Re: Is Adrenal Vein Sampling more effective to detect a tumor than MRI or Cat Scan?

[Guest guest]

Several reasons. MRI identifies bumps but not what the bump is doing. What bumps are doing can only be determined by seeing what comes out of the adrenal(s) with the bump(s). Or one can take out the bump and see if things get better. If not u have guessed wrong. May your pressure be low!CE Grim MS, MDSpecializing in DifficultHypertensionOn Apr 4, 2012, at 19:04, airlinerg <airlinerg@...> wrote:

Is it true that if an MRI or Cat Scan just shows hyperplasia constantly instead of a tumor that Adrenal Vein Sampling may detect a tumor more efficiently?If that is true than why not do Adrenal Vein Sampling for everyone whose MRI just shows hyperplasia?

[Guest guest]

I have no bumps identified from the MRI. So do I need Adrenal Vein Sampling even if there are no bumps?> > > Is it true that if an MRI or Cat Scan just shows hyperplasia constantly instead of a tumor that Adrenal Vein Sampling may detect a tumor more efficiently?> > > > > > If that is true than why not do Adrenal Vein Sampling for everyone whose MRI just shows hyperplasia?> > > >>

[Guest guest]

AVS is only done if you want to have surgery. If no bump shows then with out AVS

no way to know what side to take out.

> >

> > > Is it true that if an MRI or Cat Scan just shows hyperplasia

> constantly instead of a tumor that Adrenal Vein Sampling may detect a

> tumor more efficiently?

> > >

> > >

> > > If that is true than why not do Adrenal Vein Sampling for everyone

> whose MRI just shows hyperplasia?

> > >

> > >

> >

>

[Guest guest]

He suggested AVS even though I only have shown to have hyperplasia and never shown any tumors on an MRI nor Cat Scan.So should everyone with just hyperplasia have Adrenal Vein Sampling just to be sure, or is it too risky?

> > >> > > > Is it true that if an MRI or Cat Scan just shows hyperplasia> > constantly instead of a tumor that Adrenal Vein Sampling may detect a> > tumor more efficiently?> > > >> > > >> > > > If that is true than why not do Adrenal Vein Sampling for everyone> > whose MRI just shows hyperplasia?> > > >> > > >> > >> >>

[Guest guest]

Do you have a copy of scan report? Better still can you get CD of the scan? If

you truly have hyperplasia then no need to do AVS.

If nothing shows on scan but aldo renin test shows you have hyperaldosteronism

and you what to see if only one side is makeing to much aldo then need to have

AVS to see. So say that a PET scan can show very small bump. Maybe the new

scanner Mayo now has could show something. Again only need AVS if you think you

want to have surgery.

> > > >

> > > > > Is it true that if an MRI or Cat Scan just shows hyperplasia

> > > constantly instead of a tumor that Adrenal Vein Sampling may detect

> a

> > > tumor more efficiently?

> > > > >

> > > > >

> > > > > If that is true than why not do Adrenal Vein Sampling for

> everyone

> > > whose MRI just shows hyperplasia?

> > > > >

> > > > >

> > > >

> > >

> >

>

[Guest guest]

I have bilateral hyperplasia and small nodules on both that were not visable on

the MRI, but to the NIH docs, not the radiologist on the CT with contrast. AVS

was done and not only confirmed the bilateral hyperaldosteonism, but also

revealed a possible issue with hypercortisolism and that further eval of that

would be necessary. Upon further evaluation by a couple of dexamethasone

suppression tests (one low, one high dose), it is now confirmed that I also have

hypercortisolism. In short, without the AVS, I would not have had this info

that is very valuable. Surgery is not on the table at this time, and AVS was

worth the risk. I would only have it done, however, by a Dr. who has a lot of

experience and not many do overs, like Dr. Chang at NIH.

> > > > >

> > > > > > Is it true that if an MRI or Cat Scan just shows hyperplasia

> > > > constantly instead of a tumor that Adrenal Vein Sampling may detect

> > a

> > > > tumor more efficiently?

> > > > > >

> > > > > >

> > > > > > If that is true than why not do Adrenal Vein Sampling for

> > everyone

> > > > whose MRI just shows hyperplasia?

