Category Archives: Kidney, Liver, and Thyroid Health

Kidney, Liver, and Thyroid Health

All about Hashimoto’s disease and Graves’ disease

Posted on by dnaserver

Hashimoto’s disease and Graves’ disease are two autoimmune disorders that affect the function of the thyroid. Hashimoto’s disease almost always causes hypothyroidism (underactive thyroid), although in rare cases, it can cause hyperthyroidism (overactive thyroid). Graves’ disease causes hyperthyroidism.

What is the thyroid gland?
The thyroid gland is a small organ located just under the skin in the neck. This bow tie-shaped organ is usually only about 5 cm across and normally can’t be felt or seen. The thyroid releases specific hormones (chemical messengers) that act on almost every tissue in the body (1). These thyroid hormones help regulate so many vital body functions, including:

  • Heart rate
  • Skin maintenance
  • Heat production
  • Fertility
  • Growth
  • Digestion
  • Rate at which calories are burned

What are autoimmune disorders?
Normally the immune system defends the body against disease and infection. But sometimes, the immune system attacks healthy cells, tissues, and organs instead. This is what is known as an autoimmune disorder or disease. When one of these disorders occurs, the attacked cells, tissues, or organs cannot function properly, and can sometimes cause life-threatening disease (2). The most well-known autoimmune disorder is type 1 diabetes, where the immune system attacks and destroys the beta cells in the pancreas, resulting in an inability to produce and secrete insulin.

What is Hashimoto’s disease?
Hashimoto’s disease is an autoimmune disorder, where the immune system produces antibodies that attack the thyroid gland. This damages the thyroid gland and it is unable to make enough thyroid hormones, resulting in hypothyroidism (underactive thyroid) (3).

Hashimoto’s disease is the most common cause of hypothyroidism, which affects about 5 in 100 Americans. It is a lot more common in women than men and usually develops in women aged 30–50 years. People who have other family members with the disease and/or have other autoimmune disorders (e.g., celiac disease, lupus, type 1 diabetes) are at increased risk of developing Hashimoto’s disease (3).

What are the symptoms and complications of Hashimoto’s disease?
Many people do not show any symptoms in the early stages of Hashimoto’s disease, but as more and more thyroid damage occurs, a range of symptoms can occur (3), including:

  • Fatigue
  • Weight gain
  • Constantly feeling cold
  • Joint and muscle pain
  • Constipation
  • Dry skin
  • Dry, thinning hair
  • Irregular menstrual periods
  • Fertility problems
  • Slower heart rate
  • Enlarged thyroid (called goiter)

Untreated hypothyroidism can cause several health problems (3), including:

  • High cholesterol
  • Heart disease
  • High blood pressure
  • Pregnancy problems

What causes Hashimoto’s disease?
In many cases, the cause of Hashimoto’s disease is unknown (3), but some factors that may play a role include:

  • Genetics (as family history is common)
  • Viruses (e.g., hepatitis C)
  • Some medications for mental health problems
  • Iodine-containing medications to treat abnormal heart rhythm
  • Toxins (e.g., nuclear radiation exposure)

What is Graves’ disease?
Graves disease is also an autoimmune disorder, where the immune system produces antibodies that attack the thyroid gland. However, Graves’ disease, actually triggers the thyroid gland to produce more thyroid hormones, resulting in hyperthyroidism (overactive thyroid) (4).

Graves disease is the most common cause of hyperthyroidism, affecting about 1 in 200 Americans. Like Hashimoto’s disease, Graves’ disease is also a lot more common in women than men, usually affecting people between the ages of 30 and 50 years. People who have other family members with the disease and/or have other autoimmune disorders (e.g., celiac disease, lupus, type 1 diabetes) are at increased risk of developing Graves’ disease (4).

