RE: Virginia's AVS

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But they can do an overnight dex test easily. If they measure both cortisol and aldo they will be able to dx SCC (cortsiol will not suppress) and GRA (aldo will suppress to very low value. The problem here is that if the cortisol did not suppress one wonders if you took the dex or if the dex was bad or if you have a prob with dex metabolism. So if cortisol suppress but aldo does not you have GRA and you do not have SCC. CE Grim MDOn Jun 30, 2012, at 6:15 PM, Virginia Wall wrote: Thanks for the article, very interesting. I definitely wonder if cortisol secreting adenomas are more common than we realize. I asked the radiologist if there was any way to check cortisol while we're at it and he said no! LolVirginia Wall31 year old femaleCurrent K 3.2DASHingAVS completed June 27, 2012 at BJC Hospital St. Louis, MO3 cm adenoma in right adrenalDiagnosed February 2012Low K & High BP since appx. 2007Possible family history of hyperaldosteronismMeds: K Cl 20 meq 2 tabs tidPrenatal vitaminBreastfeeding; 5 month old with G6PDDOn Jun 29, 2012, at 10:22 PM, " " <jclark24p@...> wrote: Maybe it's different "across the pond"! Here is the view from Germany: The presence of an aldosterone- and cortisol-co-secreting adrenocortical tumor should be considered if a patient has i) PA and an adenoma that is larger than 2.5 & #8202;cm, ii) cortisol that is non-suppressible with overnight low-dose dexamethasone, or iii) grossly elevated serum levels of hybrid steroids, such as 18-OH-F. Source: http://www.ncbi.nlm.nih.gov/pubmed/21270113 Aldosterone- and cortisol-co-secreting adrenal tumors: the lost subtype of primary aldosteronism. > > > > > > > >>Hello group! I had my AVS done at 8 am this morning. They worked for a few extra minutes on the right side but got it no problem. ACTH was used and the samples are being sent to mayo clinic. I should know by Monday they said. > >> > >> > >>One interesting thing the radiologist told me. I told him how the endocrinologist offered to let me do surgery removing the right adrenal without AVS because it was so obvious on the CT scan that my right adrenal had a 3 cm adenoma that was causing the problem. The radiologist said in his experience it's the small adenomas that secrete excess hormones, not the big ones. He said he would be surprised if that adenoma is even secreting hormones. Thoughts? Obviously I will know about myself specifically soon enough but I was just wondering if this was true. I don't remember seeing any research on size of adenomas and hormone secretion. > >> > >> > >> > >>Virginia Wall > >>31 year old female > >>Current K 3.2 > >>DASHing > >>AVS completed June 27, 2012 at BJC Hospital St. Louis, MO > >>3 cm adenoma in right adrenal > >>Diagnosed February 2012 > >>Low K & High BP since appx. 2007 > >>Possible family history of hyperaldosteronism > >>Meds: K Cl 20 meq 2 tabs tid > >>Prenatal vitamin > >>Breastfeeding; 5 month old with G6PDD >

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But they can do an overnight dex test easily. If they measure both cortisol and aldo they will be able to dx SCC (cortsiol will not suppress) and GRA (aldo will suppress to very low value. The problem here is that if the cortisol did not suppress one wonders if you took the dex or if the dex was bad or if you have a prob with dex metabolism. So if cortisol suppress but aldo does not you have GRA and you do not have SCC. CE Grim MDOn Jun 30, 2012, at 6:15 PM, Virginia Wall wrote: Thanks for the article, very interesting. I definitely wonder if cortisol secreting adenomas are more common than we realize. I asked the radiologist if there was any way to check cortisol while we're at it and he said no! LolVirginia Wall31 year old femaleCurrent K 3.2DASHingAVS completed June 27, 2012 at BJC Hospital St. Louis, MO3 cm adenoma in right adrenalDiagnosed February 2012Low K & High BP since appx. 2007Possible family history of hyperaldosteronismMeds: K Cl 20 meq 2 tabs tidPrenatal vitaminBreastfeeding; 5 month old with G6PDDOn Jun 29, 2012, at 10:22 PM, " " <jclark24p@...> wrote: Maybe it's different "across the pond"! Here is the view from Germany: The presence of an aldosterone- and cortisol-co-secreting adrenocortical tumor should be considered if a patient has i) PA and an adenoma that is larger than 2.5 & #8202;cm, ii) cortisol that is non-suppressible with overnight low-dose dexamethasone, or iii) grossly elevated serum levels of hybrid steroids, such as 18-OH-F. Source: http://www.ncbi.nlm.nih.gov/pubmed/21270113 Aldosterone- and cortisol-co-secreting adrenal tumors: the lost subtype of primary aldosteronism. > > > > > > > >>Hello group! I had my AVS done at 8 am this morning. They worked for a few extra minutes on the right side but got it no problem. ACTH was used and the samples are being sent to mayo clinic. I should know by Monday they said. > >> > >> > >>One interesting thing the radiologist told me. I told him how the endocrinologist offered to let me do surgery removing the right adrenal without AVS because it was so obvious on the CT scan that my right adrenal had a 3 cm adenoma that was causing the problem. The radiologist said in his experience it's the small adenomas that secrete excess hormones, not the big ones. He said he would be surprised if that adenoma is even secreting hormones. Thoughts? Obviously I will know about myself specifically soon enough but I was just wondering if this was true. I don't remember seeing any research on size of adenomas and hormone secretion. > >> > >> > >> > >>Virginia Wall > >>31 year old female > >>Current K 3.2 > >>DASHing > >>AVS completed June 27, 2012 at BJC Hospital St. Louis, MO > >>3 cm adenoma in right adrenal > >>Diagnosed February 2012 > >>Low K & High BP since appx. 2007 > >>Possible family history of hyperaldosteronism > >>Meds: K Cl 20 meq 2 tabs tid > >>Prenatal vitamin > >>Breastfeeding; 5 month old with G6PDD >