> > > > > >

> > > > > >

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[Guest guest]

Maybe, what are the SX? MRI is the least sensitive as I understand it. Then

comes ct-scan and then ct-scan w/contrast. If they opt for the latter make real

sure they know if you are on Metformin or any drug that contains it. There is a

way to protect you but most doctors should recommend you be monitored in a

hospital, IMHO. I have not received the electronic but will figure out how to

post when I get home. In the meantime if you are considering it and are on a

T2DM Med let me know and I will tell you if it is on the list. Please

understand this will be how NIH does it and is not my recommendation!

> >

> > > Is it true that if an MRI or Cat Scan just shows hyperplasia

> constantly instead of a tumor that Adrenal Vein Sampling may detect a

> tumor more efficiently?

> > >

> > >

> > > If that is true than why not do Adrenal Vein Sampling for everyone

> whose MRI just shows hyperplasia?

> > >

> > >

> >

>

[Guest guest]

My experience and NIH, etc...I had an MRI prior to going to NIH that was " normal

adrenal glands " , etc. Sent it to NIH due to frustrations with my drs. They

looked at it, and my blood tests and admitted me into their protocol. Then,

while there, they did tons more bloodwork, ct scan and urine tests. They all

supported hyperaldosterone secretion, but even the CT scan was " Normal " to the

radiologist, but the trained eyes of the NIH endocrinologists saw several small

nodules and hyperplasia, so they did AVS. It was necessary. Revealed quite a

bit that all that bloodwork, MRI and CT with contrast suggested, but did not

conclusively diagnose. From the AVS, and further bloodwork, now have two

confirmed diagnoses, understanding of them and a treatment plan.

So, again, I say, yes to AVS, but make sure your docs are trained in reading the

scans themselves, not just the radiology reports, and make sure the person doing

the AVS has done thousands, and has minamal re do's, like Dr. Chang at NIH.

> > >

> > > > Is it true that if an MRI or Cat Scan just shows hyperplasia

> > constantly instead of a tumor that Adrenal Vein Sampling may detect a

> > tumor more efficiently?

> > > >

> > > >

> > > > If that is true than why not do Adrenal Vein Sampling for everyone

> > whose MRI just shows hyperplasia?

> > > >

> > > >

> > >

> >

>

[Guest guest]

That is not correct. No visiable bump does not = no bump IMHE. In fact I

believe I heard there is a fairly high percentage of nonvisible bumps that

produce aldo. In fact that is often why AVS lateralizes to the adrenal that

doesn't have the bump as I understand it. You might consider talking to NIH

protocol 00-CH-0160.

> > >

> > > > Is it true that if an MRI or Cat Scan just shows hyperplasia

> > constantly instead of a tumor that Adrenal Vein Sampling may detect a

> > tumor more efficiently?

> > > >

> > > >

> > > > If that is true than why not do Adrenal Vein Sampling for everyone

> > whose MRI just shows hyperplasia?

> > > >

> > > >

> > >

> >

>

[Guest guest]

If u are doing well with BP and K and feel well then sit tight. May your pressure be low!CE Grim MS, MDSpecializing in DifficultHypertensionOn Apr 6, 2012, at 21:16, <jclark24p@...> wrote:

Maybe, what are the SX? MRI is the least sensitive as I understand it. Then comes ct-scan and then ct-scan w/contrast. If they opt for the latter make real sure they know if you are on Metformin or any drug that contains it. There is a way to protect you but most doctors should recommend you be monitored in a hospital, IMHO. I have not received the electronic but will figure out how to post when I get home. In the meantime if you are considering it and are on a T2DM Med let me know and I will tell you if it is on the list. Please understand this will be how NIH does it and is not my recommendation!

> >

> > > Is it true that if an MRI or Cat Scan just shows hyperplasia

> constantly instead of a tumor that Adrenal Vein Sampling may detect a

> tumor more efficiently?

> > >

> > >

> > > If that is true than why not do Adrenal Vein Sampling for everyone

> whose MRI just shows hyperplasia?

