Guest guest Posted February 7, 2011 Report Share Posted February 7, 2011 Has anybody had any experience with Spiro from Raintree and if so please elaborate? Thank you. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 29, 2012 Report Share Posted February 29, 2012 It has been a few months since I posted in this group. I am preparing for an appointment with a new Nephrologist next week. I am hopeful for results one way or another. I received my updated lab work today. I would appreciate any help in deciphering these numbers!!!Feb 14Creatine 1.03mg/dL (H)Feb 14Aldosterone 82ng/dL (H)Feb 14Creatine Clearance Panel/24 Hour UrineVolume: 1300mLCreatine 1.0mg/dLCreatine 76.4mg/dLCreatine Clearance: 69mL/min (L)Feb 14Protein Panel/24 Hour UrineProtein Calculated: 52mg/24hrsProtein: 4mg/dLCreatine: 75.9mg/dLCreatine Calculated: 1.0g/24 hrFeb 14Basic Metabolic PanelSodium: 145mmol/LPotassium: 4.6mmol/LChloride: 103mmol/LCarbon Dioxide: 29mmol/LCalcium: 9.6mg/dLCreatine: 1.1mg/dLGlucose: 85mg/dLUrea Nitrogen: 14mg/dL27 y/o , 115 lb at 5'6, female with 4+ year history of hypertension (Avg 140/95). Taken off all bp meds because of resistance to them. Currently awaiting a second opinion consult at Renal Associates of Montgomery AL. First Aldo level taken this past June was 88 ng/dl. Taken again in July and was down to 18.8 ng/dl. The most recent aldo level was 42 ng/dl. K- 4.5, NA- 138, renin- 0.65. No known underlying illnesses other than a mild aortic murmur. Symptoms - shortness of breath, heart palpitations, nocturia 2+ times per night, fatigue/weakness. From: Clarence Grim <lowerbp2@...> "hyperaldosteronism " <hyperaldosteronism > Sent: Saturday, November 19, 2011 2:51 PM Subject: Re: spiro Suspect none claimed to be a specialist. And they skipped the day correct BP WAS taught in school. May your pressure be low!CE Grim MS, MDSpecializing in DifficultHypertensionOn Nov 19, 2011, at 12:47, Marchelle Syktich <marseachelle02@...> wrote: Wow! I have had one doctor who took bp in both arms, but took the lowest arm (rt arm was 158/102, left was 138/96). Out of all the specialists and Drs I've seen, none have done any of those steps. This is worrisome to me! :-X27 y/o , 115 lb at 5'6, female with 4+ year history of hypertension (Avg 135/95). Taken off all bp meds because of resistance to them. Currently awaiting a second opinion consult with Dr McGuffin Jr. at Renal Associates of Montgomery AL. First Aldo level taken this past June was 88 ng/dl. Taken again in July and was down to 18.8 ng/dl. The most recent aldo level was 42 ng/dl. K- 4.5, NA- 138, renin- 0.65. No known underlying illnesses other than a mild aortic murmur. Symptoms - shortness of breath, heart palpitations, nocturia 2+ times per night, fatigue/weakness. From: Clarence Grim <lowerbp2@...> "hyperaldosteronism " <hyperaldosteronism > Sent: Saturday, November 19, 2011 11:59 AM Subject: Re: spiro How Can u tell if your dr is a ht expert. 1. Bp was taken in both arms at first visit and then uses highest arm. 2. He asked if u eat licorice?3. He asked how many times u get up to pee. 4. Listened to your belly in a very quiet room and presses hard and listened under each lower rib. May your pressure be low!CE Grim MS, MDSpecializing in DifficultHypertensionOn Nov 19, 2011, at 11:24, "adifferentme@..." <adifferentme@...> wrote: My old dr. was trying to put me back on triamterene but I found another dr. Wasn't feeling like he knew what he was doing with this. RE: spiro adifferentme It isn't any potassium-sparing meds. It is spironolactone or Inspra. They block the effects of excess aldosterone coupled with excess sodium ingestion. Others do not. If the effect of high aldosterone is not blocked, you risk left ventricular thickening among other ailments. Val From: hyperaldosteronism [mailto:hyperaldosteronism ] On Behalf Of adifferentme@... So are potassium sparing diuretics the only meds used to treat hyperaldo? Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 29, 2012 Report Share Posted February 29, 2012 It has been a few months since I posted in this group. I am preparing for an appointment with a new Nephrologist next week. I am hopeful for results one way or another. I received my updated lab work today. I would appreciate any help in deciphering these numbers!!!Feb 14Creatine 1.03mg/dL (H)Feb 14Aldosterone 82ng/dL (H)Feb 14Creatine Clearance Panel/24 Hour UrineVolume: 1300mLCreatine 1.0mg/dLCreatine 76.4mg/dLCreatine Clearance: 69mL/min (L)Feb 14Protein Panel/24 Hour UrineProtein Calculated: 52mg/24hrsProtein: 4mg/dLCreatine: 75.9mg/dLCreatine Calculated: 1.0g/24 hrFeb 14Basic Metabolic PanelSodium: 145mmol/LPotassium: 4.6mmol/LChloride: 103mmol/LCarbon Dioxide: 29mmol/LCalcium: 9.6mg/dLCreatine: 1.1mg/dLGlucose: 85mg/dLUrea Nitrogen: 14mg/dL27 y/o , 115 lb at 5'6, female with 4+ year history of hypertension (Avg 140/95). Taken off all bp meds because of resistance to them. Currently awaiting a second opinion consult at Renal Associates of Montgomery AL. First Aldo level taken this past June was 88 ng/dl. Taken again in July and was down to 18.8 ng/dl. The most recent aldo level was 42 ng/dl. K- 4.5, NA- 138, renin- 0.65. No known underlying illnesses other than a mild aortic murmur. Symptoms - shortness of breath, heart palpitations, nocturia 2+ times per night, fatigue/weakness. From: Clarence Grim <lowerbp2@...> "hyperaldosteronism " <hyperaldosteronism > Sent: Saturday, November 19, 2011 2:51 PM Subject: Re: spiro Suspect none claimed to be a specialist. And they skipped the day correct BP WAS taught in school. May your pressure be low!CE Grim MS, MDSpecializing in DifficultHypertensionOn Nov 19, 2011, at 12:47, Marchelle Syktich <marseachelle02@...> wrote: Wow! I have had one doctor who took bp in both arms, but took the lowest arm (rt arm was 158/102, left was 138/96). Out of all the specialists and Drs I've seen, none have done any of those steps. This is worrisome to me! :-X27 y/o , 115 lb at 5'6, female with 4+ year history of hypertension (Avg 135/95). Taken off all bp meds because of resistance to them. Currently awaiting a second opinion consult with Dr McGuffin Jr. at Renal Associates of Montgomery AL. First Aldo level taken this past June was 88 ng/dl. Taken again in July and was down to 18.8 ng/dl. The most recent aldo level was 42 ng/dl. K- 4.5, NA- 138, renin- 0.65. No known underlying illnesses other than a mild aortic murmur. Symptoms - shortness of breath, heart palpitations, nocturia 2+ times per night, fatigue/weakness. From: Clarence Grim <lowerbp2@...> "hyperaldosteronism " <hyperaldosteronism > Sent: Saturday, November 19, 2011 11:59 AM Subject: Re: spiro How Can u tell if your dr is a ht expert. 1. Bp was taken in both arms at first visit and then uses highest arm. 2. He asked if u eat licorice?3. He asked how many times u get up to pee. 4. Listened to your belly in a very quiet room and presses hard and listened under each lower rib. May your pressure be low!CE Grim MS, MDSpecializing in DifficultHypertensionOn Nov 19, 2011, at 11:24, "adifferentme@..." <adifferentme@...> wrote: My old dr. was trying to put me back on triamterene but I found another dr. Wasn't feeling like he knew what he was doing with this. RE: spiro adifferentme It isn't any potassium-sparing meds. It is spironolactone or Inspra. They block the effects of excess aldosterone coupled with excess sodium ingestion. Others do not. If the effect of high aldosterone is not blocked, you risk left ventricular thickening among other ailments. Val From: hyperaldosteronism [mailto:hyperaldosteronism ] On Behalf Of adifferentme@... So are potassium sparing diuretics the only meds used to treat hyperaldo? Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 29, 2012 Report Share Posted February 29, 2012 Most recent also / renin ratio confirms PA. BUT WAS A 24 hr urine for Na M Na and creatinine done at same time. See dr Grim's perfect test in out intro. May your pressure be low!CE Grim MS, MDSpecializing in DifficultHypertensionOn Feb 29, 2012, at 16:23, Marchelle Syktich <marseachelle02@...> wrote: It has been a few months since I posted in this group. I am preparing for an appointment with a new Nephrologist next week. I am hopeful for results one way or another. I received my updated lab work today. I would appreciate any help in deciphering these numbers!!!Feb 14Creatine 1.03mg/dL (H)Feb 14Aldosterone 82ng/dL (H)Feb 14Creatine Clearance Panel/24 Hour UrineVolume: 1300mLCreatine 1.0mg/dLCreatine 76.4mg/dLCreatine Clearance: 69mL/min (L)Feb 14Protein Panel/24 Hour UrineProtein Calculated: 52mg/24hrsProtein: 4mg/dLCreatine: 75.9mg/dLCreatine Calculated: 1.0g/24 hrFeb 14Basic Metabolic PanelSodium: 145mmol/LPotassium: 4.6mmol/LChloride: 103mmol/LCarbon Dioxide: 29mmol/LCalcium: 9.6mg/dLCreatine: 1.1mg/dLGlucose: 85mg/dLUrea Nitrogen: 14mg/dL27 y/o , 115 lb at 5'6, female with 4+ year history of hypertension (Avg 140/95). Taken off all bp meds because of resistance to them. Currently awaiting a second opinion consult at Renal Associates of Montgomery AL. First Aldo level taken this past June was 88 ng/dl. Taken again in July and was down to 18.8 ng/dl. The most recent aldo level was 42 ng/dl. K- 4.5, NA- 138, renin- 0.65. No known underlying illnesses other than a mild aortic murmur. Symptoms - shortness of breath, heart palpitations, nocturia 2+ times per night, fatigue/weakness. From: Clarence Grim <lowerbp2@...> "hyperaldosteronism " <hyperaldosteronism > Sent: Saturday, November 19, 2011 2:51 PM Subject: Re: spiro Suspect none claimed to be a specialist. And they skipped the day correct BP WAS taught in school. May your pressure be low!CE Grim MS, MDSpecializing in DifficultHypertensionOn Nov 19, 2011, at 12:47, Marchelle Syktich <marseachelle02@...> wrote: Wow! I have had one doctor who took bp in both arms, but took the lowest arm (rt arm was 158/102, left was 138/96). Out of all the specialists and Drs I've seen, none have done any of those steps. This is worrisome to me! :-X27 y/o , 115 lb at 5'6, female with 4+ year history of hypertension (Avg 135/95). Taken off all bp meds because of resistance to them. Currently awaiting a second opinion consult with Dr McGuffin Jr. at Renal Associates of Montgomery AL. First Aldo level taken this past June was 88 ng/dl. Taken again in July and was down to 18.8 ng/dl. The most recent aldo level was 42 ng/dl. K- 4.5, NA- 138, renin- 0.65. No known underlying illnesses other than a mild aortic murmur. Symptoms - shortness of breath, heart palpitations, nocturia 2+ times per night, fatigue/weakness. From: Clarence Grim <lowerbp2@...> "hyperaldosteronism " <hyperaldosteronism > Sent: Saturday, November 19, 2011 11:59 AM Subject: Re: spiro How Can u tell if your dr is a ht expert. 1. Bp was taken in both arms at first visit and then uses highest arm. 2. He asked if u eat licorice?3. He asked how many times u get up to pee. 4. Listened to your belly in a very quiet room and presses hard and listened under each lower rib. May your pressure be low!CE Grim MS, MDSpecializing in DifficultHypertensionOn Nov 19, 2011, at 11:24, "adifferentme@..." <adifferentme@...