Confused about aldosterone levels, edema

Hi everyone
I have been diagnosed with hashi's and I also recently took an adrenal stimulation test and was diagnosed with adrenal fatigue. I am currently taking 2 grains of nature-throid and my doc just started me on a low dose of cortef.
My confusion is regarding the adlesterone numbers on my test. Before the stimulation, my aldesterone level was 43.9, which is really high. After the stimulation the number went down (?) to 28. I was told to drink saltwater, and when I did I had sever edema and felt very shaky.
Facial edema is a huge problem for me and now I am wondering if the high aldosterone is the reason for this. However, my blood pressure is low normal, and everything else on my adrenal panel is low (cortisol, dhea, etc)
Should I keep taking salt water and hope that the edema will go down and the aldesterone levels will lower? Or is there something else I should do to lower the aldesterone level?
Thankyou

[Awatson13]

Do you have Addison's?

[Liz118]

Hi Awatson
No, my doc assured me that I don't have addison's, but I do have adrenal fatigue. Is this aldesteerone thing an indication of addisons?

[estrelinha]

Have you tested for your sodium, potassium and renin levels?,

[Awatson13]

If you have low Sodium and high Potassium that would be very indicative of Addison's....Addison's effects the adrenals by decreasing the release of Cortisol...which regulates blood sugar levels and aldosterone is effected because Addison's decreases the release of mineralcorticoids which regulates sodium reabsorption and potassium excretion through urine, but with Addison's you lose alot of sodium and gain alot of potassium. Aldosterone also helps drive-up your blood pressure. High aldosterone levels, indicates too much of the hormone being released leading to high Blood pressure. I did read something about Conn Syndrome but your blood pressure would be high. Definitly check into a Renin test...that will help diagnose Conn Syndrome or secondary hyperaldosteronism. Both levels high indicates secondary. While, aldosterone high and renin low means Conn's. Goodluck!

[Liz118]

Hi estralhina
I have had my sodium and potassium levels done which were normal, but I don't think I have had my renin levels. Should I get that test even though I have normal sodium and potassium?
Thanks

[Liz118]

Thanks Awatson
I wonder if the cortef I am taking will help with this problem. I don't feel too good on it, though, I must say..

[Awatson13]

I don't know about the Cortef, but I would get the renin levels checked just in case.

[estrelinha]

Edema usually is present in secondary aldosteronism, that means  the aldosterone can be high, sodium normal/low (water retention), potassium low/normal and aldosterone and renin activity increased. In this patients hypovolemia stimulates the renin-angiotensin mechanisms resulting in high aldosterone....the blood pressure can be normal or increased.

Primary aldosteronism (Conn's) is what awatson told you ..., and usually there is mild to moderate hypertension. But it isn't normal to have edema unless there is a renal problem or cardiac congestion. Here you usually have normal (early disease) to low potassium in serum because of urinary  potassium loss.

For a good study :
You should test for cortisol 60 minutes after ACTH administration and measure aldosterone in the same samples (for addison), renin plasmatic activity, sodium and, potassium levels in plasma.

In addisson lab results can be normal or you can have low sodium, low chloride and high serum potassium, elevated BUN and plasma renin is increased . Usually there is hyperpigmentation.(but I'm sure you doctor figure out all this lab values, symptoms and signs).

[Liz118]

Thanks so much for the information!
My last blood test had these levels:

sodium 140  (ranges 135-146 mmol/L)

potassium 4.4 (3.5-5.3 mmol/L)

On this test  the Bun/Creat levels and ratio were "normal" so the levels were not shown.
However on a previous blood test, Bun/Creat ratio was 6.7 (low)

In the acth 24 hour urine stim the pre stim aldesterone level was 43.9, post was 28.8 (44 is highest on the range, and the test said it incidcates a low salt diet)
I can't seem to find a renin number on either my blood or urine acth stim analysis

So I guess none of these things points to addison's, right?

I still don't get why the aldesterone level is high.

Thanks for the info!!!

[estrelinha]

I would repeat the aldosterone, sodium , potassium and the renin activity test, without this last one is difficult to see what is going on. I think you have secondary aldosteronism, you could also test for your potassium levels in a 24 hour urine.