> > >

> > >

> >

>

[Guest guest]

Suspect no dr has done thousands. But the more the better. Agai it depends on how u are doing nowMay your pressure be low!CE Grim MS, MDSpecializing in DifficultHypertensionOn Apr 6, 2012, at 21:28, maggiekat7 <ljurkovic@...> wrote:

My experience and NIH, etc...I had an MRI prior to going to NIH that was "normal adrenal glands", etc. Sent it to NIH due to frustrations with my drs. They looked at it, and my blood tests and admitted me into their protocol. Then, while there, they did tons more bloodwork, ct scan and urine tests. They all supported hyperaldosterone secretion, but even the CT scan was "Normal" to the radiologist, but the trained eyes of the NIH endocrinologists saw several small nodules and hyperplasia, so they did AVS. It was necessary. Revealed quite a bit that all that bloodwork, MRI and CT with contrast suggested, but did not conclusively diagnose. From the AVS, and further bloodwork, now have two confirmed diagnoses, understanding of them and a treatment plan.

So, again, I say, yes to AVS, but make sure your docs are trained in reading the scans themselves, not just the radiology reports, and make sure the person doing the AVS has done thousands, and has minamal re do's, like Dr. Chang at NIH.

> > >

> > > > Is it true that if an MRI or Cat Scan just shows hyperplasia

> > constantly instead of a tumor that Adrenal Vein Sampling may detect a

> > tumor more efficiently?

> > > >

> > > >

> > > > If that is true than why not do Adrenal Vein Sampling for everyone

> > whose MRI just shows hyperplasia?

> > > >

> > > >

> > >

> >

>

[Guest guest]

go to google or pub med and search " bilateral micronodular hyperplasia " . It is

the terminology for micro bumps that may or may not be seen on imaging, but

hyperaldosteronism due to it confirmed and possibly lateralized by AVS. Several

studies indicate that even though bumps are not seen on imaging, AVS can

diagnose the disease...which is HUGE, since imaging might miss those with micro,

unseen bumps and send them down the wrong road WITHOUT AVS!!!

> > > >

> > > > > Is it true that if an MRI or Cat Scan just shows hyperplasia

> > > constantly instead of a tumor that Adrenal Vein Sampling may detect a

> > > tumor more efficiently?

> > > > >

> > > > >

> > > > > If that is true than why not do Adrenal Vein Sampling for everyone

> > > whose MRI just shows hyperplasia?

> > > > >

> > > > >

> > > >

> > >

> >

>

[Guest guest]

The smallest bump I have seen causing PA was 2 mm which will never bee seen with CT T least yet. You may want to lok at the Autopsy pictures of adrenal bumps by dr in our files. May your pressure be low!CE Grim MS, MDSpecializing in DifficultHypertensionOn Apr 6, 2012, at 21:33, <jclark24p@...> wrote:

That is not correct. No visiable bump does not = no bump IMHE. In fact I believe I heard there is a fairly high percentage of nonvisible bumps that produce aldo. In fact that is often why AVS lateralizes to the adrenal that doesn't have the bump as I understand it. You might consider talking to NIH protocol 00-CH-0160.

> > >

> > > > Is it true that if an MRI or Cat Scan just shows hyperplasia

> > constantly instead of a tumor that Adrenal Vein Sampling may detect a

> > tumor more efficiently?

> > > >

> > > >

> > > > If that is true than why not do Adrenal Vein Sampling for everyone

> > whose MRI just shows hyperplasia?

> > > >

> > > >

> > >

> >

>

[Guest guest]

My memory is unreliable, however, I think Dr. Chang said he has done " thousands "

when I asked him. Could be wrong, (had a huge dose of valium just afterward,

and AVS) but I think that's what he said.

> > > > >

> > > > > > Is it true that if an MRI or Cat Scan just shows hyperplasia

> > > > constantly instead of a tumor that Adrenal Vein Sampling may detect a

> > > > tumor more efficiently?

> > > > > >

> > > > > >

> > > > > > If that is true than why not do Adrenal Vein Sampling for everyone

> > > > whose MRI just shows hyperplasia?

> > > > > >

> > > > > >

> > > > >

> > > >

> > >

> >

> >

>

[Guest guest]

You must have been reading some of my publications for about 1976. RexTerence's are in the Evolution article. May your pressure be low!CE Grim MS, MDSpecializing in DifficultHypertensionOn Apr 6, 2012, at 21:33, <jclark24p@...> wrote:

That is not correct. No visiable bump does not = no bump IMHE. In fact I believe I heard there is a fairly high percentage of nonvisible bumps that produce aldo. In fact that is often why AVS lateralizes to the adrenal that doesn't have the bump as I understand it. You might consider talking to NIH protocol 00-CH-0160.

