Just how many hypo- issues did this patient have?
The paper does support the idea that sodium, potassium, magnesium, calcium, phosphate and chloride can all be affected by hypothyroidism.
Also wonder, as kidneys perform at least some conversion of T4 to T3, do kidney issues contribute to overall inadequate conversion? There is a very close relationship between kidneys and thyroid hormone.
BMJ Case Rep. 2014; 2014: bcr2014203895.
Published online 2014 May 21. doi: 10.1136/bcr-2014-203895
Salt-losing nephropathy in hypothyroidism
Aileen Azul Bautista,1 Jose Eduardo De Leon Duya,2 and Mark Anthony Santiago Sandoval, 1
1 Section of Endocrinology, Diabetes and Metabolism, Department of Medicine, Philippine General Hospital, Manila, Philippines.
2 Department of Medicine, Philippine General Hospital, Manila, Philippines.
This article has been cited by other articles in PMC.
A 35-year-old man presented with recurrent lower extremity weakness associated with polyuria later progressing to generalised weakness with difficulty in breathing. The patient was hypotensive and dry, with normal thyroid and chest examination, weak lower extremity and carpopedal spasm. Workup revealed hypokalaemia, hyponatraemia, hypocalcaemia, hypomagnesaemia, hypochloraemia and hypophosphataemia. Arterial blood gas showed respiratory alkalosis with good oxygenation. Twenty-four-hour urine collection showed normal volume with electrolyte wasting. Thyroid function test revealed overt hypothyroidism with negative antithyroid peroxidase. The patient was well after treatment with levothyroxine, volume and electrolyte replacement and was discharged. Thyroid hormones are related to the expression of the Na-K-ATPase, Na-Pi cotransporter, Mg-ATPase and Na-Ca exchanger pumps in the renal tubules. Sodium, potassium, phosphate, calcium, magnesium and water losses result from decreased expression of these pumps.
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