Kidney`s еndocrinologist

[Sergey]

hi! Could some advise me an endocrinologist in London who has a could understanding of kidney`s problems (such as violation of kidney`s hormone - ADH)? Thank you in advance!!

[Jackie]

Hi If you are worried about your kidneys and have had unsatisfactory U `s and E`s done. Then you need to see a Nephrologist , outside Endo`s remit.

Jackie

[Sergey in reply to Jackie]

Thank you for your reply. Frankly speaking i am not a citizen of GB, but i am coming time to time to London for some bisuness meeting. My national GP as well as nephrologist are not able to explain the incorrect level of kidney's hormones (mainly ADH and then other ones). Thats why I would like to hear an alternative opinion on the issue. Could you please tell me what is U and E tests which you are telling about in you letter?

[Jackie in reply to Sergey]

Hi I see. U`s and E`s are a full kidney function test, the ones you had and more.They have to be quite a way out to matter for kidneys.I hope this is some help. potassium is a U and E but not really relating on its own to kidneys.

Jackie

[Sergey in reply to Jackie]

Ok. Thank you.If i understood correctly U and E tests are a little bit closer to mechanical function of kidneys which is absolutely correct in my case (i have made a very complex examination of kidneys for getting clear view that everything is ok with their main (filtration and so on) functions are still good. Still as this conclusion did not really help me to resolve my problems i was informed that beside mechanical function of kidneys there is a great influence of endocrinological issues on kidneys which are the subject of investigation by the physyologist and endocrinologist. Despite i had passed the relevant endo - kidneys tests and that they showed the bad results - the endo doctor was unable to help me as the received results did not come along with existing endo disorders, but (!) were clearly stated as the endo side affect of the medical drug which I had been taking previously and after which i started suffering by those symptomes which led me both to my GP and then to nephrologist. P.s. thats why i am trying to find a good physyologist or endo doctor for resolving the endo - kidney problem.

[Jackie in reply to Sergey]

I see. I think you will find it is outside an Endo`s remit. The only other test you could have for kidneys is an ultra sound but that covers everything. I have kidney disease, severe, and it is nothing to do with my thyroid. In fact important to treat the thyroid but no influence.Potassium is your concern and must be lower or damage will occur and to heart.

Jackie

[Sergey in reply to Jackie]

Ok. Potassium has reduced greatly in the urine and is rising at this moment in the blood. I have found some information on hormone investigation in urine, i am thinking now wether the level of my problematic ADH, aldosteron and renin could be traced with this test: imperialendo.com/for-doctor...

[Jackie in reply to Sergey]

Good Idea. Also ask for LFT`s which is liver function, could be the problem.All blood tests with the U`s and E`s blood tests.

Jackie

[Sergey in reply to Jackie]

Thank you. I have passed some elements of LFT test. They are really not good sometimes. But the exceeding of normal values is not so regular as in the endo test. Moreover my GP has stressed that i have really faced with 2 negative consequences of taking my pills (the liver problem was also highlighted in this list). But as the local website is focused on endo problems i decided to touch only this side of the problem.

[Jackie in reply to Sergey]

Hi If liver function very out that is a hepatologist! But I tress both that and kidney bloods have to be very lout to be a problem

Jackie

[Sergey in reply to Jackie]

I agree. Following to the fact that liver problem is more or less clear to my GP (unlike endo) i would to focus on endo one, as i believe it has been existing too long

[Silver_Fairy]

Which 'medical drug' were you on?

[Sergey]

Prozac (fluoxetin) - its antidepressant

[greygoose]

Sergey, are you sure you mean kidneys and not adrenals? The adrenals sit on top of the kidneys and make several hormones.

On the other hand, ADH is a pituitary hormone which affects the kidneys, but is not made in the kidneys. The kidneys only produce the hormones vit D and erythropoietin.

It would be very helpful if you could post your blood test results here - with the ranges (the figures in brackets after the results) - then we would have a better idea what is going on.

[Sergey in reply to greygoose]

So, the tests are the following (blood) : (1) RAAS: rennin - 46,8 (2,8-39,9), angiotensin II - 3,8 ng/l (20-40), angiotensin-converting enzyme - 37 U/l (12-68), aldosteron - 404 pg/ml (13-145), ADH < 1 ng/l (1-3), the level of osmolarity at the point of making ADH - 0,299 osmol/kg (0-285), Copeptin (was made 3 months later then ADH - 1,52 pmol/l (1-28,2), the level of osmolarity at the point of making Copeptine - 293 mosm/kg (0-285), (2) BNP (NP-pro-BNP) 208,8 pg/ml (0-125), (3) Blood test: Na - 146,8 mmol/l (0-145), (4) Urine test (i was insisted to perform it by physyologist) - the regular lack of Na (50% of normal value), K (25% of normal value) with in 2 years, the level of osmolarity of urine - 583 (>600) at this moment.

