Re: salt and high blood pressure

[Guest guest]

well sorry im living proof i can eat over 3000 mg of salt and it goes to the b\p up i mean just under that and im fine 117\72 most the time over 3000 im at 137\96 till i get the salt out.

thanks mark

Re: Salt and high blood pressure

I also saw this and was interested, so I'll add my voice to the question. I have been on a low salt diet for several years since getting high BP and only the drugs seemed to have had affect. Now that I have been diagnosed with PA I attributed the high aldo to the high BP, per what I've been told and read. This statement about low salt with high aldo equals low BP seems to go against that.Jim> > That's very interesting. Do you have the references to back this up as I'd> like to read into this further. My BP was really high even on a very low> salt diet (as far as is possible living near the Ocean! Salt gets every> where and you ingest a lot from salt on lips, skin etc.)> > BP now averages around 130 / 90 down from 220+ / 150+ on a good day and> following a very strict coeliac / low salt diet which ended up mostly> vegetables and rice with fresh meat / fish and no added salt. > > Helen in Scotland > > > Original Message:> -----------------> From: lowerbp2@a...> > It should be noted here and I dont think I have said this before here-in > order for aldosterone to cause high blood pressure etc you also have to be> on a > high salt diet: human or rat or mouse. > > If the diet sodium is kept very low, aldo does not effect BP etc. > > > > > May your pressure be low!> > CE Grim, BS (Chem/Math), MS (Biochem), MD.> Professor of Medicine and Epidemiology> Board Certified in Internal Medicine, Geriatrics and Hypertension> Published over 230 research papers, chapters and reviews in the area of> high > blood pressure: epidemiology, history, endocrinology, genetics and> physiology.> > > > --------------------------------------------------------------------> mail2web - Check your email from the web at> http://mail2web.com/ .

[Guest guest]

i have never went that low with my salt but under 3000 works for me and mine is fine but if i get more than that it does tend to go up

thanks mark

Re: Re: Salt and high blood pressure

In animals, mice,dogs, rats, pigs, sheep and humans if you do not eat excess salt you will not get HTN and heart damage from too much aldo. The problem is that in humans you may have to get down to VERY low sodium intakes but no one has looked at this in humans recently-ie the very low sodium intake. As far as we know the only way aldo works is to block the sodium retaining effect od aldo. Therefore no salt no aldo effect. Has your doctor ever measured your salt excretion to see how lot it is-this is the only way to be certain you are on a very low sodium diet I would define a very low sodium diet in this regard to bee less than 250 mg sodium per day. Because with PA your body will store lots of sodium I would guess that it would take several months of very low sodium for reverse the aldo effect in PA. Anyone in the group who has tried very low sodium for say several months? The most effective to try would be the rice fruit diet. (Kempner) May your pressure be low!CE Grim, BS (Chem/Math), MS (Biochem), MD.Professor of Medicine and EpidemiologyBoard Certified in Internal Medicine, Geriatrics and HypertensionPublished over 230 research papers, chapters and reviews in the area of high blood pressure: epidemiology, history, endocrinology, genetics and physiology.

[Guest guest]

In animals, mice,dogs, rats, pigs, sheep and humans if you do not eat excess salt you will not get HTN and heart damage from too much aldo. The problem is that in humans you may have to get down to VERY low sodium intakes but no one has looked at this in humans recently-ie the very low sodium intake.

As far as we know the only way aldo works is to block the sodium retaining effect od aldo. Therefore no salt no aldo effect.

Has your doctor ever measured your salt excretion to see how lot it is-this is the only way to be certain you are on a very low sodium diet I would define a very low sodium diet in this regard to bee less than 250 mg sodium per day. Because with PA your body will store lots of sodium I would guess that it would take several months of very low sodium for reverse the aldo effect in PA.

Anyone in the group who has tried very low sodium for say several months? The most effective to try would be the rice fruit diet. (Kempner)

May your pressure be low!

CE Grim, BS (Chem/Math), MS (Biochem), MD.

Professor of Medicine and Epidemiology

Board Certified in Internal Medicine, Geriatrics and Hypertension

Published over 230 research papers, chapters and reviews in the area of high blood pressure: epidemiology, history, endocrinology, genetics and physiology.

[Guest guest]

I also saw this and was interested, so I'll add my voice to the

question. I have been on a low salt diet for several years since

getting high BP and only the drugs seemed to have had affect. Now

that I have been diagnosed with PA I attributed the high aldo to the

high BP, per what I've been told and read. This statement about low

salt with high aldo equals low BP seems to go against that.

Jim

>

> That's very interesting. Do you have the references to back this

up as I'd

> like to read into this further. My BP was really high even on a

very low

> salt diet (as far as is possible living near the Ocean! Salt gets

every

> where and you ingest a lot from salt on lips, skin etc.)

>

> BP now averages around 130 / 90 down from 220+ / 150+ on a good

day and

> following a very strict coeliac / low salt diet which ended up

mostly

> vegetables and rice with fresh meat / fish and no added salt.

>

> Helen in Scotland

>

>

> Original Message:

> -----------------

> From: lowerbp2@a...

>

> It should be noted here and I dont think I have said this before

here-in

> order for aldosterone to cause high blood pressure etc you also

have to be

> on a

> high salt diet: human or rat or mouse.

>

> If the diet sodium is kept very low, aldo does not effect BP

etc.

>

>

>

>

> May your pressure be low!

>

> CE Grim, BS (Chem/Math), MS (Biochem), MD.