> wrote: My old dr. was trying to put me back on triamterene but I found another dr. Wasn't feeling like he knew what he was doing with this. RE: spiro adifferentme It isn't any potassium-sparing meds. It is spironolactone or Inspra. They block the effects of excess aldosterone coupled with excess sodium ingestion. Others do not. If the effect of high aldosterone is not blocked, you risk left ventricular thickening among other ailments. Val From: hyperaldosteronism [mailto:hyperaldosteronism ] On Behalf Of adifferentme@... So are potassium sparing diuretics the only meds used to treat hyperaldo? Reply to sender | Reply to group | Reply via web post | Start a New Topic Messages in this topic (74) .. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 29, 2012 Report Share Posted February 29, 2012 Most recent also / renin ratio confirms PA. BUT WAS A 24 hr urine for Na M Na and creatinine done at same time. See dr Grim's perfect test in out intro. May your pressure be low!CE Grim MS, MDSpecializing in DifficultHypertensionOn Feb 29, 2012, at 16:23, Marchelle Syktich <marseachelle02@...> wrote: It has been a few months since I posted in this group. I am preparing for an appointment with a new Nephrologist next week. I am hopeful for results one way or another. I received my updated lab work today. I would appreciate any help in deciphering these numbers!!!Feb 14Creatine 1.03mg/dL (H)Feb 14Aldosterone 82ng/dL (H)Feb 14Creatine Clearance Panel/24 Hour UrineVolume: 1300mLCreatine 1.0mg/dLCreatine 76.4mg/dLCreatine Clearance: 69mL/min (L)Feb 14Protein Panel/24 Hour UrineProtein Calculated: 52mg/24hrsProtein: 4mg/dLCreatine: 75.9mg/dLCreatine Calculated: 1.0g/24 hrFeb 14Basic Metabolic PanelSodium: 145mmol/LPotassium: 4.6mmol/LChloride: 103mmol/LCarbon Dioxide: 29mmol/LCalcium: 9.6mg/dLCreatine: 1.1mg/dLGlucose: 85mg/dLUrea Nitrogen: 14mg/dL27 y/o , 115 lb at 5'6, female with 4+ year history of hypertension (Avg 140/95). Taken off all bp meds because of resistance to them. Currently awaiting a second opinion consult at Renal Associates of Montgomery AL. First Aldo level taken this past June was 88 ng/dl. Taken again in July and was down to 18.8 ng/dl. The most recent aldo level was 42 ng/dl. K- 4.5, NA- 138, renin- 0.65. No known underlying illnesses other than a mild aortic murmur. Symptoms - shortness of breath, heart palpitations, nocturia 2+ times per night, fatigue/weakness. From: Clarence Grim <lowerbp2@...> "hyperaldosteronism " <hyperaldosteronism > Sent: Saturday, November 19, 2011 2:51 PM Subject: Re: spiro Suspect none claimed to be a specialist. And they skipped the day correct BP WAS taught in school. May your pressure be low!CE Grim MS, MDSpecializing in DifficultHypertensionOn Nov 19, 2011, at 12:47, Marchelle Syktich <marseachelle02@...> wrote: Wow! I have had one doctor who took bp in both arms, but took the lowest arm (rt arm was 158/102, left was 138/96). Out of all the specialists and Drs I've seen, none have done any of those steps. This is worrisome to me! :-X27 y/o , 115 lb at 5'6, female with 4+ year history of hypertension (Avg 135/95). Taken off all bp meds because of resistance to them. Currently awaiting a second opinion consult with Dr McGuffin Jr. at Renal Associates of Montgomery AL. First Aldo level taken this past June was 88 ng/dl. Taken again in July and was down to 18.8 ng/dl. The most recent aldo level was 42 ng/dl. K- 4.5, NA- 138, renin- 0.65. No known underlying illnesses other than a mild aortic murmur. Symptoms - shortness of breath, heart palpitations, nocturia 2+ times per night, fatigue/weakness. From: Clarence Grim <lowerbp2@...> "hyperaldosteronism " <hyperaldosteronism > Sent: Saturday, November 19, 2011 11:59 AM Subject: Re: spiro How Can u tell if your dr is a ht expert. 1. Bp was taken in both arms at first visit and then uses highest arm. 2. He asked if u eat licorice?3. He asked how many times u get up to pee. 4. Listened to your belly in a very quiet room and presses hard and listened under each lower rib. May your pressure be low!CE Grim MS, MDSpecializing in DifficultHypertensionOn Nov 19, 2011, at 11:24, "adifferentme@..." <adifferentme@...> wrote: My old dr. was trying to put me back on triamterene but I found another dr. Wasn't feeling like he knew what he was doing with this. RE: spiro adifferentme It isn't any potassium-sparing meds. It is spironolactone or Inspra. They block the effects of excess aldosterone coupled with excess sodium ingestion. Others do not. If the effect of high aldosterone is not blocked, you risk left ventricular thickening among other ailments. Val From: hyperaldosteronism [mailto:hyperaldosteronism ] On Behalf Of adifferentme@... So are potassium sparing diuretics the only meds used to treat hyperaldo? Reply to sender | Reply to group | Reply via web post | Start a New Topic Messages in this topic (74) .. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 29, 2012 Report Share Posted February 29, 2012 Yes it was > >> > >>> > >>> My old dr. was trying to put me back on triamterene but I found another dr. Wasn't feeling like he knew what he was doing with this. > >>> > >>> RE: spiro > >>> > >>> adifferentme > >>> > >>> It isn't any potassium-sparing meds. It is spironolactone or Inspra. They > >>> block the effects of excess aldosterone coupled with excess sodium > >>> ingestion. Others do not. If the effect of high aldosterone is not > >>> blocked, you risk left ventricular thickening among other ailments. > >>> > >>> Val > >>> > >>> From: hyperaldosteronism > >>> [mailto:hyperaldosteronism ] On Behalf Of > >>> adifferentme@... > >>> > >>> So are potassium sparing diuretics the only meds used to treat hyperaldo? > >>> > >> > >> > > > > > > > > Reply to sender | Reply to group | Reply via web post | Start a New Topic > > Messages in this topic (74) > > RECENT ACTIVITY: New Members 3 > > Visit Your Group > > Switch to: Text-Only, Daily Digest • Unsubscribe • Terms of Use > > . > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 29, 2012 Report Share Posted February 29, 2012 Yes it was > >> > >>> > >>> My old dr. was trying to put me back on triamterene but I found another dr. Wasn't feeling like he knew what he was doing with this. > >>> > >>> RE: spiro > >>> > >>> adifferentme > >>> > >>> It isn't any potassium-sparing meds. It is spironolactone or Inspra. They > >>> block the effects of excess aldosterone coupled with excess sodium > >>> ingestion. Others do not. If the effect of high aldosterone is not > >>> blocked, you risk left ventricular thickening among other ailments. > >>> > >>> Val > >>> > >>> From: hyperaldosteronism > >>> [mailto:hyperaldosteronism ] On Behalf Of > >>> adifferentme@... > >>> > >>> So are potassium sparing diuretics the only meds used to treat hyperaldo? > >>> > >> > >> > > > > > > > > Reply to sender | Reply to group | Reply via web post | Start a New Topic > > Messages in this topic (74) > > RECENT ACTIVITY: New Members 3 > > Visit Your Group > > Switch to: Text-Only, Daily Digest • Unsubscribe • Terms of Use > > . > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 29, 2012 Report Share Posted February 29, 2012 But I seem to have missed the results: I do not see a urine Na and/or K.Did you leave something out?You did send the blood Na and K etc. but that is not what is needed. Here is the welcome again;See item 6. CE Grim MD Welcome to the exciting world of Hyperaldosteronism You are in the right place! I am Dr. CE Grim a retired Professor of Medicine and Endocrinology. I have had a long standing interest is Primary Aldosteronism since medical school days when I saw my first patient with Primary Aldosteronism in 1963 as a 4th year medical student. I did a Nephrology Fellowship at Duke and an Endocrinology and Metabolism Fellowship with Dr. Conn (1969-70). I have been on the faculty of the University of MO, Indiana Univ, UCLA/ R. Drew, and the Medical College of Wisconsin in Divisions of Nephrology, Endocrinology, Hypertension, Cardiology and Epidemiology. I have published over 240 papers and book chapters in most areas of the broad discipline of High Blood Pressure. My CV is in our files for details. The GOAL of our group is to teach you and your health care team about the ins and outs of the causes, diagnosis and control of the many forms of hyperaldosteronism. The steps below will introduce you into the fascinating world of high blood pressure, salt and potassium and the role of the adrenal hormone aldosterone in health and disease. Doing these in sequence will save you time and effort in getting up to speed in taking control of you health and educating your own health care team. While we can’t make you a doctor we will make you into a pretty good BP doctor-a skill that you will have for life. 1. Overview: Read my article in our files on the evolution of PA (Evolution_of_PA-Grim.pdf ) and take to all members of health care team. Tell us what stage you believe you are in. This is a brief review of most causes of hyperaldosteronism, high blood pressure, low potassium (K). Be certain that you and your health care team understand the key role of excess diet salt in HTN and especially in PA. Go to: http://www.worldactiononsalt.com/evidence/treatment_trials.htm For a state of the art and science discussion of salt and health. 2. Other patients with hyperaldosteronism (Conn’s syndrome). Read our Conn's stories in our files and then give us your own in as much detail as you can. Dr. Conn was the first to describe this disease process and the syndrome is named after him. To see others' stories, on the Hyperaldosteronism home page, go to Files/Conn’s Stories. You'll find instructions in "A - How to put your story here.doc "Then send us your story in an email and then we will likely ask more questions and make suggestions before you upload it to our files. 3. Hyperaldosteronism and Salt: The deadly Duo. Eating Plan to control high blood pressure due to hyperaldosteronism and most others with high blood pressure. This will reduce your need for medications and in many will get your BP and K to goal without meds.. Get the DASH diet book by T. et al, read it and use it: $8 in paperback at your local bookstore. If they don’t have it ask them to order it for you. Learning to eat the DASH way will play a major role in your road to good BP and K control and, in many of our folks here, will revolutionize your life. Go to chapter 9 and do the 14 day challenge. Tell your Dr you are doing this as your BP may plummet if you are on other meds in only 2-3 days. or go to http://www.nhlbi.nih.gov/health/public/heart/hbp/dash/new_dash.pdf download this 64 page booklet free and do the Week on the DASH Diet for 2 weeks. If you are on BP meds be prepared for a large fall in BP and let your Dr. know you are doing this. Or go to (but costs money) DASH Diet for Health ProgramThe DASH Diet for Health Program is designed to help you improve your eating and exercise habits. Twice each week we will provide you with information on our website about food, food preparation, eating out, losing weight, getting fit and much more. In addition to providing new information each week on our website, we create a web page specially for you where you can track progress in areas such as your weight, blood pressure, and exercise.http://www.dashforhealth.com/ I strongly recommend you get the book and read it now! 4. Measure your BP: Measure your BP daily so you can see if it is getting better. If you are taking meds be sure to tell your health care team you are doing this as your BP may plummet to normal quickly. We recommend you use a device you listen to and will help you learn how to do this. If this is not something you want to do we can teach a significant other how to do it. See sharedcareinc.com or email to sharedcare@... to order a video on how to do this. If you already have one we will teach you how to teach your health care team how to validate your device. Your life and health depends on accurate BP measurements. Go to the amricanheart.org and download the Guidelines for Human Blood Pressure Measurement. Insist the your health care team do BP the AHA way. Your life is in the hands of those who measure your BP. Never trust your life to an automatic BP machine unless you know it is accurate on YOU. 5. Genetics and your BP: Go to familyhistory.hhs.gov and do your detailed family medical history so we can review with you to help Dx familial causes of high blood pressure and heart disease. If BP runs in your family you may save lives in your family by checking their BP yourself. There is a brief discussion of this in my Evolution Article. 