[greygoose in reply to Sergey]

OK, so there are really no thyroid tests there. What is in question is the pituitary/hypothalamus. And I'm not sure how much the average endo knows about them! You would need to find a really good private one, I think! Sorry, I can help you there, but if you contact Louise Warville, she will be able to give you a list and you could try ringing them and see if they are able to help you.

However, Don't say that it's about your kidneys, because it isn't exactly, it's the pituitary/hypothalamus that need investigating. An endo will probably just say kidneys aren't his speciality.

So, I see below that you are aquanted with the diabètes link. However, I do Wonder, are you still taking the tablets in question? Would not the ADH right itself if you stopped taking them?

You are taking Prozac, and it's my opinion that people should be tested for their thyroid before being put on antidepressants. An awful lot of depression is hormonal. Low T3 will cause depression - as will low vit B12, another thing to test for. It might be better to go that route first.

Do you have symptoms of low ADH? Excessive thirst? Excessive urination? Just wondering how urgent this problem is.

[Sergey in reply to greygoose]

Ok, thank you. You wrote right in such moment when i was calling both private and NHS hospitals in London for finding the proper doctor. I have started googling for finding Louise Warville. I am planning to come to GB on weekend so i need to sum up all information I have received and try to resolve the matter. You are absolutely right that there are no any thyroid as i beleive this problem this problem does not concern me. I efforts related to publishing my post here was just to find more information on good endo doctors who, probably, could reffer me to their proper colleagues. As for P/H matter: unfortunately the problem, as it seems me know, is a little bit more complicated then finding good specialist with relevant field of exeprtice: the whole disorders of P/H (which are the subject of investigation by endo doctors) are based either on genetical mistakes (for example - the common non - sugar diabetes) or on mechanical impact (as trauma or tumor) which cause other disorders. Such thing as violation of ADH, which is stated as the back side of pilles and which (ADH) unproper level was confirmed by the tests is something (for my understanding) outstanding and can be diagnozed just like a gained endo disorder without including it to regular P/H problems mentioned above. Its my view on the matter after having consulations with my GP, endo and physyologist. Why i am insisting on the kidney? Probably there are not the subject of medical treatment, but their incorrect work is a more bright thing for examination of ADH (probably even more then the ready blood test as the level of ADH itself (in the test) is deemed to be not relieble thing - what makes the whole problem even more difficult. This means that the relevant doctor should a have good understanding of both procedures: p/h`s production of ADH as well as its infuence on the work of the kidneys based on not just endo science (as its just 1 effect of ADH from this point of view - facultative absorbtion of the water in nephrone) but from the physyology side also (as it has much more opportunities for catching the effect of ADH in this way).

[greygoose in reply to Sergey]

Louise Warville is one of the admins on this site.

healthunlocked.com/louisewa...

Send her a message.

The reason I mentioned thyroid is that you do have a symptom of underactive : depression. The idea was to get you off the Prozac, which is bad for you in many ways. The problem may then resolve - as you said it was caused by the Prozac. That would seem an easier line of attack to me.

[Sergey in reply to greygoose]

Ok. I finished taking the pills right after the first negative symptomes had appeared. It was half a year ago. But unfortunately it did not helped at all. I have read that the common issue for non sugar diabetes (which is based on a genetically determined absolutely lack of ADH) is really an excessive urination and thirst. But in my case (if it would further appear that i really have some specific *violence of ADH*) it is the more or less normal level quintity of urine which have a very low density, the probem with urination itself, the regular feeling of nausea and the specific (negative) feeling in the kidneys.

[Sergey in reply to Sergey]

Summing all up: thank you, once again, for your support!

[greygoose in reply to Sergey]

Well, I'm afraid I cannot help you any further than that. So, now the best thing to do is contact Louise for doctors, then contact the doctors themselves, and see if they know anything about this.

Good luck.

[Sergey]

Thank you for the comment. I will sent my blood tests in the next letter. I have reduced the risk for adrenal problems by making relevant blood - hormonal tests and making MRT of adrenal for avoiding of tumours - everything is ok. ADH is indeed produced by pituitary, but, for example, there is a certain endo disorder (its one of the subdivision of non - sugar diabetes) which make the kidney not sensitive to the effect of ADH. This means that the ADH its self is not quite a simle thing (to my opinion) which is just generated by pituitary and then makes some kind of minor endo work in the kidney as its stated in nephrology science. Following to the physyology and endo science - ADH generates non less then 50 osmolarity of kidney (i.e. in the interstitional space of the kidney) what in its turn is one of the key things for functioning of the kidney in general (for absorbtion of some usefull elements back to the body and conсentration of the urine in the kidney). This allows nephro doctors to use their scills for medical treatment of nephro patients. Otherwise (without hormonal element) there will be no significant problems with kidney, as it will be functioning like a pump which is quite simple to reconstructed. Its my personal view : )

As for the risk of tumour of the pituitary - it was also reduced by me as i have made relevant MRT and also following to the matter of fact: my problems has arised just from taking the medicine pills, so i hadnt any problems with pituitary prior to my medical occasion.