Re: Re: My story - from a newbie

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Which Dex suppression test did you have?One for GRA or for Cushing's?They are different causes of hyperaldosteronism.Low pancreatic peptied and DHEA are not good reasons to be feeling bad.Have you started DASHing yet to see if you feel better?CE Grim MDOn Mar 27, 2012, at 9:50 PM, danielle_cairns wrote: Thanks for writing. I just got the results from my dexmethasone suppression test today and it was normal (below ref range in fact). I also got new renin (2.35), aldo (121 ng/ml) and ratio levels (51.5). I also found out my pancreatic polypeptide and DHEA sulfate levels are low along with my carbon dioxide and vit D. No wonder I feel so crumby. I sure hope these results help my doctor figure out next steps! Thanks for your help! > > > > Hi Everyone, > > > > I wrote a few posts yesterday but the Dr. asked that I provide my detailed story with lab #'s so here it goes. I am a 33yo female that was incidentally diagnosed with a right adrenal tumor (~2cm) about 5 years ago that was deemed non-malignant and non-functioning. They kept an eye on it for about 2.5 years. Then my gynecologist told me that it "disappeared" after I had a scan done for my endometriosis. Turns out, he was wrong. The tumor is here and now they think it's producing aldosterone. I went to the Dr. for extreme fatigue, rapid weight gain (25-30 lbs in 6-8 months), night sweats/excess sweating and blood sugar fluctuations. The doc says it is hyperaldosteronism and we are following up with a few more tests and discussing surgical/treatment options. These are my test results: > > > > *PLASMA RENIN ACTIVITY,LC/MS/MS: 2.24 RANGE: 0.25-5.82 ng/mL/h NORMAL > > *ALDO/PRA RATIO: 41.1 RANGE: 0.9-28.9 Ratio HIGH > > *ALDOSTERONE, LC/MS/MS: 92 g/dL HIGH > > *CORTISOL, TOTAL: 22.7 mcg/dL HIGH > > *POTASSIUM: 4.4 Range: 3.5-5.3 mmol/L NORMAL > > > > *HEMOGLOBIN A1c: 5.1 (NORMAL) RANGE: <5.7 % of total Hgb NORMAL > > *INSULIN: 5 RANGE: <17 uIU/mL NORMAL > > *DHEA,ACTH, Glucose tol. test = ALL NORMAL > > > > Other abnormal tests: > > *CHOLESTEROL: TOTAL 209 RANGE: 125-200 mg/dL HIGH > > *TRIGLYCERIDES: 299 RANGE: <150 mg/dL HIGH > > *GLUCOSE: 61 RANGE: 65-99 mg/dL LOW > > *CARBON DIOXIDE: 17 RANGE: 21-33 mmol/L > > > > My BP is low to normal: like 70/100 or so. > > > > Any thoughts/feedback/advice is much appreciated! Thanks! le > > >

[Guest guest]

Don't know where the 21% figure came from. Please send details. CE Grim MDOn Mar 27, 2012, at 6:03 PM, maggiekat7 wrote: looks to me (IMHO) that you may have concurrent hyperaldosteronism and hypercortisolism, which occurs in about 21% of people with adrenal adenomas. They not only need to do AVS, but also a dexamethasone suppression test, esp. at your age! Could preclude issues like ovarian cysts, infertility, miscarriages. Wish I had found out before all that. > > Hi Everyone, > > I wrote a few posts yesterday but the Dr. asked that I provide my detailed story with lab #'s so here it goes. I am a 33yo female that was incidentally diagnosed with a right adrenal tumor (~2cm) about 5 years ago that was deemed non-malignant and non-functioning. They kept an eye on it for about 2.5 years. Then my gynecologist told me that it "disappeared" after I had a scan done for my endometriosis. Turns out, he was wrong. The tumor is here and now they think it's producing aldosterone. I went to the Dr. for extreme fatigue, rapid weight gain (25-30 lbs in 6-8 months), night sweats/excess sweating and blood sugar fluctuations. The doc says it is hyperaldosteronism and we are following up with a few more tests and discussing surgical/treatment options. These are my test results: > > *PLASMA RENIN ACTIVITY,LC/MS/MS: 2.24 RANGE: 0.25-5.82 ng/mL/h NORMAL > *ALDO/PRA RATIO: 41.1 RANGE: 0.9-28.9 Ratio HIGH > *ALDOSTERONE, LC/MS/MS: 92 g/dL HIGH > *CORTISOL, TOTAL: 22.7 mcg/dL HIGH > *POTASSIUM: 4.4 Range: 3.5-5.3 mmol/L NORMAL > > *HEMOGLOBIN A1c: 5.1 (NORMAL) RANGE: <5.7 % of total Hgb NORMAL > *INSULIN: 5 RANGE: <17 uIU/mL NORMAL > *DHEA,ACTH, Glucose tol. test = ALL NORMAL > > Other abnormal tests: > *CHOLESTEROL: TOTAL 209 RANGE: 125-200 mg/dL HIGH > *TRIGLYCERIDES: 299 RANGE: <150 mg/dL HIGH > *GLUCOSE: 61 RANGE: 65-99 mg/dL LOW > *CARBON DIOXIDE: 17 RANGE: 21-33 mmol/L > > My BP is low to normal: like 70/100 or so. > > Any thoughts/feedback/advice is much appreciated! Thanks! le >

