kidney disease and TSH

[Lolacatty]

Hi all, I recently had a pyeloplasty for a PUJ obstruction (June 2022) and thought probably naively that it would be the end of my kidney problems once fixed!

I’ve just had my follow up MAG3 and will get the results from that in a couple of weeks, but in the meantime I’ve just had my first follow up blood results and disappointed to see my egfr is still falling. It’s now 64 which I see is close to the range for stage 3, I assumed once my dodgy kidney started draining properly it would go up or at least stay stable. Even pre-pyeloplasty it was 72.

As an incidental, on these bloods my TSH level has gone up it’s now close to the cut off for out of range (4.15). I’ve been feeling so rubbish recently, tired, low mood, unable to shift weight despite a very good diet and excercise regime and sorry for TMI but my libido has packed up and left the country which is causing issues in my relationship. Could this be to do with my rising TSH level? I’ve read studies as well that show there’s a correlation between TSH and egfr (higher TSH has a negative impact on egfr). I see my urologist in a few weeks, I want to push for treating me for subclinical hypothyroidism and see if it has a positive impact on my kidney - am I barking up the wrong tree here or is it worth exploring?

would love to hear from peoples post pyleoplasty experiences too - did you see immediate improvement?

[nellie237]

Hi Lola,

I'm hypothyroid since 2007, and yes I have looked at the connections too as I had AKI last year. I don't suppoose they tested FT4, FT3, or antibodies along with the TSH did they?

Do you know if this is a 'one off' odd result, or has your TSH been creeping up over time?

I agree it's worth exploring, and some Dr's will be willing and some won't at all, and you need to be your own advocate. You also need good levels of basic nutrients ie Iron, Folate B12 & Vit D, so you need these tested too.

Many of us on the thyroid forum organise our own testing. I mainly use Monitor my Health (NHS lab in Exeter......finger prick test by post) for basic thyroid £29, because the NHS rarely tests FT3. If you haven't had antibodies & nutrients tested, you might want to look at Medichecks (there is a 20% discount this weekend), and post your results on the thyroid forum here on healthunlocked.

[Nana16]

I think it's definitely worth exploring. I have autoimmune hypothyroidism. It took me 17 years to get my antibodies tested, and my PC only tested once, sent me to an endocrinologist who walked into the room and announced that she only tests TSH and she does nothing for antibodies. Back to the PC I went. But last year, my TSH rose from the .8 or so that is optimal for me, to almost 3. In that same time period, my eGFR went from 38 to 32. The doctor raised my levothyroxine dosage, and within 3 months, TSH was back down to ,8, and eGFR was up to 35. She says there is a definite correlation. About 6 weeks after the increased dose, I self-ordered antibodies, TSH, T3 and T4. I sent those results to her, but when I went to see her she had ordered TSH, Free T3 and Free T4, not antibodies But she did order an antibody test that day, and they were even higher than the one I self ordered. She has sent me for a thyroid ultrasound, and has also referred me to a different endocrinologist, whom I will see in December. I haven't seen my nephrologist for a long time, because he referred me back to my PC for monitoring. I stayed around 50 for several years after diagnosis of CKD, which was about 13 years ago. When my antibodies tick up, it always causes my TSH to go down, and my eGFR with it. My Free T3 is barely above minimum, which is not optimal at all, and my Free T4 is almost out of range. I do the best I can to try to keep everything balanced, but sometimes it's out of my control. The sad thing about it is that there isn't a doctor around me anywhere who will attempt to help control antibodies. I'm 20 years past my diagnosis of hypothyroidism, and most likely had it for at least 20 years before that. I plowed through life one step at a time, dragging my body along with me, even when it didn't want to go, for a long time before anyone looked at my thyroid. I am convinced that untreated hypothyroidism was at least partly to blame for my diminished kidney function, but there isn't any medical professional I've run across who will totally agree with me. My PC does see that they are related, because she's followed all those numbers for about 12 years now, but she doesn't have the knowledge to prescribe added T3 to my levo.

So, this was a long, roundabout way to say that yes, I do believe you are on the circling the right tree.