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It is a disease where the body produces too much aldosterone. Hence, another name for the disease comes from – primary aldosteronism.
Aldosterone is a steroid hormone that, in excess, leads to an increase in sodium and water in the body, which adversely affects the blood vessels and leads to high blood pressure. This hormone also reduces the amount of potassium in the blood by removing it excessively in the urine. The bad news doesn’t stop there. Excess aldosterone, in combination with abundant salt dishes, leads to damage to the heart muscle, unfavorable remodeling of blood vessels and kidney ischemia.
The disease appears most frequently between the ages of 20 and 50 and is associated with hyperadrenocorticism, which produces an excessive amount of aldosterone while inhibiting plasma renin activity.
Symptoms of Conn’s syndrome
People suffering from primary aldosteronism may have:
– Hypertension – it is often very high and resistant to pharmacological treatment. According to medical statistics, about 10 percent. People with treatment-resistant hypertension have Conn’s syndrome.
– Low potassium levels in the blood (hypokalaemia) caused by the excretion of potassium in the urine.
– Increase in blood pH (this is metabolic alkalosis), resulting from the loss of hydrogen ions in the urine.
– Muscle weakness and increased urine output. The reason for this is that your kidneys do not absorb water from the urine you produce. The patient urinates very often, and the lack of water in the body is supplemented by drinking large amounts of fluids (polydipsia).
– Painful muscle spasms and paraesthesia, which is a feeling of tingling or tingling that is caused by hypokalemia and alkalosis.
Primary hyperaldesteronism can run in families. The first sign of concern should be high blood pressure in young people and children.
Secondary aldosteronism may be the result of pregnancy poisoning, kidney disease (nephropathy, nephrotic syndrome, renal artery stenosis), hypertension, contraceptive pill use, loss of water and electrolytes, excess potassium, overproduction of adrenocorticotropic hormone (ACTH), and liver disease. A type of secondary aldosteronism is specific cirrhosis of the liver and its passive hyperemia. Secondary aldosteronism is more common than Conn’s syndrome. In secondary hyperaldosteronism, similar symptoms occur, such as treatment-resistant hypertension, excessive thirst and large amounts of urination, muscle weakness, headaches and dizziness, decreased potassium levels and increased blood aldosterone levels, increased urinary aldosterone excretion.
Where did this aldosterone come from?
The cause of the excessive secretion of aldosterone may be bilateral adrenal hyperplasia (more than half of Conn’s syndrome cases), which occurs for as yet unknown reasons. Another reason for the high secretion of the hormone may be adrenal adenoma, a benign tumor located in one adrenal gland.
The familial occurrence of hyperaldosteronism is caused by a mutation in the gene responsible for the production of aldosterone. The defective gene is passed down from generation to generation. Rarely, the disease is caused by a malignant tumor (cancer of the adrenal cortex), which produces aldosterone itself. But aldosterone can also be produced by another cancer that is located outside the adrenal glands.
Diagnosing Conn’s syndrome
If you notice any of the symptoms previously described, see your doctor and tell you about them. The doctor usually refers the patient to an endocrinologist. After collecting a detailed interview, the doctor directs the patient to biochemical and hormonal laboratory tests and imaging tests.
The patient must be properly prepared for both laboratory and hormonal tests. Detailed information is given to him a few days before the tests are performed.
Imaging tests such as computed tomography, magnetic resonance imaging or scintigraphy allow you to assess the structure of the adrenal glands and detect tumors that are not visible on ultrasound. In addition, when it turns out that there is a tumor in the adrenal glands, surgery can be scheduled.
Conn’s syndrome – Treatment
If tests show an adrenal adenoma secreting aldosterone, the treatment of choice is surgery to remove the adrenal gland along with the tumor. It is an adrenelectomy, which is most often performed using the laparoscopic method. In some cases, the procedure must be performed using the classic technique (laparotomy), which involves cutting the body shells and removing the adrenal glands. In 30 percent In patients after surgical removal of the entire adrenal gland, it is possible to completely discontinue antihypertensive (hypotensive) medications due to the complete stabilization of blood pressure. When bilateral adrenal hyperplasia develops and the adenoma cannot be removed surgically, pharmacological treatment is used to normalize blood pressure and blood potassium levels.
If the cause of hyperaldosteronism is adrenal cancer, it is necessary to remove the tumor and administer chemotherapy.
How to take care of yourself?
There is no need to convince anyone that the lifestyle affects not only our health, but also the progress in treating many ailments. With Conn’s syndrome, it’s important to maintain the correct weight. BMI should not exceed 25.
It is equally important to follow a diet and limit the consumption of table salt, which is conducive to increasing blood pressure. You should avoid canned foods, sausages, hot dogs, ready-made pates, sauces, cheese – all dishes that contain a lot of salt.
Instead of salt, you can season your food with herbs – marjoram, thyme, oregano and garlic.
A daily exercise of exercise is also necessary to maintain a healthy heart. Physical effort, even moderate effort (e.g. walking at a brisk pace) helps to maintain proper body weight, rebuilds the blood vessel network and promotes good blood oxygenation.
Needless to say, people with cardiovascular problems should not smoke or abuse alcohol. It is also worth replacing black tea with green or fruit tea and reducing coffee consumption.