Low creatinine & sodium in urine?

Discussion in 'Fibromyalgia Main Forum' started by jaynesez, Sep 9, 2009.

  1. jaynesez

    jaynesez New Member

    this may be off topic, and I may get no answers, but I went to see an endo for excessive thirst & urination; had to pee & give blood, nurse called me yesterday and said for at least 24 hrs I can drink no more than 2-4 cups of fluid (????) because my results showed low sodium & creatinine. I have to redo the tests in 7 days. Anyone heard of this or had this result? I can ask her next time but was just wondering if any of my fellow FMer's know of this
    Thanks, Jayne
  2. richvank

    richvank New Member

    Hi, Jayne.

    Excessive thirst and urination is very common in CFS. It usually constitutes a "mild" case of diabetes insipidus (not the same as diabetes mellitus, which involves blood sugar).

    In diabetes insipidus, the hypothalamus/pituitary do not put out enough of a hormone called antidiuretic hormone (also called arginine vasopressin). This hormone normally tells the kidney how much water to excrete into the urine. When the hormone secretion is low, it kidneys dump too much water into the urine. The results are that the urine has low concentrations of its usual constituents, including sodium and creatinine.

    Also, the amount of water in the blood is decreased, and that causes the blood to become more concentrated in electolytes, and also to have a lower total volume. The person has constant thirst, but even though they drink a lot of fluids, they cannot keep up with the water loss, so they have constant hypovolemia (low blood volume). This low blood volume causes a lower than normal venous return of blood to the heart, and consequently the cardiac output also goes down, because the heart can pump out only what it receives.

    The result of this is often orthostatic intolerance. That is, the person cannot stand up very long without feeling faint, or having their blood pressure drop too much (OH or orthostatic hypotension), or having their heart rate speed up too much (POTS or postural orthostatic tachycardia syndrome). Also, if they take a warm shower standing up, they tend to faint, because the heat will cause more of their blood flow to be directed to the skin to carry away the heat, and that leaves less for the brain.

    The short-term solution to this problem is to drink more water while taking in more salt, but this should not be overdone, because it can cause problems for the kidneys. Some people also use Florinef, a prescription drug that helps to retain water. Another short-term approach has been to use the prescription drug Desmopressin, which is a synthetic form of the hormone arginine vasopressin. It is available as an oral pill or as nose spray. There can be problems with maintaining normal electrolyte levels with this drug, so that has to be monitored.

    The long-term solution is to fix the cause of the low output of this hormone by the hypothalamus/pituitary. In my hypothesis for CFS, this is one of the results of glutathione depletion. Hormones that contain cystine disulfide bonds, including this hormone, are not made properly when the cells producing them are low in glutathione. This is well supported by the medical literature. We also now have good data showing glutathione depletion in most people who have CFS. In addition, I have received a small number of reports from people who have found that when they treat the partial methylation cycle block, so that glutathione comes back up to normal, the diabetes insipidus is one of the aspects of CFS that is corrected.

    I do not want to conflict with what the nurse told you, but I would advise you to be careful in limiting your fluid intake. If you do in fact have diabetes insipidus as part of your CFS, limiting your fluids intake can cause you to become seriously dehydrated and very faint.

    There is another condition that is caused by a person simply drinking too much fluids, even though their body does not need them. In this case, the daily urine volume is also high, and the urine is diluted, but the person does not have low total blood volume. In most cases they are not actually thirsty, either. It should be possible for the doctor to determine which is the case by looking at the osmolality of the blood as well as the urine. I don't know if your doctor did that or not, or if so, whether the data were interpreted correctly. I do know that in CFS, the problem is usually caused by the first mechanism I described, and in that case, it's not a good idea to go too low on fluids intake, so please be careful.

    My suggestion for the longer term would be to have the Vitamin Diagnostics, Inc., methylation pathways panel run, and if it turns out that you have glutathione depletion and a methylation cycle block, whch has been the case for most people with CFS who have been tested, then I would suggest that together with your physician, you consider the simplified treatment approach for lifting the partial methylation cycle block.

    I have posted about this test and this treatment many times over the past two plus years on this board. There is also a Yahoo group devoted to this treatment, called the cfs_yasko group, and all the information is in the files section of that group. The membership of that group is over 900 people now, and many of them have experienced improvement. If you are unable to find the information, please feel free to email me at richvank at aol dot com.

    Best regards,

  3. jaynesez

    jaynesez New Member

    very much Rich for the information, you are, as always, a font of information! I am almost done with my 24 hour restriction (it has been hard) and did go over the 4 cup limit. I have read some of the posts re: methylation cycle, but some of it was over my head. I'll read through it again, and check into the cfs group.
    Thanks again for taking the time to relay helpful information, on this subject I've had a hard time finding anything out!
    Good Day to you,
    Oh, PS-I have to take cooler showers lately, as the heat was too much and felt sick.. interesting how the body works![This Message was Edited on 09/10/2009]
  4. TigerLilea

    TigerLilea Active Member

    Low creatinine levels can indicate that your kidneys are "hyper-filtering" which is another way of saying that your kidneys are working too hard.

    You can't always assume that a new symptom is related to CFS. While excessive thirst and urination are symptoms that some people with CFS have, in light of the test results, you should probably follow doctors orders and limit your fluids as to not do so might compromise your test results.

    Just for the record, my information comes from someone I know who works in Renal at one the local hospitals.

    Let us know how your further tests go.

    Take care.
  5. jaynesez

    jaynesez New Member

    tiger for your post as well; I have been reading (during my search) about kidney function, etc. but need more info from the dr in order to make sense of it (blood vs urine, etc)... sigh. I don't want to call them back in case it turns out to be nothing, and even though my 24 hrs is up the nurse said at LEAST 24 hr, so I'm trying to sip, not gulp and take it easy drinking.
    Thanks again for your help! I'll update this thread after my next test results come in.
    Hope you have a good and pain free day!
  6. kat0465

    kat0465 New Member

    i know this isnt quite the same thing, but i recently have been having Kidney problems. i have my Blood drawn every 3 months and this time my Creatine level was at a big Burly Mans level ( Not good) the only thing different i did was to take some herbal caps that evidently did a number on my Kidneys
    i was even having some back pain but i thought it was the fibro, WRONG!! im just hoping i quit the supps in time to not have done any long term damage to my Kidneys.

    To make a long story short, Look at any New meds or supps you may have started recently, even things like Xanax can make you Urinate More.
    Just a thought