> Professor of Medicine and Epidemiology

> Board Certified in Internal Medicine, Geriatrics and Hypertension

> Published over 230 research papers, chapters and reviews in the

area of

> high

> blood pressure: epidemiology, history, endocrinology, genetics and

> physiology.

>

>

>

> -------------------------------------------------------------------

-

> mail2web - Check your email from the web at

> http://mail2web.com/ .

[Guest guest]

I am looking for detailed studies on this but you should like you have done your own. Has you Dr ever measured the sodium in your urine on this diet? May be very low. Would like to know more details.

May your pressure be low!

CE Grim, BS (Chem/Math), MS (Biochem), MD.

Professor of Medicine and Epidemiology

Board Certified in Internal Medicine, Geriatrics and Hypertension

Published over 230 research papers, chapters and reviews in the area of high blood pressure: epidemiology, history, endocrinology, genetics and physiology.

[Guest guest]

3 years on a no salt diet (fresh fruit and veg, fresh meat, rice. no

potatoes as I'm allergic to them. No bread or other grains apart from rice)

- BP still rising.

Excreted sodium? - not enough to measure.

Helen in Scotland

Original Message:

-----------------

From: lowerbp2@...

Date: Mon, 8 Dec 2003 17:50:19 EST

hyperaldosteronism

Subject: Re: Re: Salt and high blood pressure

In animals, mice,dogs, rats, pigs, sheep and humans if you do not eat

excess

salt you will not get HTN and heart damage from too much aldo. The

problem

is that in humans you may have to get down to VERY low sodium intakes but

no

one has looked at this in humans recently-ie the very low sodium intake.

As far as we know the only way aldo works is to block the sodium retaining

effect od aldo. Therefore no salt no aldo effect.

Has your doctor ever measured your salt excretion to see how lot it is-this

is the only way to be certain you are on a very low sodium diet I would

define

a very low sodium diet in this regard to bee less than 250 mg sodium per

day.

Because with PA your body will store lots of sodium I would guess that it

would take several months of very low sodium for reverse the aldo effect in

PA.

Anyone in the group who has tried very low sodium for say several months?

The most effective to try would be the rice fruit diet. (Kempner)

May your pressure be low!

CE Grim, BS (Chem/Math), MS (Biochem), MD.

Professor of Medicine and Epidemiology

Board Certified in Internal Medicine, Geriatrics and Hypertension

Published over 230 research papers, chapters and reviews in the area of

high

blood pressure: epidemiology, history, endocrinology, genetics and

physiology.

--------------------------------------------------------------------

mail2web - Check your email from the web at

http://mail2web.com/ .

[Guest guest]

I have checked the sources I have access to with nothing of statistical

significance only odd comments.

As per my previous post my BP was rising on a " no salt " diet and the sodium

levels in my urine were too low to measure (got a well done for keeping off

the salt).

I know my body chemistry is all messed up so I'm probably not a good case

study. Also " natural " levels of sodium are high here including the water

supply so very difficult to measure just how much sodium we are ingesting

every day (remember the salt winds leave a layer of sea salt on

everything). We even have sheep here that eat seaweed rather than grass -

must be a salt rich diet!

Original Message:

-----------------

From: lowerbp2@...

Date: Mon, 8 Dec 2003 18:15:17 EST

hyperaldosteronism

Subject: Re: Salt and high blood pressure

I am looking for detailed studies on this but you should like you have done

your own. Has you Dr ever measured the sodium in your urine on this diet?

May be very low. Would like to know more details.

May your pressure be low!

CE Grim, BS (Chem/Math), MS (Biochem), MD.

Professor of Medicine and Epidemiology

Board Certified in Internal Medicine, Geriatrics and Hypertension

Published over 230 research papers, chapters and reviews in the area of

high

blood pressure: epidemiology, history, endocrinology, genetics and

physiology.

--------------------------------------------------------------------

mail2web - Check your email from the web at

http://mail2web.com/ .

[Guest guest]

3000mg of salt is a lot!

Just checked the date on my salt tub - it is a 250gm tub and was bought in

1993. 6 of us in our house at that time and that is the only source of salt

I add to our food in my kitchen. I don't use " factory food " but we do have

a high natural salt level here.

I think I am safe in saying I don't add a lot of salt in my kitchen......

After surgery I was asked to use salt again as my K levels became

dangerously high but I really don't like the taste very much.

Helen

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[Guest guest]

Yes, when you have not aldosterone then the kidney has a problem getting rid of K. By increasing diet sodium you provide more Na in the distal tubule (the end of the tiny structure that forms urine-it starts at the glomerulus) where Na is reabsorbed at the last area before urine moves into the upper part of the urinary collection system. This is where aldo does most of its work-the distal tubule.

I have agreat powerpoint lecture on this but dont know how to put in on your site if you would like to review it first.

May your pressure be low!

CE Grim, BS (Chem/Math), MS (Biochem), MD.

Professor of Medicine and Epidemiology

Board Certified in Internal Medicine, Geriatrics and Hypertension

Published over 230 research papers, chapters and reviews in the area of high blood pressure: epidemiology, history, endocrinology, genetics and physiology.

[Guest guest]

When there is no aldo and not enough salt the renin can go very high and may make BP increase. It can be a delicate balancing act to get the amount of salt and K adjusted correctly. Have you had to take and fluoro or other mineralocorticoid?

In my experience many with PA who have had both adrenals out are VERY sensitive to the BP raising effects of mineralocorticoid replace. Many require very low doses to keep K in check and not raise BP.

