Some Out Of The Box Thinking --Need Some Feedback !!!

[issie]

This was from an earlier post, Some may not have read it - But, I feel that it is important and maybe will make a difference - if we put our heads together and figure this out. (THIS IS AN OLD POST - BUT HAS SOME INTERESTING IDEAS IN IT.)

Part One - On Salt

I think that too much salt, unless you are sure that your adrenals are underproducing aldosterone -- may not be good for everyone. When I was doing alot of salt, I seemed alot worse. I've recently backed off and feel better. Still keeping my water content up and at times using electrolyte support. But not the massive salt on everything nor as many G2's. But, in so doing, I've noticed that I do seem more dehydrated. It's like the water doesn't get into the cells right, even though my whole body is swollen with too much fluid. Putting more fluid in when it's not going into the cells but into my feet, hands, legs and abdomen doesn't seem like the right thing to do. But, how do you get your cells to uptake the fluid not just go into your tissues?

I just got the latest daily newsletter from Dr. Mercola. It has a topic on salt. I'm going to share some of it. It kind of confirms my thoughts on it. In some ways -- didn't know it was because of the KIND of salt we're all using.

To break down ordinary salt - which is 97.5% sodium chloride and 2.5% chemicals - iodine and mositure absorbing elements that is dried at 1,200 degrees F - which alters the structure of the salt it takes 23 g. of cellular water to break down 1 gram of sodium chloride. Therefore, it throws off the fluid balance of the body. It can contribute to arthritis and kidney and gallbladder stones. Some of these refined salts also have aluminum in them, and we know what that can do to our brains.

The article didn't say that salt was bad for you, just that the refined salt that most of us use is bad for us because of the structure of the salt and the refinement and processing. Also that it changes the crystal structure of the salt and it changes the energy in the salt. (The wording used in the article was vibrational energy, which is restorative to your body.) In fact, it was felt that salt is good for you if you use the natural unprocessed type of salts. They were especially recommending the Himalayan salt even over the sea salt. Mostly because of the amount of other minerals included in it (84 different trace minerals). Unrefined salt is 84% sodium chloride and 16% other natural minerals. They also said that salt is good for depression.

So, unless we can start using the more natural forms, we may be dehydrating ourselves even more, not to mention the fact of the burden of processing and eliminating that our bodies have to go through. I couldn't figure out why it seemed that my tissues were completely saturated but yet I still feel dehydrated all the time. Maybe because the water wasn't getting into the cells properly because of the type of salt I was using. I don't know, what I do know is I'm going to at least start trying to have my salt source be from either sea salt (which I already have some) or try this other Himalayan salt and see if it makes a difference.

Doing research on sodium and aldestrone, I came across an article that said if you up your salt intake enough - your body will quit producting aldestrone. Aldestrone is the hormone produced in the adrenals that helps the body retain salt and helps to balance out the fluids in your body. So, if you stop the production of this very important hormone --that by the way also has something to do with potasium retention - you don't do the proper amount of salt ---and maybe not the right kind of salt -- Then we've really messed up our bodies and we are dehydrated, can't retain our water, have our BP messed up and therefore our pulse rates. ETC. Etc.

I think maybe instead of supplementing salt --which we do because that's supposed to help us retain water. (We go on this assumption because of people who exercise and sweat out their salt and fluids) --that's not what we do. Some of us don't even sweat properly. Maybe salt is not the answer. Could it be that we need to supplement our aldestrone? I know that can be done and have read about people using it transdermally from compounding pharmicies. Could it be one other hormone that we are deficient in? Since, we all have the fatigue symptoms and this is an adrenal hormone -- could this affect our energy levels too?

Part Two - Aldestrone and Renin --- Possibly too high or too low ----Issues for all of us? Could it have an association for even the peripheral things - Like Mast Cell, POTS, Orthostatic Issues, Muscles, Pains, Fatigue

But there are hyper and hypo alderstrone disorders. I looked them up and saw that they can indeed affect heart rates and hydrations.

I'm trying to think: What could cause issues in both male and female.

How does the body process fluids and what keeps them in balance.

Could there possibly be a gentic factor in play - if so could it be a hormone imbalance

What hormones play a part in fluid balance, salt retention and too much sodium wasting

So, you come up with aldestrone and renin. If you use alot of salt, your aldestrone levels will be low and that could decrease blood pressure and fluid volume. Higher aldestrone increases blood pressure and retention of water. It also helps release potassium and stimulates uptake of it into cells. When there is low aldestrone the potassium feedback is virtually inoperative (according to Wikipedia.) So potassium is necessary for proper heart function, but if there isn't enough aldestrone that feedback won't happen. The article says that this potassium feedback must take place indirectly from decreased blood flow through the liver due to constriction of capillaries. When the blood flow decreases so does the destruction of aldosterone by liver enzymes. The amount of aldosterone secreted is a direct function of potassium as determined by sensors in the carotid artery. Anxiety also increases aldestrone, as does pain.

