Midodrine Causes Low Aldosterone?

[vemee]

I went to an endo because I had tested for low aldosterone. The Endo was very nice and did the acth stress test which I passed but she said that it was probably midodrine that was lowering my aldosterone. I have never heard this before and can find nothing on the web to support this. I think she is wrong but I wanted to check to see if anyone else has heard this. I have scheduled an appointment with someone else for a second opinion since I think the low aldosterone is caused by the aldosterone/renin paradox that Vanderbilt discovered. I don't know much about it but both adosterone and renin are low in pots patients for an unknown reason maybe involving the kidneys.

[TXPOTS]

Well.... If your blood pressure is not high from the Midodrine, I would ask more questions. In patients with hypertension (high blood pressure), renin and aldosterone may be low. Constriction of the blood vessels at the level of the kidney may suppress the renin-angiotensin-aldosterone feedback loop. In fact, beta blockers and other blood pressure medications target this loop as a primary or secondary means of controlling blood pressure. Beta blockers and Florinef suppress renin production. Florinef is basically a synthetic aldosterone, so your body will not be producing mush of it's own. However many POTS patients are not making much of their own to begin with. I suspect this is one reason why beta blockers make some patients worse that have POTS (through suppression of renin and knocking out the compensatory increase in heart rate). Until we learn more about the underlying mechanisms of POTS, I would stick with the medications that make us feel better and keep working with our physicians to find the right combination, which will be different for each of us. How is your blood pressure?

[Noreen]

so your body will not be producing mush of it's own.

I think my body, especially my brain, produces way too much mush. - lol

Thanks for the typo - the chuckle helped make my laugh medicinal quotient for this morning.

You have incredible insight into the body's biochemical processes and your input is much appreciated. I've often wished I could get a consult with one of the professors at the local pharmaceutical college.

[vemee]

Thank you for your response, my blood pressure is within the normal range usually (110-124 systolic and in the 70's diastolic) Sometimes when fatigued is really bad it is something like 70/35. I have been tested in the past for blood volume and they found it is in the normal range but towards the low side of the normal range. I also have severe pooling that cause a 44% drop in circulating blood volume.

I just remembered I do take a 2.5 mg dose of kerlone which is a beta blocker which might reduce aldosterone.

[TXPOTS]

so your body will not be producing mush of it's own.

I think my body, especially my brain, produces way too much mush. - lol

Thanks for the typo - the chuckle helped make my laugh medicinal quotient for this morning.

You have incredible insight into the body's biochemical processes and your input is much appreciated. I've often wished I could get a consult with one of the professors at the local pharmaceutical college.

YES... my brain produces way too much mush!!! LOL!

Oh dear, no matter how much insight my pharmacy training has given me, I am still a POTSy. Don't worry friends, I am not working, so I won't be filling your prescriptions. I corresponded with another pharmacist member, and we agreed the brain fog was too bad to be working right now.