Re: Re: weight and my adrenal tumor

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One of the points that we can't see is it is impossible to gain weight from nothing. Water weight maybe - if we are retaining it, but we CAN'T physiologically just put things on without the body having something to use to "make" more body - even a growing fetus is getting nutrients and fat from momma. This is why the pattern never quite fits in our minds.

Most with weight issues, seems to be women much more then men, always seem to claim 100% of the time, that past diets were always done "perfect" and weight invisibly materialized. (I don't want to start an argument because I know dieters will claim perfection and that isn't something I can say is true or untrue in regards to someone else - I am ONLY saying dieters and those usually posting on here always SAY they dieted perfectly as a typical statement and maybe so, but making "sense" of weight gain in that case is hard to do). Maybe the diet is good, but a lack of exercise is the culprit.

Can't deny what you say, but hope you can see why other people get skeptical because even when adrenals are out of control it still doesn't make sense. A building can't build itself, the wood and metal has to come from somewhere. If there's less wood, you get one story. More wood and metal we can build two stories, and so on. Plus we can burn off calories, given we have the energy - which wasn't always an option as energy was fleeting in our Conn's pasts, but we have the ability to brun off more than we take in.

When I was new in practice my doc told me once that he found after 20+ years in practice that many always thinking they had Cushings etc, were found to actually eat alot more than they said. So he suggested having a family member - not the patient - keep the diet log and actually they usually took in alot more calories than they thought. I find many diet for breakfast (they skip, so they "think" they are dieting) diet for lunch, but make it up at dinner in some fashion. My wifes family eats that way - dinner is thought about and planned when they wake up - and diabetes is prevelant. Big, small, in the middle, our bodies have calorie demands it wants to meet - usually more than we need, but we get used to eating that way.

Some do have a bigger foundation and have a metabolism that's different. .

I have a skinny wife and 6 skinny kids then one oddball daughter who's a big girl, and she came out big - our biggest - so genetics is a huge factor. But her appetite and preferences match her size and I have to watch her all the time. She's bigger than the others, but her eating also seems to keep her that way. When I got her a bike I noticed a huge change in her weight. But if I let her she would go after nothing but spaghettios and pizza pockets, and stuff like that. The other kids not so much.

From: msmith_1928 <janeray1940@...>Subject: Re: weight and my adrenal tumorhyperaldosteronism Date: Friday, March 16, 2012, 12:55 PM

Perhaps I am the first woman in history to GAIN weight on a 1000-1200 calorie/day diet? Somehow I doubt it though, it sounds like there are several of us on this board who did so while we had tumors.I'm not a midget but I am just under 5'3". When I first became sick with what I now know was the tumor, I went from 89 pounds (I had never weighed over 100, and usually kept my weight down around the low 90s) to 139 pounds within less than a year, EVEN THOUGH MY DIET DID NOT EVER CHANGE.I've watched my weight obsessively since childhood. At the time of the weight gain, I was vegetarian - mostly vegan, really - and most of my calories came from grains, rice, beans, legumes, and fresh fruits veggies. I tracked my portions and calories and rarely topped 1000/day. (NB: I did not know it at the time, but I was soon to learn that I was celiac and fructose intolerant.)Yet I managed to gain 50 pounds and become insulin resistant while

eating this way. And the weight gain continued, until I hit 173 and stopped stepping on the scales.What saved me was being diagnosed with celiac disease and fructose intolerance - I dropped all grains except for rice from my diet, all beans and legumes, and most fruits and sweet/starchy veggies. This left me with not much to eat, so I added in chicken, fish, and nuts.I dropped those 50 pounds within 90 days by doing this. I still didn't go over 1200 calories a day (and I still don't, to this day) but what the calories were MADE OF had changed. Eventually I dropped rice from my diet as well, because I found that it made me gain weight easily. Still, as long as I had the tumor, I never was able to get below 120-125 pounds - which at my height always felt just a bit too heavy.Fast forward to now, 4 months after the tumor was taken out. My labs no longer show me as insulin-resistant. I eat rice to my heart's content, and I'm actually

finding it hard to keep my weight from dropping below 110 (I find 110-115 to be the perfect range for me).So - this was my longwinded way of saying that our adrenal tumors certainly do some strange stuff to us when it comes to weight, and as long as I still had the tumor, it was VERY possible for me to gain weight on 1000 calories a day!-msmith1928Successful left laparoscopic adrenalectomy 10/13/11 > Each time a med change was made I would gain at least ten pounds that could never be lost. As a result, by 1995 I carried 70 extra pounds. > .> <http://geo./serv?s=97359714/grpId=7299303/grpspId=1705132763/msgId=41551/stime=1331872149/nc1=5191951/nc2=5191946/nc3=3848640>>