What are the symptoms and complications of Graves’ disease?
A range of symptoms are associated with hyperthyroidism caused by Graves’ disease (4), including:

  • Weight loss
  • Heat intolerance
  • Muscle weakness
  • Frequent bowel movements or diarrhea
  • Trembling hands
  • Nervousness or irritability
  • Trouble sleeping
  • Faster heart rate
  • Enlarged thyroid (called goiter)

Untreated hyperthyroidism can cause several health problems (4), including:

  • Irregular heartbeat, increasing the risk of blood clots, stroke, and heart failure
  • Weakened bones and osteoporosis
  • Pregnancy problems
  • Graves’ ophthalmopathy (an eye disease that can cause double vision, light sensitivity, and eye pain

What causes Graves’ disease?
In Graves’ disease, the immune system produces an abnormal antibody called thyroid-stimulating immunoglobulin (TSI) that mimics the effects of the normal thyroid-stimulating hormone (TSH) and hence tells the thyroid to produce an excessive amount of thyroid hormones. But what actually triggers the immune system to produce TSI is not fully understood. It is likely a combination of genetics (as family history is common in affected people) and an outside influence like a virus (4).

How are Hashimoto’s disease and Graves’ disease diagnosed?
Medical history, physical exams, and blood tests are commonly used to diagnose thyroid issues, including Hashimoto’s disease and Graves’ disease. Blood tests may include:

We offer each of these tests from a self-collected finger-prick blood sample. Tests are available as individual tests (links included above) or all combined together in our Thyroid Health, Complete Panel.

References:
1. Hershnan JM. (Modified Oct 2020). Overview of the Thyroid Gland. Merck Manual Consumer Version
2. Autoimmune Diseases. (Reviewed July 2021). NIH, National Institute of Environmental Health Sciences.
3. Hashimoto’s Disease. (Reviewed June 2021). NIH, National Institute of Diabetes and Digestive and Kidney Diseases.
4. Graves’ Disease. (Reviewed Sept 2017). NIH, National Institute of Diabetes and Digestive and Kidney Diseases.

Kidney, Liver, and Thyroid Health

What are the links between thyroid health and mental health?

Posted on by dnaserver

The messenger molecules that are released from the thyroid are called thyroid hormones. These hormones are thyroxine (T4) and triiodothyronine (T3) and they act on cells all around the body by interacting with thyroid hormone receptors. And this is where the strong link to mental health comes in. The brain has some of the highest expression of these thyroid hormone receptors and neurons are often more sensitive to thyroid abnormalities than other cells (1).

Thyroid health and neurological effects in infants and children
When the brain is still developing, the actions of thyroid hormones are very important. This is because certain thyroid hormone actions must occur during specific time windows. If thyroid abnormalities occur during brain development, they may lead to irreversible brain damage. The extent of this damage depends on both the severity of thyroid problems, as well as the specific onset and duration of the thyroid problems (2).

This potentially serious impact of thyroid abnormalities is why normal thyroid function is critical during pregnancy. For the first trimester, a fetus is completely dependent on thyroid hormones from the mother (passed through the placenta). At around 12 weeks, the fetus starts to make its own thyroid hormones, but it is still reliant on maternal thyroid hormones until 18–20 weeks of pregnancy (3).

Thyroid health and mental health in adults
Most thyroid-associated mental health problems in adults are reversible with proper treatment, unlike the sometimes-irreversible brain damage seen in infants and children (2). However, that doesn’t mean that thyroid-associated mental health problems in adults should be ignored.

Hypothyroidism (underactive thyroid) is associated with:

  • Memory impairment
  • Bipolar affective disorders
  • Depression
  • Mood disorders
  • Dementia
  • Confusion
  • Personality changes
  • Loss of cognitive function

Hyperthyroidism (overactive thyroid) is associated with:

  • Anxiety
  • Irritability
  • Mood disorders
  • Dementia
  • Confusion
  • Personality changes

Of course, the lists above are only covering the thyroid dysfunction symptoms that are linked to mental health. Thyroid abnormalities can also cause a range of other symptoms, including:

  • Puffy eyes and face
  • Heart rate changes (slower for hypothyroidism, faster for hyperthyroidism)
  • Temperature changes (feeling colder for hypothyroidism and excessive sweating for hyperthyroidism
  • Weight changes (gain for hypothyroidism, loss for hyperthyroidism)
  • Fertility issues

Thyroid testing
If you are experiencing symptoms that could be associated with abnormal thyroid function, don’t hesitate to get tested. We offer a range of tests from just a simple self-collected finger-prick. Take our simple Thyroid Stimulating Hormone (TSH) Test for TSH alone, our Thyroid Health Panel to also include T4 and T3 along with TSH, or opt for the Thyroid Health, Complete Panel to also include Anti-Tg and Anti-TPO.