[Guest guest]

A couple things though about the study.......1. In the abstract they don't even spell "Cushing's" right in one instance (it's in a prominent journal). 2. 20% may be near what the general population shows in terms of higher plasma cortisol (so how did they isolate to determine that ONLY the adenoma was the reason for higher cortisol and it wasn't stress, anticipation of the procedures, or for some other reason? it's not clear)

here's good study on cortisol. Interestingly, this study found cortisol affects/corrlates with a man's BMI, but not a womans, among other things.

http://hyper.ahajournals.org/content/33/6/1364.full

> > > looks to me (IMHO) that you may have concurrent hyperaldosteronism > > and hypercortisolism, which occurs in about 21% of people with > > adrenal adenomas. They not only need to do AVS, but also a > > dexamethasone suppression test, esp. at

your age! Could preclude > > issues like ovarian cysts, infertility, miscarriages. Wish I had > > found out before all that.> >> > > > >> > > Hi Everyone,> > >> > > I wrote a few posts yesterday but the Dr. asked that I provide my > > detailed story with lab #'s so here it goes. I am a 33yo female that > > was incidentally diagnosed with a right adrenal tumor (~2cm) about 5 > > years ago that was deemed non-malignant and non-functioning. They > > kept an eye on it for about 2.5 years. Then my gynecologist told me > > that it

"disappeared" after I had a scan done for my endometriosis. > > Turns out, he was wrong. The tumor is here and now they think it's > > producing aldosterone. I went to the Dr. for extreme fatigue, rapid > > weight gain (25-30 lbs in 6-8 months), night sweats/excess sweating > > and blood sugar fluctuations. The doc says it is hyperaldosteronism > > and we are following up with a few more tests and discussing > > surgical/treatment options. These are my test results:> > >> > > *PLASMA RENIN ACTIVITY,LC/MS/MS: 2.24 RANGE: 0.25-5.82 ng/mL/h > > NORMAL> > > *ALDO/PRA RATIO: 41.1 RANGE: 0.9-28.9 Ratio HIGH> > > *ALDOSTERONE, LC/MS/MS: 92 g/dL HIGH> > > *CORTISOL, TOTAL: 22.7 mcg/dL HIGH> > > *POTASSIUM: 4.4 Range: 3.5-5.3 mmol/L NORMAL> > >> > > *HEMOGLOBIN A1c: 5.1 (NORMAL) RANGE:

<5.7 % of total Hgb NORMAL> > > *INSULIN: 5 RANGE: <17 uIU/mL NORMAL> > > *DHEA,ACTH, Glucose tol. test = ALL NORMAL> > >> > > Other abnormal tests:> > > *CHOLESTEROL: TOTAL 209 RANGE: 125-200 mg/dL HIGH> > > *TRIGLYCERIDES: 299 RANGE: <150 mg/dL HIGH> > > *GLUCOSE: 61 RANGE: 65-99 mg/dL LOW> > > *CARBON DIOXIDE: 17 RANGE: 21-33 mmol/L> > >> > > My BP is low to normal: like 70/100 or so.> > >> > > Any thoughts/feedback/advice is much appreciated! Thanks! le> > >> >> >>

[Guest guest]

Are you kidding? Something as simple as spelling in a prominent journal and it's not a random thing misspelled but part of the DISEASE being studied. I think I disagree that it wouldn't be important. If that detail as benign as it seems, is overlooked, would bigger, more complicated aspects be? I think it is important, not the end-all-be-all, but something that says "Uhmmm...". It is a spell-check word misspell BTW.