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May your pressure be low!CE Grim MS, MDSpecializing in DifficultHypertensionOn Mar 16, 2012, at 17:28, <jclark24p@...> wrote:

I have tried to stay out of this discussion but can resist no longer. As I have reported, I stopped Spironolctone on Dec. 22. At that point I had lost ~25lbs since starting Spiro. In the first 3 weeks I gained about 15lbs of which I managed to loose about 5lbs. Fast forward to yesterday. I had gained 9 more lbs from when I was weighed at the VA on Feb. 9th. Do I measure the input? No! Do I measure the output? No. Has my exersize changed? No. Has my addition of salt changed? No, we don't even have a salt shaker. We very seldom add any salt in cooking, zero, zilch, none! My wife is still the shopper and cook and is very sensitive to the salt issue. I use the same size plate, no it is a sandwich plate and my right elbow makes the same number of bends every day. The deck of cards is the same size as it was last year! I have not had "S-T-U-P-I-D" tatooed on my forehead, yet!

Now let's look at some of the known issues:

T2DM Insulin/Glucosse - "Daily sticks" are bouncing and on an upward trend, does this have any bearing?Suspect you are leeing out K which lower.body and pancreas K which decreases insulin release. Less insulin less glucose disposal blood glucose goes up.

OSA - I have been told that is affected by PA and should get better when PA is corrected. No data that correcting PA will help OSA but could if breathing muscles are weakened by low K and get better.

Quality of sleep - Waking ~2 times/night. Sleeping 2-3 hours at a time. Remember what I told you about REM sleep?Do u pee when u wake up? Has this changed since stopping Spiro. The more salt you retain the more u have to pee out at night.

Depression - Markedly worse according to phsyco testing. If the action of Spironolactone increases cortisol which increases seratonin in MDD, what happens when you take it away? Don't know data that Spiro increases cortisol chronically. What if you are already on medication, Cymbalta, to increase seratonin?

I detailed this out because if the input remains the same but the output changes is that a reason for weight gain or has logic failed me again? Let me rephrase that, If I take a bath towel and weigh it completely dry and then soak it in water and weigh it again, which will be heaver? (You didn't ask but while mt endema was completely resolved while on Spiro, I now loose my ankle bone as the day progresses.)

I may have ranged outside the actual subject area but you got me started! At least I didn't get into "Man Boobs" and no labedio! Testosterone test next week and I start weekly RTC until we get a handle on some of this.

A status update from one PTN who has been there/done that! Stay tuned for what happens after an ADX (I hope!)

> > > Each time a med change was made I would gain at least ten pounds that could never be lost. As a result, by 1995 I carried 70 extra pounds. > > > .> > > <http://geo./serv?s=97359714/grpId=7299303/grpspId=1705132763/msgId=41551/stime=1331872149/nc1=5191951/nc2=5191946/nc3=3848640>> > >> >>

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May your pressure be low!CE Grim MS, MDSpecializing in DifficultHypertensionOn Mar 16, 2012, at 17:28, <jclark24p@...> wrote:

I have tried to stay out of this discussion but can resist no longer. As I have reported, I stopped Spironolctone on Dec. 22. At that point I had lost ~25lbs since starting Spiro. In the first 3 weeks I gained about 15lbs of which I managed to loose about 5lbs. Fast forward to yesterday. I had gained 9 more lbs from when I was weighed at the VA on Feb. 9th. Do I measure the input? No! Do I measure the output? No. Has my exersize changed? No. Has my addition of salt changed? No, we don't even have a salt shaker. We very seldom add any salt in cooking, zero, zilch, none! My wife is still the shopper and cook and is very sensitive to the salt issue. I use the same size plate, no it is a sandwich plate and my right elbow makes the same number of bends every day. The deck of cards is the same size as it was last year! I have not had "S-T-U-P-I-D" tatooed on my forehead, yet!

Now let's look at some of the known issues:

T2DM Insulin/Glucosse - "Daily sticks" are bouncing and on an upward trend, does this have any bearing?

OSA - I have been told that is affected by PA and should get better when PA is corrected.

