Hyperaldosteronism?

[PeggyS512]

I went to mt Endo today to follow up on blood work she did because of episodes of high blood pressure
plus headaches, fatigue, numbness, thirst . . .

I sat for 10 minutes before sitting blood draw.
Aldosterone, serum   14.1  ng/dL
Renin Activity            0.4  ngmLhr
Vitamin D, 25 OH      28.4  ng/mL  (range 30 - 60)

previous results from blood work earlier this year:
Potassium     3.3   3.7   3.7   4.1   meq/L  (range 3.5 - 5.3)

She said that if Renin were non-existant and Aldosterone over 15, she would do further testing. Since I already take Vit. D supplements, she recommended more sunshine.

I have seen several references to the Aldosterone/PRA Ratio (she did not mention this). Mine would be 35.25.  ARUP Lab says "greater than 25 is suggestive of hyperaldosteronism" and Quest says >18.2 is Primary Hyperaldosteronism.

Any advice?

[PeggyS512]

My blood pressure is not always elevated, but when it is it lasts for a few days.
Maybe we should re-check then?

ACTH is ok.

I hope Dr Lupo responds . . .

Thank you,
P

[estrelinha]

I think he is waiting to see if aldosterone gets higher then 15, then he probablyl request further tests....,  I've noticed you have asked Dr. Lupo, just wait for he's advice (I'll be waiting too), sometimes we think a value is high but for doctors  that value isn't high enough for a diagnosis  or aren't high enought to justify further analyses ( that sometimes are invasive). About cortisol, have you tested for ACTH?

[PeggyS512]

So with an Aldosterone/PRA ratio of 35.5 and Aldosterone of 14.1,
is there a possible adrenal problem? My Endo is not planning any further testing.

My Cortisol is slightly high and Autonomic Nervous System tests areslightly abnormal.

[estrelinha]

So you did all the tests, about the Aldosterone/PRA Ratio , she didn't mention but she did, an Aldosterone/PRA Ratio over 30 with ALDOSTERONE  higher then 15 ng/dL is suggestive of primary hyperaldosteronism. Further tests are required if aldosterone gets higher then 15. Those further tests include a non suppression of plasmatic aldosterone after administration of 500 mL/ h of fisiologic serum x 4 hours, and other tests (that doctors inject something). After those tests  (if suggestive )they will ask for  a high resolution CT scan for the suprarenal glands.

[PeggyS512]

Calcium  8.8,  9.1  9.5  (8.5 - 10.1)
urine nd plasma catecholamines are low
plasmafree metanephrinesare ok
no diuretics
TSH        .7,   1.3
T3 free    2.7    --
T4 free   .94,   .99
Thyroid has multiple hurthle cell adenomas (benign)

[estrelinha]

Have you also tested for calcium? and the presence of cathecolamines in urine?, do you take diuretics? How is your thyroid? (TSH)?