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Post by mookie333 on Jan 8, 2009 11:22:24 GMT -5
ok...I finally got the rest of my labs from above date ....due to send-outs
t3-151-(97-219) free t3- 423-(220-440) aldosterone-2.0---less than 28 renin--above is 4.0 sodium 137 (135-145) potassium-3.5 (3.5-5.1)
What do you make of this? Now cut down on my armour to 2 grains. Mookie---thank you!
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Post by mookie333 on Jan 11, 2009 16:34:51 GMT -5
lethal -I have been on now 4ooo units of vit D. Calcium 1 gm., mag 500mg, sea-salt 3x a day generously putting 1/4 tsp in water, and started testosterone cream for my low levels, and dhea is the same 5mg,. b12 as well. Potassium 40 mEq per day..thanks and I sent you a pm about it. Im scared because I went into crisis yesterday. It was not very serious...but scares me because I tink it's related to my low sodium levels...my HC is up to 35mg . armour 2 grains and I think I need florinef....which I can get if I need it....and have read the stickey already.
Thank you so very much. Mookie
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Post by Lethal Lee on Jan 11, 2009 22:04:39 GMT -5
Hi Mookie,
I'm sorry to hear you have been feeling badly.
Not surprised with those Aldo Renin Sodium & Potassium results though.
Sorting them out is #1 priority for sure.
Please clarify for me what type of Potassium are you taking? Is is RX slow release? How much is in each tablet? I'm not familiar with mEQ only mg. Do you know how much 40mEQ is in mg?
Please also advise how you are dosing the Potassium ..how much & when?
Also advise waht current BP & HR at rest & standing is.
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Post by mookie333 on Jan 12, 2009 20:07:09 GMT -5
Lethal------40 meq is equal to 1560 milligrams of potassium..hr standing is 88 ....hr resting is 70 blood pressure is not known now, but I can check it at work tomorrow or at the pharmacy, I usually run low but during crisis...I become hypertensive and tachycardic. My temps are all over the place and I've had times that I was 98.0 on a temp and during a crisis checked my temp by mouth and it shoots up to 99.
I've been urinating a lot and it's even been kinda cloudy lately at times. I wonder if it's from all the supplements I take. I get mild headaches when I get low and I've had a nagging ache in my left lower back.
I don't know what I should do....my Hc is today 37.5mg...I'm worried that it's getting too high and it wears off so fast for me lately....what should I do? Mookie
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Post by mookie333 on Jan 12, 2009 20:55:18 GMT -5
OOps I take the dose of potassium 2 x a day split in half for a total of 1560mg.
I was sent to the er once about 4 ys ago when I went into a bad crisis and had a potassium of 2.8
I do the sea salt 2 to 3x a day 1/4 tsp. Mookie
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Post by chemom on Jan 12, 2009 21:58:08 GMT -5
Mookie, I knew Lee would be able to help you. Once you get on a good dose of Florinef, you'll feel better. You may be one of those folks that does better on Medrol than on HC, but I'd wait to decide about that until you get on Florinef. Be sure to start slow with it, only 1/4 pill for 5-7 days, then add another 1/4 and on you go. My aldosterone was 2.6 and once I got on Florinef, I felt better - I could actually sleep most of the night without getting up to got the bathroom every hour, and I stopped sweating so much too. Also, my potassium was 3.6 when I started, I take about 3000 mg. of slow release potassium every day.
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Post by Lethal Lee on Jan 13, 2009 3:57:17 GMT -5
Hi Mookie,
I agree you definitely need Florinef however you first need to get that Potassium up. I assume the Potassium you are on IS RX SLOW RELEASE Potassium? If not I strongly suggest you get some.
Assuming it is Slow Release RX Potassium each tablet is 20mEQ which you say is ~ 780mg and you are taking 1 tab 2 times a day for total 1560mg??? It is concerning that your levels test at 3.5 despite this I agree. When my levels were 3.4 I needed 1200mg RX SR Potassium to bring up to 4.2-4.3. That was before Florinef. After 1 1/2 tabs Florinef I needed 3000mg POtassium to maintain same levels. When I increase Florinef like I did recently to 2 tabs due to extreme heat wave here I have to increase POtassium even more 3600-4000mg.
For your particular situation I think FIRST increase the RX Potassium. I am going to suggest DOUBLING what you currently take say 2 tabs in am & 2 tabs pm~12 hours later . Maybe even 1 tab in the middle of that about 6 hours after am dose. So that would be 4-5 tabs a total of 3124-3900mg.
I do twice daily usually but maybe three times a day would be better for you to get levels up & keep them reasonly stable. The reason I say start Potassium first is Florinef WILL lower Potassium very quickly and with your current levels & symptoms you cant afford to let that happen.
At the same time keep up fluid intake & 3 x 1/4 teasp Sea Salt supping. Up to 2 teaspoons spread over the day if you can tolerate it is OK to relieve/help symptoms.