> > >

> > > > Is it true that if an MRI or Cat Scan just shows hyperplasia

> > constantly instead of a tumor that Adrenal Vein Sampling may detect a

> > tumor more efficiently?

> > > >

> > > >

> > > > If that is true than why not do Adrenal Vein Sampling for everyone

> > whose MRI just shows hyperplasia?

> > > >

> > > >

> > >

> >

>

[Guest guest]

I have a beer on it is less than 1,000. May your pressure be low!CE Grim MS, MDSpecializing in DifficultHypertensionOn Apr 6, 2012, at 22:34, maggiekat7 <ljurkovic@...> wrote:

My memory is unreliable, however, I think Dr. Chang said he has done "thousands" when I asked him. Could be wrong, (had a huge dose of valium just afterward, and AVS) but I think that's what he said.

> > > > >

> > > > > > Is it true that if an MRI or Cat Scan just shows hyperplasia

> > > > constantly instead of a tumor that Adrenal Vein Sampling may detect a

> > > > tumor more efficiently?

> > > > > >

> > > > > >

> > > > > > If that is true than why not do Adrenal Vein Sampling for everyone

> > > > whose MRI just shows hyperplasia?

> > > > > >

> > > > > >

> > > > >

> > > >

> > >

> >

> >

>

[Guest guest]

See prev note. May your pressure be low!CE Grim MS, MDSpecializing in DifficultHypertensionOn Apr 6, 2012, at 19:19, airlinerg <airlinerg@...> wrote:

He suggested AVS even though I only have shown to have hyperplasia and never shown any tumors on an MRI nor Cat Scan.So should everyone with just hyperplasia have Adrenal Vein Sampling just to be sure, or is it too risky?

> > >> > > > Is it true that if an MRI or Cat Scan just shows hyperplasia> > constantly instead of a tumor that Adrenal Vein Sampling may detect a> > tumor more efficiently?> > > >> > > >> > > > If that is true than why not do Adrenal Vein Sampling for everyone> > whose MRI just shows hyperplasia?> > > >> > > >> > >> >>

[Guest guest]

Depends on how well u are doing and are u willing to undergo risks and benefits of AVS AND SURGERY for a chance of a 50% cure or rather DASH BETTER May your pressure be low!CE Grim MS, MDSpecializing in DifficultHypertensionOn Apr 6, 2012, at 18:12, airlinerg <airlinerg@...> wrote:

I have no bumps identified from the MRI. So do I need Adrenal Vein Sampling even if there are no bumps?> > > Is it true that if an MRI or Cat Scan just shows hyperplasia constantly instead of a tumor that Adrenal Vein Sampling may detect a tumor more efficiently?> > > > > > If that

is true than why not do Adrenal Vein Sampling for everyone whose MRI just shows hyperplasia?> > > >>

[Guest guest]

Hmmm, ok, gotta go back to NIH for more hypercortisolism eval, so maybe I can

check, or maybe , if he's not too busy while stilll there? Don't want the

beer, just wanna know if memory serves...and it would be good info for the

group.

> > > > > > >

> > > > > > > > Is it true that if an MRI or Cat Scan just shows hyperplasia

> > > > > > constantly instead of a tumor that Adrenal Vein Sampling may detect

a

> > > > > > tumor more efficiently?

> > > > > > > >

> > > > > > > >

> > > > > > > > If that is true than why not do Adrenal Vein Sampling for

everyone

> > > > > > whose MRI just shows hyperplasia?

> > > > > > > >

> > > > > > > >

> > > > > > >

> > > > > >

> > > > >

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[Guest guest]

Why AVS and surgery? Why not just AVS and meds and DASH? Possibly? With AVS, it

tells more of the story, that's all.

Like mine. Didn't lateralize enough to risk surgery, but confirmed

hyperaldosteronism big time. And hypercortisolism showed up too. Worth the risk

just to know why I have suffered sooooo long with all the amazing things that

too much cortisol production causes. I am astounded that not one of my gynos

over the years tested any of this, since it's clearly related to PCOS, which I

had, infertility, which I had, miscarriages, which I had, oh, I could go on and

on. Now, I have a heads up on the stuff I still face, like the coronary effects

and osteroperosis! Oh yeah, for me, AVS was worth it. Very much so.