TSH is the thyroid-stimulating hormone, which is produced in the pituitary gland and signals for the thyroid to produce thyroid hormones. TSH is commonly the first molecule measured when investigating thyroid health. Read our previous article here for more information about TSH.

T4 and T3 are the two hormones produced by the thyroid.

Anti-Tg and Anti-TPO are antibodies to proteins produced by the thyroid gland. Elevated levels of these antibodies signal that the body’s own immune system is targeting and harming the thyroid, which is what occurs in some autoimmune disorders.

References:
1. Rege S. (Updated April 2021) 15 little known things about your thyroid that can affect your mental health. Psych Scene Hub.
2. Bernal J. Thyroid hormones in brain development and function. Endotext [Internet].
3. Thyroid disease & pregnancy. (Reviewed Dec 2017). NIH, National Institute of Diabetes and Digestive and Kidney Diseases.

Kidney, Liver, and Thyroid Health

What are the signs of liver disease?

Posted on by dnaserver

The liver is a very hard-working organ with multiple roles, including helping with the digestion of food to convert the food to energy and filtering toxic substances out of the blood. So, when the liver isn’t functioning as well as it should, there can be a multitude of different symptoms.

Liver disease can be caused by various different things, such as hepatitis, autoimmune conditions, genetics, excess alcohol, obesity, and toxic chemicals or drugs (1). Hence, the symptoms of liver disease can vary, but there are also general symptoms that usually occur in all different types of liver disease. In this article, we will discuss those general symptoms.

Jaundice
In jaundice, the skin and whites of the eyes take on a yellow tinge. This is due to having too much bilirubin in the blood. Bilirubin is a yellow pigment that forms as part of the normal process of red blood cell recycling. Usually, bilirubin travels to the liver, where it binds to bile and is moved through the bile ducts into the digestive tract. It is then eliminated from the body predominantly in the stool but also in the urine. However, when the liver is not functioning properly, bilirubin accumulates in the blood and is deposited in the skin (2).

Dark urine
Dark urine can also be caused by too much bilirubin in the blood due to reduced liver function (2). However, it is important to note that the most common cause of dark urine is dehydration. Other abnormal urine causes include kidney injury, which can lead to bloody, or reddish-colored, urine. It is very important to see a doctor if you notice any bloody urine. 

Abnormal stools
Pale stools can occur if the bilirubin that is usually excreted in the stools is instead excreted in the urine (causing the dark urine mentioned above). This may be due to a blockage in the usual pathways or another problem preventing bilirubin from being eliminated in the stool (2).

Stools can also be bloody, and appear as bright red or black and tar-like stools. Bloody stools are usually caused by bleeding from varicose veins in the esophagus or stomach. These varicose veins can form from new veins that are created to bypass the liver and are very fragile and bleed easily (3).

Swelling in the abdomen
Liver disease can cause high blood pressure in the veins that bring blood to the liver. This can lead to an accumulation of protein-containing fluid in the abdomen, known as ascites. This ascitic fluid leaks from the surface of the liver and intestine, and also due to the leakage of albumin from blood vessels into the abdomen (4).

There may be no symptoms with only a small amount of fluid accumulation. However, increasing amounts can lead to weight gain, increased waist size, and discomfort. The pressure on the stomach can cause a loss of appetite, while pressure on the lungs can result in shortness of breath. Sometimes the excess fluid can also accumulate in the ankles, causing swollen ankles and lower legs. If a spontaneous bacterial infection occurs in the ascites, it can be fatal if left untreated (4).

Other disorders can also cause ascites, including cancer, kidney failure, heart failure, pancreatitis, and tuberculosis, but liver disease is the most common cause (4).

Nausea, loss of appetite, and fatigue
Most people with liver disease will eventually suffer from general symptoms, including nausea, loss of appetite, and fatigue (3). Various underlying causes can lead to these symptoms, such as fluid accumulation in the abdomen putting pressure on the stomach.