If 20% of a general population (high stress yuppies maybe) have elevated cortisol then 20% of people with PA who also have elevated cortisol may be insignificant and nothing to do with an adenoma.

And it says HOW they collected the cortisol - big deal they collect it like everyone else collects it - I read the entire report. They do not relate how they controlled for other factors. And they didn't give cortisol data as accounting for a normal Circadian pattern - I realize they were trying to see how much they could provoke it out in this study. But if the patients were under duress, stress, scared, doing the research to get paid because they are broke and their life is falling apart, then I would gander their cortisol levels were higher. Come now, you're one of the main ones often discussing the depression and stress links related to PA and illness and background of our lives. Those "disorders" all like to bring high cortisol environments along with them. So pertinent questions could then be when were these patients diagnosed (if at all)? How were they diagnosed? How long did they wait to find out? What

happened in the meantime between diagnosis?

Alot to consider to say definitively whether cortisol is just a finding, or an actual FINDING.

If they publish your list postings one day in a journal then we can talk about your spelling.

From: <jclark24p@...>Subject: Re: My story - from a newbiehyperaldosteronism Date: Wednesday, March 28, 2012, 4:49 PM

, I'm not sure what you are implying with your first comment. This article was probably written in Japanese, translated by someone and published by someone else so anybody could have committed that typo. I don't see as it really has any bearing on the content! It's a 2011 research report and released im advance of publication.

As for how they determined the cortisol they explained that on page 2 (544) of the report. I don't know enough about Cushing to know if that is a valid answer to your question but you and Dr. Grim could take position on that! (My guess is others have reviewed it since it took > 4 months to publish it!) As far as I can tell it is a fairly new finding and could have an impact on care and treatment. (It could also turn out to be total B.S. but I bet Maggie will disagree!) I raised a couple questions on both sides of the issue that immediately came to mind and I'm sure there are many more. Refer to post #41770 for a start.

BTW, if you find typos in my postings see if I'm missing an "a", my keyboard needs replacing but I used the $$$ for a r/t ticket to Bethesda! I also might be off one key but that a vision problem! In reality I can't spell "FOR SHIT"! (Woops, I guess I just did!)

> > > >> > > > Hi Everyone,> > > >> > > > I wrote a few posts yesterday but the Dr. asked that I provide my > > > detailed story with lab #'s so here it goes. I am a 33yo female that > > > was incidentally diagnosed with a right adrenal tumor (~2cm) about 5 > > > years ago that was deemed non-malignant and non-functioning. They > > > kept an eye on it for about 2.5 years. Then my gynecologist told me > > > that it "disappeared" after I had a scan done for my endometriosis. > > > Turns out, he

was wrong. The tumor is here and now they think it's > > > producing aldosterone. I went to the Dr. for extreme fatigue, rapid > > > weight gain (25-30 lbs in 6-8 months), night sweats/excess sweating > > > and blood sugar fluctuations. The doc says it is hyperaldosteronism > > > and we are following up with a few more tests and discussing > > > surgical/treatment options. These are my test results:> > > >> > > > *PLASMA RENIN ACTIVITY,LC/MS/MS: 2.24 RANGE: 0.25-5.82 ng/mL/h > > > NORMAL> > > > *ALDO/PRA RATIO: 41.1 RANGE: 0.9-28.9 Ratio HIGH> > > > *ALDOSTERONE, LC/MS/MS: 92 g/dL HIGH> > > > *CORTISOL, TOTAL: 22.7 mcg/dL HIGH> > > > *POTASSIUM: 4.4 Range: 3.5-5.3 mmol/L NORMAL> > > >> > > > *HEMOGLOBIN A1c: 5.1 (NORMAL) RANGE: <5.7 % of total Hgb

