The patient was presented for annual exam with a 1-2 month history of decreased appetite. Blood chemistry and CBC found a potassium low at 3.2, chloride low 113, AST high 70, monocytes high 684, and T4/fPL both normal. Repeat bloodwork a month later showed potassium even lower at 2.6. The patient was started on Renacare potassium supplement and abdominal ultrasound was scheduled. The day of the ultrasound, potassium was rechecked and still low at 2.7; Renacare dose was increased and a month later the potassium level was normal. Post-ultrasound Aldosterone baseline level was high at 1194 (194-388). Prior to surgery she had a normal appetite and energy level, and CBC and chem were normal other than a mildly elevated ALT.