And the adventure begins. Again.

My BP remains erratic, enough so that my medical people are investigating several possibilities, including hyperparathyroidism and, yes, the possibility that my other adrenal is acting up. Unless something comes up sooner, the ride begins on June 3.

Meanwhile, some worthwhile reading for anybody who has or has had PA and is having problems even after adrenalectomy or other treatment:

Primary Hyperparathyroidism With Concurrent Primary Aldosteronism

Two key takeaways:

…this unique case and the related findings support the notion that undetected hyperfunctioning of the parathyroid gland can contribute to maintaining hyperaldosteronism in PA. It also suggests the existence of a bidirectional link between the adrenocortical zona glomerulosa and the parathyroid gland, which can be relevant for the regulation of calcium metabolism and blood pressure.

and

PA is held to be autonomous from the renin-angiotensin system, but the term “primary” only denotes our scant knowledge of the mechanisms underlying the hyperaldosteronism. This case is, therefore, of interest from several standpoints, because it highlights one possible such mechanism and also suggests a bifunctional link between the parathyroid gland and the adrenocortical zona glomerulosa.

Emphasis mine, of course. How little do we know.

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Well that was scary.

Back in February, I had lab work done and as usual, tested low for Vitamin D. My doctor told me to take 2000IU of Vitamin D daily for three months, and the plan was that we would re-test in May.

Last week, I noticed I was getting headaches. The kind of headaches I used to get when I had a tumor that was giving me high blood pressure. I decided to test my BP and sure enough, it was a whopping 148/90! I checked it obsessively for the next couple of days it was all over the place – 130s/80s and as far up as 140s/101 once. I had a moment of panic – holy cats, could the other adrenal have developed a tumor?! – then realized that I needed to eliminate the obvious external factors first. I stopped the Vit D a couple days later, and it’s been steadily dropping/leveling out ever since. This morning was 124/82, which is in line with my post-surgical “normal.” Assuming that trend keeps up, I’ll know for certain it was the D.

How did I know to suspect the Vitamin D? Because this happened once before. about 4 years back when I still had the tumor and still had a doctor (the bad one!) who was clueless about PA. He put me on the same 2000IU dose, and within a short time – a couple weeks, IIRC – my already high BP had skyrocketed, my pulse was racing, and I had an irregular heartbeat. There were urgent care visits and of course nobody caught the culprit; as usual, they all blamed me for being too stressed out or whatever. Yeah, right. By sheer coincidence, this article came across my radar. I stopped the D, and within a couple weeks, problem solved.

I’m sure you’re probably wondering why, after already having one scary Vitamin D encounter, I was crazy enough to try it again. The simple answer is: curiosity! I wanted to see if the same reaction would happen, post-ADx, and sure enough it did. And I wanted to see what would happen purely because if it happened again, I hope to find out WHY, exactly, it’s an issue for me.

My doctor (the good one, the one who diagnosed my PA!), at this point, knows nothing about this. I’m seeing him in two weeks and will fill him in at that time; I’m curious to see what his first guess is as to why I seem to develop Vitamin D toxicity despite low blood levels of Vitamin D. I’ve got a few guesses, but I’m not going to put them out there until I hear what he says first. Stay tuned!