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Post by snowgirl on Nov 25, 2008 16:22:48 GMT -5
In our last installment over on the yahoo boards, I was trying to determine whether or not I need florinef. I found a new doc and got my aldo retested:
Salt fasting, upright, day 6 of cycle, 8:30 AM:
Aldosterone 8 range <28 Renin 4 range .65-5 Sodium 140 range 135-146 Potassium 3.5 range 3.5-5.3
I'm currently on 27.5 HC, 1 grain armour, 2 mg testosterone. Since starting HC, the frequent urination (my only low aldo symptom) has improved measurably, so I seem to be getting some mineralcorticoid benefit from that. But my pulse has gone from around 78 to as high as 94 , and my new doc thinks that's because I'm on too much thyroid and doesn't want me to raise any further.
From what I've read here, it seems that the high pulse is due to low aldo and I would benefit from florinef. I'd appreciate any specific information I can use to explain the pulse/aldo relationship to my doc and how florinef would benefit me. Also any comments on how renin plays into that, since he seems more focues on that than on aldo.
Thanks so much.
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Post by Chris Jackson on Nov 26, 2008 14:34:22 GMT -5
Range for renin should be 3-24, so yours is very low. Your potassium matches real well with low renin and low acth. I guess your ACTH and stim showed secondary? You may need florinef, but first try this test, take pulse, drink salt water, take pulse 10,20,30,40 minutes later to see if your pulse will lower. If so then you are likely right. If your steroid is what you really need instead of medrol, then your Armour shouldn't raise your pulse like that. If you really need medrol (see my sticky on when you should switch to medrol), then it could. Read and print this sticky www.geocities.com/chrisgj@sbcglobal.net/My_explanation_renin_angiotensin_aldosterone_system_affect_blood_pressure_thoughts_hypothyroidisms_effect.htmlExplains it's connection to pulse and bp. You're welcome, Chris
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Post by snowgirl on Nov 26, 2008 17:15:46 GMT -5
Thanks for the reply, Chris.
Yes, I am secondary:
7/23 ACTH Stim test Baseline 13.7 30 min 21.4 range 3.1-22.4 60 min 26.2 range 3.1-22.4 Plasma ACTH 13 range 6-48
These were my results for the pulse test:
Starting: 92 10 min 82 20 min 88 30 min 92 40 min 90
I've found being on plain old HC to be miraculous, and I seem to be doing well at 27.5 mg. I do tend to crash around 8 pm, but I'm fine throughout the day, so it hadn't occured to me that I might need medrol. I didn't see anything in your sticky on when to switch that seemed to apply to the heart rate issue, so I'm a little confused about that.
Is there something I've said that makes you think I should give medrol a try first, or with those pulse test and aldo/renin results, should I be thinking about florinef?
Thanks again for all your help (& Happy Thanksgiving!)
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Post by Chris Jackson on Nov 27, 2008 19:49:25 GMT -5
The pulse test suggests that you do have low aldosterone, that salt and water go right through you. Since you are up on the HC, you could try the florinef, you might get glucocorticoid from it (for most people stays locked up). If you don't then you probably will have to be tried on Medrol.
You're welcome, it's 7 pm Happy Thanksgiving.
Chris
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Post by snowgirl on Nov 28, 2008 10:21:16 GMT -5
Sorry, Chris, I've managed to get confused here. I thought Florinef was for low aldo symptoms, and medrol was for people who HC doesn't last long enough for. Since the latter isn't an issue for me, I don't understand why you think I might need medrol. Is there some relationship between racing pulse and insufficient HC I'm missing?
Thanks again.
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Post by Chris Jackson on Dec 1, 2008 13:17:01 GMT -5
I'm going by you crashing at 8 pm. I was saying that if you decided HC wasn't strong enough, since you are up on the dose already, adding florinef small chance of getting glucorticoid potency from it (stays locked up for most people) which that might get you more cortisol to get you going beyond 8 pm. 1 in 20 get some gluco from florinef, 1 in 100 people or less get the full benefit of equivlent of 10 mg HC from 100 mcg florinef.
I never recommend medrol unless 30 mg hc has been tried.
You're welcome, Chris
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Post by snowgirl on Dec 1, 2008 14:16:41 GMT -5
Okay. Thanks for the clarification.
Do you have any tips for what to watch out for to see if I am getting any gluco from florinef? I know you said being on too much HC can sneak up on you, so any suggestions would be appreciated.
Would I just notice more energy? Or would there be something else that would indicate a gluco potency effect from florinef?
Thanks again.
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Post by Chris Jackson on Dec 3, 2008 19:23:08 GMT -5
if remaining AI symptoms get better or disappear. You may get increase in energy. The problem with florinef is there is no way to know you will be the one to get hit hard with it's glucocorticoid. Most end up figuring it only after Cushing's symptoms pop up. I estimate 1 in 20 get a minor amount of cortisol from florinef, maybe 1 in 100 get hit with the full potency where 100 mcg of florinef can replace 10 mg HC or 2 mg medrol.
You're welcome, Chris
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