The sheep eating seaweed may be getting lost of salt from that and may not need to be given salt licks like inland sheep must. The further away from the sea you live the lower the Na content of the rain and the soil.

May your pressure be low!

CE Grim, BS (Chem/Math), MS (Biochem), MD.

Professor of Medicine and Epidemiology

Board Certified in Internal Medicine, Geriatrics and Hypertension

Published over 230 research papers, chapters and reviews in the area of high blood pressure: epidemiology, history, endocrinology, genetics and physiology.

[Guest guest]

In a message dated 12/9/03 3:16:57 AM, Helen@... writes:

If there is not enough to measure you are very low! So it can be done in the British Isles.

3 years on a no salt diet (fresh fruit and veg, fresh meat, rice. no

potatoes as I'm allergic to them. No bread or other grains apart from rice)

- BP still rising.

Excreted sodium? - not enough to measure.

Helen in Scotland

Original Message:

-----------------

From:  lowerbp2@...

Date: Mon, 8 Dec 2003 17:50:19 EST

hyperaldosteronism

Subject: Re: Re: Salt and high blood pressure

In animals, mice,dogs, rats, pigs, sheep and humans if you do not eat

excess

salt you will not get HTN and heart damage from too much aldo.   The

problem

is that in humans you may have to get down to VERY low sodium intakes but

no

one has looked at this in humans recently-ie the very low sodium intake.

As far as we know the only way aldo works is to block the sodium retaining

effect od aldo.   Therefore no salt no aldo effect.

Has your doctor ever measured your salt excretion to see how lot it is-this

is the only way to be certain you are on a very low sodium diet I would

define

a very low sodium diet in this regard to bee less than 250 mg sodium per

day. 

Because with PA your body will store lots of sodium I would guess that it

would take several months of very low sodium for reverse the aldo effect in

PA. 

Anyone in the group who has tried very low sodium for say several months?  

The most effective to try would be the rice fruit diet.   (Kempner)

May your pressure be low!

CE Grim, BS (Chem/Math), MS (Biochem), MD.

Professor of Medicine and Epidemiology

Board Certified in Internal Medicine, Geriatrics and Hypertension

Published over 230 research papers, chapters and reviews in the area of

high

blood pressure: epidemiology, history, endocrinology, genetics and

physiology.

--------------------------------------------------------------------

mail2web - Check your email from the web at

http://mail2web.com/ .

[Guest guest]

Each person seems to have their own salt and BP "set-point". When the sodium intake is above this the BP goes up and below this the BP goes down.

This is true for all mammals but the set point can be very high (takes a lot of salt) or very low (takes little salt) to effect BP.

This set point can be shifted by reducing kidney function, by giving or making excess aldo, by renal artery stenosis. In essence you have to shift this set point or change sodium intake to change BP.

The best place to read about this is to get a copy of the Medical Physiology Textbook by Guyton or now Hall and Guyton and devour the sections on regulation of the circulation. Indeed, this text is one of the best in the world to learn about how the body works.

My guess is that all Lib and certainly all Med Lib have this and you can get cheap used or old versions on the web. Even the 10 year old versions are OK from this point of view.

In a message dated 12/9/03 12:03:10 AM, anxioushouse@... writes:

i have never went that low with my salt but under 3000 works for me and mine is fine but if i get more than that it does tend to go up

 

thanks mark

May your pressure be low!

CE Grim, BS (Chem/Math), MS (Biochem), MD.

Professor of Medicine and Epidemiology

Board Certified in Internal Medicine, Geriatrics and Hypertension

Published over 230 research papers, chapters and reviews in the area of high blood pressure: epidemiology, history, endocrinology, genetics and physiology.

[Guest guest]

Then your set point is 3000 mg of sodium per day. Above this your BP goes up and below this it goes down. And all of this will happen in 2 weeks in most cases.

This is the reason the DASH worked so fast. In just two weeks the BP had reached most of its change.

May your pressure be low!

CE Grim, BS (Chem/Math), MS (Biochem), MD.

Professor of Medicine and Epidemiology

Board Certified in Internal Medicine, Geriatrics and Hypertension

Published over 230 research papers, chapters and reviews in the area of high blood pressure: epidemiology, history, endocrinology, genetics and physiology.

[Guest guest]

Oh, it can be done. You don't eat out AT ALL. You make everything fresh.

You buy distilled water to wash everything including your face as well as

your food. You have to have enough money to be able to do this and most

people don't have that sort of cash. I spent all my savings and had to sell

my house to afford it.

Helen

Original Message:

-----------------

From: lowerbp2@...

Date: Tue, 9 Dec 2003 11:21:44 EST

hyperaldosteronism

Subject: Re: Re: Salt and high blood pressure

In a message dated 12/9/03 3:16:57 AM, Helen@...

writes:

If there is not enough to measure you are very low! So it can be done in

the

British Isles.

> 3 years on a no salt diet (fresh fruit and veg, fresh meat, rice. no

> potatoes as I'm allergic to them. No bread or other grains apart from

rice)

> - BP still rising.

>

> Excreted sodium? - not enough to measure.

>

> Helen in Scotland

>

>

> Original Message:

> -----------------

> From:  lowerbp2@...

> Date: Mon, 8 Dec 2003 17:50:19 EST

> hyperaldosteronism

> Subject: Re: Re: Salt and high blood pressure

>

>

> In animals, mice,dogs, rats, pigs, sheep and humans if you do not eat

> excess

> salt you will not get HTN and heart damage from too much aldo.   The

> problem

> is that in humans you may have to get down to VERY low sodium intakes but

> no

> one has looked at this in humans recently-ie the very low sodium intake.

