Hyperthyroid (Graves) & kidney disease after treatment

[ScarboroughFair]

Hi, I was diagnosed with Graves August23 and responded quickly to 10mg carbimazole so now on 5mg daily. I had a blood test for thyroid and electrolytes 2 weeks ago, but wasn’t told not to eat meat before it.

Results were good for thyroid (TSH 2.21 up from 0.02 [0.27-4.2] t3 4.5 down from 10.7 [3.1-6.8]; t4 14.3 down from 33 [11.1-22] ) though I did feel my foggy head and shaking hand were coming back with the reduced dose.

TRab has also gone down to 1.5 from 3.5 [0-3.3]

Creatinine had gone up 91 from 79 [44.9-84.1] and eGFR down 56 from over 60 (they only give range 60-90 but no specific number).

I was ill with flu when I had the blood test, and GP said it’s nothing to be concerned about. Which isn’t what NICE say! I see the endocrinologist mid January, and he’s the one who asked for the tests. I know Hyperthyroid can mask CKD and am currently very anxious about it. I put over a stone on over last year, unusual for hyperthyroid but does happen.

Has anyone had similar experience and advice? Thank you!

[PurpleNails Administrator]

Could you add ranges to your results, ranges vary between labs.

Your FT4 & FT3 might be too low (verging towards hypothyroidism).

The TSH is not reliable & tends to remain low for a time after being hyper. So if was reflecting normally it would show as higher. Most have a TSH under 2.

“Hyperthyroid can mask CKD” interesting, I not seen this issue raised before but have heard a vet discuss it in cats.

10% of hyperthyroid patients are said to gain weight. I know I did, I had uncontrollable appetite, Zero energy and was undiagnosed for many years.

[ScarboroughFair in reply to PurpleNails]

Hi PurpleNails, thought I’d replied but looks like it didn’t post. I’ve updated ranges. Hoping it’s just a blip, but the relationship between ckd and thyroid is interesting

[PurpleNails Administrator in reply to ScarboroughFair]

FT4: 14.3 pmol/l (Range 11.1 - 22) 29.36%

FT3: 4.5 pmol/l (Range 3.1 - 6.8) 37.84%

So both FT4 & FT3 are low in range. Many would have hypo symptoms & feel better at mid range. Doctors tend to over lower as they go by TSH & they by having FT4 & FT3 on low end they have more room & time if levels should rise again.

Lowering carbimazole will allow them to rise a little which is exact right.

[Beads]

Kidney function and thyroid function go hand in hand, from my investigations. So hyper could possibly mask low function by making it seem normal, in the same way that hypo will slow down kidney function to a degree. However the thing that I’ve noticed that affects eGFR results the most is the amount I drink, I up my fluid level and eGFR goes up, don’t drink enough and it plummets. If you had had flu had you been drinking enough? Might be worth getting into the routine of 2L a day and repeating.

[ScarboroughFair in reply to Beads]

That’s a good point, I’m overweight but no other markers for ckd so was a shock!

[Batty1 in reply to ScarboroughFair]

Are you taking any other medications besides thyroid?

[ScarboroughFair]

Just HRT patches, the b12 as was below range a few years ago. VitD also low in the summer so taking that