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What is Aldosteronism?

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  • Written By: Sara Schmidt
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  • Last Modified Date: 31 October 2016
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Aldosterone is a vital hormone produced by the adrenal glands. It provides balance for the body's levels of potassium and sodium. If the levels of aldosterone become unbalanced, a disease known as aldosteronism can result.

Primary aldosteronism is the condition in which the adrenal glands create too much of the hormone. This is often caused by a tumor within the gland, also known as Conn's syndrome. Such tumors are normally benign. Bilateral adrenal hyperplasia, a disorder in which both adrenal glands produce too much aldosterone, may also cause primary aldosteronism. The cause of this disorder is unknown.

Secondary aldosteronism results when elevated aldosterone is caused by something other than the adrenal glands. These causes could be attributed to liver failure, dehydration, congestive heart failure, or kidney disease. Some medications could also be responsible, such as fludrocortisone or diuretic drugs.

The occurrence of aldosteronism has become more and more common, and is thought to be the cause of high blood pressure and aldosterone hypertension in many patients. Results can include the loss of potassium as well as the retention of sodium. When this occurs, the body begins to retain water, ensuing both high blood volume and high blood pressure.

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Symptoms of the condition include high blood pressure, nausea, weakness, frequent urination, muscle spasms, cramping, and constipation. It is also possible for a patient to have no symptoms. A diagnosis can be made by measuring the aldosterone levels within the blood and the urine. To determine which type of aldosteronism is present, a plasma renin activity test may also be conducted. If the primary condition is present, an endocrinologist will be needed for further analysis and treatment planning.

If left untreated, several complications can occur. Patients can be susceptible to heart failure and heart attacks. Left ventricular hypertrophy, or an enlargement of part of the heart, can occur, as well as kidney disease or failure. Hypertension caused by excess aldosterone can result in heart disease or stroke later in life. Arrhythmias, though rare, can also develop, as well as paralysis, respiratory failure, and death.

To treat aldosteronism, a physician may prescribe a medication. Lifestyle modifications, such as weight loss and a cessation of smoking, may be needed. In severe cases, such as when Conn's syndrome proves to be malignant, a patient may require surgery. If the cause of the condition is discovered to be bilateral adrenal hyperplasia, the adrenal glands may be removed if medication does not provide relief.

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anon939581
Post 4

@Burcinc: To see if you are a candidate for surgery, you would need to do a test called adrenal vein sampling (AVS). It's a fairly complicated test done at a hospital to determine if the excess aldosterone is coming from just one adrenal gland. If so, you may be cured by surgical removal of that adrenal gland. Normally a CT scan spots a growth on one of the adrenals before that test is done (although not necessarily).

In general, treatment should include a low salt high potassium diet, and medication to block the excess aldosterone such as spironolactone or eplerenone.

burcinc
Post 3

@anamur-- I also have primary hyperaldosteronism. I've had high blood pressure since my mid-30s and continue to take medications for it. I have been feeling a lot more fatigue over the last couple of years though which makes me want to get to the root of the problem.

I know my high blood pressure is due to too much adrenal hormones. When I had the primary aldosteronism diagnosis, I was checked for any tumors and the doctors didn't find anything. I also don't have any of the other potential causes like liver or kidney failure, thankfully.

I'm at a loss about what to do though. I don't mind taking high blood pressure medications but I do feel that my condition is getting worse over time which makes me think that there's something else going on. Is anyone else in a similar situation?

burcidi
Post 2

@anamur-- I believe that's normal because there is a phenomenon called "sodium escape" during primary hyperaldosteronism. What this means is that the sodium escapes and leaves the body through urination.

The reason for edema in secondary hyperaldosteronism is that sodium escape does not take place. Sodium builds up in the body and sodium binds water and causes water retention. You could say that where the sodium goes, that's where the water goes. The water leaves the body along with the sodium in primary hyperaldosteronism and that is why edema doesn't take place. So please don't worry about a misdiagnosis based on this.

serenesurface
Post 1

I was diagnosed with primary hyperaldosteronism recently. I'm trying to understand this condition and its symptoms better and my doctor didn't have much time to explain to me the details of what happens.

I read that water retention or edema is a common side effect of hyperaldosteronism. But I've never had this side effect which makes me wonder if I have been misdiagnosed if there is something out of the ordinary in my condition.

Can anyone enlighten me about this?

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