Re: PA meds revisited...spiro vs. epler for women

[Guest guest]

Maggie, I didn't spend a lot of time researching the effects of Spiro on the

female gender but I would guess you would be less likely to grow chin whiskers!

When I was looking into it the biggest problem reported by women appered to be

in pre menopausal women. I don't recall any study that compared both drugs in

the same test so you have to draw conclusions based on two different test.

With that said, I know of no reason to mess w/androgen when treating PA so if

you take cost out of the picture I would choose Epler. Did NIH have a position?

>

> I just finished up testing at NIH and am awaiting AVS and some other test

results. Pheo is not yet ruled out, and although CAT revealed bilateral

nodules, we do not yet know if I have bilateral hyperplasia, or if one side is

producing more aldo than the other, etc. I will know more later this week. I

also don't know yet whether or not the AVS has to be repeated.

>

> In my last conversation, however, with one of my Drs at NIH, he discussed the

possibility of managing bilateral hyperplasia with meds as opposed to surgery

for the other issues. Spiro and Epler were mentioned and I want to revisit the

question to all of you about the pros and cons of Spiro vs. Epler, for a woman.

>

> The last time I posted a question on this topic, it evolved into a line of

messages around the negatives for men and the cost factors...I want a comparison

of the side effects, known to any of you who have taken them. Let's assume, for

this purpose, that the cost is the same.

>

> So, as a post menopausal woman, with bilateral hyperplasia causing primary

aldosteronism, thyroid issues, and non specific cardiac arythmia, lipid issues,

hirsitism, hair loss, even though labs reflect within normal ranges for

testosterone and other androgens...and close to no estrogen or progestin what

are the pros and cons of spiro vs. epler for me?

>

[Guest guest]

And what did they say about a low sodium high K diet DASH?CE Grim MDOn Mar 18, 2012, at 6:24 PM, maggiekat7 wrote: I just finished up testing at NIH and am awaiting AVS and some other test results. Pheo is not yet ruled out, and although CAT revealed bilateral nodules, we do not yet know if I have bilateral hyperplasia, or if one side is producing more aldo than the other, etc. I will know more later this week. I also don't know yet whether or not the AVS has to be repeated. In my last conversation, however, with one of my Drs at NIH, he discussed the possibility of managing bilateral hyperplasia with meds as opposed to surgery for the other issues. Spiro and Epler were mentioned and I want to revisit the question to all of you about the pros and cons of Spiro vs. Epler, for a woman. The last time I posted a question on this topic, it evolved into a line of messages around the negatives for men and the cost factors...I want a comparison of the side effects, known to any of you who have taken them. Let's assume, for this purpose, that the cost is the same. So, as a post menopausal woman, with bilateral hyperplasia causing primary aldosteronism, thyroid issues, and non specific cardiac arythmia, lipid issues, hirsitism, hair loss, even though labs reflect within normal ranges for testosterone and other androgens...and close to no estrogen or progestin what are the pros and cons of spiro vs. epler for me?

[Guest guest]

They agree with DASH, but know my diet is already more low na than dash and more

cardiac healthy than dash. Adding the k foods more now, but hasn't made a

difference yet.

>

> > I just finished up testing at NIH and am awaiting AVS and some other

> > test results. Pheo is not yet ruled out, and although CAT revealed

> > bilateral nodules, we do not yet know if I have bilateral

> > hyperplasia, or if one side is producing more aldo than the other,

> > etc. I will know more later this week. I also don't know yet whether

> > or not the AVS has to be repeated.

> >

> > In my last conversation, however, with one of my Drs at NIH, he

> > discussed the possibility of managing bilateral hyperplasia with

> > meds as opposed to surgery for the other issues. Spiro and Epler

> > were mentioned and I want to revisit the question to all of you

> > about the pros and cons of Spiro vs. Epler, for a woman.

> >

> > The last time I posted a question on this topic, it evolved into a

> > line of messages around the negatives for men and the cost

> > factors...I want a comparison of the side effects, known to any of

> > you who have taken them. Let's assume, for this purpose, that the

> > cost is the same.