Hypoaldosteronism is decreased levels of the hormone aldosterone. It can cause urinary sodium wasting, leading to volume depletion and hypotension and circulatory insufficiency, high pulse rates/ palpatations, dizziness, lightheadness when you stand, fatigue. It can also cause sweating and a feeling of thrist and craving of salt.

Hyperaldosteronism on the flip side can lead to lowered levels of potassium in the blood. Also, hypertension, muscle weakness and alkalosis, muscle spasams, numbness, tingling.

Renin is what regulates the bodies aldosterone.

So, if this is true - how do we get renin to do what it's supposed to do to regulate our aldosterone?

So, I guess now - I need to look at that function and see how that plays a part.

It seems that alot of us have both types of issues at different times. I have low and high BP and pulse rates. It's really unpredictable. I know, I personally don't sweat properly and stay dehydrated even if I've had enough fluids - it doesn't go into my cells properly. Just trying to figure this out and have it make sense. If you increase your salt, you potential lower your aldestrone and it doesn't function. When this happens your potassium isn't uptaken properly and because the potassium is higher it tries to stimulate more aldestrone so that it can be uptaken. So, potassium may increase aldostrone production if it is low. (Could be a solution for low aldosterone???)

There is an illness called Bartter syndrome - that is congenitial - it is caused by a defect in the kidney's ability to reabsorb sodium This causes a rise in aldosterone and makes the kidneys remove too much potassium from the body. This also causes abnormal acid balance - alkalosis. This disease also manifest with low blood pressure, muscle cramping and weakness, urinary and bowel issues.

Cortisol plays a part in this puzzle to.

It just seems a bit much tonight. I think I'll stop this here and dig some more tomorrow. Hoping for some input on this.

Most all this research came from Wikipidia and Dr. Mercola's newsletters also Dr. Wright's Nutrition and Healing Newsletters. And a small amount was found on a site called Stopthethyroidmadness.com.

WILL WE EVER SORT THIS ALL OUT????????

As far as supplementing with hormones, or even salt -- I think we all should be mointered closer on even the simplier things like salt, potassium etc. Something has gone wacky and we need to figure out what -- instead of blindly treating the consequences of the end result. How many band-aids are we willing to wear before the TRUE answer is found as to why we have so many boo boo's?????????

Still have to do the search to see where Renin and Cortisol play into the picture. It makes sense that we have adrenal issues. Maybe not Cushings or Addisions - but some sort of dysfunction. Then there is the relationship between the Adrenals and Thyroid.

Our bodies are so complex. For every one question I get answered, I replace them with ten. HELP ME BRAINSTORM!!!!

[firewatcher]

Issie,

you are missing a hormone or two: vasopressin (ADH) and oxytocin...plus melatonin if you really want to complicate things. I have no detectable ADH and never have, even when highly dehydrated. I could, however, concentrate my urine when severely dehydrated (not technically possible without ADH, but it happened.) My renin and aldosterone are low normal. Melatonin and oxytocin also effect renal concentration ability, but in unknown (so far) ways. I do not do well on a high salt diet, once I begin to dehydrate, I'll go hypernatremic (too much sodium.) I also have upright hypertension and tachycardia, but supine hypotension and bradycardia. Baroreflex is also involved and hypertension will cause the kidneys to "think" paradoxically. Endocrine issues are not fully investigated for POTS, so you are digging in some murky, medical depths. Good luck and keep digging!

[sue1234]

Thank you for brainstorming!!!!!! This is exactly why I am on this forum almost everyday, seeing what thoughts are thrown out there as possibilities for this problem. I, for me,don't have it for genetic reasons. I wouldn't have had a normal 46 years beforehand if it was genetic.

I do believe that something got altered in our bodies due to some environmental factor or just plain health issue, like being exposed to some elusive virus or bacteria. Well, with so many people talking about coming down with it after an illness, I've even wondered if an antibiotic taken for the illness could have led to some kind of damage.

I do follow the renin-aldosterone theory. I was found to have an aldosterone level of 3 a year into this. This is another one of my examples of inept medical care. I found out, once I converted my measurements, that my level of 3 is actually lower than the POTS patients levels in Dr. Raj's articel about POTS patients and the paradox of the renin/aldosterone system!! I went to a cardiac doctor with that article in hand and the results of my low aldosterone, and he redid the test, and it happened to be normal that day. I feel it should have been looked at a little deeper. This is yet another example of the inept level of medical care I have been having!!