Quality of sleep - Waking ~2 times/night. Sleeping 2-3 hours at a time. Remember what I told you about REM sleep?

Depression - Markedly worse according to phsyco testing. If the action of Spironolactone increases cortisol which increases seratonin in MDD, what happens when you take it away? What if you are already on medication, Cymbalta, to increase seratonin?

I detailed this out because if the input remains the same but the output changes is that a reason for weight gain or has logic failed me again? Let me rephrase that, If I take a bath towel and weigh it completely dry and then soak it in water and weigh it again, which will be heaver? (You didn't ask but while mt endema was completely resolved while on Spiro, I now loose my ankle bone as the day progresses.)That is where the retained salt is going and your weight is going up. Or u are drinking heavy water? Let's say you are ding the DASH EXACTLY and are in sodium balance, no edema, and stop Spiro the following would be expected.Your sodium reabsorbing effect should go up remarkably. So lets say you now begin to reabsorb 1/2 of the 1500 mg of sodium a day. So 750 mg is about 33 mM a day. You will also retain more water. So every day your weight will go up about 1/4 kilogram (about 1/2 a pound) a day until your BP increases enough to over come the salt retention from unantagonised aldo (previously blocked by spiro) thru pressure natriuresis. The pressure will continue to rise until sodium balance is restored or the pressure blows out a Blood vessel or the heart can no longer keep up with the pressure load and fluid begins to back up in your feet and lungs, and you start to get tired rhen begin to wake up short of breath and cant sleep lying down. THEN AKA CHF DEVELOPS. So if u plot your your weight, which must be due to salt retention as you are not eating enough to gain weight I would predict your BP will be trending up. Peeing at night will increase. Keep us posted as this evolves. Has your team checked any urine Na or K during this evolution? I may have ranged outside the actual subject area but you got me started! At least I didn't get into "Man Boobs" and no labedio! Testosterone test next week and I start weekly RTC until we get a handle on some of this.

A status update from one PTN who has been there/done that! Stay tuned for what happens after an ADX (I hope!)

> > > Each time a med change was made I would gain at least ten pounds that could never be lost. As a result, by 1995 I carried 70 extra pounds. > > > .> > > <http://geo./serv?s=97359714/grpId=7299303/grpspId=1705132763/msgId=41551/stime=1331872149/nc1=5191951/nc2=5191946/nc3=3848640>> > >> >>

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Most was likely a result of salt and water swings. High aldosterone is known to stimulate salt appetite and in an attempt to get more salt you may have been eating more. A few more calories a day adds up. May your pressure be low!CE Grim MS, MDSpecializing in DifficultHypertensionOn Mar 16, 2012, at 13:08, msmith_1928 <janeray1940@...> wrote:

I'm not saying that I gained weight from "nothing" - I'm saying that all the excess stuff put out by the tumor made me susceptible to weight gain in an abnormal way. My weight gain/loss story shows that for whatever reason, while I had the tumor my metabolism slowed way down, and something happened that made a carb-based diet (my vegetarian diet) promote weight gain, and made a protein-based diet (my post-celiac and -fructose intolerance diet) promote weight loss/maintenance, and that regardless of diet, pre-adrenalectomy I gained weight really easily and now I don't. I wish there was a simple explanation of what the tumor had been doing to me weight-wise, but there doesn't seem to be.

I'm kind of an odd case since I don't have family pressures or food issues to deal with at all - eating is an inconvenience rather than a pleasure, and if I could take a "food pill" and be done with it I would! I have no problem refusing food and am not afraid to say "no thank you" to anybody offering it. Even though medical professionals can safely assume that *most* people take in more calories than they realize, I certainly am not "most people" in this regard. I don't snack, I don't eat mindlessly, I don't derive ANY pleasure from food other than it makes me un-hungry when the stomach starts to growl. I'm also incredibly obsessive and self-controlling about weight and have been my whole life - I feel so uncomfortable the minute I begin to put on any extra that I've always been willing to starve if I have to in order to prevent it. So I am confident that my "experiment" was pretty well controlled.

I only wish I knew what my experiment proved!

> > Each time a med change was made I would gain at least ten pounds that could never be lost. As a result, by 1995 I carried 70 extra pounds.

> > .

