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Are You Deficient In The Adrenal Hormone Aldosterone?

I have been reading Thierry Hertoghe’s book ‘The Hormone Handbook’. He says Aldosterone’s major role is to keep water in the body and the blood pressure up during the day. To achieve this, aldosterone makes the kidneys retain sodium, and this water by osmosis thereby filling the blood vessels and tissues up with more fluid. At the same time, aldosterone makes the kidneys secrete a supplementary amount of potassium, the antagonistic ion to sodium, to increase further sodium’s water-retaining action.

Daily secretion of aldosterone in young health adults averages around 150 ug a day. Aldosterone is produced by the cortex of the adrenal glands. Higher daytime aldosterone levels are found because individuals stand up during the day. The upright position strongly stimulates aldosterone secretion in order to maintain normal blood pressure.

Aldosterone production is increased with physical activity, by standing up, stress, low salt intake, increased salt losses (caused by sweating or a diuretic), high protein and saturated fat diets.

However, aldosterone levels decline with age. The excretion of aldosterone in the 24-hour urine urines during a normal salted diet declines by about 20% in elderly persons, aged 70 to 80, compared to young adults. When the diet is low in salt, the difference between young and old is more pronounced. To compensate for the low intake of salt, aldosterone levels, increase both in young and old, but the compensatory increase is about 50% less in elderly person than in young people, showing that individuals with increasing age lose part of the ability to increase aldosterone production to respond to increased salt and fluid needs.

Symptoms of aldosterone deficiency include: tendency to lie down, tendency to move all the time when standing up to increase blood pressure. Drowsiness, zombie-like feeling: Easily distracted, absent-minded, day dreaming. Difficulty focusing on tasks, feels better in head when lying flat on a bed or moving all the time. troubled vision with difficulties in focusing on objects and tasks when standing up. Salt and salty food cravings, thirsty often, strong tendency to drinking a lot of water and other liquids and popping to the toilet several times during the day.

Physical signs of aldosterone deficiency are: pale face, a drowsy, absent-minded look, low blood pressure (arterial hypotension), : Below 100/60 mmHg. Orthostatic hypotension. Hollow face, sharp wrinkles, eyes deep in orbit, soft eyes (eye ball fells soft to pressure because of low eyeball pressure), tongue with teeth marks visible at tongue borders (tongue indentation), and skin tenting-prolonged still skin fold after pinching the skin of the back of the hand.

Several diseases may be aggravated or possibly caused by the dehydration that accompanies aldosterone deficiency, in particular cardiovascular diseases (thrombosis, coronary heart disease), rheumatoid and digestive diseases and possibly Alzheimer’s dementia.

For aldesterone deficiency you need 9-alpha-fluoro-hydrocortisone) fludrocortisone such as Florinef). You take 50 to 2000 mgs daily (most frequent starting dose is 100 mgs daily and you take one tablet in the morning. Alternatively, you can take oral Aldosterone, 70 to 200 mgs daily, but you take 3 tablets of Aldosterone a day. However, there are two exceptions to the rule> patients with a tendency to swell or who suffer from arterial hypertension (high blood pressure) should not receive aldosterone or should start at lower doses. Also, patients with severe low blood pressure (90mmHg of systolic blood pressure) may start at 125 to 150 mg per day.

Doses should be increased in conditions where more aldosterone is needed (low salt diet etc.) or is used up (prolonged standing up or sitting position, heavy sweating, severe stress, etc) or less is produced (jet lag).

Sometimes, after starting treatment, the increase in blood pressure, which is usually the first improvement noticed, may occur quickly, even the first day of therapy. In some subjects, it takes several weeks before a noticeable improvement. The slow progress is often due to low water or salt intake or an insufficient dose of fludrocortisone.

Contraindications to treatment: Caution is recommended with individuals whose feet, ankles and/or hands easily swell, or who have high blood pressure, as these are all signs that may exacerbate with aldosterone replacement without significant benefit from the therapy. Patients who tend to swell or have high blood pressure should not take fludrocortisone nor aldosterone, or if they do, should start on doses as low as 25 to 50 mgs every 10 days up to 100 mgs unless the patient shows signs of excess.


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