So from what you say, low aldosterone would be associated with high potassium? I have been having high K+ on my last few blood tests, and the doctors just say not to worry about them. I know in Addison's, you can have high K+, but I obviously don't have Addison's or I would be at the ER!! But, I agree that there could be some level of "disease" with the adrenals and their control of aldosterone, without having a full-blown Addisons or Cushings.

Let's do keep throwing these ideas around. I am the same--I don't want a bandaid, I want to know why so it can be fixed.

[sue1234]

Firewatcher--I know we've talked about the ADH issue. I just wanted to say that I, also, can concentrate urine with my lowish ADH. That is kind of strange--any thoughts on why we do this? I can drink my usual 100 oz. of liquids and pee all day, but still make yellow urine.

Also, I have been to an endo all along for my POTS. I initially thought Addison's right away, and then with the higher b/p on standing, we tested for Cushing's. Then I learned some more, and we looked at aldosterone, parathyroid, and finally ADH. The two stand-outs were the aldosterone and ADH, but be darned if a dr. would address them correctly and thoroughly!!

[firewatcher]

Firewatcher--I know we've talked about the ADH issue. I just wanted to say that I, also, can concentrate urine with my lowish ADH. That is kind of strange--any thoughts on why we do this? I can drink my usual 100 oz. of liquids and pee all day, but still make yellow urine.

Also, I have been to an endo all along for my POTS. I initially thought Addison's right away, and then with the higher b/p on standing, we tested for Cushing's. Then I learned some more, and we looked at aldosterone, parathyroid, and finally ADH. The two stand-outs were the aldosterone and ADH, but be darned if a dr. would address them correctly and thoroughly!!

I drank my 100+ oz. of daily liquid before and always had absolutely clear urine. My urinalysis always came back flagged as being too dilute. I only concentrate when on dDAVP or when severely dehydrated (serum osm. > 300.) I don't have a pituitary bright spot either. I know I have always had POTS, but not the polyuria, that began in winter of 2007 suddenly. I believe the lack of bloodflow or eventual chronic lack of bloodflow to the pituitary and hypothalamus eventually deplete or damage those glands and that causes the endocrine wackiness. Even with no ADH, the other pituitary hormones will pick up the slack. Melatonin, something I don't make either, will assist the kidneys in urine concentration. I did not know this before my formal H20 deprivation test, or I would have never taken it the night before.

I believe the reasons that the docs don't address these issues is simply a lack of knowledge about the whole endocrine feedback system. We just don't know enough about all of it, even in healthy people!

[issie]

I had not seen the report from Dr. Raj. So, maybe I am on to something and maybe the key is the salt. If salt lowers our aldosterone levels and we have considerably upped our salt intake and thus lowered our aldosterone, maybe the extra salt is the WRONG treatment for us. Before my POTS diagnosis, I seldomed wanted salt. Everything tasted too salty. I think maybe the key is possibly the right kind of salt and getting our bodies to uptake it properly. We may not need more salt. In fact, we may be compounding the issues by using more. (I just scanned the article - have to really read it. But, wanted to do a quick note.) The more salt you take in, the more you want. Could we have created this low aldestrone by our salt intake and now because it's low - we are replacing our aldestrone with salt because we basically don't have enough aldestrone?????? I guess it depends on what type of POTS we have, and what our BP's are doing at any given moment. Since there are severe swings - in mine - the balance is way off. So, could it be that salt has become a drug? Will our bodies re-adjust themselves if we lower our salt (and get the right kind of salt)? Okay, now I'm dizzy and tired. More later...................

[issie]

Issie,

you are missing a hormone or two: vasopressin (ADH) and oxytocin...plus melatonin if you really want to complicate things. I have no detectable ADH and never have, even when highly dehydrated. I could, however, concentrate my urine when severely dehydrated (not technically possible without ADH, but it happened.) My renin and aldosterone are low normal. Melatonin and oxytocin also effect renal concentration ability, but in unknown (so far) ways. I do not do well on a high salt diet, once I begin to dehydrate, I'll go hypernatremic (too much sodium.) I also have upright hypertension and tachycardia, but supine hypotension and bradycardia. Baroreflex is also involved and hypertension will cause the kidneys to "think" paradoxically. Endocrine issues are not fully investigated for POTS, so you are digging in some murky, medical depths. Good luck and keep digging!

According to Wikipedia - Low Aldestrone can cause low vasopressin.