> >

> > So, as a post menopausal woman, with bilateral hyperplasia causing

> > primary aldosteronism, thyroid issues, and non specific cardiac

> > arythmia, lipid issues, hirsitism, hair loss, even though labs

> > reflect within normal ranges for testosterone and other

> > androgens...and close to no estrogen or progestin what are the pros

> > and cons of spiro vs. epler for me?

> >

> >

>

[Guest guest]

They agree with DASH, but know my diet is already more low na than dash and more

cardiac healthy than dash. Adding the k foods more now, but hasn't made a

difference yet.

>

> > I just finished up testing at NIH and am awaiting AVS and some other

> > test results. Pheo is not yet ruled out, and although CAT revealed

> > bilateral nodules, we do not yet know if I have bilateral

> > hyperplasia, or if one side is producing more aldo than the other,

> > etc. I will know more later this week. I also don't know yet whether

> > or not the AVS has to be repeated.

> >

> > In my last conversation, however, with one of my Drs at NIH, he

> > discussed the possibility of managing bilateral hyperplasia with

> > meds as opposed to surgery for the other issues. Spiro and Epler

> > were mentioned and I want to revisit the question to all of you

> > about the pros and cons of Spiro vs. Epler, for a woman.

> >

> > The last time I posted a question on this topic, it evolved into a

> > line of messages around the negatives for men and the cost

> > factors...I want a comparison of the side effects, known to any of

> > you who have taken them. Let's assume, for this purpose, that the

> > cost is the same.

> >

> > So, as a post menopausal woman, with bilateral hyperplasia causing

> > primary aldosteronism, thyroid issues, and non specific cardiac

> > arythmia, lipid issues, hirsitism, hair loss, even though labs

> > reflect within normal ranges for testosterone and other

> > androgens...and close to no estrogen or progestin what are the pros

> > and cons of spiro vs. epler for me?

> >

> >

>

[Guest guest]

And the urine Na and K tests are?They must have done it every day at NIH I suspect.CE Grim MDOn Mar 19, 2012, at 9:59 AM, maggiekat7 wrote: They agree with DASH, but know my diet is already more low na than dash and more cardiac healthy than dash. Adding the k foods more now, but hasn't made a difference yet. > > > I just finished up testing at NIH and am awaiting AVS and some other > > test results. Pheo is not yet ruled out, and although CAT revealed > > bilateral nodules, we do not yet know if I have bilateral > > hyperplasia, or if one side is producing more aldo than the other, > > etc. I will know more later this week. I also don't know yet whether > > or not the AVS has to be repeated. > > > > In my last conversation, however, with one of my Drs at NIH, he > > discussed the possibility of managing bilateral hyperplasia with > > meds as opposed to surgery for the other issues. Spiro and Epler > > were mentioned and I want to revisit the question to all of you > > about the pros and cons of Spiro vs. Epler, for a woman. > > > > The last time I posted a question on this topic, it evolved into a > > line of messages around the negatives for men and the cost > > factors...I want a comparison of the side effects, known to any of > > you who have taken them. Let's assume, for this purpose, that the > > cost is the same. > > > > So, as a post menopausal woman, with bilateral hyperplasia causing > > primary aldosteronism, thyroid issues, and non specific cardiac > > arythmia, lipid issues, hirsitism, hair loss, even though labs > > reflect within normal ranges for testosterone and other > > androgens...and close to no estrogen or progestin what are the pros > > and cons of spiro vs. epler for me? > > > > >

[Guest guest]

No, we haven't discussed it yet, but since you and others have had so much

experience and done so much research, I wanted to go into the discussion with

more information, that's all. They haven't given me any treatment plan yet,

since my results aren't all back yet. I don't even know if the AVS has to be

repeated yet. Will know that later today and more on Thursday. Did you get an

admission date? If so, I have some serious advise on the schedule...I got

dehydrated with all the NPO orders back to back and had to be given fluids...

> >

> > I just finished up testing at NIH and am awaiting AVS and some other test

results. Pheo is not yet ruled out, and although CAT revealed bilateral

nodules, we do not yet know if I have bilateral hyperplasia, or if one side is

producing more aldo than the other, etc. I will know more later this week. I

also don't know yet whether or not the AVS has to be repeated.