> > <http://geo./serv?s=97359714/grpId=7299303/grpspId=1705132763/msgId=41551/stime=1331872149/nc1=5191951/nc2=5191946/nc3=3848640>

> >

>

[Guest guest]

Salt and water weight gain occurs without changing calories and this may be more sensitive when one is making excess and not suppressible aldo. Has not really been well studied. I will buy the weight was related to salt and water but not that it was calorie related if you were on 1,000 calories.Lets say you eat 1500 mg of salt a day and we give you excess aldo = to 1/2 of what your adrenal normally makes (as illustrated in my Evolution of PA article). Your ENa will drop to nearly zero and you will gain about 1 lb a day as the salt and water is retained. I detailed reasons the body eventually "escapes" from the salt retention caused by a sudden jump in aldo yesterday I think. However patients with tumors may not escape as fast as their BP may already be high. Not been well studied as I recall. Also reducing BP by other means other than diuretics would generally lead to weight gain for the same reasons. Well you can also go to a site somewhere and calculate the minimum number of calories to keep your BMI steady when you are lying down. Not lying down will always reduce calorie related weight. The basic equation is: change in Calories in - change in calories out = weight changeor calorie related weight = calories in - calories outVery simple in concept, difficult in execution for most of us who want to lose weight.CE Grim MDOn Mar 16, 2012, at 12:39 PM, Bingham wrote: One of the points that we can't see is it is impossible to gain weight from nothing. Water weight maybe - if we are retaining it, but we CAN'T physiologically just put things on without the body having something to use to "make" more body - even a growing fetus is getting nutrients and fat from momma. This is why the pattern never quite fits in our minds. Most with weight issues, seems to be women much more then men, always seem to claim 100% of the time, that past diets were always done "perfect" and weight invisibly materialized. (I don't want to start an argument because I know dieters will claim perfection and that isn't something I can say is true or untrue in regards to someone else - I am ONLY saying dieters and those usually posting on here always SAY they dieted perfectly as a typical statement and maybe so, but making "sense" of weight gain in that case is hard to do). Maybe the diet is good, but a lack of exercise is the culprit. Can't deny what you say, but hope you can see why other people get skeptical because even when adrenals are out of control it still doesn't make sense. A building can't build itself, the wood and metal has to come from somewhere. If there's less wood, you get one story. More wood and metal we can build two stories, and so on. Plus we can burn off calories, given we have the energy - which wasn't always an option as energy was fleeting in our Conn's pasts, but we have the ability to brun off more than we take in. When I was new in practice my doc told me once that he found after 20+ years in practice that many always thinking they had Cushings etc, were found to actually eat alot more than they said. So he suggested having a family member - not the patient - keep the diet log and actually they usually took in alot more calories than they thought. I find many diet for breakfast (they skip, so they "think" they are dieting) diet for lunch, but make it up at dinner in some fashion. My wifes family eats that way - dinner is thought about and planned when they wake up - and diabetes is prevelant. Big, small, in the middle, our bodies have calorie demands it wants to meet - usually more than we need, but we get used to eating that way. Some do have a bigger foundation and have a metabolism that's different. . I have a skinny wife and 6 skinny kids then one oddball daughter who's a big girl, and she came out big - our biggest - so genetics is a huge factor. But her appetite and preferences match her size and I have to watch her all the time. She's bigger than the others, but her eating also seems to keep her that way. When I got her a bike I noticed a huge change in her weight. But if I let her she would go after nothing but spaghettios and pizza pockets, and stuff like that. The other kids not so much. From: msmith_1928 <janeray1940@...>Subject: Re: weight and my adrenal tumorhyperaldosteronism Date: Friday, March 16, 2012, 12:55 PM Perhaps I am the first woman in history to GAIN weight on a 1000-1200 calorie/day diet? Somehow I doubt it though, it sounds like there are several of us on this board who did so while we had tumors.I'm not a midget but I am just under 5'3". When I first became sick with what I now know was the tumor, I went from 89 pounds (I had never weighed over 100, and usually kept my weight down around the low 90s) to 139 pounds within less than a year, EVEN THOUGH MY DIET DID NOT EVER CHANGE.I've watched my weight obsessively since childhood. At the time of the weight gain, I was vegetarian - mostly vegan, really - and most of my calories came from grains, rice, beans, legumes, and fresh fruits veggies. I tracked my portions and calories and rarely topped 1000/day. (NB: I did not know it at the time, but I was soon to learn that I was celiac and fructose intolerant.)Yet I managed to gain 50 pounds and become insulin resistant while eating this way. And the weight gain continued, until I hit 173 and stopped stepping on the scales.What saved me was being diagnosed with celiac disease and fructose intolerance - I dropped all grains except for rice from my diet, all beans and legumes, and most fruits and sweet/starchy veggies. This left me with not much to eat, so I added in chicken, fish, and nuts.I dropped those 50 pounds within 90 days by doing this. I still didn't go over 1200 calories a day (and I still don't, to this day) but what the calories were MADE OF had changed. Eventually I dropped rice from my diet as well, because I found that it made me gain weight easily. Still, as long as I had the tumor, I never was able to get below 120-125 pounds - which at my height always felt just a bit too heavy.Fast forward to now, 4 months after the tumor was taken out. My labs no longer show me as insulin-resistant. I eat rice to my heart's content, and I'm actually finding it hard to keep my weight from dropping below 110 (I find 110-115 to be the perfect range for me).So - this was my longwinded way of saying that our adrenal tumors certainly do some strange stuff to us when it comes to weight, and as long as I still had the tumor, it was VERY possible for me to gain weight on 1000 calories a day!-msmith1928Successful left laparoscopic adrenalectomy 10/13/11 > Each time a med change was made I would gain at least ten pounds that could never be lost. As a result, by 1995 I carried 70 extra pounds. > .> <http://geo./serv?s=97359714/grpId=7299303/grpspId=1705132763/msgId=41551/stime=1331872149/nc1=5191951/nc2=5191946/nc3=3848640>>