Since vasopressin and oxytocin are similiar and oxytocin is considered an antoginist of vasopressin. Not sure that really plays a part in POTS. But the vasopressin could since low aldestrone can inhibit it. These two hormones are released in the pititary and there is the Adrenal - Thyroid - Pitutary/hypothlamus axis to consider. They all interact.

So I think, at this point - I'm still focused on the Adrenal/Kidney connection. But I think once I explore this - my next search will be on the Adrenal/thyroid connection.

Thanks for your input. Keep the observations coming.

[issie]

Firewatcher--I know we've talked about the ADH issue. I just wanted to say that I, also, can concentrate urine with my lowish ADH. That is kind of strange--any thoughts on why we do this? I can drink my usual 100 oz. of liquids and pee all day, but still make yellow urine.

Also, I have been to an endo all along for my POTS. I initially thought Addison's right away, and then with the higher b/p on standing, we tested for Cushing's. Then I learned some more, and we looked at aldosterone, parathyroid, and finally ADH. The two stand-outs were the aldosterone and ADH, but be darned if a dr. would address them correctly and thoroughly!!

Hey sue, notice my comments to Firewatcher regarding the aldosterone and ADH.

[Sarah4444]

I am new to all this, but I have a feeling that you're on the right track. I have had multiple POTS episodes over 25 years (just didn't know what to call it or what was going on) and I have been trying to figure out why I always "bounced back" to some degree without medical treatment that recognized POTS, while this time I went downhill hard and fast and have been having much more trouble recovering. I don't have the answers, but know that in the past, when episodes seemed to be triggered by trauma or illness I did recover quite well - when I was hospitalized, I was always given IV potassium. This time, the long slide downhill seems to have begun during pregnancy and have been exacerbated by SNRI use, but I haven't been hospitalized. But this morning I had to pee seven times in three hours, before I was able to really start the fluid/salt loading. Like you all I spend hours of insomnia time trying to sort this all out, wishing the doctors I see would help.

[issie]

Just another little bit of information I've discovered.

(This and the following by Eberhard Ritz)

High salt reduces NO generation and increases endothelial cell stiffness

Renin is released in the kidneys and is stimulated by the sympathetic nerve action, renal artery hypotension and decreased sodium delivery to the kidneys.

Renin's function is to constrict resistance vessels, stimulate release of vasopression - which increases fluid and retention, stimulate the release of aldosterone which acts on the kidneys to increase sodium and fluid rention, stimulate thirst, facilitates norepinephrine release and inhibits re-uptake by nerve endings. (Articles from Cardiovascular Physiology Concepts by Richard Klabundle, PhD

When sodium is high, more sodium is reabsorbed and more potassium and hydrogen ion are excreted. Increased aldosterone is the transporter that regulates this and stimulates the reabsorption of sodium, which also increases the loss of potassium and hydrogen in the urine. ADH increases the permeability of the collecting duct to water, which leads to increased water reabsorption. If the kidney excretes more sodium, then water excretion will also increase. Increased sodium and water retention increases blood volume and contributes to elevated venous pressures which could lead to heart failure and pulmonary and systemic edema.

The next info comes from Medline Plus:

Renin is a protein released by kidney cells when you have decreased sodium levels or low blood volume. It plays a role in the release of aldosterone which helps control the body's salt and water balance.

If it's too high: Addison's disease, dehydration, cirrhosis, high bp, low potassium, renal tumors

too low: ADH therapy, sodium sensitive high bp, sodium retaining steriod - Florineff

Aldosterone is tested for certain fluid and electrolyte disorders, hard to control bp, low bp upon standing. It helps regulate bp and increases the reabsorption of sodium and water tne the release of potassium - this raises bp.

High levels indicate: Bartter syndrome, hyperaldosteronism from heart or kidney disease, low sodium

Low " " : Addison's disease, adrenal hyperplasia, hypoaldosteronism, very high salt diet

Hypokalemia is too low potassium in the blood: Symptoms are: Abnormal heart rhythms, breakdown of muscle fiber, constipation, fatigue, muscle weakness or spasms, paralysis (Which can occur when there is too much thyroid hormone in the blood - which causes low potassium - if you lower the thyroid hormone it will increase the potassium), can lead to kidney dammage

Wikipedia brings out that there is a relationship between aldosterone and cortisol. Licorice can inhibit a certain enzyme that helps with the converson of cortisol into cortisone. This could lead to mineralcorticoid excess syndrome. Anxiety increases aldosterone. Potassium levels as determined by sensors in the carotid artery determine the amount of aldosterone secreated. Aldesterone is increased with low sodium intakes.

