Hyperaldosteronism (Aldosteronism)

What is Hyperaldosteronism?

It is a medical syndrome characterized by the production of high amounts of aldosterone by the adrenal glands, which may result in reduced levels of potassium in the human bloodstream.

The disorder is also known as Aldosteronism.

Hyperaldosteronism Types

Doctors typically differentiate Hyperaldosteronism into two general types, depending on the underlying causes of enhanced aldosterone production. These are:

Primary Aldosteronism (Hyperaldosteronism)

This condition results from a tumor that develops in one of the adrenal glands and produces excessive amounts of the hormone aldosterone. Adrenal tumors are typically benign (non-dangerous) in nature. However, these growths may become cancerous over time. This form of the disease is most common in people aged between 30 and 50 years.

Secondary Aldosteronism (Hyperaldosteronism)

It is caused by a condition that changes the chemical signals obtained by the adrenal glands, thereby making them manufacture excessive aldosterone. Adrenal functioning can be affected by pituitary gland abnormalities, renal disorders and high blood pressure.

Hyperaldosteronism Symptoms

Normal amounts of aldosterone hormone help regulate the level of water, sodium and potassium in body tissues and blood. Hyperaldosteronism, characterized by high level of aldosterone, makes the kidneys discharge excessive amounts of potassium from the body. This may lead to symptoms like:

  • Chronic fatigue
  • Muscular weakness
  • Blood pressure problems
  • Occasional spasms

Very low level of potassium may give rise to problems like:

  • Chronic abdominal pain
  • Chronic headaches
  • Numbness in the extremities
  • Tingling sensations in limbs after an episode of physical activity

Changes in sodium and potassium levels can lead to increase in blood pressure, which can make symptoms worse. However, it is only in rare cases that the condition turns serious enough to give rise to life-threatening complications.

Hyperaldosteronism Causes

Majority of the cases of Primary Hyperaldosteronism arise from the presence of a benign (noncancerous) tumor of the adrenal gland. Secondary Hyperaldosteronism usually results due to high blood pressure. It is also associated with diseases like:

  • Heart failure
  • Cirrhosis of the liver
  • Nephrotic Syndrome

Hyperaldosteronism Diagnosis

Early diagnosis and treatment is essential to restore proper functioning in the endocrine system. A doctor can diagnose either type of Hyperaldosteronism with the aid of:

  • A thorough physical examination
  • Considering the medical history of a patient
  • Analysis of the results of urine tests
  • Analysis of the results of blood tests

Typically, positive lab tests detect excess potassium level in the urine and unusually elevated aldosterone levels in blood plasma. Physical signs of an adrenal tumor may also be detected with the help of diagnostic tests like:

  • Plasma Renin Activity
  • Serum potassium level
  • Plasma aldosterone level
  • ECG
  • Urinary aldosterone test
  • Abdominal CT scan

In some cases, healthcare professionals need to insert a catheter into adrenal gland veins to find out which of the adrenals comprise of the growth. When the condition is diagnosed by a doctor, tests are performed to detect a suppressed plasma renin and an excess of the aldosterone hormone in the urine and bloodstream.

Other useful diagnostic tests for this condition involve:

  • Detecting other adrenal steroid hormones
  • Detecting normal physiological changes in hormones in the morning as well as in the evening
  • Analyzing responses to sodium restriction or sodium challenge

These tests can help distinguish bilateral hyperplasia from an adrenal tumor. If a tumor is suspected, radiologic proof with an MRI or CT scan generally helps confirm the diagnosis.

Hyperaldosteronism Treatment

Treatment for hyperaldosteronism depends to a large extent on the underlying cause. If a noncancerous (benign) tumor is detected, surgical removal may be necessary. Symptoms usually begin to improve soon after excision though patients may require following a special diet and use of blood pressure-regulating drugs for a complete recovery.

Hyperaldosteronism treatment also depends on the type of the condition that a person is suffering from.

Primary Hyperaldosteronism Treatment

Primary hyperaldosteronism, resulting from a tumor, is generally cured by surgery. Removal of adrenal tumors may help keep the symptoms in check. Some patients are found to suffer from high blood pressure even after surgery and require use of medicines. However, they are often able to lower the doses or number of medicines that they take.

Secondary Hyperaldosteronism Treatment

This form can be usually managed with medicines that lower blood pressure and bring Aldosteronism levels to normal. Diet and medicines are generally enough to cure this problem. Surgery is not required.

Hyperaldosteronism Medications

Medicinal management of Hyperaldosteronism is found to yield good results in many patients. If the condition arises due to Bilateral Hyperplasia, specific medications can be used to block the effect of Aldosterone. Amiloride (Midamor) and Spironalactone (Aldactone) are two such medications. Both of these are highly effective. However, they are sometimes used together with other antihypertensive drugs for managing hypertension in people affected with Hyperaldosteronism.

Some common medicines used to cure this condition include:

  • Triamterene
  • Amiloride
  • Spironolactone (Aldactazide; Aldactone), which is a diuretic

Hyperaldosteronism Surgery

The use of surgical treatment depends on the causative condition. If a single tumor is found to be the cause, it surgical removal can ensure cure of the disease. The rest of the adrenal gland generally functions normally. It continues to produces enough adrenal hormone to ensure that patients live normally. Unfortunately, patients are often found to suffer from mild hypertension even after the operation. This makes it necessary to use antihypertensive medication in some cases.

Generally, surgery is not used to cure this problem. Use of medicines and monitoring of salt intake may control the symptoms without operative cure.

Hyperaldosteronism Prognosis

With early diagnosis and treatment, the outcome of the disease appears quite good. The prognosis of Secondary Hyperaldosteronism depends on the cause of the syndrome.

Hyperaldosteronism Complications

Some of the main complications of this disorder are:

  • Impotence
  • High blood pressure
  • Muscular cramps
  • Gynecomastia (enhanced breasts in men), which may arise with long-term spironolactone treatment
  • Reduced tolerance to glucose

If you are experiencing fatigue, spasms and headaches for quiet sometime and suspect yourself to be having Hyperaldosteronism, make an appointment with your doctor immediately. Early diagnosis and cure will help you get faster relief from the symptoms of this debilitating condition and carry on your daily activities as usual.

References:

http://emedicine.medscape.com/article/920713-overview

http://www.nlm.nih.gov/medlineplus/ency/article/000330.htm

http://www.cushings-help.com/hyperaldosteronism.htm

http://www.nadf.us/diseases/hyperaldosteronism.htm

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