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I am in complete agreement with you.  I think it is very naive to think that everyone has the same metabolism.  We all know of people who can eat even 4,000 calories a day and stay skinny.I have always had trouble with my endocrine system and a year ago I was diagnosed with PA.  I am 68 years of age, 5'4 " , and have always had to just about starve myself to remain at about 135 lbs.  However, over the last six months I have put on about 35 lbs. and it's really upsetting.  It doesn't matter what I do....eat....not eat.....exercise....not exercise----the weight just does not fluctuate any way except up.

I find it very upsetting when people tell me to just cut back on calories.  I have lived with my body for 68 years and know it very well.  If it was as easy as that, I would be weighing 118 lbs. which is the weight I feel I should weigh.

I have not had a CT scan or an AVS because my thought was that at my age I did not want to have any more surgery.  The last surgery was not pleasant.  That was 5 years ago.  I was diagnosed with thyroid cancer and had my entire thyroid gland removed.  However, there was an emergency situation during the surgery with my blood pressure and they had to administer meds to bring it down.  I then crashed and they had to give me meds to bring it back up.  For three days after the surgery I was in a private ward with a nurse attending at all times.

I just don't feel confident about being put under again.I am not happy with the way I look and just don't know what to do about it.  On Sat, Mar 17, 2012 at 6:41 PM, msmith_1928 <janeray1940@...> wrote:

 

Calories in/calories out may be that simple in someone with a NORMAL endocrine system. I cannot believe this one-size-fits-all approach can be applied to those of us with adrenal tumors.

I've read a lot of posts from others on this board who, like myself, went from normal weight to overweight really rapidly after the onset of their PA. I do not believe that it's a lack of self-control; instead, I am certain that there is something going on metabolically that causes us to store fat. Even though my pre-adrenalectomy weight/BMI were " normal, " my weight distribution followed a pattern similar to Cushing's patients - skinny legs with lots of abdominal fat, and fat around the shoulders and upper arms. I knew this wasn't normal.

Before the tumor was removed, there was no amount of calorie restriction/exercise/salt restriction that allowed me to get my weight down below 120. And keeping it at 120, which I felt was the top end of " healthy " for my small frame, was a struggle, but I figured out what worked and stuck with it.

Post-surgery, I've had no trouble at all keeping my weight to a more healthy range of 110-115, even though I'm eating more (and eating more salt!) than I did while I had the tumor.

If calories in/calories out was all there was to it, then I should be GAINING weight, as I am eating more than I did before the surgery.

> > > Each time a med change was made I would gain at least ten pounds

> > that could never be lost. As a result, by 1995 I carried 70 extra

> > pounds.

> > > .

> > > <http://geo./serv?s=97359714/grpId=7299303/grpspId=1705132763/msgId=41551/stime=1331872149/nc1=5191951/nc2=5191946/nc3=3848640

> > >

> > >

> >

> >

> >

>

-- Jan ShimanoHealth & Wellness Advocate

[Guest guest]

No one thinks everyone has the same metabolism.