Itchiness
Severe itchiness is another symptom that affects some people with liver disease. It is more common in liver disease caused by autoimmune disorders and biliary obstructive diseases, which may occur due to stones or cancer. Drug-induced liver disease and liver damage due to viral hepatitis can also lead to itchy skin. However, it is rare in alcohol-induced liver disease and fatty liver disease (5).

There are various possible causes of itchy skin in relation to liver disease, including higher levels of bile salts and/or alkaline phosphatase, raised histamine levels, and varying levels of female sex hormones (6). Of course, itchy skin can also occur due to other health issues, such as psoriasis, eczema, allergic reactions, other internal diseases, and nerve disorders.

Easily bruised and abnormal bleeding
The liver is important for producing blood clotting factors; hence, when the liver is not functioning normally, there is a decreased ability to help injured blood vessels stop bleeding. This can result in more bruising than normal, prolonged bleeding after just minor cuts, and unexplained nose bleeds (7).

Liver disease is one of the most common causes of easy bleeding. Other causes can include severe platelet deficiency, anticoagulants to inhibit clotting (e.g. warfarin), and hemophilia (7).

Conclusions:
Other symptoms of liver disease are also possible and depend on the underlying cause of the liver disease. It is also important to note that many of the symptoms described in this article are not just specific to liver disease. An accurate diagnosis of liver disease requires a thorough doctor’s evaluation and blood tests to detect abnormal levels of specific blood components.

We offer a comprehensive Liver Health Panel to measure a broad range of proteins and enzymes in the blood, as well as individual tests for each of the tested components. These tests just require a simple finger-prick blood sample, which can easily be collected at home. However, we do recommend that you discuss your results with a healthcare provider.

References:
1. The Progression of Liver Disease. American Liver Foundation.
2. Tholey D. (2021) Jaundice in Adults. Merck Manual Consumer Version.
3. Tholey D. (2021) Liver Failure. Merck Manual Consumer Version.
4. Tholey D. (2021) Ascites. Merck Manual Consumer Version.
5. Hegade VS (2015). Itch and liver: management in primary care. Br J Gen Pract. 65(635): e418-e420.
6. Pietrangelo A (reviewed by Sethi S) (2019). What causes itching in liver disease and how to treat it. Healthline.
7. Moake JL (2020). Bruising and Bleeding. Merck Manual Consumer Version.

Kidney, Liver, and Thyroid Health, Women's Health

Why is hypothyroidism more common in women?

Posted on by dnaserver

Thyroid problems can affect men, women, children, and even infants. However, by far the most commonly affected group is middle-aged and older women, with one in eight women likely to develop a thyroid disorder during her lifetime. This rate is five to eight times higher than the rate in men (1). So, the question is, why are rates so much higher in women?

First, let’s quickly go over the functions of the thyroid
The thyroid gland is a small organ located just under the skin in the neck. This bow tie-shaped organ is usually only about 5 cm across and normally can’t be felt or seen. The thyroid releases specific hormones (chemical messengers) that act on almost every tissue in the body (2). These thyroid hormones help regulate so many vital body functions, including:

  • Heart rate
  • Skin maintenance
  • Heat production
  • Fertility
  • Growth
  • Digestion
  • Rate at which calories are burned

What happens when the thyroid isn’t functioning properly?
Thyroid hormones influence so many different parts of the body, so when they are out of balance, lots of different symptoms can occur.

Hypothyroidism is an underactive thyroid, so it does not release enough thyroid hormones. This causes many of the body’s functions to slow down, causing symptoms like fatigue, slow heart rate, constipation, weight gain, and constantly feeling cold (3).

Hyperthyroidism is an overactive thyroid, so too many thyroid hormones are released into the bloodstream. This speeds up many of the body’s functions, causing symptoms like weight loss (even though appetite is increased), rapid or irregular heart rate, frequent bowel movements, sweating, and shaky hands (4).

To learn more about things that can affect your thyroid health, read our previous article here.

