3) before spiro. I started spiro --

> 100

> > > mg daily -- last June, and at July labs, my K had increased to

> 4.4,

> > > with my sodium and chloride being slightly low. I just had labs

> taken

> > > again in December, and my K has increased again to 4.9. The cutoff

> > > for normal K at my lab is 5.1. All my other measures (glucose,

> CO2,

> > > calcium etc) were good, sodium once again was slightly low. I feel

> > > good.

> > >

> > > My question is -- I am concerned that my K is going up. I am

> reducing

> > > the spiro to 50 mg a day and will monitor BP to see how I do on

> the

> > > lower maintenance dose.

> > >

> > > I have stopped eating high K foods, like bananas, raisins and

> > > oranges. But I am used to eating healthily and fruits and

> vegetables

> > > are what I like to eat.

> > >

> > > My endo didn't seem concerned that my K had risen from 4.4 to 4.9

> > > within 5 mos. He has ordered labs for 6 mos from now -- shouldnt

> I be

> > > monitored more often that that? He made no suggestions about

> reducing

> > > spiro dosage, so I'm reducing it on my own. I feel like I;m really

> > > directing my own care.

> > >

> > > I'd like some input from people who are on spiro about what their

> K

> > > levels are like, and are K levels dosage dependent on the spiro?

> Has

> > > anyone had K rise to danger levels while on spiro? Thanks,

> > >

> > >

> > >

> >

> >

> >

> >