NORMAL> > > > *INSULIN: 5 RANGE: <17 uIU/mL NORMAL> > > > *DHEA,ACTH, Glucose tol. test = ALL NORMAL> > > >> > > > Other abnormal tests:> > > > *CHOLESTEROL: TOTAL 209 RANGE: 125-200 mg/dL HIGH> > > > *TRIGLYCERIDES: 299 RANGE: <150 mg/dL HIGH> > > > *GLUCOSE: 61 RANGE: 65-99 mg/dL LOW> > > > *CARBON DIOXIDE: 17 RANGE: 21-33 mmol/L> > > >> > > > My BP is low to normal: like 70/100 or so.> > > >> > > > Any thoughts/feedback/advice is much appreciated! Thanks! le> > > >> > >> > >> >>

[Guest guest]

Interesting study from Japan. Only 6 had surgery to evaluate effect of ADx.Not clear if they used 2 caths to do simultaneous sampling. When one does not do this there can be very large changes in cortisol during AVS. Also no clear if they used dex suppression night before AVS.Also not the low body weight which is not typical for Cushing;s. We must wait for more reports and longer term follow up.CE Grim MDOn Mar 28, 2012, at 2:49 PM, wrote: , I'm not sure what you are implying with your first comment. This article was probably written in Japanese, translated by someone and published by someone else so anybody could have committed that typo. I don't see as it really has any bearing on the content! It's a 2011 research report and released im advance of publication.As for how they determined the cortisol they explained that on page 2 (544) of the report. I don't know enough about Cushing to know if that is a valid answer to your question but you and Dr. Grim could take position on that! (My guess is others have reviewed it since it took > 4 months to publish it!) As far as I can tell it is a fairly new finding and could have an impact on care and treatment. (It could also turn out to be total B.S. but I bet Maggie will disagree!) I raised a couple questions on both sides of the issue that immediately came to mind and I'm sure there are many more. Refer to post #41770 for a start.BTW, if you find typos in my postings see if I'm missing an "a", my keyboard needs replacing but I used the $$$ for a r/t ticket to Bethesda! I also might be off one key but that a vision problem! In reality I can't spell "FOR SHIT"! (Woops, I guess I just did!) > > > >> > > > Hi Everyone,> > > >> > > > I wrote a few posts yesterday but the Dr. asked that I provide my > > > detailed story with lab #'s so here it goes. I am a 33yo female that > > > was incidentally diagnosed with a right adrenal tumor (~2cm) about 5 > > > years ago that was deemed non-malignant and non-functioning. They > > > kept an eye on it for about 2.5 years. Then my gynecologist told me > > > that it "disappeared" after I had a scan done for my endometriosis. > > > Turns out, he was wrong. The tumor is here and now they think it's > > > producing aldosterone. I went to the Dr. for extreme fatigue, rapid > > > weight gain (25-30 lbs in 6-8 months), night sweats/excess sweating > > > and blood sugar fluctuations. The doc says it is hyperaldosteronism > > > and we are following up with a few more tests and discussing > > > surgical/treatment options. These are my test results:> > > >> > > > *PLASMA RENIN ACTIVITY,LC/MS/MS: 2.24 RANGE: 0.25-5.82 ng/mL/h > > > NORMAL> > > > *ALDO/PRA RATIO: 41.1 RANGE: 0.9-28.9 Ratio HIGH> > > > *ALDOSTERONE, LC/MS/MS: 92 g/dL HIGH> > > > *CORTISOL, TOTAL: 22.7 mcg/dL HIGH> > > > *POTASSIUM: 4.4 Range: 3.5-5.3 mmol/L NORMAL> > > >> > > > *HEMOGLOBIN A1c: 5.1 (NORMAL) RANGE: <5.7 % of total Hgb NORMAL> > > > *INSULIN: 5 RANGE: <17 uIU/mL NORMAL> > > > *DHEA,ACTH, Glucose tol. test = ALL NORMAL> > > >> > > > Other abnormal tests:> > > > *CHOLESTEROL: TOTAL 209 RANGE: 125-200 mg/dL HIGH> > > > *TRIGLYCERIDES: 299 RANGE: <150 mg/dL HIGH> > > > *GLUCOSE: 61 RANGE: 65-99 mg/dL LOW> > > > *CARBON DIOXIDE: 17 RANGE: 21-33 mmol/L> > > >> > > > My BP is low to normal: like 70/100 or so.> > > >> > > > Any thoughts/feedback/advice is much appreciated! Thanks! le> > > >> > >> > >> >>