So, why are thyroid problems more common in women?
The risk of thyroid problems, in particular hypothyroidism, increases as a woman ages, as well as during pregnancy and the postpartum period (5). This is thought to be linked to the female hormone fluctuations that occur during each menstrual cycle, during pregnancy and the postpartum period, and especially the major hormonal changes that occur around menopause (6). Read our previous article here to learn more about the changes that occur at menopause.

Another reason for the increased risk of thyroid problems in women is because thyroid problems are often triggered by autoimmune responses, and these autoimmune responses are more common in women than in men (6).

What health problems in women are linked to thyroid disorders?
Thyroid problems in women are not only more common than in men, but they also can cause multiple additional symptoms. These symptoms can include:

  • Delaying or speeding up of puberty
  • Affecting period regularity and flow
  • Fertility issues
  • Premenstrual syndrome (PMS)
  • Increasing risk of ovarian cysts
  • Complications during pregnancy, including severe morning sickness, premature labour, or miscarriage
  • Earlier menopause

How can I get my thyroid function checked?
Checking the function of your thyroid is simple with a range of tests offered by us. Take our simple Thyroid Stimulating Hormone (TSH) Test for TSH alone, our Thyroid Health Panel to also include T4 and T3 along with TSH, or opt for the Thyroid Health, Complete Panel to also include Anti-Tg and Anti-TPO.

References:
1. General Information/Press Room. American Thyroid Association.
2. Hershnan JM. (Modified Oct 2020). Overview of the Thyroid Gland. Merck Manual Consumer Version
3. Hypothyroidism (Underactive Thyroid). National Institute of Diabetes and Digestive Kidney Diseases. NIH. Reviewed March 2021.
4. Hyperthyroidism (Overactive Thyroid). National Institute of Diabetes and Digestive Kidney Diseases. NIH. Reviewed August 2021.
5. Dunn D & Turner C (2016). Hypothyroidism in Women. Nursing for Women’s Health. 20(1): 93-98.
6. Why Women Are More Prone to Thyroid Problems? The Harley Street Ear Nose & Throat Clinic. (March 2018).

Kidney, Liver, and Thyroid Health

What could be affecting my thyroid health?

Posted on by dnaserver

What is the thyroid gland?
The thyroid gland is a small organ located just under the skin in the neck. This bow tie-shaped organ is usually only about 5 cm across and normally can’t be felt or seen. The thyroid releases specific hormones (chemical messengers) that act on almost every tissue in the body (1). These thyroid hormones help regulate so many vital body functions, including:

  • Heart rate
  • Skin maintenance
  • Heat production
  • Fertility
  • Growth
  • Digestion
  • Rate at which calories are burned

What happens when the thyroid isn’t functioning properly?
Thyroid hormones influence so many different parts of the body, so when they are out of balance, lots of different symptoms can occur.

Hypothyroidism is an underactive thyroid, so it does not release enough thyroid hormones. This causes many of the body’s functions to slow down, causing symptoms like fatigue, slow heart rate, constipation, weight gain, and constantly feeling cold (2).

Hyperthyroidism is an overactive thyroid, so too many thyroid hormones are released into the bloodstream. This speeds up many of the body’s functions, causing symptoms like weight loss (even though appetite is increased), rapid or irregular heart rate, frequent bowel movements, sweating, and shaky hands (3).

What are the possible causes of hypothyroidism?
An underactive thyroid is quite common, affecting nearly 5 out of 100 Americans 12 years and older, although many are only minimally affected (2). The causes of hypothyroidism include:

Hashimoto’s disease. An autoimmune disorder where your own immune system attacks the thyroid. This is the most common cause of hypothyroidism.

Thyroiditis. Inflammation of the thyroid can cause thyroid hormones to leak out (and initially increase the levels in the blood) until the thyroid eventually becomes underactive. Thyroiditis can be one of three different types:

  • Subacute thyroiditis (painfully inflamed and enlarged)
  • Postpartum thyroiditis (after pregnancy)
  • Silent thyroiditis (painless and maybe from an autoimmune condition)

Congenital hypothyroidism. Some infants are born with a thyroid that is not fully developed or not fully functional. Prompt treatment is important to prevent intellectual disability and growth failure.