6. How to DX and treat PA: Go to our file/Conn's Articles of Note/Medications/Bravo spir 1973.pdf and read this article and take to your health care team. It is old but still one of the best in the medical management of PA. Also see our file from the Endocrine Society Guidelines on PA. Dr. Grim's Perfect Primary Aldosteronism Blood and Urine Testing to diagnose PA in one day. 1. Eat a high salt diet for 2 weeks-at least 4000 mg of Na a day.2. No BP meds in last 4-12 weeks depending on meds and Drs advice.3. Collect 24 hr urine for Na, K and creatinine and aldosterone. Do not lose a drop of this liquid gold. It is impossible to interpret the renin and aldo without this.4. The morning you finish the 24 hr urine have fasting blood drawn for renin, aldo and K using our guidelines to get an accurate K. Try to get this done about 1-4 hours after you have been out of bed.5. Send us the results with the normal values for your lab.6. If you ever have a salt (saline) infusion test for PA be certain to ask them to measure how much you pee during the 4 hours of the infusion. If it is 1-1.5 liter of urine it strongly suggests that you may have PA. If more tha 1.5 L you almost certainly have PA. I call this Dr. Grim’s “Quick Pee Test” for PA. Our PA Registry: If you have been Dxed with PA already and are on Rx or have had surgery please go to http://www.kwiksurveys.com/online-survey.php?surveyID=HIJIO_f2685379 and complete our survey with as much information as you know. If there is some information you don't know ask us and we will help. If you need to update this as you journey thru the diagnostic/treatment process you can add another entry but label it as Nameyymmdd. For example today 4/20/11 for me would be Grim110420. This way of writing the date is an ever increasing number and will allow us and you to sort your multiple entries into a dated order. We are working on a more extensive database. 8. Learn the language: If you are new to medical lingo then download the acroyms from bloodpressureline/message/291869. Salt and high blood pressure: To learn the state of the science of salt and blood pressure please spend some time looking at http://www.worldactiononsalt.com/evidence/treatment_trials.htm10. Become a HBP expert consumer: Expect that it will take at least several weeks to get all this digested and to learn the new language of high blood pressure health care. As most doctors and nurses in practice have had very little training in high blood pressure you must become an expert yourself. For example most have never had anyone listen with them with a double stethoscope to verify that they can hear BP sounds. We cannot make you a doctor but we will make you a pretty good BP doctor.11. How High Blood Pressure should be managed: Go to nih.gov and download and read the Joint National Commission (JNC) Report 7 to get an overview on current guidelines. I ask all my secretaries to read this so they can communicate the importance of high blood pressure to my patients. JNC 8 will be out soon.Then: get (and study) the Hypertension Primer from americanheart.org. This is the most up-to-date compendium of what is known about high blood pressure and what every Dr. should know when they graduate from Medical School. Every chapter is only 2-3 pages. Read one chapter every week-night and you will finish it in about a year. I am working on a reading guide for lay people for the Primer. Stay tuned.12. Ask us questions: Ask any questions about high blood pressure you want answered. That is what we are here for.13. One-on-one Consulting: I can provide individual consulting if you do not want to go public. If you want individual one-on-one consulting for you and your Doctor contract me directly at lowerbp2@....May your pressure be low!Clarence E. Grim BS, MS, MD, FACP, FACCBoard Certified in Internal Medicine, Geriatrics, and High Blood Pressure Specializing in Primary Aldosteronism and Difficult to Control High Blood Pressure. On Feb 29, 2012, at 10:04 PM, marseachelle02 wrote: Yes it was > >> > >>> > >>> My old dr. was trying to put me back on triamterene but I found another dr. Wasn't feeling like he knew what he was doing with this. > >>> > >>> RE: spiro > >>> > >>> adifferentme > >>> > >>> It isn't any potassium-sparing meds. It is spironolactone or Inspra. They > >>> block the effects of excess aldosterone coupled with excess sodium > >>> ingestion. Others do not. If the effect of high aldosterone is not > >>> blocked, you risk left ventricular thickening among other ailments. > >>> > >>> Val > >>> > >>> From: hyperaldosteronism > >>> [mailto:hyperaldosteronism ] On Behalf Of > >>> adifferentme@... > >>> > >>> So are potassium sparing diuretics the only meds used to treat hyperaldo? > >>> > >> > >> > > > > > > > > Reply to sender | Reply to group | Reply via web post | Start a New Topic > > Messages in this topic (74) > > RECENT ACTIVITY: New Members 3 > > Visit Your Group > > Switch to: Text-Only, Daily Digest • Unsubscribe • Terms of Use > > . > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 29, 2012 Report Share Posted February 29, 2012 But I seem to have missed the results: I do not see a urine Na and/or K.Did you leave something out?You did send the blood Na and K etc. but that is not what is needed. Here is the welcome again;See item 6. CE Grim MD Welcome to the exciting world of Hyperaldosteronism You are in the right place! I am Dr. CE Grim a retired Professor of Medicine and Endocrinology. I have had a long standing interest is Primary Aldosteronism since medical school days when I saw my first patient with Primary Aldosteronism in 1963 as a 4th year medical student. I did a Nephrology Fellowship at Duke and an Endocrinology and Metabolism Fellowship with Dr. Conn (1969-70). I have been on the faculty of the University of MO, Indiana Univ, UCLA/ R. Drew, and the Medical College of Wisconsin in Divisions of Nephrology, Endocrinology, Hypertension, Cardiology and Epidemiology. I have published over 240 papers and book chapters in most areas of the broad discipline of High Blood Pressure. My CV is in our files for details. The GOAL of our group is to teach you and your health care team about the ins and outs of the causes, diagnosis and control of the many forms of hyperaldosteronism. The steps below will introduce you into the fascinating world of high blood pressure, salt and potassium and the role of the adrenal hormone aldosterone in health and disease. Doing these in sequence will save you time and effort in getting up to speed in taking control of you health and educating your own health care team. While we can’t make you a doctor we will make you into a pretty good BP doctor-a skill that you will have for life. 1. Overview: Read my article in our files on the evolution of PA (Evolution_of_PA-Grim.pdf ) and take to all members of health care team. Tell us what stage you believe you are in. This is a brief review of most causes of hyperaldosteronism, high blood pressure, low potassium (K). Be certain that you and your health care team understand the key role of excess diet salt in HTN and especially in PA. Go to: http://www.worldactiononsalt.com/evidence/treatment_trials.htm For a state of the art and science discussion of salt and health. 2. Other patients with hyperaldosteronism (Conn’s syndrome). Read our Conn's stories in our files and then give us your own in as much detail as you can. Dr. Conn was the first to describe this disease process and the syndrome is named after him. To see others' stories, on the Hyperaldosteronism home page, go to Files/Conn’s Stories. You'll find instructions in "A - How to put your story here.doc "Then send us your story in an email and then we will likely ask more questions and make suggestions before you upload it to our files. 3. Hyperaldosteronism and Salt: The deadly Duo. Eating Plan to control high blood pressure due to hyperaldosteronism and most others with high blood pressure. This will reduce your need for medications and in many will get your BP and K to goal without meds.. Get the DASH diet book by T. et al, read it and use it: $8 in paperback at your local bookstore. If they don’t have it ask them to order it for you. Learning to eat the DASH way will play a major role in your road to good BP and K control and, in many of our folks here, will revolutionize your life. Go to chapter 9 and do the 14 day challenge. Tell your Dr you are doing this as your BP may plummet if you are on other meds in only 2-3 days. or go to http://www.nhlbi.nih.gov/health/public/heart/hbp/dash/new_dash.pdf download this 64 page booklet free and do the Week on the DASH Diet for 2 weeks. If you are on BP meds be prepared for a large fall in BP and let your Dr. know you are doing this. Or go to (but costs money) DASH Diet for Health ProgramThe DASH Diet for Health Program is designed to help you improve your eating and exercise habits. Twice each week we will provide you with information on our website about food, food preparation, eating out, losing weight, getting fit and much more. In addition to providing new information each week on our website, we create a web page specially for you where you can track progress in areas such as your weight, blood pressure, and exercise.http://www.dashforhealth.com/ I strongly recommend you get the book and read it now! 4. Measure your BP: Measure your BP daily so you can see if it is getting better. If you are taking meds be sure to tell your health care team you are doing this as your BP may plummet to normal quickly. We recommend you use a device you listen to and will help you learn how to do this. If this is not something you want to do we can teach a significant other how to do it. See sharedcareinc.com or email to sharedcare@... to order a video on how to do this. If you already have one we will teach you how to teach your health care team how to validate your device. Your life and health depends on accurate BP measurements. Go to the amricanheart.org and download the Guidelines for Human Blood Pressure Measurement. Insist the your health care team do BP the AHA way. Your life is in the hands of those who measure your BP. Never trust your life to an automatic BP machine unless you know it is accurate on YOU. 5. Genetics and your BP: Go to familyhistory.hhs.gov and do your detailed family medical history so we can review with you to help Dx familial causes of high blood pressure and heart disease. If BP runs in your family you may save lives in your family by checking their BP yourself. There is a brief discussion of this in my Evolution Article. 