Re: Potassium Levels/Calcium Levels/Other....
10/5/01 8:13 AM

Julie, Thanks for the information....very interesting. 

I've looked into this a little bit, too, to try to figure out the association between glucocorticoids and bone loss; also Lupron and bone loss, something Kay pointed out a while ago, which I was unaware of.  What I've gathered is that these medications have a negative effect on bone because they reduce the production of sex steroids in the body.  Sex steroids (such as estrogen and testosterone) are primary factors in the  accrual of bone mineral density, especially during the pubertal years.  I am guessing that that is why women often have more problems with osteoporosis than men---because they undergo menopause and stop producing estrogen when they are older---while men continue to produce testosterone into old age. 

Re. Sodium and Potassium: Danette, What kind of florinef dose are you taking? Could your low potassium levels and low urine output be caused by a too big dose of florinef?  From what Julie says, "Diuretic medications and those that help to store and retain sodium can also cause Potassium deficiency,"  as well as a couple of articles that I've found (see below for cites), it appears that this could be the case.  I know I've said this before, but I still think it's odd that a SW-CAH patient should be given potassium supplements, even if your potassium levels are too low.  I'm wondering again if the doctor might be taking the approach of just treating the symptoms (by supplementing your potassium intake), rather than trying to figure out why this might be happening.  In an adrenal crisis, sodium levels tend to fall, while potassium levels tend to rise.  As someone for whom an adrenal crisis is a very real possibility, I just wonder if increasing potassium intake is the best way to approach your problem, rather than making sure the medications that you already take for treatment of the CAH are in proper balance. 

HYPOKALEMIA - too little potassium
http://author.emedicine.com/PED/topic1121.htm

HYPERKALEMIA - too much potassium
http://author.emedicine.com/PED/topic1076.htm 

Carol
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