hypothyroidism and ckd progression - Kidney Disease

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hypothyroidism and ckd progression

Futureckd profile image
18 Replies

Hello everyone ,

Did anyone have information based on experience regarding hypothyroidism and ckd progression? My kidney function and blood test were stable for almost 2 years now. Last month TSH (thyroid hormone) was high in blood test, so the primary physician increased levothyroxine from 125 mg to 150mg. This month i did the blood test yesterday and here it is creatinine jumped to 4 from 3.2 last month. This was disturbing . I wonder if I go back to 125mg or what? Also if there is a damage because of levothyroxine , is it permanent or temporarily ?

Thanks if you can help

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Futureckd
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18 Replies
Tolmezzo profile image
Tolmezzo

Have you took levothyroxine same morning day before blood test? If yes this could be the cause, I repeat could be. And check also all other kideney values. rgs

Futureckd profile image
Futureckd in reply to Tolmezzo

In fact yes I did take the levothyroxine the morning of the test and I did the test in the morning, I plan to repeat the test and will not take the med the day of testing. Thank you.

Turtlepad513 profile image
Turtlepad513

I’m the opposite. I have hyperthyroidism, but I don’t think any of my meds are specifically to control it. I would look at meds to make sure your other meds are safe for kidneys.

horsie63 profile image
horsie63 in reply to Turtlepad513

I too have hyperthyroidism which was discovered when I had a thyroid storm. I took the meds for about 6 months and then went into remission. Coincidently or not that's about the time my eGFR was 60 and then began dropping.

Futureckd profile image
Futureckd in reply to horsie63

I am reading articles that hypothyroidism is correlated with ckd progression but all these articles, at least the ones I read, are not really clear on the conclusion. So it is correlated but not clear what affects which. They never mentioned hyperthyroidism. The primary physician does not know for sure and doing research, and I am waiting for the renal specialist to say something. I just met the renal less than a month ago and all test numbers were stable so he was ok. My suspicion about the levothyroxine is that it was the only change in meds that I did in the month between the two blood tests. Thanks for the response.

horsie63 profile image
horsie63 in reply to Futureckd

Here's a pubmed article with some interesting notes. Especially sections 13 and 14. I've never seen a correlation between CKD and hyperthyroidism just hypothyroidism. But I think it affects people differently especially if they have other diseases. I've heard that if you have one autoimmune disease chances are good you'll develop another.

ncbi.nlm.nih.gov/pmc/articl....

Futureckd profile image
Futureckd in reply to horsie63

I should add also that I was on supplent levothyroxine 125 mg per day for long time and the reason the doctor increased it last month to 150mg was the blood test of TSH of 21. The recent TSH after 1 month dropped to 4.8. She is puzzled about the severe drop after one month only. But no T3 or T4 were tested at that time. She now ordered T3 and T4 in blood test. Waiting for results.

The 3 articles received from horsie63 and userotc are very important to read. I will share with the doctor also. Thank you.

userotc profile image
userotc

There seems to be significant uncertainty in this area with drugs. Note:

1. 2012 link below: "Drugs used in thyroid or kidney disease may have adverse effects on the other organ's functions" and "....it is not clear as to what level of thyroid dysfunction forms the threshold necessary for treatment by thyroxine replacement in CKD. In general, mild elevations of TSH (less than 20 IU/ml) with or without low T3/T4generally do not warrant thyroid hormone supplementation".

ncbi.nlm.nih.gov/pmc/articl...

2. 2021 link 2 below: "....there are many remaining gaps in knowledge in regards to the clinical management of CKD patients with hypothyroidism".

pubmed.ncbi.nlm.nih.gov/341...

Futureckd profile image
Futureckd

I should have said that my thyroid was totally removed around 12 years or more ago due to being over hyper reactive. They tried by meds to slow it down but no use. So it was removed. since then I was on levothyroxine as a replacement supplement. At that time my kidney was perfectly fine. Now I wonder if that had contributed to being ckd patient now. I am not sure. All what I read about on levothyroxine as a drug that is safe and widely used with no known side effects. They call it the economic med also.

thank you userotc for sharing these articles. I will share with the primary physician who is sincerely trying to research the problem.

Grateful2021 profile image
Grateful2021

I have Hashimoto’s and Stage 3 CKD. I’m working with an endocrinologist who, for the first time in 25 years, explained to me to suspend taking and supplements containing biotin 48 hours before thyroid testing. Many multivitamins contain biotin. So for years, I have been taking too much synthroid. My endocrinologist has reduced my dosage twice and I’m due to be tested again in a month. Biotin can really throw off tests.

hope1419 profile image
hope1419

My nephrologist did not relate with hypothyroidism CDK, but he did relate hypoparathyroidism, the hormones behind the thyroid with it. Have you had yours checked?

Futureckd profile image
Futureckd

Yes. But not in this last blood test with TSH. The month before it was tested and parathyroid level was 121. My renal doctor related it with ckd in past appointments and said parathyroid level will always be abnormal with ckd.