6. How to DX and treat PA: Go to our file/Conn's Articles of Note/Medications/Bravo spir 1973.pdf and read this article and take to your health care team. It is old but still one of the best in the medical management of PA. Also see our file from the Endocrine Society Guidelines on PA. Dr. Grim's Perfect Primary Aldosteronism Blood and Urine Testing to diagnose PA in one day. 1. Eat a high salt diet for 2 weeks-at least 4000 mg of Na a day.2. No BP meds in last 4-12 weeks depending on meds and Drs advice.3. Collect 24 hr urine for Na, K and creatinine and aldosterone. Do not lose a drop of this liquid gold. It is impossible to interpret the renin and aldo without this.4. The morning you finish the 24 hr urine have fasting blood drawn for renin, aldo and K using our guidelines to get an accurate K. Try to get this done about 1-4 hours after you have been out of bed.5. Send us the results with the normal values for your lab.6. If you ever have a salt (saline) infusion test for PA be certain to ask them to measure how much you pee during the 4 hours of the infusion. If it is 1-1.5 liter of urine it strongly suggests that you may have PA. If more tha 1.5 L you almost certainly have PA. I call this Dr. Grim’s “Quick Pee Test” for PA. Our PA Registry: If you have been Dxed with PA already and are on Rx or have had surgery please go to http://www.kwiksurveys.com/online-survey.php?surveyID=HIJIO_f2685379 and complete our survey with as much information as you know. If there is some information you don't know ask us and we will help. If you need to update this as you journey thru the diagnostic/treatment process you can add another entry but label it as Nameyymmdd. For example today 4/20/11 for me would be Grim110420. This way of writing the date is an ever increasing number and will allow us and you to sort your multiple entries into a dated order. We are working on a more extensive database. 8. Learn the language: If you are new to medical lingo then download the acroyms from bloodpressureline/message/291869. Salt and high blood pressure: To learn the state of the science of salt and blood pressure please spend some time looking at http://www.worldactiononsalt.com/evidence/treatment_trials.htm10. Become a HBP expert consumer: Expect that it will take at least several weeks to get all this digested and to learn the new language of high blood pressure health care. As most doctors and nurses in practice have had very little training in high blood pressure you must become an expert yourself. For example most have never had anyone listen with them with a double stethoscope to verify that they can hear BP sounds. We cannot make you a doctor but we will make you a pretty good BP doctor.11. How High Blood Pressure should be managed: Go to nih.gov and download and read the Joint National Commission (JNC) Report 7 to get an overview on current guidelines. I ask all my secretaries to read this so they can communicate the importance of high blood pressure to my patients. JNC 8 will be out soon.Then: get (and study) the Hypertension Primer from americanheart.org. This is the most up-to-date compendium of what is known about high blood pressure and what every Dr. should know when they graduate from Medical School. Every chapter is only 2-3 pages. Read one chapter every week-night and you will finish it in about a year. I am working on a reading guide for lay people for the Primer. Stay tuned.12. Ask us questions: Ask any questions about high blood pressure you want answered. That is what we are here for.13. One-on-one Consulting: I can provide individual consulting if you do not want to go public. If you want individual one-on-one consulting for you and your Doctor contract me directly at lowerbp2@....May your pressure be low!Clarence E. Grim BS, MS, MD, FACP, FACCBoard Certified in Internal Medicine, Geriatrics, and High Blood Pressure Specializing in Primary Aldosteronism and Difficult to Control High Blood Pressure. On Feb 29, 2012, at 10:04 PM, marseachelle02 wrote: Yes it was > >> > >>> > >>> My old dr. was trying to put me back on triamterene but I found another dr. Wasn't feeling like he knew what he was doing with this. > >>> > >>> RE: spiro > >>> > >>> adifferentme > >>> > >>> It isn't any potassium-sparing meds. It is spironolactone or Inspra. They > >>> block the effects of excess aldosterone coupled with excess sodium > >>> ingestion. Others do not. If the effect of high aldosterone is not > >>> blocked, you risk left ventricular thickening among other ailments. > >>> > >>> Val > >>> > >>> From: hyperaldosteronism > >>> [mailto:hyperaldosteronism ] On Behalf Of > >>> adifferentme@... > >>> > >>> So are potassium sparing diuretics the only meds used to treat hyperaldo? > >>> > >> > >> > > > > > > > > Reply to sender | Reply to group | Reply via web post | Start a New Topic > > Messages in this topic (74) > > RECENT ACTIVITY: New Members 3 > > Visit Your Group > > Switch to: Text-Only, Daily Digest • Unsubscribe • Terms of Use > > . > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 1, 2012 Report Share Posted March 1, 2012 Well, here I was thinking I finally got the testing I needed, and am proven wrong- again! Doesn't surprise me in the least. I'll take another look at my records to see if I can find those numbers. I am just hoping for some answers at my upcoming Nephrology appointment this coming Wednesday. I got excited when they said a 24 hour urine + blood test was needed within a few hours of each other, but it doesn't seem they measured everything that was needed. :-(Thank you very much for your input!27 y/o , 115 lb at 5'6, female with 4+ year history of hypertension (Avg 140/95). Taken off all bp meds because of resistance to them. Currently awaiting a second opinion consult at Renal Associates of Montgomery AL. First Aldo level taken this past June was 88 ng/dl. Taken again in July and was down to 18.8 ng/dl. The most recent aldo level was 42 ng/dl. K- 4.5, NA- 138, renin- 0.65. No known underlying illnesses other than a mild aortic murmur. Symptoms - shortness of breath, heart palpitations, nocturia 2+ times per night, fatigue/weakness. From: Clarence Grim <lowerbp2@...> hyperaldosteronism Cc: Clarence Grim <lowerbp2@...> Sent: Thursday, March 1, 2012 12:47 AM Subject: Re: Re: spiro But I seem to have missed the results: I do not see a urine Na and/or K.Did you leave something out?You did send the blood Na and K etc. but that is not what is needed. Here is the welcome again;See item 6. CE Grim MD Welcome to the exciting world of Hyperaldosteronism You are in the right place! I am Dr. CE Grim a retired Professor of Medicine and Endocrinology. I have had a long standing interest is Primary Aldosteronism since medical school days when I saw my first patient with Primary Aldosteronism in 1963 as a 4th year medical student. I did a Nephrology Fellowship at Duke and an Endocrinology and Metabolism Fellowship with Dr. Conn (1969-70). I have been on the faculty of the University of MO, Indiana Univ, UCLA/ R. Drew, and the Medical College of Wisconsin in Divisions of Nephrology, Endocrinology, Hypertension, Cardiology and Epidemiology. I have published over 240 papers and book chapters in most areas of the broad discipline of High Blood Pressure. My CV is in our files for details. The GOAL of our group is to teach you and your health care team about the ins and outs of the causes, diagnosis and control of the many forms of hyperaldosteronism. The steps below will introduce you into the fascinating world of high blood pressure, salt and potassium and the role of the adrenal hormone aldosterone in health and disease. Doing these in sequence will save you time and effort in getting up to speed in taking control of you health and educating your own health care team. While we can’t make you a doctor we will make you into a pretty good BP doctor-a skill that you will have for life. 1. Overview: Read my article in our files on the evolution of PA (Evolution_of_PA-Grim.pdf ) and take to all members of health care team. Tell us what stage you believe you are in. This is a brief review of most causes of hyperaldosteronism, high blood pressure, low potassium (K). Be certain that you and your health care team understand the key role of excess diet salt in HTN and especially in PA. Go to: http://www.worldactiononsalt.com/evidence/treatment_trials.htm For a state of the art and science discussion of salt and health. 2. Other patients with hyperaldosteronism (Conn’s syndrome). Read our Conn's stories in our files and then give us your own in as much detail as you can. Dr. Conn was the first to describe this disease process and the syndrome is named after him. To see others' stories, on the Hyperaldosteronism home page, go to Files/Conn’s Stories. You'll find instructions in "A - How to put your story here.doc "Then send us your story in an email and then we will likely ask more questions and make suggestions before you upload it to our files. 3. Hyperaldosteronism and Salt: The deadly Duo. Eating Plan to control high blood pressure due to hyperaldosteronism and most others with high blood pressure. This will reduce your need for medications and in many will get your BP and K to goal without meds.. Get the DASH diet book by T. et al, read it and use it: $8 in paperback at your local bookstore. If they don’t have it ask them to order it for you. Learning to eat the DASH way will play a major role in your road to good BP and K control and, in many of our folks here, will revolutionize your life. Go to chapter 9 and do the 14 day challenge. Tell your Dr you are doing this as your BP may plummet if you are on other meds in only 2-3 days. or go to http://www.nhlbi.nih.gov/health/public/heart/hbp/dash/new_dash.pdf download this 64 page booklet free and do the Week on the DASH Diet for 2 weeks. If you are on BP meds be prepared for a large fall in BP and let your Dr. know you are doing this. Or go to (but costs money) DASH Diet for Health ProgramThe DASH Diet for Health Program is designed to help you improve your eating and exercise habits. Twice each week we will provide you with information on our website about food, food preparation, eating out, losing weight, getting fit and much more. In addition to providing new information each week on our website, we create a web page specially for you where you can track progress in areas such as your weight, blood pressure, and exercise.http://www.dashforhealth.com/ I strongly recommend you get the book and read it now! 4. Measure your BP: Measure your BP daily so you can see if it is getting better. If you are taking meds be sure to tell your health care team you are doing this as your BP may plummet to normal quickly. We recommend you use a device you listen to and will help you learn how to do this. If this is not something you want to do we can teach a significant other how to do it. See sharedcareinc.com or email to sharedcare@... to order a video on how to do this. If you already have one we will teach you how to teach your health care team how to validate your device. Your life and health depends on accurate BP measurements. Go to the amricanheart.org and download the Guidelines for Human Blood Pressure Measurement. Insist the your health care team do BP the AHA way. Your life is in the hands of those who measure your BP. Never trust your life to an automatic BP machine unless you know it is accurate on YOU. 5. Genetics and your BP: Go to familyhistory.hhs.gov and do your detailed family medical history so we can review with you to help Dx familial causes of high blood pressure and heart disease. If BP runs in your family you may save lives in your family by checking their BP yourself. There is a brief discussion of this in my Evolution Article. 