And you didn't likely have the same metabolism at 20 that you do at 54. Most of ours changes over time.

I couldn't put a muscle on no matter how much I lifted in my youth. And I ate anything with no qualms about anything. I sure put on muscle now, not body builder like, but nicely. Now, I no doubt I burned fat and have a good metabolism because I was so aerobically active until the first signs of low K in my late 30's (of course I didn't know it then). I had to be the skinniest high school QB there was my age. You know, as an aside, girls said all the time to me "I wish I was skinny as you" because they were OBSESSED with weight and I hated it and cringed every single time someone said it (always a girl or woman). It's not a picnic for men with the other weight issues - and since I was skinny and never smoked, drank, etc, I should be healthy at age 44, but I am not. Today a kid would be in the counselors office and on SSRI's over it.

As to wieght gain though I am sorry but something is amiss. Either you're not/weren't exercising enough to overcome it, maybe because you couldn't, who knows, or your caloric intake is/was more than you thought, or you just broke even because metabolism changed as you aged and also your exercise never increased enough to meet the demands of over riding your metabolism and intake - which again, likely changed as you aged - or exercise was somewhat weight bearing (lifting weights, swimming, etc) and muscle replaced some fat, which weighs more, again giving you a net and no loss or gain. I acknowledge there certainly could have been some issue maybe hormonally or not at play.

We all have caloric demands regardless of our weight or metabolism or we'd be dead and not discussing this on the list - if we did not meet them, and it is human nature for the body, consciously or not, to meet those demands.

Sorry if it ruffles feathers but once again we cannot build something from nothing.

There is no magical immaculate fat conception where we burned off more than took in, and yet somehow weight piled on in some miraculous way. It wasn't burned off or we took in more than we thought. There was a factor at play somehow somewhere involving taking in more than we burned off. Maybe hormones helped those factors along, but hormones don't make us gain even if we literally starved ourself, they can only make us more prone to losing fat slower - or faster, say in the case of hyperthyroidism. This is basic science.

I honestly think this is one reason docs get so frustrated and cringe when the lady comes in dying of heart disease, or has incredible cholesterol levels, or a blood sugar out-of-control but only wants to talk about weight. Patients come in and say or imply over and over that everything was 100% done perfect, every diet, every exercise regimen, everything, and yet that weight came on and the only factor that ever could be in the world has to be hormonal. And scientifically, naturally, whaterverly, THAT cannot happen as to immaculate weight gain.

Yeah yeah I know I am the only one to say it, and we're among friends here, so it's a discussion, not a fight...but......my perception is often that......

Maybe it is hormonal, but honestly if a woman gets it in her mind it is hormonal than nothing on the planet in a million years is ever gonna change that and I say that every single woman that ever lived can't have only hormones to blame for their weight. So how then does one treat that? A doc then can't say ANYTHING related to eating or exercise because the woman has worked out in her mind already those factors are moot points and so so often will tell us no matter what the diet again was perfect, the exercise was perfect, etc etc.

As to hormones, If it is hormonal, then the key is correcting the "why" one or the other didn't work - either getting them healthy enough to exercise enough, or uncovering the food flaw, or fixing the hormonal imbalance so they can do it all. But if we fail to "find" the hormonal imbalance though in that particular woman, we then aren't allowed to discuss ANY other factor because we'll offend them. Even if let's say the doc WAS complete and left no stone unturned and all labs were even normal, even the aldosterones and cortisols, it's going to be hormonal in that patient in her mind. That's a reality in practice, not a misconception, and sometimes is going to be a can't win no matter what they do or find, even if they are kind and thorough.

But no less difficult from either side. This is partially a factor why a doc, male or female, can just wish it all to go away and get as or more frustrated as the patient. Sadly ego takes over or rudeness does instead of compassion too many times.

Okay....before you all attack me for just giving an opinion, let me say I KNOW there are different examples on this list and everyone is the exception on here, but we are here writing because we already are sick people WITH hormonal issues already existing. So we are the exceptions not the rules.

I still say no matter the cause we still aren't building a house without enough wood.

Maybe the foundation/ground is a bigger plot to start with, but it takes the material to go upward.