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I usually say that it is common for both glands to be producing a lot of hormones. Not likely the one opposite the bump is the only one. CE Grim MDOn Jun 29, 2012, at 5:26 PM, Natalia Kamneva wrote: Your radiologist most likely is right. I am the case. My AVS showed that my right adrenal produces more hormones than left one with 2.5 cm adenoma. All my doctors, including Dr. Grim :-) insist that it's very often the case. Surgeon-onkologist said there were many people with big fat adenomas not producing hormones. Natalia Kamneva 68 Russian F with 2.5 cm left adrenal adenoma, recently diagnosed with PA; diabetic; on 100 mg eplerenone, 80 mg Micardis, 2000 mg metformin, 60 mg Dexilant and 2 mg Lorazepam; Dashing; still have some occasional problems with BP, K and Na; on private consultation with Dr Grim. From: Virginia Wall <virgwall@...> "hyperaldosteronism " <hyperaldosteronism > Sent: Wednesday, June 27, 2012 5:15 PM Subject: Re: Virginia's AVS I will definitely include results. The radiologist is inclined to believe I have many small adenomas on one or both sides that are not visible on the CT scan. Of course he realizes this is a theory. VirginiaOn Jun 27, 2012, at 5:04 PM, Clarence Grim <lowerbp2@...> wrote: So what did radiologist think was causing low K? Please send results whenu get them. May your pressure be low!CE Grim MS, MDSpecializing in DifficultHypertensionOn Jun 27, 2012, at 14:03, Virginia Wall <virgwall@...> wrote: Hello group! I had my AVS done at 8 am this morning. They worked for a few extra minutes on the right side but got it no problem. ACTH was used and the samples are being sent to mayo clinic. I should know by Monday they said. One interesting thing the radiologist told me. I told him how the endocrinologist offered to let me do surgery removing the right adrenal without AVS because it was so obvious on the CT scan that my right adrenal had a 3 cm adenoma that was causing the problem. The radiologist said in his experience it's the small adenomas that secrete excess hormones, not the big ones. He said he would be surprised if that adenoma is even secreting hormones. Thoughts? Obviously I will know about myself specifically soon enough but I was just wondering if this was true. I don't remember seeing any research on size of adenomas and hormone secretion. Virginia Wall31 year old femaleCurrent K 3.2DASHingAVS completed June 27, 2012 at BJC Hospital St. Louis, MO3 cm adenoma in right adrenalDiagnosed February 2012Low K & High BP since appx. 2007Possible family history of hyperaldosteronismMeds: K Cl 20 meq 2 tabs tidPrenatal vitaminBreastfeeding; 5 month old with G6PDD

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I usually say that it is common for both glands to be producing a lot of hormones. Not likely the one opposite the bump is the only one. CE Grim MDOn Jun 29, 2012, at 5:26 PM, Natalia Kamneva wrote: Your radiologist most likely is right. I am the case. My AVS showed that my right adrenal produces more hormones than left one with 2.5 cm adenoma. All my doctors, including Dr. Grim :-) insist that it's very often the case. Surgeon-onkologist said there were many people with big fat adenomas not producing hormones. Natalia Kamneva 68 Russian F with 2.5 cm left adrenal adenoma, recently diagnosed with PA; diabetic; on 100 mg eplerenone, 80 mg Micardis, 2000 mg metformin, 60 mg Dexilant and 2 mg Lorazepam; Dashing; still have some occasional problems with BP, K and Na; on private consultation with Dr Grim. From: Virginia Wall <virgwall@...> "hyperaldosteronism " <hyperaldosteronism > Sent: Wednesday, June 27, 2012 5:15 PM Subject: Re: Virginia's AVS I will definitely include results. The radiologist is inclined to believe I have many small adenomas on one or both sides that are not visible on the CT scan. Of course he realizes this is a theory. VirginiaOn Jun 27, 2012, at 5:04 PM, Clarence Grim <lowerbp2@...> wrote: So what did radiologist think was causing low K? Please send results whenu get them. May your pressure be low!CE Grim MS, MDSpecializing in DifficultHypertensionOn Jun 27, 2012, at 14:03, Virginia Wall <virgwall@...> wrote: Hello group! I had my AVS done at 8 am this morning. They worked for a few extra minutes on the right side but got it no problem. ACTH was used and the samples are being sent to mayo clinic. I should know by Monday they said. One interesting thing the radiologist told me. I told him how the endocrinologist offered to let me do surgery removing the right adrenal without AVS because it was so obvious on the CT scan that my right adrenal had a 3 cm adenoma that was causing the problem. The radiologist said in his experience it's the small adenomas that secrete excess hormones, not the big ones. He said he would be surprised if that adenoma is even secreting hormones. Thoughts? Obviously I will know about myself specifically soon enough but I was just wondering if this was true. I don't remember seeing any research on size of adenomas and hormone secretion. Virginia Wall31 year old femaleCurrent K 3.2DASHingAVS completed June 27, 2012 at BJC Hospital St. Louis, MO3 cm adenoma in right adrenalDiagnosed February 2012Low K & High BP since appx. 2007Possible family history of hyperaldosteronismMeds: K Cl 20 meq 2 tabs tidPrenatal vitaminBreastfeeding; 5 month old with G6PDD