6. How to DX and treat PA: Go to our file/Conn's Articles of Note/Medications/Bravo spir 1973.pdf and read this article and take to your health care team. It is old but still one of the best in the medical management of PA. Also see our file from the Endocrine Society Guidelines on PA. Dr. Grim's Perfect Primary Aldosteronism Blood and Urine Testing to diagnose PA in one day. 1. Eat a high salt diet for 2 weeks-at least 4000 mg of Na a day.2. No BP meds in last 4-12 weeks depending on meds and Drs advice.3. Collect 24 hr urine for Na, K and creatinine and aldosterone. Do not lose a drop of this liquid gold. It is impossible to interpret the renin and aldo without this.4. The morning you finish the 24 hr urine have fasting blood drawn for renin, aldo and K using our guidelines to get an accurate K. Try to get this done about 1-4 hours after you have been out of bed.5. Send us the results with the normal values for your lab.6. If you ever have a salt (saline) infusion test for PA be certain to ask them to measure how much you pee during the 4 hours of the infusion. If it is 1-1.5 liter of urine it strongly suggests that you may have PA. If more tha 1.5 L you almost certainly have PA. I call this Dr. Grim’s “Quick Pee Test†for PA. Our PA Registry: If you have been Dxed with PA already and are on Rx or have had surgery please go to http://www.kwiksurveys.com/online-survey.php?surveyID=HIJIO_f2685379 and complete our survey with as much information as you know. If there is some information you don't know ask us and we will help. If you need to update this as you journey thru the diagnostic/treatment process you can add another entry but label it as Nameyymmdd. For example today 4/20/11 for me would be Grim110420. This way of writing the date is an ever increasing number and will allow us and you to sort your multiple entries into a dated order. We are working on a more extensive database. 8. Learn the language: If you are new to medical lingo then download the acroyms from bloodpressureline/message/291869. Salt and high blood pressure: To learn the state of the science of salt and blood pressure please spend some time looking at http://www.worldactiononsalt.com/evidence/treatment_trials.htm10. Become a HBP expert consumer: Expect that it will take at least several weeks to get all this digested and to learn the new language of high blood pressure health care. As most doctors and nurses in practice have had very little training in high blood pressure you must become an expert yourself. For example most have never had anyone listen with them with a double stethoscope to verify that they can hear BP sounds. We cannot make you a doctor but we will make you a pretty good BP doctor.11. How High Blood Pressure should be managed: Go to nih.gov and download and read the Joint National Commission (JNC) Report 7 to get an overview on current guidelines. I ask all my secretaries to read this so they can communicate the importance of high blood pressure to my patients. JNC 8 will be out soon.Then: get (and study) the Hypertension Primer from americanheart.org. This is the most up-to-date compendium of what is known about high blood pressure and what every Dr. should know when they graduate from Medical School. Every chapter is only 2-3 pages. Read one chapter every week-night and you will finish it in about a year. I am working on a reading guide for lay people for the Primer. Stay tuned.12. Ask us questions: Ask any questions about high blood pressure you want answered. That is what we are here for.13. One-on-one Consulting: I can provide individual consulting if you do not want to go public. If you want individual one-on-one consulting for you and your Doctor contract me directly at lowerbp2@....May your pressure be low!Clarence E. Grim BS, MS, MD, FACP, FACCBoard Certified in Internal Medicine, Geriatrics, and High Blood Pressure Specializing in Primary Aldosteronism and Difficult to Control High Blood Pressure. On Feb 29, 2012, at 10:04 PM, marseachelle02 wrote: Yes it was > >> > >>> > >>> My old dr. was trying to put me back on triamterene but I found another dr. Wasn't feeling like he knew what he was doing with this. > >>> > >>> -----Original Message----- > >>> Date: Saturday, November 19, 2011 12:18:43 pm > >>> hyperaldosteronism > >>> From: Valarie <val@...> > >>> Subject: RE: spiro > >>> > >>> adifferentme > >>> > >>> It isn't any potassium-sparing meds. It is spironolactone or Inspra. They > >>> block the effects of excess aldosterone coupled with excess sodium > >>> ingestion. Others do not. If the effect of high aldosterone is not > >>> blocked, you risk left ventricular thickening among other ailments. > >>> > >>> Val > >>> > >>> From: hyperaldosteronism > >>> [mailto:hyperaldosteronism ] On Behalf Of > >>> adifferentme@... > >>> > >>> So are potassium sparing diuretics the only meds used to treat hyperaldo? > >>> > >> > >> > > > > > > > > Reply to sender | Reply to group | Reply via web post | Start a New Topic > > Messages in this topic (74) > > RECENT ACTIVITY: New Members 3 > > Visit Your Group > > Switch to: Text-Only, Daily Digest • Unsubscribe • Terms of Use > > . > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 1, 2012 Report Share Posted March 1, 2012 Need to post all renin tests as well. Do you have lab ranges? if so post them as well. > >> >> > >> >>> > >> >>> My old dr. was trying to put me back on triamterene but I found another dr. Wasn't feeling like he knew what he was doing with this. > >> >>> > >> >>> RE: spiro > >> >>> > >> >>> adifferentme > >> >>> > >> >>> It isn't any potassium-sparing meds. It is spironolactone or Inspra. They > >> >>> block the effects of excess aldosterone coupled with excess sodium > >> >>> ingestion. Others do not. If the effect of high aldosterone is not > >> >>> blocked, you risk left ventricular thickening among other ailments. > >> >>> > >> >>> Val > >> >>> > >> >>> From: hyperaldosteronism > >> >>> [mailto:hyperaldosteronism ] On Behalf Of > >> >>> adifferentme@ > >> >>> > >> >>> So are potassium sparing diuretics the only meds used to treat hyperaldo? > >> >>> > >> >> > >> >> > >> > > >> > > >> > > >> > Reply to sender | Reply to group | Reply via web post | Start a New Topic > >> > Messages in this topic (74) > >> > RECENT ACTIVITY: New Members 3 > >> > Visit Your Group > >> > Switch to: Text-Only, Daily Digest • Unsubscribe • Terms of Use > >> > . > >> > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 1, 2012 Report Share Posted March 1, 2012 Hopefully they did but did not give you the numbers. Fingers crossed.CE Grim MDOn Mar 1, 2012, at 8:41 AM, Marchelle Syktich wrote: Well, here I was thinking I finally got the testing I needed, and am proven wrong- again! Doesn't surprise me in the least. I'll take another look at my records to see if I can find those numbers. I am just hoping for some answers at my upcoming Nephrology appointment this coming Wednesday. I got excited when they said a 24 hour urine + blood test was needed within a few hours of each other, but it doesn't seem they measured everything that was needed. :-(Thank you very much for your input!27 y/o , 115 lb at 5'6, female with 4+ year history of hypertension (Avg 140/95). Taken off all bp meds because of resistance to them. Currently awaiting a second opinion consult at Renal Associates of Montgomery AL. First Aldo level taken this past June was 88 ng/dl. Taken again in July and was down to 18.8 ng/dl. The most recent aldo level was 42 ng/dl. K- 4.5, NA- 138, renin- 0.65. No known underlying illnesses other than a mild aortic murmur. Symptoms - shortness of breath, heart palpitations, nocturia 2+ times per night, fatigue/weakness. From: Clarence Grim <lowerbp2@...> hyperaldosteronism Cc: Clarence Grim <lowerbp2@...> Sent: Thursday, March 1, 2012 12:47 AM Subject: Re: Re: spiro But I seem to have missed the results: I do not see a urine Na and/or K.Did you leave something out?You did send the blood Na and K etc. but that is not what is needed. Here is the welcome again;See item 6. CE Grim MD Welcome to the exciting world of Hyperaldosteronism You are in the right place! I am Dr. CE Grim a retired Professor of Medicine and Endocrinology. I have had a long standing interest is Primary Aldosteronism since medical school days when I saw my first patient with Primary Aldosteronism in 1963 as a 4th year medical student. I did a Nephrology Fellowship at Duke and an Endocrinology and Metabolism Fellowship with Dr. Conn (1969-70). I have been on the faculty of the University of MO, Indiana Univ, UCLA/ R. Drew, and the Medical College of Wisconsin in Divisions of Nephrology, Endocrinology, Hypertension, Cardiology and Epidemiology. I have published over 240 papers and book chapters in most areas of the broad discipline of High Blood Pressure. My CV is in our files for details. The GOAL of our group is to teach you and your health care team about the ins and outs of the causes, diagnosis and control of the many forms of hyperaldosteronism. The steps below will introduce you into the fascinating world of high blood pressure, salt and potassium and the role of the adrenal hormone aldosterone in health and disease. Doing these in sequence will save you time and effort in getting up to speed in taking control of you health and educating your own health care team. While we can’t make you a doctor we will make you into a pretty good BP doctor-a skill that you will have for life. 1. Overview: Read my article in our files on the evolution of PA (Evolution_of_PA-Grim.pdf ) and take to all members of health care team. Tell us what stage you believe you are in. This is a brief review of most causes of hyperaldosteronism, high blood pressure, low potassium (K). Be certain that you and your health care team understand the key role of excess diet salt in HTN and especially in PA. Go to: http://www.worldactiononsalt.com/evidence/treatment_trials.htm For a state of the art and science discussion of salt and health. 2. Other patients with hyperaldosteronism (Conn’s syndrome). Read our Conn's stories in our files and then give us your own in as much detail as you can. Dr. Conn was the first to describe this disease process and the syndrome is named after him. To see others' stories, on the Hyperaldosteronism home page, go to Files/Conn’s Stories. You'll find instructions in "A - How to put your story here.doc "Then send us your story in an email and then we will likely ask more questions and make suggestions before you upload it to our files. 