>

> As far as we know the only way aldo works is to block the sodium retaining

> effect od aldo.   Therefore no salt no aldo effect.

>

> Has your doctor ever measured your salt excretion to see how lot it

is-this

> is the only way to be certain you are on a very low sodium diet I would

> define

> a very low sodium diet in this regard to bee less than 250 mg sodium per

> day. 

> Because with PA your body will store lots of sodium I would guess that it

> would take several months of very low sodium for reverse the aldo effect

in

> PA. 

>

>

> Anyone in the group who has tried very low sodium for say several

months?  

> The most effective to try would be the rice fruit diet.   (Kempner)

>

>

>

>

> May your pressure be low!

>

> CE Grim, BS (Chem/Math), MS (Biochem), MD.

> Professor of Medicine and Epidemiology

> Board Certified in Internal Medicine, Geriatrics and Hypertension

> Published over 230 research papers, chapters and reviews in the area of

> high

> blood pressure: epidemiology, history, endocrinology, genetics and

> physiology.

>

>

>

> --------------------------------------------------------------------

> mail2web - Check your email from the web at

> http://mail2web.com/ .

>

>

>

>

>

[Guest guest]

In a message dated 12/10/03 5:44:07 AM, Helen@... writes:

Oh, it can be done. You don't eat out AT ALL. You make everything fresh.

You buy distilled water to wash everything including your face as well as

your food. You have to have enough money to be able to do this and most

people don't have that sort of cash. I spent all my savings and had to sell

my house to afford it.

Helen

See you have reached the max on low sodium. I know how hard this is but in you and your families case it is very important.

I have heard there is an English bread that is salt free but do not know what it is. Do you?

May your pressure be low!

CE Grim, BS (Chem/Math), MS (Biochem), MD.

Professor of Medicine and Epidemiology

Board Certified in Internal Medicine, Geriatrics and Hypertension

Published over 230 research papers, chapters and reviews in the area of high blood pressure: epidemiology, history, endocrinology, genetics and physiology.

[Guest guest]

I think you have missed the point completely by saying it is hard. Hard is

a very mild word to use about what I have been through over the last 3

years. I have been to hell and I'm not back yet. It is the cost of the no

salt diet that makes things too difficult.

A no-salt diet can attained here but the cost is not one any normal family

can afford to pay or be willing to pay. I used all my savings, my kids'

college funds and had to sell my house to pay for the pure water to wash

everything.

I still have no home and move from temporary roof to temporary roof. There

is no provision for me as the powers that be consider I am intentionally

homeless. The route I took to eliminate salt from my diet is not to be

recommended and I wouldn't ever consider it again. Special diet is not

covered by social payment legislation here.

Now imagine this lack of home going on when you have a serious illness. I

was on the point of suicide many, many times and it was only that I was too

weak to carry out my intention that prevented me taking my own life.

I don't eat bread (coeliac remember?) so don't know anything about any

brands of bread.

Helen

Original Message:

-----------------

From: lowerbp2@...

Date: Wed, 10 Dec 2003 13:32:23 EST

hyperaldosteronism

Subject: Re: Re: Salt and high blood pressure

In a message dated 12/10/03 5:44:07 AM, Helen@...

writes:

> Oh, it can be done. You don't eat out AT ALL. You make everything fresh.

> You buy distilled water to wash everything including your face as well as

> your food. You have to have enough money to be able to do this and most

> people don't have that sort of cash. I spent all my savings and had to

sell

> my house to afford it.

>

> Helen

>

See you have reached the max on low sodium. I know how hard this is but

in

you and your families case it is very important.

I have heard there is an English bread that is salt free but do not know

what

it is. Do you?

May your pressure be low!

CE Grim, BS (Chem/Math), MS (Biochem), MD.

Professor of Medicine and Epidemiology

Board Certified in Internal Medicine, Geriatrics and Hypertension

Published over 230 research papers, chapters and reviews in the area of

high

blood pressure: epidemiology, history, endocrinology, genetics and

physiology.

--------------------------------------------------------------------

mail2web - Check your email from the web at

http://mail2web.com/ .

[Guest guest]

I think you have missed the point completely by saying it is hard. Hard is

a very mild word to use about what I have been through over the last 3

years. I have been to hell and I'm not back yet. It is the cost of the no

salt diet that makes things too difficult.

A no-salt diet can attained here but the cost is not one any normal family

can afford to pay or be willing to pay. I used all my savings, my kids'

college funds and had to sell my house to pay for the pure water to wash

everything.

I still have no home and move from temporary roof to temporary roof. There

is no provision for me as the powers that be consider I am intentionally

homeless. The route I took to eliminate salt from my diet is not to be

recommended and I wouldn't ever consider it again. Special diet is not

covered by social payment legislation here.

Now imagine this lack of home going on when you have a serious illness. I

was on the point of suicide many, many times and it was only that I was too

weak to carry out my intention that prevented me taking my own life.

I don't eat bread (coeliac remember?) so don't know anything about any

brands of bread.

Helen

Original Message:

-----------------

From: lowerbp2@...

Date: Wed, 10 Dec 2003 13:32:23 EST

hyperaldosteronism

Subject: Re: Re: Salt and high blood pressure

In a message dated 12/10/03 5:44:07 AM, Helen@...

writes:

> Oh, it can be done. You don't eat out AT ALL. You make everything fresh.

