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Feeling Moody And Stressed. Have Kidney Problem. Blood Test And Urine Test Done. Any Suggestion?

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Posted on Wed, 17 Oct 2012
Question: Dear Doctor,

I wonder if you could help me,

In April this year so 5 months ago I went to my doctor due to low mood and stress. The doctor did a routine blood test due to me not eating a lot at the time (mainly due to the stress) but just to rule out any stomach problems. The results came back with an abnormally high ALT/GGT on my liver test and Low Sodium(Hyponatremia). I had two repeat blood tests the latest one showing the GGT had risen from 120 to 240 and the sodium was still low (not sure of the exact number). The doctor booked me in for an abdomen ultrasound (liver mainly but they also looked at my kidneys, pancreas, spleen, etc)

I am getting the results of the Scan next Tues (9th Oct) but they also want to test my urine for Urine Osmolality and Urine Sodium and they want me to do another blood test with a range of extra things on especially regarding the function of my liver and kidneys.

Symptoms wise I feel fine in myself although I have felt quite tired the last few months but have put that down to late nights/not working (although people have commented on why I should be so tired at 26!) I am slightly overweight for my height at 5"1, 14 stone.
For the last 2 years I have had intermittent pain in my calves mainly when walking (at a normal pace) Someone told me it was due to lack of salts so I tried drinking more water as I know I dont drink enough, it did get better for a while but I seem to have bouts intermittenly of a few weeks/months of it being really bad, and then it gets a bit better and then gets bad again. I do drink a lot of caffeine of 2-3 strong cups a day which I know doesn't help)

I have also noticed for the last two years that my ankles sometimes swell especially after doing a lot of walking/being on my feet for quite a while, I thought this maybe due to my job (I did a job where I was on my feet 12 hours a day) but my ankle swelling still happens even now.

I seem to also get bad headaches and dizziness and very dark urine, I have tried to increase my intake of fluid but I have read online that doesn't help the low sodium.

I know I am getting the results of the scan and urine analysis on Tues but Iam getting really worried about the cause of this all.

have you got any ideas what this could be? Also I read that Hyponatremia also causes excess water but how can that be if my fluid intake is so low?

Any help would be really appreciated

XXXXXX
doctor
Answered by Dr. Muhammad Ishfaq Habib (2 hours later)
Hi XXXXXX
Thanks for providing such detailed history

One thing i want to clear is that the conditions i will be mentioning here does not mean to scare you but its for general explanation and its not necessary that you might be having one of them. hope you understands that.
First I would like to comment on the raised ALT. The ALT is in blood results from liver cells. when the liver is having any kind of damage the result is raised ALT. It can be due to hepatitis ( viral or non viral) or autoimmune hepatitis. but these conditions can be rule out scans you already had and an advanced scan known as HIDA scan. the symptoms of being lethargic and generalized bodyaches are due to raised ALT.
Second is your Kidney function and hyponatremia. hyponatremia can be due to several conditions common of which is dehydration, malabsorption, vomiting or diarrhea or some kidney related problems. Both liver and kidney disease can cause swelling of ankles along puffiness of face. For better assessment of renal problem a urea and creatinine level is necessary to rule out any pathology. however your symptoms are having very close association with dehydration as you are also having concentrated urine. better option is to wait for the results

If you still have some queries, feel free to ask

Thanks
Regards
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Muhammad Ishfaq Habib (4 hours later)
Hi Dr,

Firstly thank you very much for your detailed reply,

Just one thing, my urine isn't always very dark but is particully dark in the mornings, it then maybe becomes a dark yellow/yellow colour and can sometimes remain that colour even when I have had litre of water, I also do have a particularly bad thirst . If the hyponatremia is caused by dehydration what would be the best way to resolve it?

Many Thanks

XXXXXX

doctor
Answered by Dr. Muhammad Ishfaq Habib (3 hours later)
Hi
Thanks for the reply

The dark color urine is due to dehydration. It is actually the concentrated urine. The recommended daily water intake is 2-2.5 liters/24hours. The best home remedy for hyponatremia is citric juices and especially lemonade with added salt.

If you still have some query, feel free to ask

Thanks
Regards
Note: For further queries related to kidney problems and comprehensive renal care, talk to a Nephrologist. Click here to Book a Consultation.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
Answered by
Dr.
Dr. Muhammad Ishfaq Habib

General & Family Physician

Practicing since :2010

Answered : 661 Questions

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Feeling Moody And Stressed. Have Kidney Problem. Blood Test And Urine Test Done. Any Suggestion?

Hi XXXXXX
Thanks for providing such detailed history

One thing i want to clear is that the conditions i will be mentioning here does not mean to scare you but its for general explanation and its not necessary that you might be having one of them. hope you understands that.
First I would like to comment on the raised ALT. The ALT is in blood results from liver cells. when the liver is having any kind of damage the result is raised ALT. It can be due to hepatitis ( viral or non viral) or autoimmune hepatitis. but these conditions can be rule out scans you already had and an advanced scan known as HIDA scan. the symptoms of being lethargic and generalized bodyaches are due to raised ALT.
Second is your Kidney function and hyponatremia. hyponatremia can be due to several conditions common of which is dehydration, malabsorption, vomiting or diarrhea or some kidney related problems. Both liver and kidney disease can cause swelling of ankles along puffiness of face. For better assessment of renal problem a urea and creatinine level is necessary to rule out any pathology. however your symptoms are having very close association with dehydration as you are also having concentrated urine. better option is to wait for the results

If you still have some queries, feel free to ask

Thanks
Regards