3. Hyperaldosteronism and Salt: The deadly Duo. Eating Plan to control high blood pressure due to hyperaldosteronism and most others with high blood pressure. This will reduce your need for medications and in many will get your BP and K to goal without meds.. Get the DASH diet book by T. et al, read it and use it: $8 in paperback at your local bookstore. If they don’t have it ask them to order it for you. Learning to eat the DASH way will play a major role in your road to good BP and K control and, in many of our folks here, will revolutionize your life. Go to chapter 9 and do the 14 day challenge. Tell your Dr you are doing this as your BP may plummet if you are on other meds in only 2-3 days. or go to http://www.nhlbi.nih.gov/health/public/heart/hbp/dash/new_dash.pdf download this 64 page booklet free and do the Week on the DASH Diet for 2 weeks. If you are on BP meds be prepared for a large fall in BP and let your Dr. know you are doing this. Or go to (but costs money) DASH Diet for Health ProgramThe DASH Diet for Health Program is designed to help you improve your eating and exercise habits. Twice each week we will provide you with information on our website about food, food preparation, eating out, losing weight, getting fit and much more. In addition to providing new information each week on our website, we create a web page specially for you where you can track progress in areas such as your weight, blood pressure, and exercise.http://www.dashforhealth.com/ I strongly recommend you get the book and read it now! 4. Measure your BP: Measure your BP daily so you can see if it is getting better. If you are taking meds be sure to tell your health care team you are doing this as your BP may plummet to normal quickly. We recommend you use a device you listen to and will help you learn how to do this. If this is not something you want to do we can teach a significant other how to do it. See sharedcareinc.com or email to sharedcare@... to order a video on how to do this. If you already have one we will teach you how to teach your health care team how to validate your device. Your life and health depends on accurate BP measurements. Go to the amricanheart.org and download the Guidelines for Human Blood Pressure Measurement. Insist the your health care team do BP the AHA way. Your life is in the hands of those who measure your BP. Never trust your life to an automatic BP machine unless you know it is accurate on YOU. 5. Genetics and your BP: Go to familyhistory.hhs.gov and do your detailed family medical history so we can review with you to help Dx familial causes of high blood pressure and heart disease. If BP runs in your family you may save lives in your family by checking their BP yourself. There is a brief discussion of this in my Evolution Article. 6. How to DX and treat PA: Go to our file/Conn's Articles of Note/Medications/Bravo spir 1973.pdf and read this article and take to your health care team. It is old but still one of the best in the medical management of PA. Also see our file from the Endocrine Society Guidelines on PA. Dr. Grim's Perfect Primary Aldosteronism Blood and Urine Testing to diagnose PA in one day. 1. Eat a high salt diet for 2 weeks-at least 4000 mg of Na a day.2. No BP meds in last 4-12 weeks depending on meds and Drs advice.3. Collect 24 hr urine for Na, K and creatinine and aldosterone. Do not lose a drop of this liquid gold. It is impossible to interpret the renin and aldo without this.4. The morning you finish the 24 hr urine have fasting blood drawn for renin, aldo and K using our guidelines to get an accurate K. Try to get this done about 1-4 hours after you have been out of bed.5. Send us the results with the normal values for your lab.6. If you ever have a salt (saline) infusion test for PA be certain to ask them to measure how much you pee during the 4 hours of the infusion. If it is 1-1.5 liter of urine it strongly suggests that you may have PA. If more tha 1.5 L you almost certainly have PA. I call this Dr. Grim’s “Quick Pee Test” for PA. Our PA Registry: If you have been Dxed with PA already and are on Rx or have had surgery please go to http://www.kwiksurveys.com/online-survey.php?surveyID=HIJIO_f2685379 and complete our survey with as much information as you know. If there is some information you don't know ask us and we will help. If you need to update this as you journey thru the diagnostic/treatment process you can add another entry but label it as Nameyymmdd. For example today 4/20/11 for me would be Grim110420. This way of writing the date is an ever increasing number and will allow us and you to sort your multiple entries into a dated order. We are working on a more extensive database. 8. Learn the language: If you are new to medical lingo then download the acroyms from bloodpressureline/message/291869. Salt and high blood pressure: To learn the state of the science of salt and blood pressure please spend some time looking at http://www.worldactiononsalt.com/evidence/treatment_trials.htm10. Become a HBP expert consumer: Expect that it will take at least several weeks to get all this digested and to learn the new language of high blood pressure health care. As most doctors and nurses in practice have had very little training in high blood pressure you must become an expert yourself. For example most have never had anyone listen with them with a double stethoscope to verify that they can hear BP sounds. We cannot make you a doctor but we will make you a pretty good BP doctor.11. How High Blood Pressure should be managed: Go to nih.gov and download and read the Joint National Commission (JNC) Report 7 to get an overview on current guidelines. I ask all my secretaries to read this so they can communicate the importance of high blood pressure to my patients. JNC 8 will be out soon.Then: get (and study) the Hypertension Primer from americanheart.org. This is the most up-to-date compendium of what is known about high blood pressure and what every Dr. should know when they graduate from Medical School. Every chapter is only 2-3 pages. Read one chapter every week-night and you will finish it in about a year. I am working on a reading guide for lay people for the Primer. Stay tuned.12. Ask us questions: Ask any questions about high blood pressure you want answered. That is what we are here for.13. One-on-one Consulting: I can provide individual consulting if you do not want to go public. If you want individual one-on-one consulting for you and your Doctor contract me directly at lowerbp2@....May your pressure be low!Clarence E. Grim BS, MS, MD, FACP, FACCBoard Certified in Internal Medicine, Geriatrics, and High Blood Pressure Specializing in Primary Aldosteronism and Difficult to Control High Blood Pressure. On Feb 29, 2012, at 10:04 PM, marseachelle02 wrote: Yes it was > >> > >>> > >>> My old dr. was trying to put me back on triamterene but I found another dr. Wasn't feeling like he knew what he was doing with this. > >>> > >>> RE: spiro > >>> > >>> adifferentme > >>> > >>> It isn't any potassium-sparing meds. It is spironolactone or Inspra. They > >>> block the effects of excess aldosterone coupled with excess sodium > >>> ingestion. Others do not. If the effect of high aldosterone is not > >>> blocked, you risk left ventricular thickening among other ailments. > >>> > >>> Val > >>> > >>> From: hyperaldosteronism > >>> [mailto:hyperaldosteronism ] On Behalf Of > >>> adifferentme@... > >>> > >>> So are potassium sparing diuretics the only meds used to treat hyperaldo? > >>> > >> > >> > > > > > > > > Reply to sender | Reply to group | Reply via web post | Start a New Topic > > Messages in this topic (74) > > RECENT ACTIVITY: New Members 3 > > Visit Your Group > > Switch to: Text-Only, Daily Digest • Unsubscribe • Terms of Use > > . > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 2, 2012 Report Share Posted March 2, 2012 I only had one renin test previously and it was 0.65. I do have lab ranges:Feb 14> >> > Creatine 1.03mg/dL (H) Range: 0.51-0.95mg/dL> >> > > >> > Feb 14> >> > Aldosterone 82ng/dL (H) Range: 4.0-31.o ng/dL> >> > > >> > Feb 14> >> > Creatine Clearance Panel/24 Hour Urine> >> > Volume: 1300mL Range: none provided> >> > Creatine 1.0mg/dL Range: 0.6-1.4 mg/dL> >> > Creatine 76.4mg/dL Range: none provided> >> > Creatine Clearance: 69mL/min (L) Range: 88-128 mL/min> >> > > >> > Feb 14> >> > Protein Panel/24 Hour Urine > >> > Protein Calculated: 52mg/24hrs Range: 0-135mg/24hrs> >> > Protein: 4mg/dL Range: 2-200 mg/dL> >> > Creatine: 75.9mg/dL Range: none provided> >> > Creatine Calculated: 1.0g/24 hr Range: 0.8-1.8 g/24hr> >> > > >> > Feb 14> >> > Basic Metabolic Panel> >> > Sodium: 145mmol/L Range: 136-145mmol/L> >> > Potassium: 4.6mmol/L Range: 3.5-5.1 mmol/L> >> > Chloride: 103mmol/L Range: 98-107mmol/L> >> > Carbon Dioxide: 29mmol/L Range: 21-32 mmol/L> >> > Calcium: 9.6mg/dL Range: 8.5-10.1 mg/dL> >> > Creatine: 1.1mg/dL Range:0.6-1.3mg/dL> >> > Glucose: 85mg/dL Range: 74-106mg/dL> >> > Urea Nitrogen: 14mg/dL Range: 7.0-18.0 md/dL> >> > > >> > 27 y/o , 115 lb at 5'6, female with 4+ year history of hypertension (Avg 140/95). Taken off all bp meds because of resistance to them. Currently awaiting a second opinion consult at Renal Associates of Montgomery AL. First Aldo level taken this past June was 88 ng/dl. Taken again in July and was down to 18.8 ng/dl. Then back up to 42 ng/dl. K- 4.5, NA- 138, renin- 0.65. Most recently aldo was taken with 24 hour urine. Aldo was 82 ng/dL. No known underlying illnesses other than a mild aortic murmur. Symptoms - shortness of breath, heart palpitations, nocturia 2+ times per night, fatigue/weakness. From: Francis Bill SUSPECTED PA <georgewbill@...> hyperaldosteronism Sent: Thursday, March 1, 2012 10:59 AM Subject: Re: spiro Need to post all renin tests as well. Do you have lab ranges? if so post them as well. > >> >> > >> >>> > >> >>> My old dr. was trying to put me back on triamterene but I found another dr. Wasn't feeling like he knew what he was doing with this. > >> >>> > >> >>> RE: spiro > >> >>> > >> >>> adifferentme > >> >>> > >> >>> It isn't any potassium-sparing meds. It is spironolactone or Inspra. They > >> >>> block the effects of excess aldosterone coupled with excess sodium > >> >>> ingestion. Others do not. If the effect of high aldosterone is not > >> >>> blocked, you risk left ventricular thickening among other ailments. > >> >>> > >> >>> Val > >> >>> > >> >>> From: hyperaldosteronism > >> >>> [mailto:hyperaldosteronism ] On Behalf Of > >> >>> adifferentme@ > >> >>> > >> >>> So are potassium sparing diuretics the only meds used to treat hyperaldo? > >> >>> > >> >> > >> >> > >> > > >> > > >> > > >> > Reply to sender | Reply to group | Reply via web post | Start a New Topic > >> > Messages in this topic (74) > >> > RECENT ACTIVITY: New Members 3 > >> > Visit Your Group > >> > Switch to: Text-Only, Daily Digest • Unsubscribe • Terms of Use > >> > . > >> > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 2, 2012 Report Share Posted March 2, 2012 Are u hard to get blood from. Read our guidelines on how to get an accurate plasma K. So you have normokalemic PA the most common cause. Not taking any BCPS or OTC STUFF or supplements. Are you DASHing yet?May your pressure be low!CE Grim MS, MDSpecializing in DifficultHypertensionOn Mar 2, 2012, at 9:53, Marchelle Syktich <marseachelle02@...