[Liz118]

Thanks Estrelinha,
I will suggest this to my doc. Secondary aldosteronism. Sigh. I will add to my list...LOL

[sick and tired 47]

Hi ! Just wanted to tell you  I have had high aldosterone levels.. mine were 24-26 when top of range was 21. I went thru lots of tests, including seeing a renal specialists... nothing was ever found. I have low BP, hypothryoidism, SVT. My potassium and magnesium were slightly low...everything else normal.  I had these tests when I was on low dose of cortef...  maybe there is a relationship... I am off cortef and still slightly elevated levels but nothing was ever found... and I had a lot of testing done. Good luck and let me know if they ever discover the relationship.. would love to know

[Liz118]

Hi Sick and Tired
Your situation sounds a lot like mine. Strange. Do you have a problem with retaining too much water, or with puffy eyes/face, like me?
It is really strange because everything else in my adrenal seems to be low. I just started taking cortef but I took the test before that. I will let you know what I find out
Thanks

[estrelinha]

When you started cortef you already had the edema? hydrocortisone can give low potassium and sodium retention, hyperglicemia etc. your potassium and sodium levels look normal, just discuss all these with your doctor, I'm sure he knows what he is doing.

In secondary hyperaldosteronism, the excess aldosterone is caused by something outside the adrenal gland that mimics the primary condition it can occur as a result of anything that decreases blood flow to the kidneys, decreases blood pressure, or lowers sodium levels. Only thing missing is the plasma renin activity (when you test that you should repeat again the other analyses). Good luck

[sick and tired 47]

liz118,
Hi!  I notice sometimes in the morning when I awake I have puffy eyes, face, but it quickly goes away... no other edema at all.
  I know I had the renin test... I have had every test there is... just no answers. Maybe I am just unusual... a freak of sorts... I don't worry anymore. I need to get this hypothyroid /heart tachycarida issue under control first.

[Memenne]

Hi,  how should i be tested for adrenal tumors, i am taking spironolactone
50mg daily, have high blood pressure, normal weigh, exercise 5 days a
week. I feel so nervous and anxious unable to relax. Please help?
Armelle.

[Waterbegone]

Hi, did you all find out what's causing hyperaldosterone ? Did u have it tested during your period? I. Had mine down mid cycle and it was 50! What type of dr do u c for this? Ihave gained 20 lbs fluid! I'm on Dexedrine for idiopathic edema not it's not working!
Any ideas?
Pot is 4.0 sodium 141

[Waterbegone]

Also by bp low but pulse high

[Barb135]

We haven't seen estrelinha on the forum for quite some time, so it's unlikely she will respond.  

Since this is a very old post, your situation would get more attention if you start your own post, listing your issues, blood tests, etc.  Do you also have hypothyroidism?  You might also get some answers on the adrenal forum.

[drmom5]

All my life, my adrenals and kidneys have been repeatedly tested.  (Poor response to stress and unilateral kidney cysts.  Had extensive scald injury as a toddler.)  The only abnormal test was I did not get supressed by the dexamethasone suppression test.  I take 10 mg of prednisone a day to control the 'undiagnosed autoimmune disease.'  Before I started the prednisone on a regular basis, I had my first attack of Hashimoto in 2000.  Ever since then, I have increasingly worse edema.  BP dropped from 120/80 to 100/70 and is now 90/60.  I feel light-headed when walking.  I've had a complete work up for the edema incluing cardiology, endocrinology (they've only tested cortisol, sex hormones and thyroid.)  I have had huge weight gain and vary as much as 8lbs a day.  So it's safe to say I don't have Addisons.  I had 24 hr. electolyte monitoring because I can't metabolize/control my mineral balance.  The family doc wants to send me back to the endocrinologist but the two I've gone to seem not to be able to think outside of hypothyroidism and diabetes.

[Barb135]

As stated above, this is a very old thread and most, if not all, of the previous posters no longer participate in the forum.  

Your situation would get much better attention if you'd post a new thread, listing your own situation.

You can post a new thread, by clicking on the orange "Post a Question" button at the top of this page; you'll get a blank form to fill out and when finished, simply click the green "Post a Question" button.  

When you post your new thread, be sure to include any thyroid tests that have been done, along with results and reference ranges, which vary lab to lab, so must come from your own report.  Also include tests, results and reference ranges, that diagnosed you with Hashimoto's.

Be sure to include thyroid medication(s)/dosage(s) you  might be on.