> >

> > In my last conversation, however, with one of my Drs at NIH, he discussed

the possibility of managing bilateral hyperplasia with meds as opposed to

surgery for the other issues. Spiro and Epler were mentioned and I want to

revisit the question to all of you about the pros and cons of Spiro vs. Epler,

for a woman.

> >

> > The last time I posted a question on this topic, it evolved into a line of

messages around the negatives for men and the cost factors...I want a comparison

of the side effects, known to any of you who have taken them. Let's assume, for

this purpose, that the cost is the same.

> >

> > So, as a post menopausal woman, with bilateral hyperplasia causing primary

aldosteronism, thyroid issues, and non specific cardiac arythmia, lipid issues,

hirsitism, hair loss, even though labs reflect within normal ranges for

testosterone and other androgens...and close to no estrogen or progestin what

are the pros and cons of spiro vs. epler for me?

> >

>

[Guest guest]

yep, they did indeed...but not sure how to read them. There's a serum k of 3.6

and serum sodium of 133, but I was on 30 eq of k tabs, and being given a saline

supression test at the time that was drawn. Another one is a sodium, timed

urine...sodium,, urine 88, socium excretion 284; this is the day after the

saline supression test. The next day, sodium urine 76, excreton 160. That's all

the sodium labs I have so far. Does that tell you anything? My k varied all

throughout serum from 3.2-3.6 and they supplemented me with k throughout. I was

NOP most of the time I was there and had to be given fluids as well. What, Dr.

Grim, is an AML or solid echodense lesion on the kidney (5mm)?

> > >

> > > > I just finished up testing at NIH and am awaiting AVS and some

> > other

> > > > test results. Pheo is not yet ruled out, and although CAT revealed

> > > > bilateral nodules, we do not yet know if I have bilateral

> > > > hyperplasia, or if one side is producing more aldo than the other,

> > > > etc. I will know more later this week. I also don't know yet

> > whether

> > > > or not the AVS has to be repeated.

> > > >

> > > > In my last conversation, however, with one of my Drs at NIH, he

> > > > discussed the possibility of managing bilateral hyperplasia with

> > > > meds as opposed to surgery for the other issues. Spiro and Epler

> > > > were mentioned and I want to revisit the question to all of you

> > > > about the pros and cons of Spiro vs. Epler, for a woman.

> > > >

> > > > The last time I posted a question on this topic, it evolved into a

> > > > line of messages around the negatives for men and the cost

> > > > factors...I want a comparison of the side effects, known to any of

> > > > you who have taken them. Let's assume, for this purpose, that the

> > > > cost is the same.

> > > >

> > > > So, as a post menopausal woman, with bilateral hyperplasia causing

> > > > primary aldosteronism, thyroid issues, and non specific cardiac

> > > > arythmia, lipid issues, hirsitism, hair loss, even though labs

> > > > reflect within normal ranges for testosterone and other

> > > > androgens...and close to no estrogen or progestin what are the

> > pros

> > > > and cons of spiro vs. epler for me?

> > > >

> > > >

> > >

> >

> >

>

[Guest guest]

I have not heard back with an admission date yet. I presume he is pulling a

schedule together today. I look forward to any advice you can provide and will

let you know as soon as I hear. I'm sure I'll have questions!

> > >

> > > I just finished up testing at NIH and am awaiting AVS and some other test

results. Pheo is not yet ruled out, and although CAT revealed bilateral

nodules, we do not yet know if I have bilateral hyperplasia, or if one side is

producing more aldo than the other, etc. I will know more later this week. I

also don't know yet whether or not the AVS has to be repeated.

> > >

> > > In my last conversation, however, with one of my Drs at NIH, he discussed

the possibility of managing bilateral hyperplasia with meds as opposed to

surgery for the other issues. Spiro and Epler were mentioned and I want to

revisit the question to all of you about the pros and cons of Spiro vs. Epler,

for a woman.

> > >

> > > The last time I posted a question on this topic, it evolved into a line of

messages around the negatives for men and the cost factors...I want a comparison

of the side effects, known to any of you who have taken them. Let's assume, for

this purpose, that the cost is the same.