I feel I am on the top of uncertainty with this hypothyroidism/ckd and not sure what to do except repeating the kidney blood test without taking levothyroxine, vitamin b12, folic acid, or vitamin D3 before the test. I still think that the drop in TSH in one month from 21 to 4.8 is what bothered kidney function. I just hope that this is not a permanent additional damage. I am border line between stage 4 and 5. Even if I see an endocrinologist , the gap in knowledge and communications between endocrinology and nephrology is still there.

Thanks

Nana16 profile image
Nana16 in reply to Futureckd

I can tell you that, in my 20 years of dealing with hypothroidism, caused by Hashimotos, I have always found that when my TSH goes to high, my kidney function decreases, sometimes takes a big drop. After my thyroid meds are adjusted, and TSH is in a good range for me, the eGFR usually goes back up. As I get older, the drops are more severe, and the recovery not as good each time it happens. I would suggest watching the two for a couple of months to see if your kidney function comes back up now that you have the TSH down. I do know that you need to cease biotin, or any multivitamin containing it, for a few days before you're due to have a thyroid test. It was explained to me that biotin is not a problem for the thyroid itself, it just affects the results of the tests. Apparently there's a reaction between biotin and some of the testing protocols. I also have my thyroid labs done early in the day and wait until after the blood draw to take that day's levothyroxine pill. I've done it that way a long time.

I believe that there is a correlation between hypothyroidism, kidney disease, and heart disease. My body does not convert levothyroxine (synthetic T4) to T3 very well, and on the rare occasions I can get the T3 tested, it is always very low in range, or just below range. I think the T3 is the place where all of those 3 conditions collide, but that is just my own opinion based on my personal experience. And every body is different in the way it reacts. It's great that you've found a good endocrinologist. I've been to 2 of them. The first one told me that the high levels of antibodies I always have will cause symptoms of pain, fatigue, poor sleep, etc and are related to poor quality of life. She told me to take a few supplements that might help, but that she will not monitor them or follow up with any blood tests, and she only tests TSH, and refuses to do a complete thyroid profile. The second one told me that the high antibodies would have absolutely no effect on me, and that even though T3 is very low in range, just a hair over the bottom end of the range, as long as it was in range it was fine. He also said he goes by TSH, not T3 or T4 levels. Both of them immediately referred me back to my primary care doctor.

Best of luck to you, and I hope that your kidney function will improve, and not stay at that lower level.

Futureckd profile image
Futureckd in reply to Nana16

thank you so much Nana16 for sharing this valuable experience with thyroid and kidney function. I think your response is priceless in my opinion as it hits directly my case. Doctors unfortunately focus on his thing and ignore the other factors. So my TSH was not often tested nor the T3 or T4. Last time was almost 2 years ago! I never thought it was told that thyroid and kidney are that correlated. In fact now I realize that both were attacked by my immune system , causing Vasculitis in kidney and thyroidectomy of thyroid. So now I rely totally on levothyroxine.

I got 2 very important points from your response:

1) may be the kidney function will improve with improving the TSH with fixing the dose. I plan to request both tests to be done together in the coming few months to monitor.

2) the latest TSH results could be inaccurate as I took the levothyroxine bill, B12, Folic axis, and D3 right before blood test in the morning.

The doctor asked for T3, T4 and results are confusing to me based on my readings (I did not discuss with her yet). Free T4 is normal 1.32 (range 0.78-2.19). Total T4 is high 13.1 (range 5.53-11), and T3 free is a bit above lower limit 2.88 (range 2.77-5.27) like yours. Thank you again.

TaffyStretch profile image
TaffyStretch in reply to Futureckd

I have hashimoto and take 50mg levothyroxine and also take D3, folate, B12, weird.

WinJ3 profile image
WinJ3

What was your TSH results that caused you to take Levothyroxine?

Futureckd profile image
Futureckd

my thyroid was removed many years ago and since then I was on levothyroxine dose 125 mcg per day. Last month TSH test showed level of 21 which is very high as the normal maximum is around 5. That made me hypothyroidism. So the doctor tol increased the dose from 125to 150 per day. After the month of this dose, the TSH result became a bit over 5. That drop according to the doctor is also strange. The drop should not be that large within a month. She wants me to stay on 150 for another month. that what triggered my post. Now reading papers, it seems 21 for TSH is high but for ckd patients is kind of common. Still need treatment by increasing levothyroxine or something. Hope this answered your question.

Futureckd profile image
Futureckd in reply to Futureckd

I had a new blood test for TSH level, creatinine, potassium, BUN, and cystatin c.

Now my TSH went down to 0.91 from 4.8 from 21. Like it drops drastically every 4 weeks. Creatinine stayed at 3.8 , BUN 29, potassium went back to normal after stopping eating avocado, banana, and potatoes. Cystatin c now jumped to 4.53 from 3.4 last month. That was unexpected for me! my primary physician adjusted levothyroxine again from 150 to 137. She wants to see TSH at 1.5.

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