Cause of high blood pressure and other symptoms?

[maraclara214]

30 years old/female

Hello everyone.

- Out of no where 2017 began having critically low potassium, chest pain, panic attacks, weakness, extreme high blood pressure, nightmares, diverticulitis. all of this came on suddenly and hasn't stopped/ braig fog/ unable to handle stress,mild LVH, weakness, . i had none of these symptoms prior to June 2018 besides feeling weak and restless.
- normal suppression test for cushings, conns and pheo ruled out.

results so far
renin .51
aldosterone 26
aldosterone/renin ratio 47.2
Endoscopy performed twice 3x found 1.5 cm benign Stromal Tumor
Cat Scan: Abdomen - subcentimeter adenoma which could be functioning or nonfunctional
Mild Right kidney enlargement suspected not determined
Stress test: Normal
MRI of Heart: Mild LVH and septum thickness

I am seeing an endocrinologist not sure where to go from here any thoughts or suggestions? could this be caused by a tumor? hyperaldosteronism?

[tacolino]

Hi there. I note from scan it says adenama. Is this on one of  the Adrenal glands? It may be early to rule out Conns? Given that the gold standard test for this is Adrenal vein sample tests. Both veins must be done at the same time. It is a tricky test to perform, and many medics dont like doing it. Research has found 15% of High BP can be caused by Adrenal Adenomatas?? You dont say what meds you are taking? If any? Also if the meds are successful at lowering the BP. Its noteworthy that Adrenal causes are hard to treat with standard BP meds. They tend not to lower BP very successfully. There is a me called Aldactone, this is shown to be successful at lowering BP in this instance. You should look at Kings college London website. Prof Morris Brown and Prof John Kennedy Cruickshank are experts in the field. From your description above, you definitely need to look at their extensive work on line. do let us know how you get on?

[specialmom]

Hi.  Sounds like it has been a roller coaster. That's hard.   I would have guessed a cardiologist as the specialty to be helpful here but am guessing you see the endocrinologist for the sodium/renin issue?.  How are you being monitored for cardiac issues?  A cardiologist may also be helpful. Do they have a handle on your blood pressure? What is it normally read?  If you are unsure, get a home bp cuff and just take your bp two or three times a day max and write down the numbers.  Important to put your feet flat on the floor, relax, visualize something calming to you, have your arm resting heart level.  You will have different readings each time.  You'll get a general feel after a month or so of what is your 'normal'.  My doctor has had me do this to understand if I have hypertension that needs treated or not.  

Since you wrote on the hypertension forum, I bring that up first.  You want to rule out heart issues that need to be treated.  Are you on any medications or have anything that has been officially diagnosed as a chronic issue?  

I see some anxiety and mention of panic as well.  That feels so terrible.  I feel for you if you have those symptoms!  And it mimics other things.  So, it all then makes you just that much more nervous and anxious and panicky.  Always important to address mental health.  Psychologists, doctors are pretty good at this although I have found sometimes you have to search a bit to get the right match for you in terms of who is really helpful.  I don't like a lot of fluff.  I wouldn't be good with a counselor that used a lot of meaningless words, for example.  Others may respond best to that.  And obviously some might be better at their job than others.  So, interviewing someone before you start with them helps speed up the evaluation process.  And the biggest advice I give to people going to the counselor is to let go of that fear of what people will think of you and go deep with honesty.  Don't try to please them for fear they will think bad of you.  That derails real therapy.  Anyway, just throwing that out there if this is something that you haven't done in your lifetime.  

In looking at some of the other numbers.
Renin is sodium?  And that is still low?  Got it. THIS is why you are going to an endocrinologist.  Your adrenal glands are dysfunctional?  https://www.webmd.com/hypertension-high-blood-pressure/renin-test     That link talks about this test and tells the ins and outs of it.  Here is an article on hypertension caused by low renin.  
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3475896/  

This article has all of the reasons for why someone has low renin that could be possibilities for you.  Understanding that aspect will then give you the treatment guidelines.  https://onlinelibrary.wiley.com/doi/full/10.1111/j.1365-2265.2007.02898.x

What does your endocrinologist think the reason is for your low sodium?

Your aldosterone seems normal. But I'm not sure about that.  It wouldn't make sense if it were since it takes sodium levels into account and your sodium is low.

When do you meet with your endo to discuss this?