[Guest guest]

FYI: the SSRI system and depression is not my area of expertise. here is a recent pubmed article which I have not reviewed.11.Horm Metab Res. 2012 Mar;44(3):202-7. Epub 2012 Feb 20.Psychopathological symptoms in patients with primary hyperaldosteronism - possible pathways.Künzel HE.SourceMedizinische Klinik Innenstadt, Klinikum der Ludwig-Maximilians-Universität München, München, Germany.AbstractA close comorbidity between endocrine diseases and psychopathological symptoms has been described in the literature. Until now only a few studies have reported about an increased anxiety and depressive symptoms in patients with primaryhyperaldosteronism (PHA). The exact pathways of psychiatric comorbidities have not been totally clarified yet, although the renin-angiotensin-aldosterone-system has gained more attention in research on anxiety and depression. There are several structures and factors, which could mediate anxiety or a depressive symptomatology. Additionally a possible influence of the standardised treatment with a mineralocorticoidreceptor (MR) antagonist or adrenalectomy should be investigated as they have been shown to affect mood. Psychiatric comorbidities are not only an additional burden in these patients, but as depression and anxiety are additional risk factors in patients with cardiovascular diseases. Possible pathomechanisms in the relation between PHA and psychiatric symptoms should be more closely investigated. For the clinical practice a regular screening for psychiatric comorbidities and an adequate treatment are required.© Georg Thieme Verlag KG Stuttgart · New York.Stress and CV effects is one if my areas--- once one defines stress.A common problem I see with those in the field of medicine is that they find a single study or two that fits with their concept of what is going on and latch on to that. I myself may be guilty of this. For example when I searched pubmed for aldosterone articles I got >33,000 listings.For Conn's I get 7,760 tonight. Including one new one from NIH where they have studied 53 patients. Note that we have about 10x that many here in our 10 year Hx. But not as well studied. Would be great if we could get all of our folks here to NIH for a free and detailed study. 13.Endocr Relat Cancer. 2012 Feb 9. [Epub ahead of print]KCNJ5 mutations in the National Institutes of Health cohort of patients with primaryhyperaldosteronism: an infrequent genetic cause of Conn's syndrome.Xekouki P, Hatch MM, Lin L, Rodrigo DA, Azevedo M, Sierra MD, Levy I, Saloustros E, Moraitis A, Horvath A, Kebebew E, Hoffman D, Stratakis CA.SourceP Xekouki, Section Endocrinology and Genetics, NICHD, National Institutes of Health, Bethesda, 20892, United States.AbstractKCNJ5 mutations were recently described in primary hyperaldosteronism (PH or Conn syndrome). The frequency of these mutations in PH and the way KCNJ5 defects cause disease remain unknown.A total of 53 patients with PH have been seen at the National Institutes of Health (NIH) over the last 12 years. Their peripheral and tumor DNA (the latter from 16 that were operated) was screened for KCNJ5 mutations; functional studies of the identified defects were done after transient transfection. Only 2 mutations were identified, both in the tumor DNA only. There were no germline sequencing defects in any of the patients except for known synonymous variants of the KCNJ5 gene. One mutation was the previously described c.G451C alteration; the other was a novel one in the same codon: c.G451A; both lead to the same amino acid substitution (G151R) in the KCNJ5 protein. Functional studies confirmed previous findings: both mutations caused loss of channel selectivity and a positive shift in the reversal potential. The KCNJ5 protein was strongly expressed in the zona glomerulosa of normal adrenal glands but showed variable expression in the APAs with mutation and without.The rate of KCNJ5 mutations among patients with PH and/or their tumors is substantially lower than what was previously reported. The G151R amino acid substitution appears to be the only one so far detected in PH, despite additional nucleotide changes. The mutation causes loss of this potassium channel's selectivity and may assist in the design of new therapies for PH.I have prob read 75% of these. So it is fairly easy to find a few or only one report on almost any topic and aldo.One needs to be careful about reaching for straws to connect symptoms and aldo/salt excess. But