Calories in/calories out may be that simple in someone with a NORMAL endocrine system. I cannot believe this one-size-fits-all approach can be applied to those of us with adrenal tumors.I've read a lot of posts from others on this board who, like myself, went from normal weight to overweight really rapidly after the onset of their PA. I do not believe that it's a lack of self-control; instead, I am certain that there is something going on metabolically that causes us to store fat. Even though my pre-adrenalectomy weight/BMI were "normal," my weight distribution followed a pattern similar to Cushing's patients - skinny legs with lots of abdominal fat, and fat around the shoulders and upper arms. I knew this wasn't normal.Before the tumor was removed, there was no amount of calorie restriction/exercise/salt restriction that allowed me to get my weight down below 120. And keeping it at 120, which I felt was the top end of "healthy" for

my small frame, was a struggle, but I figured out what worked and stuck with it.Post-surgery, I've had no trouble at all keeping my weight to a more healthy range of 110-115, even though I'm eating more (and eating more salt!) than I did while I had the tumor.If calories in/calories out was all there was to it, then I should be GAINING weight, as I am eating more than I did before the surgery.

> > > Each time a med change was made I would gain at least ten pounds > > that could never be lost. As a result, by 1995 I carried 70 extra > > pounds.> > > .> > > <http://geo./serv?s=97359714/grpId=7299303/grpspId=1705132763/msgId=41551/stime=1331872149/nc1=5191951/nc2=5191946/nc3=3848640 > > >> > >> >> >> >>

-- Jan ShimanoHealth & Wellness Advocate

[Guest guest]

Most with chest pain do not have heart trouble (the cause is often something like GERD) but doesn't matter, as we HAVE to rule out heart trouble. So I see the same principle with weight (and a GOOD historian should uncover other issues if it's really more than just weight) in that we owe it to the patient at least to give them the news they don't want or uncover the actual cause of it .

I am saying regardless it is difficult to broach that topic and it is a subject very difficult in practice because many women have been taught that everything negative is hormonal (that's why I always say "men have hormones too!" ) and if they believe it's hormones there aint nuttin gonna change the mind. We owe it to them to check at least without preconceived notions, understanding that every living woman wouldn't be a model size if they had no hormones, and that many men and woman are where they are because they do not exercise or eat right. But sadly, when one frustrates the doc, "it" rolls downhill.

From: lk.barns <lk.barns@...>Subject: Re: weight and my adrenal tumorhyperaldosteronism Date: Sunday, March 18, 2012, 12:55 PM

The key statements in your post that really struck home with me all dealt with frustration. I'm sure I was the umpteenth woman who walked into each of my specialists offices complaining about weight gain and the inability to lose weight. Unlike my small town GP, they did not have the pleasure of waiving to me as he passed me on my daily walk. I was dismissed as yet another overweight woman looking for something to blame or a quick fix.However, the purpose of the the consultation was never to seek the quick fix - the weight fluctuation was just one symptom and one part of the overall condition - an evaluation of an adrenal adenoma and uncontrolled hypertension. Complicating this was sporadic appearance and disappearance of symptoms. It was not until medically monitored and controlled rehabilitation that any of the specialist began to observe what was happening. My ability to quickly gain muscular strength and endurance clearly

demonstrated my prior physical conditioning. Then symptoms began during rehab and I quickly began to decline. Suddenly, I no longer received a smirk from medical professionals when the numbers on the scale rose dramatically or praise when the numbers fell just as dramatically. This was finally seen as one of my symptoms.Over the past year my weight has ranged from a low of 192 in February 2011 to a high of 226 in November 2011. As of this morning, I am back down to 209. By following these fluctuations and scheduling tests when symptoms were their worst, I have finally been able to get a clear diagnosis. Most of the stories here regarding dramatic weigh gain and loss are from women. Women are cyclical creatures. Healthy women experience minor fluctuations in weight depending on the level of hormones available during a particular part of her cycle - that's normal. Add to the mix an abnormal level of aldosternone and what happens then? Since most

medical research until recently has been conducted on male subjects, the answers may yet to be established.