Removal of part or all of the thyroid or radiation treatment of the thyroid, head, or neck. These may occur as a treatment for hyperthyroidism, large goiter, thyroid nodules, or thyroid cancers.

Medications. Certain medications can interfere with thyroid function, including some heart, bipolar, and cancer medicines.

Who is at increased risk of hypothyroidism?

  • Women, particularly if had a child within the previous 6 months
  • People over 60 years
  • People with previous thyroid issues or a family history of thyroid issues
  • Diabetics
  • People affected by certain autoimmune conditions, including celiac disease, rheumatoid arthritis, and lupus

What are the possible causes of hyperthyroidism?
Hyperthyroidism (overactive thyroid) is less common than hypothyroidism, affecting about 1 out of 100 Americans 12 years and older (3). The causes of hyperthyroidism include:

Graves’ disease. An autoimmune disorder where your own immune system attacks the thyroid causing it to make too many hormones. This is the most common cause of hyperthyroidism.

Overactive thyroid nodules. Noncancerous lumps in the thyroid that produce too many thyroid hormones.

Thyroiditis. Inflammation of the thyroid can cause thyroid hormones to leak out and increase the levels in the blood. In some cases, thyroiditis can eventually cause the thyroid to become underactive and cause hypothyroidism. Thyroiditis can be one of three different types:

  • Subacute thyroiditis (painfully inflamed and enlarged)
  • Postpartum thyroiditis (after pregnancy)
  • Silent thyroiditis (painless and maybe from an autoimmune condition)

Excess iodine. Iodine is required to make thyroid hormones, so consuming too much iodine (either through foods (e.g., kelp), supplements, or medicines) can result in hyperthyroidism.

Excess thyroid medication. This may occur in people suffering from hypothyroidism who take too much of their thyroid medication, as the amount required may differ over time.

Noncancerous tumors of the pituitary gland. The pituitary gland releases thyroid-stimulating hormone (TSH), which signals for the thyroid to produce hormones, so issues with the pituitary function can also affect thyroid function.

Who is at increased risk of hyperthyroidism?

  • Women, particularly if had a child within the previous 6 months
  • People over 60 years
  • People with previous thyroid issues or a family history of thyroid issues
  • People affected by other health problems, including diabetes, primary adrenal insufficiency (hormone disorder), and pernicious anemia (caused by vitamin B12 deficiency)
  • People who eat large amounts of food containing iodine (e.g., kelp) or take medicines with iodine

References:
1. Hershnan JM. (Modified Oct 2020). Overview of the Thyroid Gland. Merck Manual Consumer Version
2. Hypothyroidism (Underactive Thyroid). National Institute of Diabetes and Digestive Kidney Diseases. NIH. Reviewed March 2021.
3. Hyperthyroidism (Overactive Thyroid). National Institute of Diabetes and Digestive Kidney Diseases. NIH. Reviewed August 2021.

Kidney, Liver, and Thyroid Health

Kidney function – what is normal and what is not?

Posted on by dnaserver

What are the functions of the kidneys?
The kidneys are the major player in our body’s waste disposal system. We each have two kidneys about the size of a fist located just below the ribcage. These mighty organs continuously filter the blood at a rate of about half a cup every minute. And just like a filter in a swimming pool system, the kidneys also filter out waste through about a million filtering units (nephrons) per kidney. This waste (e.g., toxins, urea, and extra salt) is removed along with extra water and it all becomes urine, flowing from the kidneys to the bladder, where it is stored until urination occurs (1).

The kidneys are not just powerful filters, as they also play several other essential roles in the body. The kidneys remove acid that is produced by our cells, and are important for maintaining the right balance of water, salts, and minerals. If this balance is off, lots of cells, tissues, and organs in the body will not function properly (1).

Kidneys are also little hormone factories, producing erythropoietin to stimulate the production of red blood cells, activating vitamin D for healthy bones and a good immune response, and producing prostaglandins (hormone-like substances) to help control blood pressure (2).

How is kidney function measured?
Kidney function is commonly determined by measuring blood creatinine levels and calculating the estimated glomerular function (eGFR).

