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High blood cortisol, high urine creatinine, high blood aldosterone
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High blood cortisol, high urine creatinine, high blood aldosterone

Hi, I'm a 31 y.o. F. and have been dealing with what seems to be a medical mystery that doctors haven’t been able to figure out. Long story, but here is some  history:

Heart issues since age 24. Have high resting heart rate of over 100. Experiencing series of skipped beats. Had holter monitor at 24 and stress test. Recently did another holter monitor, ave. heartrate over 24 hours was 98. Found PVCs on the recording. Otherwise normal rhythm, just fast. Did ulrasound of heart, normal. Now heart symptoms at worst. Just standing makes heart go up 20-35 beats. Walk up stairs goes up to 140-150. Was an athlete as a teenager, so this is not how I used to be. These symptoms are all worse if I drink alcohol. Now can’t tolerate alcohol, I used to be able to. Age 24 noticed I peed too frequently, saw urologist. Can’t remember what came of it. Had a bladder infection in the past. Did ultrasound of bladder, came back normal. Sleeping problems as long as I can remember, still to this day. Have trouble falling asleep and don’t feel rested. Saw neurologist for suspected POTS. Did tilt table test and sweat and blood pressure test. Had positive tilt table test (i.e. heart rate went up 30-40 beats from supine to elevated) but was negative for an autonomic failure. Recently did ambulatory blood pressure test,normal. Recently did 24 hour urine test. Normal results for catecholamines. However had high urine creatinine levels (don’t have exact levels). Recently did some blood work. Results came back as high random cortisol (581 nmol/L), high aldosterone (1017 pmol/L). Renin was normal (1.10 ng/L/S). Everything else was normal (blood creatinine, glucose,B12, iron, sodium (140) potassium (3.8), ALT,sTSH,T4 free, Free T3, Hemoglobin, Hematocrit,RBC, RDW, WBC.

Any ideas on what could be going on? This is really affecting my life. I’m seeing an internist and he wants to put me on Atenolol. I’d really like to get to the bottom of this, not sure where to turn to next?
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Dear friend,

I read your history and other reports - there seem to be some cardiac changes starting to appear. First of all stop your alcohol. High creatinine shows changes in the heart, You should understand that once these changes happen in the heart it may mean that they are permanent. PVCs on recording show arrythmias - for that you probably have to consider medications.  I can suggest you talk to your doctor about beta blockers, antiarrythmic drugs, statins and also getting your lipid profile done, also.

Consult your cardiologist ,

Thanks
Jyoti.
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