> > >

> > > So, as a post menopausal woman, with bilateral hyperplasia causing primary

aldosteronism, thyroid issues, and non specific cardiac arythmia, lipid issues,

hirsitism, hair loss, even though labs reflect within normal ranges for

testosterone and other androgens...and close to no estrogen or progestin what

are the pros and cons of spiro vs. epler for me?

> > >

> >

>

[Guest guest]

On Mar 19, 2012, at 10:43 AM, maggiekat7 wrote: yep, they did indeed...but not sure how to read them. There's a serum k of 3.6 and serum sodium of 133, but I was on 30 eq of k tabs, and being given a saline supression test at the time that was drawn. Another one is a sodium, timed urine...sodium,, urine 88, socium excretion 284; this is the day after the saline supression test. This is a high sodium excretion but related to both saline infusion of about 300 mM and what they fed you.How much volume did you pee during the saline infusion. I suspect they quantitated that but may not have given it to you. Recall I asked you to be sure they did this as it is Dr. Grim's pee test for PA.The next day, sodium urine 76, excreton 160. That's all the sodium labs I have so far. Does that tell you anything? My k varied all throughout serum from 3.2-3.6 and they supplemented me with k throughout. I was NOP most of the time I was there and had to be given fluids as well. What, Dr. Grim, is an AML or solid echodense lesion on the kidney (5mm)?Don't know what AML stands for. Most common would acute myeologenous leukemia but not that I am sure or they would have stopped the tests.echodense lesion is not something I recognize. 5 mm is small. Surprised they can see one that small with an echo. What was the test they were reporting: echocardiogram, abd ultra sound, MRI or CT. Different techniques use different terms.Need to ask them. CE Grim MD > > > > > > > I just finished up testing at NIH and am awaiting AVS and some > > other > > > > test results. Pheo is not yet ruled out, and although CAT revealed > > > > bilateral nodules, we do not yet know if I have bilateral > > > > hyperplasia, or if one side is producing more aldo than the other, > > > > etc. I will know more later this week. I also don't know yet > > whether > > > > or not the AVS has to be repeated. > > > > > > > > In my last conversation, however, with one of my Drs at NIH, he > > > > discussed the possibility of managing bilateral hyperplasia with > > > > meds as opposed to surgery for the other issues. Spiro and Epler > > > > were mentioned and I want to revisit the question to all of you > > > > about the pros and cons of Spiro vs. Epler, for a woman. > > > > > > > > The last time I posted a question on this topic, it evolved into a > > > > line of messages around the negatives for men and the cost > > > > factors...I want a comparison of the side effects, known to any of > > > > you who have taken them. Let's assume, for this purpose, that the > > > > cost is the same. > > > > > > > > So, as a post menopausal woman, with bilateral hyperplasia causing > > > > primary aldosteronism, thyroid issues, and non specific cardiac > > > > arythmia, lipid issues, hirsitism, hair loss, even though labs > > > > reflect within normal ranges for testosterone and other > > > > androgens...and close to no estrogen or progestin what are the > > pros > > > > and cons of spiro vs. epler for me? > > > > > > > > > > > > > > > >

[Guest guest]

Maggie, I use estrogen. On spiro, I got uterine hyperplasia and had to get a D & C. On Inspra, I haven't had any problems. I had to add Inspra slowly as it made me nauseous at first. If you don't use estrogen, and if you have hirsutism, spiro might be good for you. Val >> So, as a post menopausal woman, with bilateral hyperplasia causing primary aldosteronism, thyroid issues, and non specific cardiac arythmia, lipid issues, hirsitism, hair loss, even though labs reflect within normal ranges for testosterone and other androgens...and close to no estrogen or progestin what are the pros and cons of spiro vs. epler for me?>

[Guest guest]

Thanks Val,

I do not use estrogen and have had a hysterectomy (still have ovaries and

cervix, but evenso, am menopausal) In any case, thanks for the input. And the

heads up on nausea, everything makes me nauseated. I am also wondering if I try

Spiro or Epler, is it hard to switch if I don't like one or the other?

