Blood results and liver

[naryshkin]

I wrote last week about a series of blood tests, which showed I needed more levothyroxine and iron. I want to thank everyone again for helping me out since my dose was raised to 75mcg levo earlier this week!

I showed the results to my GP who then had me do another set of blood tests on Wednesday and received the results early this morning.

A full blood count alongside a full iron panel show that I'll need to raise my iron and ferritin, which will be done through prescribed supplements. Everything else is fine.

But what puzzles me is the following:

Does this all mean that I am in early stage kidney and liver disease? Is this common with thyroid disease? My GP said we'll need to chat over phone next week to discuss the elevated ALT levels, which could be a sign of an inflamed liver.

I try to eat well given the circumstances, as I cannot exercise much due to low ferritin/iron and thyroid-associated tiredness (I also work, sick leave isn't an option for me, sadly). I used to run 5k almost daily and do 1-hr bike commutes last summer, until the flare arrived in September. Red meat was reintroduced on a daily basis to my diet last October, told that it would help improve my energy and levels. Alongside this, I tend to eat healthy full fat products like olive oil as they keep me full, although cravings can grow strong before or during my period. I am working on turning fully gluten-free, too. I have gained, but I am not grossly overweight and much of the weight is water-based so it fluctuates wildly even within the span of a few hours (jumped from sizes 2-4 to 10-12, or 42-43kg to 55-60kg, being at 5" nothing). I have found that supplementing with iron helps with the bloats!

I do not smoke since 2015 and I no longer drink alcohol (not since 2017).

As far as I am aware, we have neither kidney nor liver conditions in the family, only thyroid (some cases with PCOS). I think my paternal grandfather could have had a liver condition which he cultivated throughout his lifetime, though I am not sure. My father, who is in his mid-60s, recently developed Type 2 diabetes. My mother and sister are confirmed hypo and Hashi. This puzzles me because, though ill, I was always the fitter and more active one out of us three.

Test done with NHS 17 March 9.30am

Serum sodium: 140mmol/L (normal 133-146) [1 Oct: 139 (137-145)]

Serum potassium: 4.0mmol/L (normal 3.5-5.3) [1 Oct: 4.2 (3.5-4.4)]

Serum chloride: 101mmol/L (normal 95-108)

Serum creatinine: 64umol/L (normal 45-84) [1 Oct test: 61 (45-90)]

GFR calculated abbreviated MDRD: 90ml/min (no ranges added)

Serum total protein: 68g/L (normal 60-80)

Serum albumin: 48g/L (normal 35-50) [1 Oct test: 46 (36-48)]

Serum total bilirubin: 5umol/L (0-21)

Serum alkaline phosphatase: 49U/L (30-130)

Serum ALT level: 118U/L (normal 0-33)

[radd]

naryshkin,

The liver metabolises hormones, filters toxins and cleans the blood. High liver enzymes and inadequately treated hypothyroidism are common because low thyroid hormones slows these processes down.

I had elevated liver enzymes when first diagnosed with hypothyroidism, that reversed when thyroid hormone levels were optimised through replacement.

Have you had cholesterol tested?

[naryshkin in reply to radd]

radd,

Thank you for this, very happy to hear that this is reversible! Come to think of it, my sister had similar issues many years ago but they cleared up after she tweaked her diet, like using lemongrass in her morning smoothies and keeping them low in sugar. I am going to do this too, as sugar-cravings return during my flares, otherwise sugar-/fructose-intake isn't a problem.

Cholesterol hasn't been tested but will have this looked into too.

Thank you once again and have a lovely evening 🌻

[nellie237]

Hi Naryshkin,

Your kidney results look good. Your GFR of 90 is as high as most NHS Labs will calculate to, and is based on age, sex and creatinine level (exercise can raise creatinine thereby lowering GFR, so don't exercise before testing). If the GFR number gets near or drops below 60....then you need to discuss with your GP.

Like radd my ALT has fluctuated over the years - in 2013 I was x3 over the top range for many months and at one point my GP sent me for a liver scan, which showed a little scarring but nothing to be concerned about. Results gradually went back to normal , and then had another wobble in 2018 which also corrected itself. Yes, get it checked but don't worry too much. 😊

[humanbean]

Does this all mean that I am in early stage kidney and liver disease?

Well, as far as your kidneys are concerned a GFR of 90 is excellent. All the other results are good too - well within range.

Apart from the ALT.

My ALT went over the range once. I've seen it being reported as high on this forum quite often. If someone has a liver function test with one result out of range it is almost guaranteed to be the ALT in my experience of reading results on here.

Read all the sections on this link (click on all the + signs) :

labtestsonline.org.uk/tests...

When I got the high level of ALT I had been through a few months of being stupid about my diet - I was eating too much sugar (I love ice cream) and carbs. I researched high ALT and found it was often related to diet, and particularly high sugar and carbs. I got a grip on my diet, cut down on the sugar and carbs. My ALT went from 42 to 18 in eight months.

Given the right conditions the liver can heal itself. So it's worth a try.

[naryshkin]

Thank you, everyone! I'm relieved to hear that the kidneys are doing fine, and the liver largely so. I've kept to a healthy diet to my best capacity since the flare even if I've had a little bit more sugar and carbs than usual (no more than 2-4 biscuits/day, but these have been entirely replaced with fruits and juices since February).

When in remission, I eat hardly anything sweet, usually satisfied with a homemade green smoothie (avocado, spinach, kale, oats, pineapple, lime/lemon juice - sometimes a dash of kefir or oat milk).

It's VERY reassuring to hear that ALT can be reversed!!

Have a lovely Sunday everyone ✨🌻

[humanbean in reply to naryshkin]

Some fruit and fruit juices have a lot of sugar in. In some cases fruit juice has more sugar than coke or pepsi. So it might be worth investigating how much sugar you are getting from those.