> wrote: I only had one renin test previously and it was 0.65. I do have lab ranges:Feb 14> >> > Creatine 1.03mg/dL (H) Range: 0.51-0.95mg/dL> >> > > >> > Feb 14> >> > Aldosterone 82ng/dL (H) Range: 4.0-31.o ng/dL> >> > > >> > Feb 14> >> > Creatine Clearance Panel/24 Hour Urine> >> > Volume: 1300mL Range: none provided> >> > Creatine 1.0mg/dL Range: 0.6-1.4 mg/dL> >> > Creatine 76.4mg/dL Range: none provided> >> > Creatine Clearance: 69mL/min (L) Range: 88-128 mL/min> >> > > >> > Feb 14> >> > Protein Panel/24 Hour Urine > >> > Protein Calculated: 52mg/24hrs Range: 0-135mg/24hrs> >> > Protein: 4mg/dL Range: 2-200 mg/dL> >> > Creatine: 75.9mg/dL Range: none provided> >> > Creatine Calculated: 1.0g/24 hr Range: 0.8-1.8 g/24hr> >> > > >> > Feb 14> >> > Basic Metabolic Panel> >> > Sodium: 145mmol/L Range: 136-145mmol/L> >> > Potassium: 4.6mmol/L Range: 3.5-5.1 mmol/L> >> > Chloride: 103mmol/L Range: 98-107mmol/L> >> > Carbon Dioxide: 29mmol/L Range: 21-32 mmol/L> >> > Calcium: 9.6mg/dL Range: 8.5-10.1 mg/dL> >> > Creatine: 1.1mg/dL Range:0.6-1.3mg/dL> >> > Glucose: 85mg/dL Range: 74-106mg/dL> >> > Urea Nitrogen: 14mg/dL Range: 7.0-18.0 md/dL> >> > > >> > 27 y/o , 115 lb at 5'6, female with 4+ year history of hypertension (Avg 140/95). Taken off all bp meds because of resistance to them. Currently awaiting a second opinion consult at Renal Associates of Montgomery AL. First Aldo level taken this past June was 88 ng/dl. Taken again in July and was down to 18.8 ng/dl. Then back up to 42 ng/dl. K- 4.5, NA- 138, renin- 0.65. Most recently aldo was taken with 24 hour urine. Aldo was 82 ng/dL. No known underlying illnesses other than a mild aortic murmur. Symptoms - shortness of breath, heart palpitations, nocturia 2+ times per night, fatigue/weakness. From: Francis Bill SUSPECTED PA <georgewbill@...> hyperaldosteronism Sent: Thursday, March 1, 2012 10:59 AM Subject: Re: spiro Need to post all renin tests as well. Do you have lab ranges? if so post them as well. > >> >> > >> >>> > >> >>> My old dr. was trying to put me back on triamterene but I found another dr. Wasn't feeling like he knew what he was doing with this. > >> >>> > >> >>> RE: spiro > >> >>> > >> >>> adifferentme > >> >>> > >> >>> It isn't any potassium-sparing meds. It is spironolactone or Inspra. They > >> >>> block the effects of excess aldosterone coupled with excess sodium > >> >>> ingestion. Others do not. If the effect of high aldosterone is not > >> >>> blocked, you risk left ventricular thickening among other ailments. > >> >>> > >> >>> Val > >> >>> > >> >>> From: hyperaldosteronism > >> >>> [mailto:hyperaldosteronism ] On Behalf Of > >> >>> adifferentme@ > >> >>> > >> >>> So are potassium sparing diuretics the only meds used to treat hyperaldo? > >> >>> > >> >> > >> >> > >> > > >> > > >> > > >> > Reply to sender | Reply to group | Reply via web post | Start a New Topic > >> > Messages in this topic (74) > >> > RECENT ACTIVITY: New Members 3 > >> > Visit Your Group > >> > Switch to: Text-Only, Daily Digest • Unsubscribe • Terms of Use > >> > . > >> > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 2, 2012 Report Share Posted March 2, 2012 No, not that I know of. No medications except for yasmin BC, no OTC stuff or supplements unless I have a headache, then advil is all that I take. I've been dashing for about 4 months now. This may be a silly question, but does the high creatine level and low creatine clearance level mean anything in regard to PA?27 y/o , 115 lb at 5'6, female with 4+ year history of hypertension (Avg 140/95). Taken off all bp meds because of resistance to them. Currently awaiting a second opinion consult at Renal Associates of Montgomery AL. First Aldo level taken this past June was 88 ng/dl. Taken again in July and was down to 18.8 ng/dl. Then back up to 42 ng/dl. K- 4.5, NA- 138, renin- 0.65. Most recently aldo was taken with 24 hour urine. Aldo was 82 ng/dL. No known underlying illnesses other than a mild aortic murmur. Symptoms - shortness of breath, heart palpitations, nocturia 2+ times per night, fatigue/weakness. From: Clarence Grim <lowerbp2@...> "hyperaldosteronism " <hyperaldosteronism > Sent: Friday, March 2, 2012 12:51 PM Subject: Re: Re: spiro Are u hard to get blood from. Read our guidelines on how to get an accurate plasma K. So you have normokalemic PA the most common cause. Not taking any BCPS or OTC STUFF or supplements. Are you DASHing yet?May your pressure be low!CE Grim MS, MDSpecializing in DifficultHypertensionOn Mar 2, 2012, at 9:53, Marchelle Syktich <marseachelle02@...> wrote: I only had one renin test previously and it was 0.65. I do have lab ranges:Feb 14> >> > Creatine 1.03mg/dL (H) Range: 0.51-0.95mg/dL> >> > > >> > Feb 14> >> > Aldosterone 82ng/dL (H) Range: 4.0-31.o ng/dL> >> > > >> > Feb 14> >> > Creatine Clearance Panel/24 Hour Urine> >> > Volume: 1300mL Range: none provided> >> > Creatine 1.0mg/dL Range: 0.6-1.4 mg/dL> >> > Creatine 76.4mg/dL Range: none provided> >> > Creatine Clearance: 69mL/min (L) Range: 88-128 mL/min> >> > > >> > Feb 14> >> > Protein Panel/24 Hour Urine > >> > Protein Calculated: 52mg/24hrs Range: 0-135mg/24hrs> >> > Protein: 4mg/dL Range: 2-200 mg/dL> >> > Creatine: 75.9mg/dL Range: none provided> >> > Creatine Calculated: 1.0g/24 hr Range: 0.8-1.8 g/24hr> >> > > >> > Feb 14> >> > Basic Metabolic Panel> >> > Sodium: 145mmol/L Range: 136-145mmol/L> >> > Potassium: 4.6mmol/L Range: 3.5-5.1 mmol/L> >> > Chloride: 103mmol/L Range: 98-107mmol/L> >> > Carbon Dioxide: 29mmol/L Range: 21-32 mmol/L> >> > Calcium: 9.6mg/dL Range: 8.5-10.1 mg/dL> >> > Creatine: 1.1mg/dL Range:0.6-1.3mg/dL> >> > Glucose: 85mg/dL Range: 74-106mg/dL> >> > Urea Nitrogen: 14mg/dL Range: 7.0-18.0 md/dL> >> > > >> > 27 y/o , 115 lb at 5'6, female with 4+ year history of hypertension (Avg 140/95). Taken off all bp meds because of resistance to them. Currently awaiting a second opinion consult at Renal Associates of Montgomery AL. First Aldo level taken this past June was 88 ng/dl. Taken again in July and was down to 18.8 ng/dl. Then back up to 42 ng/dl. K- 4.5, NA- 138, renin- 0.65. Most recently aldo was taken with 24 hour urine. Aldo was 82 ng/dL. No known underlying illnesses other than a mild aortic murmur. Symptoms - shortness of breath, heart palpitations, nocturia 2+ times per night, fatigue/weakness. From: Francis Bill SUSPECTED PA <georgewbill@...> hyperaldosteronism Sent: Thursday, March 1, 2012 10:59 AM Subject: Re: spiro Need to post all renin tests as well. Do you have lab ranges? if so post them as well. > >> >> > >> >>> > >> >>> My old dr. was trying to put me back on triamterene but I found another dr. Wasn't feeling like he knew what he was doing with this. > >> >>> > >> >>> RE: spiro > >> >>> > >> >>> adifferentme > >> >>> > >> >>> It isn't any potassium-sparing meds. It is spironolactone or Inspra. They > >> >>> block the effects of excess aldosterone coupled with excess sodium > >> >>> ingestion. Others do not. If the effect of high aldosterone is not > >> >>> blocked, you risk left ventricular thickening among other ailments. > >> >>> > >> >>> Val > >> >>> > >> >>> From: hyperaldosteronism > >> >>> [mailto:hyperaldosteronism ] On Behalf Of > >> >>> adifferentme@ > >> >>> > >> >>> So are potassium sparing diuretics the only meds used to treat hyperaldo? > >> >>> > >> >> > >> >> > >> > > >> > > >> > > >> > Reply to sender | Reply to group | Reply via web post | Start a New Topic > >> > Messages in this topic (74) > >> > RECENT ACTIVITY: New Members 3 > >> > Visit Your Group > >> > Switch to: Text-Only, Daily Digest • Unsubscribe • Terms of Use > >> > . > >> > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 2, 2012 Report Share Posted March 2, 2012 Hold everything - Yasmin increases serum potassium!!! The progestin in, drospirenone, is an analog to spironolactone. This may be the ONLY thing keeping you normokalemic. While I was being screened for PA I was switched to a progestin-only pill (Jolivette, which caused no problems). I'm actually surprised that you have HTN and have a doctor who is willing to prescribe an estrogen/progestin pill at all - perhaps it's because you are still so young. > >> >> >> > >> >> >>> > >> >> >>> My old dr. was trying to put me back on triamterene but I found another dr. Wasn't feeling like he knew what he was doing with this. > >> >> >>> > >> >> >>> RE: spiro > >> >> >>> > >> >> >>> adifferentme > >> >> >>> > >> >> >>> It isn't any potassium-sparing meds. It is spironolactone or Inspra. They > >> >> >>> block the effects of excess aldosterone coupled with excess sodium > >> >> >>> ingestion. Others do not. If the effect of high aldosterone is not > >> >> >>> blocked, you risk left ventricular thickening among other ailments. > >> >> >>> > >> >> >>> Val > >> >> >>> > >> >> >>> From: hyperaldosteronism > >> >> >>> [mailto:hyperaldosteronism ] On Behalf Of > >> >> >>> adifferentme@ > >> >> >>> > >> >> >>> So are potassium sparing diuretics the only meds used to treat hyperaldo? > >> >> >>> > >> >> >> > >> >> >> > >> >> > > >> >> > > >> >> > > >> >> > Reply to sender | Reply to group | Reply via web post | Start a New Topic > >> >> > Messages in this topic (74) > >> >> > RECENT ACTIVITY: New Members 3 > >> >> > Visit Your Group > >> >> > Switch to: Text-Only, Daily Digest • Unsubscribe • Terms of Use > >> >> > . > >> >> > >> > > >> > > >> > > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 2, 2012 Report Share Posted March 2, 2012 That is very interesting! I had an Ob/gyn mention going on a progestin only but said to ask my pcp about it. The pcp's I've had in the last 2 states I've lived in had no concerns about yasmin and my hypertension so I went along with them. So are you saying that if I were on a progestin-only pill I would feel better or worse? I know the low potassium has some uncomfortable side effects, but I'm not sure if I'm understanding what you're saying for sure. That I really do have low K but am getting a false reading because of the pill, or the pill is providing me with more K? 27 y/o , 115 lb at 5'6, female with 4+ year history of hypertension (Avg 140/95). Taken off all bp meds because of resistance to them. Currently awaiting a second opinion consult at Renal Associates of Montgomery AL. First Aldo level taken this past June was 88 ng/dl. Taken again in July and was down to 18.8 ng/dl. Then back up to 42 ng/dl. K- 4.5, NA- 138, renin- 0.65. Most recently aldo was taken with 24 hour urine. Aldo was 82 ng/dL. No known underlying illnesses other than a mild aortic murmur. Symptoms - shortness of breath, heart palpitations, nocturia 2+ times per night, fatigue/weakness. From: msmith_1928 <janeray1940@...