> > >

> > > > Is it true that if an MRI or Cat Scan just shows hyperplasia constantly

instead of a tumor that Adrenal Vein Sampling may detect a tumor more

efficiently?

> > > >

> > > >

> > > > If that is true than why not do Adrenal Vein Sampling for everyone whose

MRI just shows hyperplasia?

> > > >

> > > >

> > >

> >

>

[Guest guest]

AVS isn't the normal way to test for too much cortisol production. This is done

by 24 hr urine or doing blood or Saliva tests during the 24 hr. If you are

making too much cortisol then would have to test pituitary gland as well.

Might want to search cushings for more information. Note that there is Cushing's

disease caused by Pituitary adenomas and Cushing's syndrome caused by adrenal

adenomas or taking meds like Prednisone

> > > >

> > > > > Is it true that if an MRI or Cat Scan just shows hyperplasia

constantly instead of a tumor that Adrenal Vein Sampling may detect a tumor more

efficiently?

> > > > >

> > > > >

> > > > > If that is true than why not do Adrenal Vein Sampling for everyone

whose MRI just shows hyperplasia?

> > > > >

> > > > >

> > > >

> > >

> >

>

[Guest guest]

It is possible he has done 1000. Depends on if he does most all AVS at NIH.

looks likes many of the trials are trying to get 2000 people in them.

> > > > > > >

> > > > > > > > Is it true that if an MRI or Cat Scan just shows hyperplasia

> > > > > > constantly instead of a tumor that Adrenal Vein Sampling may detect

a

> > > > > > tumor more efficiently?

> > > > > > > >

> > > > > > > >

> > > > > > > > If that is true than why not do Adrenal Vein Sampling for

everyone

> > > > > > whose MRI just shows hyperplasia?

> > > > > > > >

> > > > > > > >

> > > > > > >

> > > > > >

> > > > >

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[Guest guest]

New scanners can now show something the size of a grain of sand.

> > > > >

> > > > > > Is it true that if an MRI or Cat Scan just shows hyperplasia

> > > > constantly instead of a tumor that Adrenal Vein Sampling may detect a

> > > > tumor more efficiently?

> > > > > >

> > > > > >

> > > > > > If that is true than why not do Adrenal Vein Sampling for everyone

> > > > whose MRI just shows hyperplasia?

> > > > > >

> > > > > >

> > > > >

> > > >

> > >

> >

> >

>

[Guest guest]

What is not correct? That AVS is only done if you want to have surgery. OK then

should say only should be done. Or that if no bump shows then with out AVS no

way to know what side to take out. How else are you to know what side to take

out?

> > > >

> > > > > Is it true that if an MRI or Cat Scan just shows hyperplasia

> > > constantly instead of a tumor that Adrenal Vein Sampling may detect a

> > > tumor more efficiently?

> > > > >

> > > > >

> > > > > If that is true than why not do Adrenal Vein Sampling for everyone

> > > whose MRI just shows hyperplasia?

> > > > >

> > > > >

> > > >

> > >

> >

>

[Guest guest]

DASHing likely helps osteoporosis because high salty pees out Ca and it is a high Ca diet. CE Grim MDOn Apr 6, 2012, at 10:51 PM, maggiekat7 wrote: Why AVS and surgery? Why not just AVS and meds and DASH? Possibly? With AVS, it tells more of the story, that's all. Like mine. Didn't lateralize enough to risk surgery, but confirmed hyperaldosteronism big time. And hypercortisolism showed up too. Worth the risk just to know why I have suffered sooooo long with all the amazing things that too much cortisol production causes. I am astounded that not one of my gynos over the years tested any of this, since it's clearly related to PCOS, which I had, infertility, which I had, miscarriages, which I had, oh, I could go on and on. Now, I have a heads up on the stuff I still face, like the coronary effects and osteroperosis! Oh yeah, for me, AVS was worth it. Very much so. > > > > > > > Is it true that if an MRI or Cat Scan just shows hyperplasia constantly instead of a tumor that Adrenal Vein Sampling may detect a tumor more efficiently? > > > > > > > > > > > > If that is true than why not do Adrenal Vein Sampling for everyone whose MRI just shows hyperplasia? > > > > > > > > > > > > > >