The next part is from stopthethyroidmadness .com

If aldosterone gets too high, potassium levels get too low - this can cause muscle cramps, muscle weakness, numbness or tingling in extremities. But if too low - which can be commom in people with low cortisol - you excrete too much salt which leads to low blood pressure, low blood volume, high pulse and/or palpitations, dizziness and or lightheadedness when you stand, fatigue and craving for salt.

This article recommends sea salt because there is salt wasting. When sodium is excreted it takes water with it. They also recommend Florineff if the sea salt doesn't do enough. Florineff imitates what Aldosterone does. They also suggest that there may be a need for cortisol and the drug for this is Cortef.

To have mineralcorticoid activity means it controls electrolyte and water levels, by promoting sodium retention in the kidney - Florinef - Like Aldesterone

To have glucocorticoid activity means it controls carbohydrate, fat and protein metabolism and is anti inflammatory and allows thyroid hormones to get to your cells - Cortef - cortisol

This article had people telling how they had improved since starting to use both of these things along with Armour thyroid. Of course this would be if there are thyroid issues.

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I found this interesting because years ago - a doctor who did alternative testing said I was very deficient in cortisol. I had to take it at two differnt times in my life and any time I have surgery I have to use it. It makes me wonder if a little might be the key to taming the adrenal issues down. Since I feel that I have the adrenal type of POTS - it makes me wonder. I did great with the cortisol this last time with my surgery - they didn't mention to me that they had an issue with my POTS during the surgery. I woke up fine and felt fine too. They hydrated me well too and I had I.V.'s for about 3 hours before I went into surgery.

My conclusion in regard to the renin is: I really don't think it is the key player here. It is mostly talked about in the light of hypertension. Some of us do have hypertension at times - but I still think it has something to do with the aldosterone. Maybe also the cortisol. These are both adrenal hormones.

An article I found from Dr. Wright's newsletters - found hearing loss in people low in aldesterone. He did give some places to get aldesterone compounded : Canada Global Drugs, www.canadaglobaldrugs.com, (866)323-2520; and Key Pharmacy, www.keypharmacy.net, (800)878-1322

This would require a RX and he recommends having electrolyte testing done regularly to make sure everything stays in balance in addition to keeping a check on the aldosterone.

Okay, I'm tired of researching this topic. Now, hoping a doctor will maybe see this and give us some feedback. I'm sure there has been testing done - but, I've only seen the one paper on it in regard to POTS and it really didn't give a solution.

For me, I want to get some of the Himalyian salt and start using it. Not do the high salt loading and see if the kind of salt makes a difference. See if my aldosterone levels will rebalance without the salt taking over the job. I'd rather try the natural salts with all the minerals - instead of the Florineff - which I did try and it gave me worse miagrains. It also made my BP go up too high and I swelled like mad. It could have been that they had me starting out too high with it. But, I didn't like it. Then, if that doesn't seem to do the trick - find a doctor who is willing to experiment with me and try the aldosterone and maybe the cortisol. I have to get my thyroid checked again too. I think my tumor there may be having an impact on it's function.

So, there's my hours and days worth of research - and the conclusions I've come to.

What's your conclusion???????

[issie]

I think this is important too!!!! Maybe even more so than the "More Aldosterone" post - that came latter. Can I get some thoughts on this salt topic? I've gotten some PM's but would like to get your thoughts on the forum.

[issie]

....

[issie]

BUMP!

[issie]

bump

[anna]

Issie I forgot to send you this link! it may be of interest!! http://www.caresfoundation.org/productcart/pc/ncah_late_onset_cah.html

[ramakentesh]

ANother angle on this is that any of these substances or the receptors that are stimulated by these substances can be subject to an autoimmune process either activating receptors, occupying receptors or destroying receptors.

Autoantibodies against beta 2 receptors, angiotensin II receptors as example have been found in M.gravis - and abnormal activation of these receptors could have effects that are quite similar to POTS in some ways.

[futurehope]

ramakentesh,

I don't understand what you are saying, really, but that is okay. I am interested in your statement about autoantibodies being found in M. gravis and the possible abnormal activation of beta 2 receptors and angiotensin II receptors because of it.

I am interested because I have autoantibodies that signify M. gravis, but thankfully, I have not displayed symptoms of this disease. So, since I do not understand what you are saying about the two different kinds of receptor (beta 2 angiotensin II), if I had autoantibodies to the above, what symptoms could result?

I'm trying to figure out if my form of POTS has something to do with my being positive when tested for the M. gravis AB? Thanks in advance.

[issie]

More info. This is an oldie too.

Issie