everything needs to be considered. Keep at it and perhaps we will make sense out of many of out groups problems and findings. CE Grim MD On Mar 28, 2012, at 7:13 PM, wrote: Please understand that in my professional career I managed the technical writers for years. When we published something it went through many reviews and we passed it through programs to check grammar, etc. When it was published it was expected to be perfect and all critical information had been verified. Was everything 100%? NO, but the critical information had better be! I read tons of IBM, Microsoft, AT & T, etc. manuals. Were they all perfect? NO. I applied updates to manuals myself when others had a clerk do it. I did it primarily to see what had changed but many times it was spelling or grammar which made no difference to the data or outcome! Spelling is simple for some but not others, IMHE! Since you brought up my discussions of depression and stress maybe we should consider your views also. I get the feeling you have very little consideration of these issues. You and I tend to be on the opposite ends of the spectrim. In fact I've heard your opinion re SSRIs. When I make a statement regarding depression and PTSD it is based on a study I have found. If you disagree, show me the study, but don't question ME, I'm the messenger and I try to remain neutral and report both sides of an issue. If you don't believe that the action of Spironolctone affects Cortisol which in turn affects seratonin (which you are trying to control with duloxetine) and the problem is exacerbated in PTN's w/MDD because of some shortened loop in PTNs w/MDD that's fine with me! If you don't believe there is a possibility of SCS in people with an adenoma and CONN's that's okay with me but you can be assured they will check me starting next week. Some people believe you have to have a tumor to have CONN's, High K etc. I don't believe Dr. Conn identified 5 different versions of hyperldosteronism back in 1956 but we all know good research has identified all that and we accept it. Is SCS indicated in 20% of the PTNs with PA? IDK but nobody will ever know if we don't research it. Is it a reason to do further testing before you go in and remove an adrenal that is producing excess adosterone? Is it reason to proceed to ADx with caution? Is that DR. Grim right and you should proceed to ADx only after MCB & DASH fail. We won't know unless others do quality/controlled research and the professionals validate their findings. Somebody has to start the process and I certainly hope it doesn't get derailed because they can't spell "Cuhing's Syndrome"! > > > > > > > > > > Hi Everyone, > > > > > > > > > > I wrote a few posts yesterday but the Dr. asked that I provide my > > > > detailed story with lab #'s so here it goes. I am a 33yo female that > > > > was incidentally diagnosed with a right adrenal tumor (~2cm) about 5 > > > > years ago that was deemed non-malignant and non-functioning. They > > > > kept an eye on it for about 2.5 years. Then my gynecologist told me > > > > that it "disappeared" after I had a scan done for my endometriosis. > > > > Turns out, he was wrong. The tumor is here and now they think it's > > > > producing aldosterone. I went to the Dr. for extreme fatigue, rapid > > > > weight gain (25-30 lbs in 6-8 months), night sweats/excess sweating > > > > and blood sugar fluctuations. The doc says it is hyperaldosteronism > > > > and we are following up with a few more tests and discussing > > > > surgical/treatment options. These are my test results: > > > > > > > > > > *PLASMA RENIN ACTIVITY,LC/MS/MS: 2.24 RANGE: 0.25-5.82 ng/mL/h > > > > NORMAL > > > > > *ALDO/PRA RATIO: 41.1 RANGE: 0.9-28.9 Ratio HIGH > > > > > *ALDOSTERONE, LC/MS/MS: 92 g/dL HIGH > > > > > *CORTISOL, TOTAL: 22.7 mcg/dL HIGH > > > > > *POTASSIUM: 4.4 Range: 3.5-5.3 mmol/L NORMAL > > > > > > > > > > *HEMOGLOBIN A1c: 5.1 (NORMAL) RANGE: <5.7 % of total Hgb NORMAL > > > > > *INSULIN: 5 RANGE: <17 uIU/mL NORMAL > > > > > *DHEA,ACTH, Glucose tol. test = ALL NORMAL > > > > > > > > > > Other abnormal tests: > > > > > *CHOLESTEROL: TOTAL 209 RANGE: 125-200 mg/dL HIGH > > > > > *TRIGLYCERIDES: 299 RANGE: <150 mg/dL HIGH > > > > > *GLUCOSE: 61 RANGE: 65-99 mg/dL LOW > > > > > *CARBON DIOXIDE: 17 RANGE: 21-33 mmol/L > > > > > > > > > > My BP is low to normal: like 70/100 or so. > > > > > > > > > > Any thoughts/feedback/advice is much appreciated! Thanks! le > > > > > > > > > > > > > > > > > > >

