Conn's Syndrome Or Aldosteronism
5 mins read
Aldosteronism also known as Conn’s syndrome is a disorder related to hormonal imbalance. Aldosterone is one of the essential hormones produced by adrenal glands. It balances sodium and potassium in blood level. Associated symptoms such as rise in blood volume (hypervolemia) and a low potassium level (hypokalemic alkalosis) are known to occur in affected individuals. Conn’s syndrome is revealed through weakness, tingling sensations, transient paralysis, and muscular cramps. A spike in blood pressure (hypertension), excessive urination (polyuria), and thirst (polydipsia) are also found to arise.
Primary aldosteronism leads to loss of potassium and retention of sodium. The excess sodium tends to store water thereby, increasing blood pressure.
Significant characterstics of primary aldosteronism are:
- Moderate to severe high blood pressure
- High blood pressure requiring several combative medications
- Low potassium levels (hypokalemia)
Overproduction of aldosterone is indicated through the following:
- An aldosterone producing growth in adrenal glands
- Hyperactivity of both adrenal glands
At times, primary aldosteronism is also said to be caused due to a malignant growth in the cortical layer (outer) of the adrenal gland. This dysfuntion may also be inherited in families with history of high blood pressure.
Usually scans are undertaken to find the levels of dysfunction in both adrenal glands. Several tests are undertaken to diagnose primary aldosteronism. Blood tests revealing secretion of hormones through adrenal glands are performed.
A screening test can help in determining presence of aldosteronism. Renin, an enzyme secreted by kidneys promotes regulation of blood pressure. A ratio of low renin and a high aldosterone is likely to be the cause of high blood pressure.
If primary aldosteronism is detected, confirmatory test to determine sodium and aldosterone levels need to be undertaken. A high sodium diet is prescribed to measure aldosternone and sodium levels in the urine as well as blood. Subsequently, Fludrocortisone suppression test (FST) is undertaken to measure aldosternone levels in blood.
Additional tests are done to study the over-activity of adrenal glands. These include:
- Abdominal computerized tomography (CT) scan – It identifies tumor or enlargement on adrenal gland that indicates overactivity.
- Adrenal vein sampling – Through this procedure, blood from adrenal veins is compared. A radiologist draws blood from both the right and left adrenal veins and compares the two samples. Aldosterone levels corresponding to a particular side indicates aldosteronoma in that region.
Patients with hyperplasia may be treated with drugs that block the effect of aldosterone.
An adrenal gland tumor may be treated with surgery or medications and lifestyle changes.
- Surgical removal of the gland: Laparoscopic adrenalectomy, a treatment involving surgical removal is most recommended choice of treatment. This helps in resolving high blood pressure and potassium deficiency, consequently normalizing aldosterone levels. Blood pressure is shown to decline after a unilateral adrenalectomy. Though this operation usually carries risks such as bleeding and infection, it does not necessitate adrenal hormone replacement since other adrenal gland is capable of producing hormones on its own.
- Aldosterone-restraining drugs.If primary aldosteronism is due to a benign tumor, it can be treated with aldosterone-blocking drugs (mineralocorticoid receptor antagonists) such as spironolactone. However, it is likely for high blood pressure and low potassium to return if one discontinues taking medications. Though this medication rectifies high blood pressure and low potassium. Side effects such as male breast enlargement (gynecomastia), decreased sexual desire, impotence, menstrual irregularities and gastrointestinal distress are manifested.
- Mineralocorticoid receptor antagonists block the action of aldosterone in your body. Your doctor may first prescribe (Aldactone).
It is essential to imbibe a healthy lifestyle to keep blood pressure in check and restore long-term heart health. Suggestions for a healthy lifestyle include:
- Healthy diet: Including fresh foods and low-sodium ingredients and cutting down on sodium in diet by avoiding condiments and reducing salt in food is the first step to prevention. Whole grains, fruits, vegetables and low-fat dairy products are helpful in combating hypertension and maintaining optimum weight. Avoid excessive consumption of caffeine and alcohol to maintain a better health.
- Exercise: Aerobics plays a key role in lowering blood pressure. Brisk walking is said to have a significant impact on your health. Try walking with a friend at lunch instead of dining out.
- Avoid smoking:By giving up on smoking, one can enhance his cardiovascular health. Nicotine creates a strain on blood vessels and stimulates blood pressure.
- Limit alcohol and caffeine.Both substances can raise your blood pressure, and alcohol can interfere with the effectiveness of some blood pressure medications. Ask your doctor whether moderate alcohol consumption is safe for you.
Arsenicum album and Magnesium Chloride are some of the commonly used medicines to counter aldosteronism and extreme hypertension.
2. Stowasser, M., Gordon, R. D., Rutherford, J. C., Nikwan, N. Z., Daunt, N. & Slater, G. S. Diagnosis and management of primary aldosteronism. Journal of Renin-Angiotensin-Aldosterone System. 2001vol. 2 no. 3 156-169 doi: 10.3317/jraas.2001.022