Re: Testing was done correclty it seems to me.

[Guest guest]

Thank you Dr. Grim for your reply.

Yes, my Na was 163 mM/24H and K+ in urine was mM/24hr. I assumed that it was

then 163 not 198. My aldosterone is ng/dl. That is why I was wondering if I

needed to do another confirmatory test to be sure I got the correct sodium

loading.

I have looked at the dashing diet and I already do a pretty low salt diet.

Normally my salt excretion when tested in the past is 80 mM/24h. I just need to

feel better and so far none of the doctors want to agree that it could be an

endocrine issue. I will take this information with me to the next doctor I see.

Thanks,

>

> >> Just a refresher on my sxs. Dec ,2008 woke with a headache and it

> >> has not gone away (3 years), new onset of high BP 162-170/100 and

> >> found out recently low K (3.1) in 2008. Also tachycardia, sever

> >> fatigue, palpatations, dizziness and feeling like I will pass out.

> >> Pain in legs ( much like lactic acid build up) going up stairs or

> >> inclines, exercise intolerance. Much work up for high BP by

> >> cardiologist, many meds, work up by neuro on headaches. I am a

> >> physical therapist so I knew to continue to push for an answer as

> >> my BP was normal one day and then not the next. Put on ACE and my K

> >> was 3.7. 2010 put on Maxide for swelling in the legs after being on

> >> a plane, had gained 10 lbs of fluid and K+ dropped. Placed on 20meq

> >> and went down again, increased to 40meq. Taken off ACE due to

> >> possible cause of burning mouth syndrome and in 1 month my K+ on 40

> >> meq was 2.8. Cardio put me on Spiro but did not want to do any

> >> testing. Pushed for tests but current endo I saw said no way I had

> >> it. Did find I had hypogammaglobulinemia and started IGg treatments.

> >> Got the testing done after being off Spiro for 6 weeks and other BP

> >> meds 4 weeks. I tried hard to get 4000mg of sodium for the testing

> >> but I do not take in much sodium so I know I kept falling short.

> >> Here are the results. My question is since I did not get enough

> >> sodium, does this negate the test. I go to a new Endo in 2 weeks,

> >> but unsure if they will take me seriously. Been to 4 so far.

> >>

> Renin is very low 0.33

> Aldo is not 9 mg.

>

> Your salt excretion is not clear. Is the 163 the excretion of Na in

> 24 hrs or the concentration (mM/L).

>

> Same for the U aldo is it per 24 hr or the concentration.

>

> If the latter then your ENa is 1.2 x 163 = 195.6 mM so good.

>

>

>

> Urine volume 1200 cc x urine Na concentration.

>

> At the present it appears you have early PA. See my evolution article.

> I would recommend DASHing till your urine Na is less than your urine K

> and see if your BP and K and you get better.

>

> Keep us posted.

>

> CE Grim MD

>

> >> Renin .33 norm (1.31-3.95) with salt excretion >150 .39-1.31

> >> Aldosterone 9 ng/Dl (0-30), Creatinine .91 Norm. K+ 2.5 (2.5-5.4)

> >> Urine testing as follows: Total vol. 1200, creatinine 1.3 (.8-1.8),

> >> sodium 163mM (40-220) K+ 30mM (25-125)aldosterone 7 ug/L.

> >> From what I have read, it is important to get an excretion of at

> >> least 200-250 sodium for the urine tests to be accurate.

> >> ANy ideas?

>