Creatinine is mainly produced within muscles from the breakdown of a compound called creatine, which is part of the energy production cycle in muscles. Almost all creatinine is filtered from the blood by the kidneys and excreted from the body in the urine (3).

The eGFR value is calculated from creatinine levels and also takes into account the age and gender of the tested person. The eGFR value shows how well the kidneys are functioning (3).

Measurements of blood urea (or urea nitrogen) levels are also helpful for detecting kidney damage. Normally urea is filtered from the blood by the kidneys, but blood levels can increase when the kidneys are not functioning normally.

What is considered normal kidney function?
Normal eGFR is more than 90 for adults. eGFR declines with age, even in the absence of kidney disease, so younger adults should usually have an eGFR value considerably higher than 90. For example, the average eGFR for someone aged 20–29 years is 116 (3).

eGFR values between 60 and 89 may indicate kidney disease. Values less than 60 for more than 3 months occur during moderate-to-severe chronic kidney disease (3).

Normal urea nitrogen levels in the blood are between approximately 7 and 25 mg/dL for adults with the higher levels often occurring in older people (5).

What are the signs of chronic kidney disease?
Chronic kidney disease (CKD) occurs when the kidneys are damaged and cannot function as well they should. They are unable to efficiently filter the blood and other functions are also disrupted, including the stimulation of red blood cells production and activation of vitamin D (4).

CKD can contribute to heart disease and stroke due to the inefficient removal of wastes and excessive fluid (4). Other health consequences include:

  • Reduced number of red blood cells (anemia)
  • Increased infections (in part due to low vitamin D activation)
  • Mineral imbalances in the blood
  • Appetite loss
  • Depression

More than 1 in 7 US adults are estimated to have CKD, that’s about 37 million people! However, most of these people have not been diagnosed, including as many as 40% of people with severely reduced kidney function (4). This is because many people with CKD do not notice any symptoms, or they think the symptoms are due to something else, and they don’t get a simple blood test to determine their kidney function.

People with later stage CKD often do experience symptoms (3), including:

  • Change in urination frequency
  • Itchiness
  • Fatigue
  • Swelling in their arms, legs, or feet
  • Muscle cramps
  • Nausea and vomiting

What can cause chronic kidney disease?
The major risk factors for CKD are diabetes and high blood pressure, which are estimated to cause 3 out of 4 CKD cases (4). Other risk factors include heart disease, family history of CKD, and obesity.

Tips for reducing the risk of CKD include:

  • Keep a healthy blood pressure (below 140/90 mm Hg)
  • Stay in the target blood sugar range (for diabetics)
  • Get regular physical activity
  • Lose weight if overweight
  • Abstain from smoking (it can worsen CKD and interfere with medications)
  • Take medications as prescribed by your health care professional (e.g., to lower blood pressure)
  • Get tested regularly if you are at risk. Testing is quick and easy from a simple finger-prick blood sample. 

How can I check my kidney function?
We offer very informative lab tests to evaluate your kidney function. The Kidney Health Panel measures your urea nitrogen and creatinine levels and calculates your eGFR to determine your kidney function. Alternatively, you can select the Urea Nitrogen test or the Creatinine and eGFR test.

Each test just requires a very small blood sample collected from a simple finger-prick. No doctor’s visits or needles are required.

Of course, if you receive an abnormal test result, we recommend consulting your health care professional for follow-up treatment, medication, and any other analyses.

It is also important to note that various other factors can also result in elevated blood creatinine and/or urea nitrogen, including dehydration, kidney or other urinary tract obstruction, increased protein intake, shock and stress, and severe burns. Reduced creatinine in the blood can be a sign of muscle disease (e.g., muscular dystrophy), while both reduced creatinine and reduced urea can occur due to liver disease. 

References:
1. Your Kidneys and How They Work. National Institute of Diabetes and Digestive and Kidney Diseases. NIH. Reviewed June 2018.
2. Kidneys. You and your hormones. Reviewed April 2019.
3. Estimated Glomerular Filtration Rate (eGFR). National Kidney Foundation. Reviewed September 2021.
4. Chronic Kidney Disease Basics. Chronic Kidney Disease Initiative. CDC. Reviewed August 2021.
5. Thomas L. Clinical Laboratory Diagnostics: Use and Assessment of Clinical Laboratory Results. Frankfurt/Main, Germany: TH-Books Verlagsgesellschaft mbH; 1998:374–377.

