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Hyperaldosteronism or aldosteronism is a condition wherein very large quantities of aldosterone is produced and released by the adrenal glands. This can result to very low potassium levels in the blood leading to a variety of symptoms like high blood pressure. Aldosterone is responsible for maintaining normal sodium and potassium levels in the blood so too much of it can actually cause the body to hoard salt. The disorder is also known as Conn’s syndrome, primary aldosteronism and secondary aldosteronism. It is not actually hyperaldosteronism which is considered to be dangerous but the resulting hypertension and excessive sodium and water retention that can damage other internal organs and lead to serious problems like stroke and myocardial infarction.


The problem usually starts with a tumor in the adrenal gland which produces aldosterone. Aldosterone is normally produced by the adrenal cortex. Some underlying disorders and factors may also lead to the overproduction of aldosterone which disrupts the balance in the body. Aldosteronism is more common among women compared to men. The condition is considered to be a rare disease which generally does not present any specific signs or symptoms making it hard to detect.


Although most cases of hyperaldosteronism can be asymptomatic or do not present any noticeable symptoms specific to the disease, there are a number of identifying factors. Usually these symptoms are present namely fatigue, high blood pressure, headache, muscle spasm or cramps, muscle weakness, numbness, excessive thirst, frequent urination, temporary paralysis episodes and tingling sensations in the extremities.


Laboratory exams will also help identify whether a person truly has the disorder. Lab tests will show hypokalemia or low potassium levels, hypernatremia or high sodium levels and adenoma or a non-cancerous tumor in the adrenal glands. An abdominal CT scan will show the presence of a mass. Plasma aldosterone level will also be elevated together with increased urinary aldosterone and decreased plasma rennin activity. An ECG may show heart rhythm abnormalities due to low levels of potassium.

There are two main types namely primary hyperaldosteronism and secondary hyperaldosteronism. Primary hyperaldosteronism is a rare condition thought to be caused by high blood pressure. The problem is more common among individuals between 30 to 50 years of age and starts with a benign tumor located on the adrenal gland. Excess aldosterone released by primary aldosteronism raises sodium reabsorption and loss of potassium in the kidneys resulting to electrolyte imbalance which generally leads to symptoms of excessive thirst and frequent urination. Once the cause is confirmed to be a single benign adrenal tumor, the problem is then referred to as Conn’s syndrome.
Image: Hyperaldosteronism

Secondary hyperaldosteronism is associated with high blood pressure as will as other underlying conditions such as liver cirrhosis, cardiac failure and nephritic syndrome. These disorders can cause aldosterone levels to rise abnormally. The renin-angiotensin system is overactive in this state thereby spurring the adrenal cortex to release more hormones that usual. Renin is an enzyme produced in the kidneys which controls angiotensin hormone production thereby causing the adrenal glands to produce aldosterone through stimulation.


Primary is basically referring to the direct pathology of the disease since the tumor directly boosts aldosterone production. Secondary refers to the indirect pathology of the disease wherein there is an abnormality in the system that triggers abnormal and excessive production of hormones. Aldosteronism is sometimes a response to the presence of other diseases or the narrowing of one or more arteries leading to the kidneys.

Treatment approaches for hyperaldosteronism is highly dependent on the cause and type. Adrenal tumors may be surgically removed to stop the production of excess hormones. The adrenal gland remains to be in a healthy state able to produce sufficient aldosterones for the gland to survive as well as provide for the body’s needs. Residual hypertension may remain post-surgery requiring the patient to take antihypertensive medications and calcium channel blockers as necessary. It is possible for patients to have more than one tumor which can also be removed surgically safely.

If the problem is caused by bilateral hyperplasia, medications and drugs may be prescribed that inhibit the effect of aldosterone. Spironalactone and amiloride are known to be effective in stopping overactive effects of the hormones. These are also used in conjunction with antihypertensive medications to alleviate high blood pressure. Epleronone is useful in controlling the enlargement of the adrenal gland. or hyperplasia. Patients should only take these drugs with a doctor’s recommendations and prescription since side effects can cause further complications. Dosage and consumption should only be based on the type and cause of the condition as well as patient’s response.

Alternative treatment options are also available to alleviate accompanying symptoms of the disease such as stress reduction techniques, low-fat diet, exercise, meditation, biofeedback, massage and herbal remedies. All these aim to help make the patient feel more relaxed and improve blood circulation. The adenoma however, may only be treated surgically.


The prognosis of patients drastically improves once the tumor is removed. More than half of all post-surgery patients have full remission will majority of those who had adrenal hyperplasia will become hypertensive for the rest of their lives requiring lifetime antihypertensive medications and lifestyle modifications. Kidney damage may happen to a number of patients. This may be treated with medications, kidney dialysis or kidney transplant. Long term reatment complications include development of gynecomastia or enlargement of breasts and impotence among male patients.


There is no known preventive measure for hyperaldosteronism. Some experts suggest that healthy lifestyle habits like eating healthy, exercising regularly and sleeping well will help prevent the development of tumors. Staying away from alcohol, smoking and harmful substances and drugs are also helpful ways of ridding the body of toxins that may predispose individuals to tumor development and abnormal hormone production. The disease is also not genetic in nature. Early detection of the tumor will help improve prognosis for all patients. Having a regular checkup with an endocrinologist will be helpful to diagnose early formation and abnormal hormone levels.
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