See what one week of above does then retest Sodium & Potassium. Hopefully levels of Potassium will be at least above 4. At that point I would then start on the Florinef. I would start 1/4 tab in am & increase by 1/4 tab every few days. Usually every 5-7 days interval between doses but you may be better with every 3-5 days. As the electrolytes alter body fluid levels a lot of changes happen in the body & it can cause uncomfortable symptoms if you move too quick. So be guided there by how you feel.
Once you reach 1 tab Florinef all in am pause & assess how you are feeling, how symptoms have changed. If you are left with some low Aldo/Sodium related symptoms perhaps symptoms returning later in the day/evening you may need to add in a second dose. But only add in 1/4 tab at a time as before. I need a 1 tab am & 1/2 tab pm dose 12 hours later. In Summer I up my pm dose by another 1/4-1/2 tab (and adjust up Potassium by another 600-1200mg).
Note some people feel benefits with Florinef immediately but others need to get up to around 1 tab to feel benefits. It is still not a good idea to rush the increases regardless.
While you are titrating up your Florinef dose you need to be especially vigilant for return or worsening of any low Potassium symptoms. For me that was severe muscle cramping. Immediatly any sign of that INCREASE the RX Potassium dosing.
Sea Salt supping should be reduced as Flronef is introduced. It should NOT be stopped altogether as Florinef works best with SOME Salt supping. Basic supping of 1/4 to 1/2 teasp twice a day is usually enough. With a little more as required when weather heats up & sweating is increased (also if exercising or doing physical work etc).
In any case I would strongly recommend electrolytes be retested after starting Florinef. Dont leave it more than 2 weeks after starting. Check Sodium & Potassium levels carefully make sure Potassium is at least over 4. I need 3000mg Potassium to keep levels at 4.2-4.3 when on 1 1/2 tabs Florinef. When on 1 3/4 tabs I need 3600 mg Potassium. You need to find what Potassium dosing works for you to maintain at least mid levels in blood testing & relieves/prevents any symptoms.
Chris & some Adrenal competant Docs think that Potassium is optimal ~5 however as I said above I'm relatively happy with my Sodium at 145 & Potassium at 4.2-4.3 as I seem to be symptom free.
So from your DH/Doc you need
1) RX Potassium 2) RX Florinef 3) Lab orders for electrolytes to be tested at least twice - one week into increased dosing of RX Potassium - two weeks after on BOTH Florinef & Potassium.
In fact you may need/want to test the electrolytes a few more times to sort out dosing/symptoms & levels. I did this every couple of weeks the first couple of months on Florinef till I was stable & symptom free.
Put that to DH see if he is happy with that or something close to that.
Hopefully that will see the electrolytes under control & low Aldo/Sodium resolved.
Then at that point you can look to other priorities such as steroid dosing, timing, whether stick with HC or try Medrol. I think trying to do that at the same time as fixing Sodium & Potassium may be too much to try & monitor. You may well find dealing with the electrolytes will greatly reduce body stress & Cortisol HRT requirements too.
I am heading off on holiday & wont be around for ~10 days. Please post if you have any problems Chris or one of the other mods will be able to help I'm sure.
I am hoping too that you may not need super high doses of Potassium after Sodium is sorted with Florinef. It may be body is spilling Potassium in order to balance the low Sodium. In any case make sure that you first raise Potassium & test that has happened. Then introduce the Florinef. Florinef can lowers Potassium very quickly so just adding Florinef could cause you a lot of grief.
Always test early am fasting before taking any meds & supps. No need to Salt fast previous day or anything just wait until after am test before taking Salt & florinef that day.
You may also want to consider supping Magnesium if you arent already doing that. I have read that low Magnesium may make optimising Potassium difficult & as many Hypot folk are suboptimal for Mag its a good idea anyway. Dont go overboard with it 500-800mg daily is enough. Find a good bioavailable form too.
If you have a BP monitor at home that can help monitor how things are going. When Potassium/Sodium is optimal & balanced BP will rise consisitently from sitting to standing. It will also regularise/normalise BP. Those with low BP it will increase while those with high BP will decrease. Will also reduce fast heart beat & palps.
I hope this works for you.
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Post by mookie333 on Jan 13, 2009 8:10:19 GMT -5
thank you, thank you, thank you!!!
For being so sweet and answering my questions...and spelling it out for me. I needed that bad. My plan will be to bump up the potassium like you said for the week and salt and then I will test the electrolytes. After that I will add the florinef as you suggested 1/4 tab working my way up to what you suggested....then retest.
I suspect I may need medrol down the road but I will follow these steps first and then let you know in a couple weeks what's going on with my labs.
I'm hoping that I'll feel better...and I could never do this without the help of you guys......I really appreciate you! By theway I am on 500mg mag per day 1000 of calcium, and 4000 mg vit d.
we'll see what happens...have a wonderful vacation. Mookie
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