> >

> > So, as a post menopausal woman, with bilateral hyperplasia causing primary

> aldosteronism, thyroid issues, and non specific cardiac arythmia, lipid

> issues, hirsitism, hair loss, even though labs reflect within normal ranges

> for testosterone and other androgens...and close to no estrogen or progestin

> what are the pros and cons of spiro vs. epler for me?

> >

>

[Guest guest]

Most find it easy to change but u need 2x as much eplereMay your pressure be low!CE Grim MS, MDSpecializing in DifficultHypertensionOn Mar 21, 2012, at 18:51, maggiekat7 <ljurkovic@...> wrote:

Thanks Val,

I do not use estrogen and have had a hysterectomy (still have ovaries and cervix, but evenso, am menopausal) In any case, thanks for the input. And the heads up on nausea, everything makes me nauseated. I am also wondering if I try Spiro or Epler, is it hard to switch if I don't like one or the other?

> >

> > So, as a post menopausal woman, with bilateral hyperplasia causing primary

> aldosteronism, thyroid issues, and non specific cardiac arythmia, lipid

> issues, hirsitism, hair loss, even though labs reflect within normal ranges

> for testosterone and other androgens...and close to no estrogen or progestin

> what are the pros and cons of spiro vs. epler for me?

> >

>

[Guest guest]

I have a script (from nephrologist prior to NIH) for 25mg Spiro, twice daily. I

have another script (from cardiologist, prior to NIH) for Epler for 50 mg, once

daily. I do not know yet what NIH will suggest or prescribe, but I will let you

know and would appreciate your opinion, as ever.

> > > >

> > > > So, as a post menopausal woman, with bilateral hyperplasia causing

primary

> > > aldosteronism, thyroid issues, and non specific cardiac arythmia, lipid

> > > issues, hirsitism, hair loss, even though labs reflect within normal

ranges

> > > for testosterone and other androgens...and close to no estrogen or

progestin

> > > what are the pros and cons of spiro vs. epler for me?

> > > >

> > >

> >

> >

>

[Guest guest]

Cards are used to using lower doses for CHF pts. May your pressure be low!CE Grim MS, MDSpecializing in DifficultHypertensionOn Mar 22, 2012, at 5:06, maggiekat7 <ljurkovic@...> wrote:

I have a script (from nephrologist prior to NIH) for 25mg Spiro, twice daily. I have another script (from cardiologist, prior to NIH) for Epler for 50 mg, once daily. I do not know yet what NIH will suggest or prescribe, but I will let you know and would appreciate your opinion, as ever.

> > > >

> > > > So, as a post menopausal woman, with bilateral hyperplasia causing primary

> > > aldosteronism, thyroid issues, and non specific cardiac arythmia, lipid

> > > issues, hirsitism, hair loss, even though labs reflect within normal ranges

> > > for testosterone and other androgens...and close to no estrogen or progestin

> > > what are the pros and cons of spiro vs. epler for me?

> > > >

> > >

> >

> >

>

[Guest guest]

What's a CHF patient?

> > > > > >

> > > > > > So, as a post menopausal woman, with bilateral hyperplasia causing

primary

> > > > > aldosteronism, thyroid issues, and non specific cardiac arythmia,

lipid

> > > > > issues, hirsitism, hair loss, even though labs reflect within normal

ranges

> > > > > for testosterone and other androgens...and close to no estrogen or

progestin

> > > > > what are the pros and cons of spiro vs. epler for me?

> > > > > >

> > > > >

> > > >

> > > >

> > >

> >

> >

>

[Guest guest]

Congestive Heart Failure

> > > > > > >

> > > > > > > So, as a post menopausal woman, with bilateral hyperplasia causing

primary

> > > > > > aldosteronism, thyroid issues, and non specific cardiac arythmia,

lipid

> > > > > > issues, hirsitism, hair loss, even though labs reflect within normal

ranges

> > > > > > for testosterone and other androgens...and close to no estrogen or

progestin

> > > > > > what are the pros and cons of spiro vs. epler for me?

> > > > > > >

> > > > > >

> > > > >

> > > > >

> > > >

> > >

> > >

> >

>