Could I be suffering from an Autonomic Dysfunction?

[BlueStone44]

Hello,

I am 44 years old and have just recently been diagnosed with chronic renal failure. I've been dealing with very difficult to control hypertension for about 15 years. I have also been dealing with diabetes for about 5 years. Most of my doctors feel that my hypertension and diabetes are the cause of my kidney failure, however my nephrologist feels that defective kidneys due to heredity are the cause of my hypertension and perhaps my diabetes.

Somehow I'm not totally comfortable with the answers that I've gotten because I am also dealing with an enormous list of other symptoms that my docs won't take seriously. Just as an example, while recently being treated for blood pressure in excess of 240/140, it seems my bowels stopped functioning (no bowel movement for about 2 months), I began to have trouble urinating, I began to have extreme loss of appetite, and I went into Congestive Heart Failue. Also, I've developed an extreme intolerance to cold.

During a recent hospital stay where I was being treated for the Congestive Heart Failure and hypertension, I was put on fairly high doses of nitroglycerin and hydralazine and lasix. At some point during the stay I started having these unbelievably strong heart palpatations.  My heart rate began to exceed 90 beats per minute and would drum like a mighty army in my head. When I asked about this sudden change my cardiologist and nephrologist both said that the increased heart rate was not abnormal and nothing to be concerned about.

When I plugged in some of the symptoms I've developed into a google search I found things like Hypothyroidism (with symptoms like palpations, constipation and intolerance to cold). I have read that hypothyroidism sometimes occurs with renal failure but when I asked my nephrologist to check my thyroid function she seemed hesitant to consider it. I'm hoping to find an endocrinologist who will be willing to look into this

I have many other symptoms too numerous to mention here. Whenever I look at a chart of Autonomic Nervous System functions, and take note of the Sympathetic Nervous System in particular it seems that I can find all of my symptoms in lists of Sympathetic Nervous System disorders. I'm wondering if it would be sensible to consult some type of Neurologist as to an underlying cause of my various conditions.

[BlueStone44]

Hello shannonkim,

Sorry, I've taken so long to respond.  I haven't been able to sit down for 5 minutes it seems with constant doctor visits adjusting and readjusting my medications. My endocrinologist says my thyroid is fine but I seem to have developed another symptom - persistent hoarseness.  My feet and legs are still swollen with water like two big baloons.  Lasix is no help whatsoever, but they just keep increasing it. I'm freezing to death even though we're having 60 and 70 degree weather. My endo is happy that my A1C has dropped to 6 and says to come back and see him in a few months.

At various times I have had low potassium levels and have been severely dehydrated. I've even been dehydrated by doctors at the hospital because of constant diuretic treatment.  In fact, once they rehydrated me my blood pressure would actually drop. I believe that twice that lead to acute renal failure. Now that my kidney failure is chronic, my potassium levels seem to be maintaing fairly normal levels.

I don't think I've ever really been tested for aldosteronism because they always seem to rule it out with the cursory blood tests they perform and because they haven't seen physical evidence of any tumors on my adrenals. I believe some of the hypertensive medications I've been given, ( e.g. ACE inhibitors) have actually been interfering with a diagnosis of aldosteronism.

My wife is originally from that part of Minnesota and she has mentioned that perhaps I should consider going to Mayo. An autonomic lab ?? Interesting.

Well, I just looked at my thermostat on the wall.  It's 74 degrees and I'm shivering and juat about chilled to the bone.  This is insane!

Thanks so much for your response,

[shannonkim]

I am so sorry for all that you have been through. I hope you have some sort of support system in place to help you through (family, friends, pastor, etc.).  I also have intractable high blood pressure and have had acute kidney failure, among other problems. My nephrologist attributed the kidney failure to dehydration, my neurologist though not (although he did not have a clear answer as to why it happened). Of course, acute and chronic are two very different birds. What you have is very serious and my heart goes out to you. Have you ever had low potassium (not at the same time as being dehydrated or on a diuretic)? Ever been tested for primary aldostoronism? I have both primary aldosteronism and autonomic dysfunction of an undetermined type and am also hyperadrenergic. Have you ever fainted or felt like you were going to? I was diagnosed at the Mayo. They have an excellent autonomic lab there and I love my doctor, Dr. Robert Fealey. This is the Mayo in Rochester, southern Minnesota. I understand that the Vanderbilt, I believe which is in Ohio, perhaps Cincinnati? is also excellent. I can only hope that I have been of some help to you and wish you the best. Kim.

[BlueStone44]

Thanks so much for your response. I checked out the ZRT Lab website.  I'm going to present the info to my doctors.

Cheers!

[Melissalec]

I am so sorry for everything that you have been going through.I know how frustrating it can be. Go to  ZRT laboratories online and look into the saliva testing. It saved my life. Blood test are not accurate and sounds like you have alot going on. Good luck. They can measure your thyroid,hormones,etc. I promise you will be amazed at the results.

Melissa