I had been to the emergency room 10 times in the past 6 months. 

Very scary.

Third time, I demanded a blood test. Doctor said high blood pressure is not an emergency! Since troponin I, EKG, chest X-ray, d dimer (later), CT scan with contrast — all normal.

I said — “but my potassium may be low.”

He ordered test.

Potassium: 3.1

Though most lab tests consider potassium as low as 3.5 to be normal, most doctors know that ideal levels should always be above 4.0 — preferably around 4.5.

I went home and looked up my potassium levels in the past 5 years.

They were all below 4.0

Which means my PA may have been going on all this time.

I went to my regular clinic. I seduced my primary care physician to think of all the reasons why I would have these scary symptoms along with a peculiar low potassium level. It worked.

She, my physician, thought of many tests. One of them was the Aldosterone-to-Renin Ratio (ARR). Renin is an enzyme produced by the kidneys that triggers aldosterone (produced) by the adrenal glands to retain sodium and water, which then raises blood pressure.

So we ordered both renin and aldosterone together. One test is useless without the other.

Results:

Renin 0.01

Aldosterone 13.4

Which means renin is non existent since the lowest number is 0.01 — not 0.00.

Aldosterone-to-renin ratio should be less than 20.

Mine was 1340: hundreds of times disproportionately higher.

What that means is that my renin is suppressed on purpose, yet aldosterone is being rogue — acting on its own, autonomously maintaining a disproportionately high level.

High aldosterone is well known for along raising blood pressure, also causes fibrosis and scarring of the blood vessel walls. And of course, potassium excretion through the kidneys.

I was taking magnesium all this time, hoping it would help safeguard my potassium level.

It did not!

I did a carotid ultrasound: still pending after two weeks.

In two days, a echocardiogram. 

Another three days, discussion with endocrinologist about adrenal vein sampling (AVS): to discuss whether it’s one adrenal gland or both damaged (by tumor), and whether operation or medication (spironolactin) is appropriate.

Up to 20 percent of the blood pressure population has this condition, and they don’t know it.

In the meantime: kidneys are being destroyed, left heart ventricle thickening, vena cava narrowing, lowered hydrogen, low potassium, low magnesium, low ionized calcium, low zinc, and deregulation of blood pH.