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Hyperaldosteronism - primary and secondary
Conn syndrome; Mineralocorticoid excess
Hyperaldosteronism is a disorder in which the adrenal gland releases too much of the hormone aldosterone into the blood.
Adrenal gland
The adrenal glands are two triangle-shaped glands. One gland is located on top of each kidney.
Aldosterone
The aldosterone blood test measures the level of the hormone aldosterone in blood. Aldosterone can also be measured using a urine test.
Hyperaldosteronism can be primary or secondary.
Causes
Primary hyperaldosteronism is due to a problem of the adrenal glands themselves, which causes them to release too much aldosterone.
In contrast, with secondary hyperaldosteronism, a problem elsewhere in the body causes the adrenal glands to release too much aldosterone. These problems can be with genes, diet, or a medical disorder such as with the heart, liver, kidneys, or high blood pressure.
Most cases of primary hyperaldosteronism are caused by a noncancerous (benign) tumor of the adrenal gland. The condition is most common in people 30 to 50 years old.
Symptoms
Primary and secondary hyperaldosteronism have common symptoms, including:
- High blood pressure
- High level of calcium in the blood
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Fatigue
Fatigue
Fatigue is a feeling of weariness, tiredness, or lack of energy.
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Headache
Headache
A headache is pain or discomfort in the head, scalp, or neck. Serious causes of headaches are rare. Most people with headaches can feel much better...
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Muscle weakness
Muscle weakness
Weakness is reduced strength in one or more muscles.
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Numbness
Numbness
Numbness and tingling are abnormal sensations that can occur anywhere in your body, but they are often felt in your fingers, hands, feet, arms, or le...
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Paralysis
that comes and goes
Paralysis
Muscle function loss is when a muscle does not work or move normally. The medical term for complete loss of muscle function is paralysis.
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Exams and Tests
Tests that may be ordered to diagnose hyperaldosteronism include:
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Abdominal CT scan
Abdominal CT scan
An abdominal CT scan is an imaging method. This test uses x-rays to create cross-sectional pictures of the belly area. CT stands for computed tomog...
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ECG
ECG
An electrocardiogram (ECG) is a test that records the electrical activity of the heart.
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Plasma aldosterone
level
Plasma aldosterone
The aldosterone blood test measures the level of the hormone aldosterone in blood. Aldosterone can also be measured using a urine test.
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Plasma renin activity
Plasma renin activity
The renin test measures the level of renin in blood.
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Serum potassium
level
Serum potassium
This test measures the amount of potassium in the fluid portion (serum) of the blood. Potassium (K+) helps nerves and muscles communicate. It also ...
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Urinary aldosterone
Urinary aldosterone
The 24-hour urinary aldosterone excretion test measures the amount of aldosterone removed in the urine in a day. Aldosterone can also be measured wit...
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A procedure to insert a catheter into the veins of the adrenal glands may need to be done. This helps check which of the two adrenal glands is making too much aldosterone.
Treatment
Primary hyperaldosteronism caused by an adrenal gland tumor is usually treated with surgery. It can sometimes be treated with medicines. Removing the adrenal tumor may control the symptoms. Even after surgery, some people still have high blood pressure and need to take medicine. But often, the number of medicines or doses can be lowered.
Tumor
A tumor is an abnormal growth of body tissue. Tumors can be cancerous (malignant) or noncancerous (benign).
Limiting salt intake and taking medicine may control the symptoms without surgery. Medicines to treat hyperaldosteronism include:
- Drugs that block the action of aldosterone
- Diuretics (water pills), which help manage fluid buildup in the body
Secondary hyperaldosteronism is treated with medicines (as described above) and limiting salt intake. Surgery is not used.
Outlook (Prognosis)
The outlook for primary hyperaldosteronism is good with early diagnosis and treatment.
The outlook for secondary hyperaldosteronism depends on the cause of the condition.
Possible Complications
Primary hyperaldosteronism can cause very high blood pressure, which can damage many organs, including the eyes, kidneys, heart and brain.
Impotence and gynecomastia (enlarged breasts in men) may occur with long-term use of medicines. But this is uncommon.
Impotence
An erection problem occurs when a man cannot get or keep an erection that is firm enough for intercourse. You may not be able to get an erection at ...
Gynecomastia
When abnormally large breasts develop in males, it is called gynecomastia. It is due to the excess growth of breast tissue, not excess fat tissue....
When to Contact a Medical Professional
Call for an appointment with your health care provider if you develop symptoms of hyperaldosteronism.
References
Carey RM, Padia SH. Primary mineralocorticoid excess disorders and hypertension. In: Jameson JL, De Groot LJ, de Kretser DM, et al, eds. Endocrinology: Adult and Pediatric . 7th ed. Philadelphia, PA: Elsevier Saunders; 2015:chap 108.
Nieman LK. Adrenal cortex. In: Goldman L, Schafer AI, eds. Goldman's Cecil Medicine . 25th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 227.
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Endocrine glands - illustration
Endocrine glands release hormones (chemical messengers) into the bloodstream to be transported to various organs and tissues throughout the body. For instance, the pancreas secretes insulin, which allows the body to regulate levels of sugar in the blood. The thyroid gets instructions from the pituitary to secrete hormones which determine the pace of chemical activity in the body (the more hormone in the bloodstream, the faster the chemical activity; the less hormone, the slower the activity).
Endocrine glands
illustration
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Adrenal gland hormone secretion - illustration
Adrenal glands produce hormones such as estrogen, progesterone, steroids, cortisol, and cortisone, and chemicals such as adrenalin (epinephrine), norepinephrine, and dopamine. When the glands produce more or less hormones than required by the body, disease conditions may occur.
Adrenal gland hormone secretion
illustration
-
Endocrine glands - illustration
Endocrine glands release hormones (chemical messengers) into the bloodstream to be transported to various organs and tissues throughout the body. For instance, the pancreas secretes insulin, which allows the body to regulate levels of sugar in the blood. The thyroid gets instructions from the pituitary to secrete hormones which determine the pace of chemical activity in the body (the more hormone in the bloodstream, the faster the chemical activity; the less hormone, the slower the activity).
Endocrine glands
illustration
-
Adrenal gland hormone secretion - illustration
Adrenal glands produce hormones such as estrogen, progesterone, steroids, cortisol, and cortisone, and chemicals such as adrenalin (epinephrine), norepinephrine, and dopamine. When the glands produce more or less hormones than required by the body, disease conditions may occur.
Adrenal gland hormone secretion
illustration
Review Date: 7/24/2015
Reviewed By: Brent Wisse, MD, Associate Professor of Medicine, Division of Metabolism, Endocrinology & Nutrition, University of Washington School of Medicine, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.