> You buy distilled water to wash everything including your face as well as

> your food. You have to have enough money to be able to do this and most

> people don't have that sort of cash. I spent all my savings and had to

sell

> my house to afford it.

>

> Helen

>

See you have reached the max on low sodium. I know how hard this is but

in

you and your families case it is very important.

I have heard there is an English bread that is salt free but do not know

what

it is. Do you?

May your pressure be low!

CE Grim, BS (Chem/Math), MS (Biochem), MD.

Professor of Medicine and Epidemiology

Board Certified in Internal Medicine, Geriatrics and Hypertension

Published over 230 research papers, chapters and reviews in the area of

high

blood pressure: epidemiology, history, endocrinology, genetics and

physiology.

--------------------------------------------------------------------

mail2web - Check your email from the web at

http://mail2web.com/ .

[Guest guest]

I do understand the difficult and financial problems. They are worse in the US.

If you have no money and are of working age there is no insurance coverage at

all available. Therefore there is not health care except for emergencies.

The basic rice-fruit diet should not cost a lot. Adding the coeliac problem

would be the kicker. I would think that with a diet related disease that your

system woulc cover the speical needs-esp coeliac but then the workings of the

health care system are a mystery to me. As I am now 65 and covered by SSI in

the US it is becoming an eyeopener for me too!

CE Grim MD

[Guest guest]

I do understand the difficult and financial problems. They are worse in the US.

If you have no money and are of working age there is no insurance coverage at

all available. Therefore there is not health care except for emergencies.

The basic rice-fruit diet should not cost a lot. Adding the coeliac problem

would be the kicker. I would think that with a diet related disease that your

system woulc cover the speical needs-esp coeliac but then the workings of the

health care system are a mystery to me. As I am now 65 and covered by SSI in

the US it is becoming an eyeopener for me too!

CE Grim MD

[Guest guest]

It was the cost of the pure water as well.....

The health service covers some (not luxury) coeliac food (at £6.50 for

every item) but most packaged coeliac food is high in salt, sugar and fat

(to make it taste remotely nice). The things you can get on the NHS are

basic bread (6 slices count as an item), some types of chees cracker and

gluten free pasta. Every thing else is counted as a luxury, including

gluten free bread buns! Now bear in mind I had to provide for 6 people on

£50 a week so the money just didn't go far at all. Fresh fruit is not

available here unless you grow your own. Too remote for fresh produce to be

stocked - the same with fresh veggies. Shops here only sell what is

preserved and can be stored otherwise there is too much waste. We're coming

to the end of the garden produce now so it is all canned stuff from here on

in until the spring greens are ready.

It is free for you to see a Dr here and no charge for hospital admission

(unless you go private) but all drugs, aids etc cost money. Drugs are a

£6.50 fixed charge per item and other things cost as well. My specs come in

around £150. You do pay for dental treatment and eye tests and that sort of

thing.

We actually now do have case law that a special diet is a disability

recognised under the Disability Discrimination Act but it came too late for

me to use that with the social welfare people.

I'm still fighting for the rights of people who can't fight for themselves

and fall through the cracks in the system. Actually I think that is one of

the things that keeps me going. The weather is better today so I'm a lot

more positive, I hate the short winter days.........

Helen

--------------------------------------------------------------------

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[Guest guest]

It was the cost of the pure water as well.....

The health service covers some (not luxury) coeliac food (at £6.50 for

every item) but most packaged coeliac food is high in salt, sugar and fat

(to make it taste remotely nice). The things you can get on the NHS are

basic bread (6 slices count as an item), some types of chees cracker and

gluten free pasta. Every thing else is counted as a luxury, including

gluten free bread buns! Now bear in mind I had to provide for 6 people on

£50 a week so the money just didn't go far at all. Fresh fruit is not

available here unless you grow your own. Too remote for fresh produce to be

stocked - the same with fresh veggies. Shops here only sell what is

preserved and can be stored otherwise there is too much waste. We're coming

to the end of the garden produce now so it is all canned stuff from here on

in until the spring greens are ready.

It is free for you to see a Dr here and no charge for hospital admission

(unless you go private) but all drugs, aids etc cost money. Drugs are a

£6.50 fixed charge per item and other things cost as well. My specs come in

around £150. You do pay for dental treatment and eye tests and that sort of

thing.

We actually now do have case law that a special diet is a disability

recognised under the Disability Discrimination Act but it came too late for

me to use that with the social welfare people.

I'm still fighting for the rights of people who can't fight for themselves

and fall through the cracks in the system. Actually I think that is one of

the things that keeps me going. The weather is better today so I'm a lot

more positive, I hate the short winter days.........

Helen

--------------------------------------------------------------------

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[Guest guest]

Thanks for your insightful comments and observations. I will try to answer each and outline the physiology of my responses-please ask for additional clarifications anytime.

In a message dated 12/16/03 16:04:13, tn_weldys@... writes:

Dr Grim,

Please know first that I am coming at this statement from two very

different directions.   This statement is very confusing to me because

as a former PA patient and the mother of one I understand that sodium

and aldosterone walk hand in hand.   But, as an ian, I know

daily what is like to be without aldosterone at all and to live on

the supplement Florinef.  When I go into a crisis it is from having

too little cortisol in the blood when a stressful event is happening(

illness, severe emotional stress, or some sort of accident). 

