CKD & T3

[Nickinoo1]

I have my last blood results in and also getting copies later of my blood results going back 10 years. Last results all 'normal' will investigate more when I get my copy but my GFR is now reduced to 55 not been that low in a while but always under 60 - I am stage 3 CKD. So off I go to google as had read Hashi's reduces GFR by 40%. Reading further CKD often presents with normal TSH & T4 but low T3. If low T3 what symptoms can you get? Hypothyroid ones? As you know I am not getting any assistance from any health care bod because bloods are in range but don't think T3 has been done. Will know more later.

[Clutter]

Nickinoo, it's low T3 which causes hypo symptoms. You can order a private FT3 test from Genova or Blue Horizon via thyroiduk.org.uk/tuk/testin...

[Jackie in reply to Clutter]

I agree.

Jackie

[Parbrook]

My view on this, and my experience with the loss of one kidney and CKD on my remaining kidney, is that the T3 will be reduced because of the loss (or impairment) of the T4 to T3 conversion in the kidney.

The level of impact of this in terms of hypothyroid symptoms is debateable and may be in proportion to the CKD level.

Seeing as T3 is the (only) active thyroid hormone, it is logical to assume that there will be some hypothyroid symptoms resulting from there being less T3 available for circulation to the other organs.

Whether the thyroid compensates for this (assuming that it is fully functional) is probably unknown.

So, to answer your question, it would be reasonable to assume that you will experience some hypothyroid symptoms with CKD due to having a lower level of T3 as the result of the reduced kidney function.

In my case, I experienced some brain fog and periods of concentration difficulty, which I had to live with for 30 years. It was only when I was diagnosed hypothyroid following a course of treatment with Interferon Alpha (which is know to damage the thyroid gland) that I experienced the more obvious hypothyroid symptoms.

I made the connection between T3 and kidney loss/CKD only recently by reading about T3 on this forum.

[Nickinoo1 in reply to Parbrook]

Thank you for that informative response - really helpful. I am in the hands of my GP. Never been referred for my kidneys.

I try to be careful with diet but otherwise a wait and see approach.

[Parbrook in reply to Nickinoo1]

A further thought on this ...

The kidneys will need an adequate amount of T3 in order to function correctly, so there could be a chicken and egg situation if you have had low T3 for a long time.

My recommendation is to ask your GP for a referral to a Nephrologist.

This is the best route for getting diet advice, regular renal blood tests and medication to cover the loss of kidney function.

[Nickinoo1]

So I have a huge list of results which are interesting. All in range except GFR and TPO antibodies but think from what I have learned here ferritin is low and look at my red blood cell results - COPD cause?

Serum creatinine 94 (50-98)

Gfr 55

Serum potassium 3.7 (3.5-5.3)

Serum sodium 141 (133-146)

ESR 6 (6-13)

Serum globulin 31 (20-34)

Serum protein 68 (60-80)

Hemoglobin concentration 14.6 (11.5-14.8)

Total white blood count 5 (4.5-13)

Platelet 173 (140-400)

Red blood cell count 4.5 (3.82-4.98)

Mean cell volume 95 (84-99)

Hematocrit 0.428 (0.36-0.46)

Mean cell hemoglobin level 32.5 (27.5-32.5)

B12 361 (187-883)

Serum folate 7.8 (1.8-18.3)

Serum ferritin 50.4 (10-204)

Free T3 4.17 (3.6-6.5)

Free T4 12.5 (9-19.1)

TSH 2.6 (0.35-4.94)

TPO antibodies 203

Serum prolactin 208 (108-557)

There you have it any ideas what is wrong with me? Think hypo symptoms and thyroid nodule so I have Hashi's but also CKD 3 and new last year a tentative COPD diagnosis after pleurisy for two months but a lifetime of bronchitis too. Your comments would be appreciated.

Or with MCV & mch on high side anaemias?

[Jackie]

HI 55 is fine, just a fraction low depends also on the other U`s and E`s, kidney function.MY eGFR is always below 30, end stage.

jackie

[Nickinoo1 in reply to Jackie]

Hi jackie thanks it has been as low as 43 so yes it's not bad at the moment and certainly not end stage.

[Jackie in reply to Nickinoo1]

HI Make sure you drink plenty of water and watch the Potassium and sodium levels.

Best wishes,

Jackie

[Nickinoo1 in reply to Jackie]

Potassium / sodium up or down in ranges lol? Best wishes to you too.

[Jackie in reply to Nickinoo1]

Hi Sodium must only be low in range.Potassium ideally at 4 but not too high as can cause coma for kidney patents. It has happened 3 times to me,lethal usually. Potassium too low may cause cardiac arrests.Only take Potassium or magnesium under doc and weekly tests , calcium too and watch the D as affects calcium. They are electrolytes so very important.Food no problem.

Jackie

[Parbrook in reply to Jackie]

You also need to monitor the phosphate level. High phosphate in CKD patients is a contributory factor for heart-failure, especially when on dialysis.

Reduced kidney function has a negative impact on vitamin D levels. At some point, probably when you reach CKD 4, your nephrologist can be expected to put you on a vitamin D analogue, such as Alfacalcidol, which bypasses the kidney where vitamin D is normally processed.

Also, I recommend that you get a blood pressure machine for use at home. The ideal resting BP is around 120/80, but a systolic of up to 140 should not be a problem.

Anything above this (and a diastolic of 90) and your nephrologist (or GP) can be expected to put you on something to manage this (i.e. Ace Inhibitor, Beta Blocker, Calcium Channel Blocker, depending on how you tolerate each of these).

[Jackie in reply to Parbrook]

HI Yes, you are quite right. Additional info is always useful.

Jackie

[eeng]

TSH of 2.6 is high. I would feel pretty rubbish at that level. Are you on thyroid meds?

[Nickinoo1 in reply to eeng]

Absolutely nothing lol self medicating is the only way forward!