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Primary Hyperaldosteronism

What is primary hyperaldosteronism?

Primary aldosteronism is a condition that occurs when the cells of one of the adrenal glands enlarge and make too much of the hormone aldosterone. This hormone regulates the fluid and salt levels in the body. Excess production of this hormone by an adrenal gland tumor can cause high blood pressure and lower the potassium levels in the blood (hypokalemia).

Most of the people with this condition do not have any symptoms. They had undiagnosed or poorly controlled blood pressure, often requiring two or more anti-blood pressure medications. Without the appropriate treatment, they can also present to the hospital with life-threatening complications of high blood pressure like heart attack, stroke, and kidney failure.

Diagnosing primary aldosteronism requires a high degree of clinical suspicion to diagnose and successfully treat this condition. Dr Thomas will do a comprehensive medical evaluation by eliciting all the different symptoms and signs of the condition and doing a thorough physical examination. She will order the relevant blood, salivary, and urine tests to help with the diagnosis of this condition. She will arrange for you to have the appropriate radiology imaging – either a CT scan or MRI of the adrenal gland for localization of the adrenal gland tumor. She will also recommend any further investigations if needed.

A prompt, successful diagnosis is important for early diagnosis, treatment, and prevention of complications due to the disease.

The overall treatment goal in patients with primary aldosteronism is to prevent the adverse outcomes associated with excess aldosterone, including hypertension, hypokalemia, kidney failure, and cardiovascular damage. Dr Thomas will review all the results of the blood tests and the relevant imaging studies (CT scan/MRI adrenal glands). She will educate you on the condition, explain all the results of the tests, discuss your treatment options, and formulate an individualized treatment plan for you.

For an adrenal adenoma producing excess aldosterone, Dr Thomas will refer you to an experienced endocrine glands surgeon for surgery to remove the adrenal gland that is producing excess aldosterone.

For people with adrenal gland tumors producing excess aldosterone, who are not candidates for surgery, or have bilateral (both sides) disease or do not want surgery, Dr Thomas will start you on oral medications called mineralocorticoid antagonists that will block the cells producing excess of aldosterone. She will explore the benefits and side effects of the medications.

You will need long-term follow-up to monitor any recurrence of this condition. During your follow-up, Dr Thomas will do a comprehensive medical evaluation and arrange for you to have relevant blood tests to monitor for any tumor recurrence.

At a Glance

Dr. Reena Thomas, MD

  • Dual American board-certified endocrinologist
  • Author of numerous academic and clinic research
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