High Renin, High Aldosterone & Low Potassium

[dba3mom]

I am a 39 year old female...back in my early 20's my doctor would tell me my potassium was a little low -told me to eat more bananna's, drink orange juice, etc...eventually they prescribed potassium pills. (I never took them because I thought it was stupid to take) at age 29 (10 years ago) I was diagnosed with High Blood pressure & low potassium (again) So started taking Atenoretic 50 mg  - 1 a day for blood pressure and potassium pills as I could hardly make it through the day w/out a nap.   2-3 years later, I had swelling so they put me on Atenolol/Chlorthal 50/25 - 1 a day. Each year my potassium has gotton worse.  They added Spironolactone 25 mg twice a day to help w/potassium about 5 yrs ago.  In the past year my potassium pills have doubled (I now take 12 - 10meq potassium pills a day) we are having difficulty keeping my potassium above the "low" normal.  My doctor tested for aldosterone and renin, both of which came back high.  She sent me to a Endocrinologist who did a renal artery duplex test which came back normal.  The Endocrinologist then sent me back to my doctor, neither of which has ordered any more test or changed any medications.  Basically the endocrinologist is done w/me & my doctor said she would see me at my check up in March.  I feel like I have been left high and dry with no explanations.  BTW:  all kidney blood test have come back normal.  I am tired all the time, I have muscle weakness, when I excerise I get sick with cramps and diarrhea.  I accidentally did not take the spironlactone for 3 days (kept forgetting to pick it up at the pharmacy) on the 3rd day I had tingeling in hands, legs and face along with chest pains) Once I got the medicne in my system, all symptoms went away.  My blood pressure has remained in control all these years and still is (113/68) give or take a few on each.

Are the more test that I should have my doctor do?   Just worried that SOMETHING is wrong and I feel like the doctors should be doing more to find out??

[Kevin Pho, MD]

I agree with the testing thus far.  It has been comprehensive and would rule out many of the major disorders.

The referral to the endocrinologist can evaluate for hyperaldosteronism, which can lead to some of the symptoms you describe.   An MRI can be done to examine the adrenal gland to rule out tumors that can lead to this.  

I would also consider another opinion, preferably at a major academic medical center.  

Followup with your personal physician is essential.

This answer is not intended as and does not substitute for medical advice - the information presented is for patients education only. Please see your personal physician for further evaluation of your individual case.

Kevin, M.D.
www.kevinmd.com