Stress normally activates ACTH production from the pituitary gland which then stimulates the adrenal to increase cortisol AND aldosterone. This modulation of cortisol and aldo goes on almost minute to minute when the brain, pituitary and adrenals glands are working normal. Aldosterone production is also controlled by the enzyme renin which comes from the kidney. The brain also can send signals to the kidney to make more or less renin. Renin acts on another large protein in the blood(made in the liver) called renin substrate or angiotensinogen (AGT). Renin cleaves a 10 amino acid polypeptide from AGT. This is called AI or angiotensin one. Another enzyme in the lungs and blood cleaves another 2 amino acid peptide from AI. This 8 unit octapeptide (8 amino acids) is called AII (angiotensin two). This is the most potent vasopressor known (makes blood vessels constrict and raises blood pressure). AII also stimulates the adrenal gland to make aldosterone (ALDO) the most potent salt and water retaining hormone in the body. The ALDO acts throughout the body: makes the kidney retain sodium and excrete potassium (K) in the urine, the sweat glands retain sodium and excrete K, and the gut to retain Na and excrete K and the salivary glands to retain sodium and excrete K.

The level of renin and aldo also varies from minute to minute and therefore regulates BP and salt and K balance.

If the body does not make ALDO then one loses sodium in the kidneys, sweat, salvia and stools and if not replaced will die in a matter of days depending on the heat and water stress of the situation and the salt intake. Death can come from very low BP (shock) or too high of a K. However, one can overcome the fall in blood pressure and high K by eating huge amounts of salt-children have been reported to eat salt by the handful when they have this problem.

Classic ian patients, who have lost all adrenal gland function (in the old days from tuberculosis,now from surgery) will also get very dark skin because the pituitary gland (which recognizes that the cortisol is too low) puts out large amounts of ACTH which can be broken down in to MT (melanocyte stimulating hormone) which makes the dark granules in all of our skin melanocytes spread out and the skin can become very dark. If cortisol is given back the skin will become lighter.

Cortisol is critical to almost all of the body's cell functions and a deficiency in this also leads to shock and heart failure and death.

Where the body normally varies the amount of cortisol aldo from minute to minute this is not possible when the adrenals are not there.

I have my patients carry a syringe that contains injectable cortisol in case the under go an injury or severe stress such as diarrhea. They must also wear a bracelet and have a card in their wallet or purse that states they have 's disease as any ER person will know the first thing you do is to give the a shot of cortisol immediately and start an IV infusion of cortisol (or cortisol like drug). Most of the no aldo effect can be taken care of by giving lots of IV salt-if the K is high then Florinef may also be needed.

High doses of cortisol act like aldosterone also and can cause K wasting, HTN etc. This is called Cushing's syndrome when it is caused by a pituitary tumor that makes too much ACTH which drives the adrenal to make too much cortisol.

..

This will cause my body to call on the aldosterone to keep my BP up

high enough to work out whatever the problem is. 

The problem is that you cannot make aldo with no adrenals.

The problem lies in

when the stress is caused by illness or environmental changes that

cause the body to dehydrate.  When the body dehydrates it will at

some point begin dumping potassium. 

The K will be dumped in the urine only if the blood K increases. The K can also be lost by diarrhea or vomiting as Na and K are in saliva and the stomach and the stool.

Whether through vomiting or

diareah (sp), it happens.  Without potassium then the sodium is

useless.  In my daughters and my cases of PA we were next to nothing

in the K department. 

This is the classical way the Dx of PA is made. Low K for no apparent reason.

Her meds keep it up but one good illness or day

in the sun will suck it right out.  Same here.  So how is it that the

sodium has a greater affect than the potassium on the BP. 

K is almost all inside the cell. Na is almost all outside the cell in the blood and tissue fluid.

Changes in K do not affect BP much, but Na will very rapidly.

Another point is that the amount of sodium that I must take in in the summer

is nausiating.   In addition to the Florinef which holds the

aldostrone level good for most of the year will not do it alone in

the summer.  I must supplement my diet with high doses of sodium.   I

can eat an entire jar of pickles and then add salt to the juice and

drink it in the summer and not have a problem at all with BP.   If I

am lucky it will get over 100/70.   So I personally think that for

some here that regardless of the sodium levels ingested  it will

affect their BP very little. 

The problem you describe is "right on" in the summer. You are losing more sodium in your sweat and must replace it. The problem is exactly as you describek if you try to take in enough sodium to keep in balance you will become nauseated. I some experiments we have done in give normal subjects 1200 mM of sodium a day (about 22,500 mg of sodium or about 22 teaspoons of salt a day) per day we have to give part of it by vein as they could not stomach that much salt-it was thrown up or they got diarrhea.

Many patients who are taking BP meds for high BP will not need as much during the summer and some can stop their diuretics altogether during the summer-it depend son how hot it is and the humidity.

Therefore if their is no aldosterone (or Florinef) it is not possible to take in enough salt to stay alive if the weather is hot or one is vomiting or having diarrhea.

It is an educated guess and nothing

more though based on 28 years experience living it.   PS I know that

it is more technical than that but I have tried to make it easy for

everyone to understand as it is hard enough learning about your own

disease much less somone elses.    W. 

May your pressure be low!

CE Grim, BS (Chem/Math), MS (Biochem), MD.

Professor of Medicine and Epidemiology

Board Certified in Internal Medicine, Geriatrics and Hypertension

Published over 230 research papers, chapters and reviews in the area of high blood pressure: epidemiology, history, endocrinology, genetics and physiology.

[Guest guest]

Thanks for your insightful comments and observations. I will try to answer each and outline the physiology of my responses-please ask for additional clarifications anytime.

