In hyperaldosteronism, overproduction of aldosterone leads to fluid retention and increased blood pressure, weakness, and, rarely, periods of paralysis.

• Hyperaldosteronism can be caused by a tumor in the adrenal gland or may be a response to some diseases.
• High aldosterone levels can cause high blood pressure and low potassium levels. Low potassium levels may cause weakness, tingling, muscle spasms, and periods of temporary paralysis.
• Doctors measure the levels of sodium, potassium, and aldosterone in the blood.
• Sometimes, a tumor is removed, or people take drugs that block the action of aldosterone.

Aldosterone, a hormone produced and secreted by the adrenal glands, signals the kidneys to retain more sodium and excrete more potassium. Aldosterone production is regulated partly by corticotropin (secreted by the pituitary gland) and partly through the renin-angiotensin-aldosterone system (see High Blood Pressure: High Blood Pressure). Renin, an enzyme produced in the kidneys, controls the activation of the hormone angiotensin, which stimulates the adrenal glands to produce aldosterone.

Hyperaldosteronism can be caused by a tumor (usually a noncancerous adenoma) in the adrenal gland (a condition called Conn syndrome), although sometimes both glands are involved and are overactive. Sometimes hyperaldosteronism is a response to certain diseases, such as very high blood pressure (hypertension) or narrowing of one of the arteries to the kidneys.

Eating Real Licorice
Eating large amounts of real licorice can cause all the symptoms of hyperaldosteronism. Real licorice contains a chemical that can act as though there is too much aldosterone. However, most candy sold as licorice contains little or no real licorice.

Symptoms and Diagnosis

High aldosterone levels can lead to low potassium levels. Low potassium levels often cause no symptoms but may lead to weakness, tingling, muscle spasms, and periods of temporary paralysis. Some people become extremely thirsty and urinate frequently.

Doctors who suspect hyperaldosteronism first test the levels of sodium and potassium in the blood. Doctors may also measure aldosterone levels. If they are high, spironolactoneSome Trade Names
ALDACTONE
or eplerenoneSome Trade Names
INSPRA
, drugs that block the action of aldosterone, may be given to see if the levels of sodium and potassium return to normal. Doctors also measure the levels of renin. In Conn syndrome, the levels of renin are also very low.

When too much aldosterone is being produced, doctors examine the adrenal glands for a noncancerous tumor (adenoma). Computed tomography (CT) or magnetic resonance imaging (MRI) can be helpful, but sometimes blood samples from each of the adrenal glands must be tested to determine the source of the hormone.

Treatment

If a tumor is found, it can usually be surgically removed. When the tumor is removed, blood pressure returns to normal, and other symptoms disappear about 70% of the time. If no tumor is found and both glands are overactive, partial removal of the adrenal glands may not control high blood pressure, and complete removal will cause Addison disease, requiring treatment for life. However, spironolactoneSome Trade Names
ALDACTONE
or eplerenoneSome Trade Names
INSPRA
can usually control the symptoms, and drugs for high blood pressure are readily available. Rarely do both adrenal glands have to be removed.

Last full review/revision September 2012 by Ashley B. Grossman, MD, FRCP, FMedSci