> hyperaldosteronism Sent: Friday, March 2, 2012 1:44 PM Subject: Re: spiro Hold everything - Yasmin increases serum potassium!!! The progestin in, drospirenone, is an analog to spironolactone. This may be the ONLY thing keeping you normokalemic. While I was being screened for PA I was switched to a progestin-only pill (Jolivette, which caused no problems). I'm actually surprised that you have HTN and have a doctor who is willing to prescribe an estrogen/progestin pill at all - perhaps it's because you are still so young. > >> >> >> > >> >> >>> > >> >> >>> My old dr. was trying to put me back on triamterene but I found another dr. Wasn't feeling like he knew what he was doing with this. > >> >> >>> > >> >> >>> RE: spiro > >> >> >>> > >> >> >>> adifferentme > >> >> >>> > >> >> >>> It isn't any potassium-sparing meds. It is spironolactone or Inspra. They > >> >> >>> block the effects of excess aldosterone coupled with excess sodium > >> >> >>> ingestion. Others do not. If the effect of high aldosterone is not > >> >> >>> blocked, you risk left ventricular thickening among other ailments. > >> >> >>> > >> >> >>> Val > >> >> >>> > >> >> >>> From: hyperaldosteronism > >> >> >>> [mailto:hyperaldosteronism ] On Behalf Of > >> >> >>> adifferentme@ > >> >> >>> > >> >> >>> So are potassium sparing diuretics the only meds used to treat hyperaldo? > >> >> >>> > >> >> >> > >> >> >> > >> >> > > >> >> > > >> >> > > >> >> > Reply to sender | Reply to group | Reply via web post | Start a New Topic > >> >> > Messages in this topic (74) > >> >> > RECENT ACTIVITY: New Members 3 > >> >> > Visit Your Group > >> >> > Switch to: Text-Only, Daily Digest • Unsubscribe • Terms of Use > >> >> > . > >> >> > >> > > >> > > >> > > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 2, 2012 Report Share Posted March 2, 2012 > So are you saying that if I were on a progestin-only pill I would feel better or worse? I'm saying that your testing would be more accurate. Estrogen can raise BP, and the progestin in Yazmin or Yaz can elevate potassium (so much that it has killed people as a result; I've read there are pending lawsuits about this.) As for whether you'd feel better or worse on a POP - my guess would be the same, or worse. The progestin in Yazmin acts somewhat like spironolactone, so it's probably lowering your BP somewhat and raising your K somewhat. If anything, this would make you feel better, but would give you false BP and K readings. The main takeaway here is that if testing for PA isn't considered accurate when done while on spironolactone, it shouldn't be considered accurate when done on Yazmin. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 2, 2012 Report Share Posted March 2, 2012 If you lost any urine during the 24 hr collection the CCR will be falsely low. If you faster or had been walking around or dehydrated the plasma creat would be increased. I would keep a running average of you tests which u can do with excell. And why at u on Yasmin. And why did u not tell us everything at the start. Saves u and us time and as they say time is money. May your pressure be low!CE Grim MS, MDSpecializing in DifficultHypertensionOn Mar 2, 2012, at 12:44, msmith_1928 <janeray1940@...> wrote: Hold everything - Yasmin increases serum potassium!!! The progestin in, drospirenone, is an analog to spironolactone. This may be the ONLY thing keeping you normokalemic. While I was being screened for PA I was switched to a progestin-only pill (Jolivette, which caused no problems). I'm actually surprised that you have HTN and have a doctor who is willing to prescribe an estrogen/progestin pill at all - perhaps it's because you are still so young. > >> >> >> > >> >> >>> > >> >> >>> My old dr. was trying to put me back on triamterene but I found another dr. Wasn't feeling like he knew what he was doing with this. > >> >> >>> > >> >> >>> RE: spiro > >> >> >>> > >> >> >>> adifferentme > >> >> >>> > >> >> >>> It isn't any potassium-sparing meds. It is spironolactone or Inspra. They > >> >> >>> block the effects of excess aldosterone coupled with excess sodium > >> >> >>> ingestion. Others do not. If the effect of high aldosterone is not > >> >> >>> blocked, you risk left ventricular thickening among other ailments. > >> >> >>> > >> >> >>> Val > >> >> >>> > >> >> >>> From: hyperaldosteronism > >> >> >>> [mailto:hyperaldosteronism ] On Behalf Of > >> >> >>> adifferentme@ > >> >> >>> > >> >> >>> So are potassium sparing diuretics the only meds used to treat hyperaldo? > >> >> >>> > >> >> >> > >> >> >> > >> >> > > >> >> > > >> >> > > >> >> > Reply to sender | Reply to group | Reply via web post | Start a New Topic > >> >> > Messages in this topic (74) > >> >> > RECENT ACTIVITY: New Members 3 > >> >> > Visit Your Group > >> >> > Switch to: Text-Only, Daily Digest • Unsubscribe • Terms of Use > >> >> > . > >> >> > >> > > >> > > >> > > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 2, 2012 Report Share Posted March 2, 2012 BCPs are a well known cause of senior moderate or severe HTN. If u do a pub med search on Yasmin u will note at least one case report from Italy in with a patient who was falsely DXED with PA. IT WENT AWAY WITH STOPPING YASMINE. IF IT is like the other BCPS THE ONLY way to tell if it is causing a problem is to stop it and see. If you look in my CV U will note at least one study I worked on. Estrogens increase renin substrate which in turn increases renin activity and usually aldo. When first measured in HTN IN preg it was found that renin was very high as was also. Recommend u discuss with your team stopping Yasmin. Beware as u maY get pregnant. May your pressure be low!CE Grim MS, MDSpecializing in DifficultHypertensionOn Mar 2, 2012, at 17:40, Marchelle Syktich <marseachelle02@...> wrote: That is very interesting! I had an Ob/gyn mention going on a progestin only but said to ask my pcp about it. The pcp's I've had in the last 2 states I've lived in had no concerns about yasmin and my hypertension so I went along with them. So are you saying that if I were on a progestin-only pill I would feel better or worse? I know the low potassium has some uncomfortable side effects, but I'm not sure if I'm understanding what you're saying for sure. That I really do have low K but am getting a false reading because of the pill, or the pill is providing me with more K? 27 y/o , 115 lb at 5'6, female with 4+ year history of hypertension (Avg 140/95). Taken off all bp meds because of resistance to them. Currently awaiting a second opinion consult at Renal Associates of Montgomery AL. First Aldo level taken this past June was 88 ng/dl. Taken again in July and was down to 18.8 ng/dl. Then back up to 42 ng/dl. K- 4.5, NA- 138, renin- 0.65. Most recently aldo was taken with 24 hour urine. Aldo was 82 ng/dL. No known underlying illnesses other than a mild aortic murmur. Symptoms - shortness of breath, heart palpitations, nocturia 2+ times per night, fatigue/weakness. From: msmith_1928 <janeray1940@...> hyperaldosteronism Sent: Friday, March 2, 2012 1:44 PM Subject: Re: spiro Hold everything - Yasmin increases serum potassium!!! The progestin in, drospirenone, is an analog to spironolactone. This may be the ONLY thing keeping you normokalemic. While I was being screened for PA I was switched to a progestin-only pill (Jolivette, which caused no problems). I'm actually surprised that you have HTN and have a doctor who is willing to prescribe an estrogen/progestin pill at all - perhaps it's because you are still so young. > >> > >> Well, here I was thinking I finally got the testing I needed, and am proven wrong- again! Doesn't surprise me in the least. I'll take another look at my records to see if I can find those numbers. > >> > >> I am just hoping for some answers at my upcoming Nephrology appointment this coming Wednesday. I got excited when they said a 24 hour urine + blood test was needed within a few hours of each other, but it doesn't seem they measured everything that was needed. :-( > >> > >> Thank you very much for your input! > >> > >> > >> 27 y/o , 115 lb at 5'6, female with 4+ year history of hypertension (Avg 140/95). Taken off all bp meds because of resistance to them. Currently awaiting a second opinion consult at Renal Associates of Montgomery AL. First Aldo level taken this past June was 88 ng/dl. Taken again in July and was down to 18.8 ng/dl. The most recent aldo level was 42 ng/dl. K- 4.5, NA- 138, renin- 0.65. No known underlying illnesses other than a mild aortic murmur. Symptoms - shortness of breath, heart palpitations, nocturia 2+ times per night, fatigue/weakness. > >> > >> > >> > >> ________________________________ > >> From: Clarence Grim <lowerbp2@> > >> hyperaldosteronism > >> Cc: Clarence Grim <lowerbp2@> > >> Sent: Thursday, March 1, 2012 12:47 AM > >> Subject: Re: Re: spiro > >> > >> > >> > >> But I seem to have missed the results: I do not see a urine Na and/or K. > >> > >> Did you leave something out? > >> > >> You did send the blood Na and K etc. but that is not what is needed. > >> > >> Here is the welcome again; > >> > >> See item 6. > >> > >> CE Grim MD > >> > >> > >> > >> Welcome to the exciting world of Hyperaldosteronism > >> > >> You are in the right place! > >> > >> I am Dr. CE Grim a retired Professor of Medicine and Endocrinology. > >> > >> I have had a long standing interest is Primary Aldosteronism since medical school days when I saw my first patient with Primary Aldosteronism in 1963 as a 4th year medical student. I did a Nephrology Fellowship at Duke and an Endocrinology and Metabolism Fellowship with Dr. Conn (1969-70). I have been on the faculty of the University of MO, Indiana Univ, UCLA/ R. Drew, and the Medical College of Wisconsin in Divisions of Nephrology, Endocrinology, Hypertension, Cardiology and Epidemiology. > >> > >> I have published over 240 papers and book chapters in most areas of the broad discipline of High Blood Pressure. My CV is in our files for details. > >> > >> The GOAL of our group is to teach you and your health care team about the ins and outs of the causes, diagnosis and control of the many forms of hyperaldosteronism. > >> > >> The steps below will introduce you into the fascinating world of high blood pressure, salt and potassium and the role of the adrenal hormone aldosterone in health and disease. Doing these in sequence will save you time and effort in getting up to speed in taking control of you health and educating your own health care team. > >> > >> While we can’t make you a doctor we will make you into a pretty good BP doctor-a skill that you will have for life. > >> > >> 1. Overview: Read my article in our files on the evolution of PA (Evolution_of_PA-Grim.pdf ) and take to all members of health care team. Tell us what stage you believe you are in. This is a brief review of most causes of hyperaldosteronism, high blood pressure, low potassium (K). > >> > >> Be certain that you and your health care team understand the key role of excess diet salt in HTN and especially in PA. > >> > >> Go to: http://www.worldactiononsalt.com/evidence/treatment_trials.htm > >> > >> For a state of the art and science discussion of salt and health. > >> > >> 2. Other patients with hyperaldosteronism (Conn’s syndrome). Read our Conn's stories in our files and then give us your own in as much detail as you can. Dr. Conn was the first to describe this disease process and the syndrome is named after him. To see others' stories, on the Hyperaldosteronism home page, go to Files/Conn’s Stories. You'll find instructions in "A - How to put your story here.doc " > >> Then send us your story in an email and then we will likely ask more questions and make suggestions before you upload it to our files. > >> > >> 3. Hyperaldosteronism and Salt: The deadly Duo. > >> > >> > >> Eating Plan to control high blood pressure due to hyperaldosteronism and most others with high blood pressure. This will reduce your need for medications and in many will get your BP and K to goal without meds.. Get the DASH diet book by T. et al, read it and use it: $8 in paperback at your local books Quote Link to comment Share on other sites More sharing options...
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