In a message dated 12/16/03 16:04:13, tn_weldys@... writes:

Dr Grim,

Please know first that I am coming at this statement from two very

different directions.   This statement is very confusing to me because

as a former PA patient and the mother of one I understand that sodium

and aldosterone walk hand in hand.   But, as an ian, I know

daily what is like to be without aldosterone at all and to live on

the supplement Florinef.  When I go into a crisis it is from having

too little cortisol in the blood when a stressful event is happening(

illness, severe emotional stress, or some sort of accident). 

Stress normally activates ACTH production from the pituitary gland which then stimulates the adrenal to increase cortisol AND aldosterone. This modulation of cortisol and aldo goes on almost minute to minute when the brain, pituitary and adrenals glands are working normal. Aldosterone production is also controlled by the enzyme renin which comes from the kidney. The brain also can send signals to the kidney to make more or less renin. Renin acts on another large protein in the blood(made in the liver) called renin substrate or angiotensinogen (AGT). Renin cleaves a 10 amino acid polypeptide from AGT. This is called AI or angiotensin one. Another enzyme in the lungs and blood cleaves another 2 amino acid peptide from AI. This 8 unit octapeptide (8 amino acids) is called AII (angiotensin two). This is the most potent vasopressor known (makes blood vessels constrict and raises blood pressure). AII also stimulates the adrenal gland to make aldosterone (ALDO) the most potent salt and water retaining hormone in the body. The ALDO acts throughout the body: makes the kidney retain sodium and excrete potassium (K) in the urine, the sweat glands retain sodium and excrete K, and the gut to retain Na and excrete K and the salivary glands to retain sodium and excrete K.

The level of renin and aldo also varies from minute to minute and therefore regulates BP and salt and K balance.

If the body does not make ALDO then one loses sodium in the kidneys, sweat, salvia and stools and if not replaced will die in a matter of days depending on the heat and water stress of the situation and the salt intake. Death can come from very low BP (shock) or too high of a K. However, one can overcome the fall in blood pressure and high K by eating huge amounts of salt-children have been reported to eat salt by the handful when they have this problem.

Classic ian patients, who have lost all adrenal gland function (in the old days from tuberculosis,now from surgery) will also get very dark skin because the pituitary gland (which recognizes that the cortisol is too low) puts out large amounts of ACTH which can be broken down in to MT (melanocyte stimulating hormone) which makes the dark granules in all of our skin melanocytes spread out and the skin can become very dark. If cortisol is given back the skin will become lighter.

Cortisol is critical to almost all of the body's cell functions and a deficiency in this also leads to shock and heart failure and death.

Where the body normally varies the amount of cortisol aldo from minute to minute this is not possible when the adrenals are not there.

I have my patients carry a syringe that contains injectable cortisol in case the under go an injury or severe stress such as diarrhea. They must also wear a bracelet and have a card in their wallet or purse that states they have 's disease as any ER person will know the first thing you do is to give the a shot of cortisol immediately and start an IV infusion of cortisol (or cortisol like drug). Most of the no aldo effect can be taken care of by giving lots of IV salt-if the K is high then Florinef may also be needed.

High doses of cortisol act like aldosterone also and can cause K wasting, HTN etc. This is called Cushing's syndrome when it is caused by a pituitary tumor that makes too much ACTH which drives the adrenal to make too much cortisol.

..

This will cause my body to call on the aldosterone to keep my BP up

high enough to work out whatever the problem is. 

The problem is that you cannot make aldo with no adrenals.

The problem lies in

when the stress is caused by illness or environmental changes that

cause the body to dehydrate.  When the body dehydrates it will at

some point begin dumping potassium. 

The K will be dumped in the urine only if the blood K increases. The K can also be lost by diarrhea or vomiting as Na and K are in saliva and the stomach and the stool.

Whether through vomiting or

diareah (sp), it happens.  Without potassium then the sodium is

useless.  In my daughters and my cases of PA we were next to nothing

in the K department. 

This is the classical way the Dx of PA is made. Low K for no apparent reason.

Her meds keep it up but one good illness or day

in the sun will suck it right out.  Same here.  So how is it that the

sodium has a greater affect than the potassium on the BP. 

K is almost all inside the cell. Na is almost all outside the cell in the blood and tissue fluid.

Changes in K do not affect BP much, but Na will very rapidly.

Another point is that the amount of sodium that I must take in in the summer

is nausiating.   In addition to the Florinef which holds the

aldostrone level good for most of the year will not do it alone in

the summer.  I must supplement my diet with high doses of sodium.   I

can eat an entire jar of pickles and then add salt to the juice and

drink it in the summer and not have a problem at all with BP.   If I

am lucky it will get over 100/70.   So I personally think that for

some here that regardless of the sodium levels ingested  it will

affect their BP very little. 

The problem you describe is "right on" in the summer. You are losing more sodium in your sweat and must replace it. The problem is exactly as you describek if you try to take in enough sodium to keep in balance you will become nauseated. I some experiments we have done in give normal subjects 1200 mM of sodium a day (about 22,500 mg of sodium or about 22 teaspoons of salt a day) per day we have to give part of it by vein as they could not stomach that much salt-it was thrown up or they got diarrhea.

Many patients who are taking BP meds for high BP will not need as much during the summer and some can stop their diuretics altogether during the summer-it depend son how hot it is and the humidity.

Therefore if their is no aldosterone (or Florinef) it is not possible to take in enough salt to stay alive if the weather is hot or one is vomiting or having diarrhea.