[Guest guest]

More women have PA than men and have been better studied. The first Conn's was a women. If you read my evolution article you will see her summary.So you must be retaining salt and water that causes your weight fluctuations. Only way to test this is to feed know sodium K and fixed calorie intake which i have done many times on a CRC.Then you measure the daily sodium, K and weight. It will all become clear. But I have found patients smuggling food in thru friends even using a rope thru the window at Duke to get food in. So I have been there and done that. And know that to study this issue one must control all access to food and water to get it right.CE Grim MDOn Mar 18, 2012, at 10:55 AM, lk.barns wrote: The key statements in your post that really struck home with me all dealt with frustration. I'm sure I was the umpteenth woman who walked into each of my specialists offices complaining about weight gain and the inability to lose weight. Unlike my small town GP, they did not have the pleasure of waiving to me as he passed me on my daily walk. I was dismissed as yet another overweight woman looking for something to blame or a quick fix. However, the purpose of the the consultation was never to seek the quick fix - the weight fluctuation was just one symptom and one part of the overall condition - an evaluation of an adrenal adenoma and uncontrolled hypertension. Complicating this was sporadic appearance and disappearance of symptoms. It was not until medically monitored and controlled rehabilitation that any of the specialist began to observe what was happening. My ability to quickly gain muscular strength and endurance clearly demonstrated my prior physical conditioning. Then symptoms began during rehab and I quickly began to decline. Suddenly, I no longer received a smirk from medical professionals when the numbers on the scale rose dramatically or praise when the numbers fell just as dramatically. This was finally seen as one of my symptoms. Over the past year my weight has ranged from a low of 192 in February 2011 to a high of 226 in November 2011. As of this morning, I am back down to 209. By following these fluctuations and scheduling tests when symptoms were their worst, I have finally been able to get a clear diagnosis. Most of the stories here regarding dramatic weigh gain and loss are from women. Women are cyclical creatures. Healthy women experience minor fluctuations in weight depending on the level of hormones available during a particular part of her cycle - that's normal. Add to the mix an abnormal level of aldosternone and what happens then? Since most medical research until recently has been conducted on male subjects, the answers may yet to be established.

[Guest guest]

or you can recommend the DASH book. I have had good results with this as a method to sell healthy eaitng. I had one patient lose 70 lbs. just by following it.Again: weight = calories in - calories out. The choice is up to them. Guess I should add BP = salt in -salt out.CE Grim MD On Mar 18, 2012, at 8:49 PM, Bingham wrote: Most with chest pain do not have heart trouble (the cause is often something like GERD) but doesn't matter, as we HAVE to rule out heart trouble. So I see the same principle with weight (and a GOOD historian should uncover other issues if it's really more than just weight) in that we owe it to the patient at least to give them the news they don't want or uncover the actual cause of it . I am saying regardless it is difficult to broach that topic and it is a subject very difficult in practice because many women have been taught that everything negative is hormonal (that's why I always say "men have hormones too!" ) and if they believe it's hormones there aint nuttin gonna change the mind. We owe it to them to check at least without preconceived notions, understanding that every living woman wouldn't be a model size if they had no hormones, and that many men and woman are where they are because they do not exercise or eat right. But sadly, when one frustrates the doc, "it" rolls downhill. From: lk.barns <lk.barns@...>Subject: Re: weight and my adrenal tumorhyperaldosteronism Date: Sunday, March 18, 2012, 12:55 PM The key statements in your post that really struck home with me all dealt with frustration. I'm sure I was the umpteenth woman who walked into each of my specialists offices complaining about weight gain and the inability to lose weight. Unlike my small town GP, they did not have the pleasure of waiving to me as he passed me on my daily walk. I was dismissed as yet another overweight woman looking for something to blame or a quick fix.However, the purpose of the the consultation was never to seek the quick fix - the weight fluctuation was just one symptom and one part of the overall condition - an evaluation of an adrenal adenoma and uncontrolled hypertension. Complicating this was sporadic appearance and disappearance of symptoms. It was not until medically monitored and controlled rehabilitation that any of the specialist began to observe what was happening. My ability to quickly gain muscular strength and endurance clearly demonstrated my prior physical conditioning. Then symptoms began during rehab and I quickly began to decline. Suddenly, I no longer received a smirk from medical professionals when the numbers on the scale rose dramatically or praise when the numbers fell just as dramatically. This was finally seen as one of my symptoms.Over the past year my weight has ranged from a low of 192 in February 2011 to a high of 226 in November 2011. As of this morning, I am back down to 209. By following these fluctuations and scheduling tests when symptoms were their worst, I have finally been able to get a clear diagnosis. Most of the stories here regarding dramatic weigh gain and loss are from women. Women are cyclical creatures. Healthy women experience minor fluctuations in weight depending on the level of hormones available during a particular part of her cycle - that's normal. Add to the mix an abnormal level of aldosternone and what happens then? Since most medical research until recently has been conducted on male subjects, the answers may yet to be established.