Kidney, Liver, and Thyroid Health

Facts about thyroid-stimulating hormone (TSH)

Posted on by dnaserver

Do you have symptoms that suggest that your thyroid is not functioning quite right? Or just want to know more about thyroid health?

Firstly, what is the thyroid gland?
The thyroid gland is a small organ located just under the skin in the neck. This bow tie-shaped organ is usually only about 5 cm across and normally can’t be felt or seen. The thyroid releases specific hormones (chemical messengers) that act on almost every tissue in the body (1).

These thyroid hormones are called thyroxine (T4) and triiodothyronine (T3). T4 and T3 influence a whole range of bodily functions, including skin health, growth, heart rate, fertility, digestion, and weight control.

Normal thyroid hormone levels are very important for a healthy functioning body. But what controls the levels of T4 and T3?

That is where thyroid-stimulating hormone (TSH) comes into the picture. TSH is another hormone, but this one is produced in the pituitary gland, a small gland at the base of the brain. As the name suggests, TSH stimulates the thyroid to produce the T4 and T3 hormones that then go on to act on cells throughout the body (1).

When thyroid hormone levels in the blood are high, the pituitary gland slows the release of TSH, so fewer thyroid hormones are produced. When thyroid hormone levels fall, the pituitary gland speeds up the release of TSH, so it stimulates the thyroid to produce more thyroid hormones (1).

Why measure TSH levels?
TSH levels are usually the best indicator of thyroid function.

If TSH levels are high, it is generally indicative of an underactive thyroid (hypothyroidism), meaning it requires more stimulation (higher TSH) than normal.

If TSH levels are low, it usually indicates an overactive thyroid (hyperthyroidism), which requires less stimulation (lower TSH) than normal.

What are the symptoms of hypothyroidism?
Hypothyroidism means the thyroid is not producing as much T4 and T3 as normal. This effectively slows down functions throughout the body, leading to symptoms such as:

  • Fatigue
  • Puffy eyes and face
  • Slower heart rate
  • Constant feeling of cold
  • Confusion
  • Depression
  • Weight gain
  • Constipation
  • Dry and brittle hair and skin
  • Fertility issues

Treatment options for hypothyroidism include daily medications (e.g. levothyroxine), natural thyroxine hormone extracts, and reduced consumption of substances that affect levothyroxine absorption (2).

What are the symptoms of hyperthyroidism?
Hyperthyroidism means that the thyroid is overproducing T4 and T3. This overproduction speeds up lots of processes in the body, leading to symptoms such as:

  • Fast heart rate
  • High blood pressure
  • Excess sweating
  • Weight loss
  • Anxiety
  • Shaky hands
  • Sleeping issues
  • Increased bowel movements
  • Mood changes

Medication, radioactive iodine, or surgical removal of the thyroid gland are effective treatments for hyperthyroidism (2).

It is important to note that abnormal TSH levels sometimes do not accurately reflect thyroid function. For example, if there is a health issue with the pituitary gland that is interfering with the detection of thyroid hormones in the blood and/or the release of TSH. Additional tests may be required in some instances for an accurate diagnosis. These additional tests can include measuring the levels of T4 and T3, as well as measuring the levels of specific antibodies that are altered in certain health conditions.

Checking the function of your thyroid is simple with a range of tests offered by us. Take our simple Thyroid Stimulating Hormone (TSH) Test for TSH alone, our Thyroid Health Panel to also include T4 and T3 along with TSH, or opt for the Thyroid Health, Complete Panel to also include Anti-Tg and Anti-TPO.

References:
1. Hershnan JM. (Modified Oct 2020). Overview of the Thyroid Gland. Merck Manual Consumer Version
2. Rugge JB, Bougatsos C, & Chou R. (2014) Screening for and Treatment of Thyroid Dysfunction: An Evidence Review for the U.S. Preventive Services Task Force [Internet]. In Evidence Syntheses, No.118. Rockville, MD: Agency for Healthcare Research and Quality (US).