It is an educated guess and nothing

more though based on 28 years experience living it.   PS I know that

it is more technical than that but I have tried to make it easy for

everyone to understand as it is hard enough learning about your own

disease much less somone elses.    W. 

May your pressure be low!

CE Grim, BS (Chem/Math), MS (Biochem), MD.

Professor of Medicine and Epidemiology

Board Certified in Internal Medicine, Geriatrics and Hypertension

Published over 230 research papers, chapters and reviews in the area of high blood pressure: epidemiology, history, endocrinology, genetics and physiology.

[Guest guest]

Dr Grim,

Please know first that I am coming at this statement from two very

different directions. This statement is very confusing to me because

as a former PA patient and the mother of one I understand that sodium

and aldosterone walk hand in hand. But, as an ian, I know

daily what is is like to be without aldosterone at all and to live on

the supplement Florinef. When I go into a crisis it is from having

too little cortisol in the blood when a stressful event is happening(

illness, severe emotional stress, or some sort of accident). This

will cause my body to to call on the aldosterone to keep my BP up

high enough to work out whatever the problem is. The problem lies in

when the stress is caused by illness or environmental changes that

cause the body to dehydrate. When the body dehydrates it will at

some point begin dumping potassium. Whether through vomiting or

diareah (sp), it happens. Without potassium then the sodium is

useless. In my daughters and my cases of PA we were next to nothing

in the K department. Her meds keep it up but one good illness or day

in the sun will suck it right out. Same here. So how is it that the

sodium has a greater affect than the potassium on the BP. Another

point is that the amount of sodium that I must take in in the summer

is nausiating. In addition to the Florinef which holds the

aldostrone level good for most of the year will not do it alone in

the summer. I must supplement my diet with high doses of sodium. I

can eat an entire jar of pickles and then add salt to the juice and

drink it in the summer and not have a problem at all with BP. If I

am lucky it will get over 100/70. So I personally think that for

some here that regardless of the sodium levels ingested it will

affect their BP very little. It is an educated guess and nothing

more though based on 28 years experience living it. PS I know that

it is more technical than that but I have tried to make it easy for

everyone to understand as it is hard enough learning about your own

disease much less somone elses. W.

> Yes, when you have not aldosterone then the kidney has a problem

getting rid

> of K. By increasing diet sodium you provide more Na in the distal

tubule

> (the end of the tiny structure that forms urine-it starts at the

glomerulus)

> where Na is reabsorbed at the last area before urine moves into the

upper part of

> the urinary collection system. This is where aldo does most of

its work-the

> distal tubule.

>

> I have agreat powerpoint lecture on this but dont know how to put

in on your

> site if you would like to review it first.

>

>

>

>

> May your pressure be low!

>

> CE Grim, BS (Chem/Math), MS (Biochem), MD.

> Professor of Medicine and Epidemiology

> Board Certified in Internal Medicine, Geriatrics and Hypertension

> Published over 230 research papers, chapters and reviews in the

area of high

> blood pressure: epidemiology, history, endocrinology, genetics and

physiology.

[Guest guest]

Dr Grim,

Please know first that I am coming at this statement from two very

different directions. This statement is very confusing to me because

as a former PA patient and the mother of one I understand that sodium

and aldosterone walk hand in hand. But, as an ian, I know

daily what is is like to be without aldosterone at all and to live on

the supplement Florinef. When I go into a crisis it is from having

too little cortisol in the blood when a stressful event is happening(

illness, severe emotional stress, or some sort of accident). This

will cause my body to to call on the aldosterone to keep my BP up

high enough to work out whatever the problem is. The problem lies in

when the stress is caused by illness or environmental changes that

cause the body to dehydrate. When the body dehydrates it will at

some point begin dumping potassium. Whether through vomiting or

diareah (sp), it happens. Without potassium then the sodium is

useless. In my daughters and my cases of PA we were next to nothing

in the K department. Her meds keep it up but one good illness or day

in the sun will suck it right out. Same here. So how is it that the

sodium has a greater affect than the potassium on the BP. Another

point is that the amount of sodium that I must take in in the summer

is nausiating. In addition to the Florinef which holds the

aldostrone level good for most of the year will not do it alone in

the summer. I must supplement my diet with high doses of sodium. I

can eat an entire jar of pickles and then add salt to the juice and

drink it in the summer and not have a problem at all with BP. If I

am lucky it will get over 100/70. So I personally think that for

some here that regardless of the sodium levels ingested it will

affect their BP very little. It is an educated guess and nothing

more though based on 28 years experience living it. PS I know that

it is more technical than that but I have tried to make it easy for

everyone to understand as it is hard enough learning about your own

disease much less somone elses. W.

> Yes, when you have not aldosterone then the kidney has a problem

getting rid

> of K. By increasing diet sodium you provide more Na in the distal

tubule

> (the end of the tiny structure that forms urine-it starts at the

glomerulus)

> where Na is reabsorbed at the last area before urine moves into the

upper part of

> the urinary collection system. This is where aldo does most of

its work-the

> distal tubule.

>

> I have agreat powerpoint lecture on this but dont know how to put

in on your

> site if you would like to review it first.

>

>

>

>

> May your pressure be low!

>

> CE Grim, BS (Chem/Math), MS (Biochem), MD.

> Professor of Medicine and Epidemiology

> Board Certified in Internal Medicine, Geriatrics and Hypertension

> Published over 230 research papers, chapters and reviews in the

area of high

> blood pressure: epidemiology, history, endocrinology, genetics and

physiology.