[Guest guest]

Hmmm he forgot down under?May your pressure be low!CE Grim MS, MDSpecializing in DifficultHypertensionOn Mar 29, 2012, at 18:46, maggiekat7 <ljurkovic@...> wrote:

Dr. M. at NIH was one of the reviewers for this study. He has since told me that there are three groups of researchers in this area; the USA, Italy and Japan. Japanese research subjects, he said, eat way more salt than the US subjects, overall, and their research has other differences, such as their normal values for protocols. In any case, it might be good to read his review, he is one fine Dr.

> > > > > >

> > > > > > Hi Everyone,

> > > > > >

> > > > > > I wrote a few posts yesterday but the Dr. asked that I

> > provide my

> > > > > detailed story with lab #'s so here it goes. I am a 33yo

> > female that

> > > > > was incidentally diagnosed with a right adrenal tumor (~2cm)

> > about 5

> > > > > years ago that was deemed non-malignant and non-functioning.

> > They

> > > > > kept an eye on it for about 2.5 years. Then my gynecologist

> > told me

> > > > > that it "disappeared" after I had a scan done for my

> > endometriosis.

> > > > > Turns out, he was wrong. The tumor is here and now they think

> > it's

> > > > > producing aldosterone. I went to the Dr. for extreme fatigue,

> > rapid

> > > > > weight gain (25-30 lbs in 6-8 months), night sweats/excess

> > sweating

> > > > > and blood sugar fluctuations. The doc says it is

> > hyperaldosteronism

> > > > > and we are following up with a few more tests and discussing

> > > > > surgical/treatment options. These are my test results:

> > > > > >

> > > > > > *PLASMA RENIN ACTIVITY,LC/MS/MS: 2.24 RANGE: 0.25-5.82 ng/mL/h

> > > > > NORMAL

> > > > > > *ALDO/PRA RATIO: 41.1 RANGE: 0.9-28.9 Ratio HIGH

> > > > > > *ALDOSTERONE, LC/MS/MS: 92 g/dL HIGH

> > > > > > *CORTISOL, TOTAL: 22.7 mcg/dL HIGH

> > > > > > *POTASSIUM: 4.4 Range: 3.5-5.3 mmol/L NORMAL

> > > > > >

> > > > > > *HEMOGLOBIN A1c: 5.1 (NORMAL) RANGE: <5.7 % of total Hgb

> > NORMAL

> > > > > > *INSULIN: 5 RANGE: <17 uIU/mL NORMAL

> > > > > > *DHEA,ACTH, Glucose tol. test = ALL NORMAL

> > > > > >

> > > > > > Other abnormal tests:

> > > > > > *CHOLESTEROL: TOTAL 209 RANGE: 125-200 mg/dL HIGH

> > > > > > *TRIGLYCERIDES: 299 RANGE: <150 mg/dL HIGH

> > > > > > *GLUCOSE: 61 RANGE: 65-99 mg/dL LOW

> > > > > > *CARBON DIOXIDE: 17 RANGE: 21-33 mmol/L

> > > > > >

> > > > > > My BP is low to normal: like 70/100 or so.

> > > > > >

> > > > > > Any thoughts/feedback/advice is much appreciated! Thanks!

> > le

> > > > > >

> > > > >

> > > > >

> > > >

> > >

> >

> >

> >

>