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Hypothyroidism, Hashimoto’s, and Your Kidneys

Explore the connection between your thyroid and kidney health and what you can do to protect your health.
Hypothyroidism, Hashimoto’s, and Your Kidneys
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Are you struggling with hypothyroidism or Hashimoto’s and kidney health? You’re not alone. Recent studies have shown that these conditions are linked, and understanding the relationship is crucial for proper diagnosis and treatment. In this article, we’ll explore the connection between hypothyroidism, Hashimoto’s, and kidney health and provide practical tips to help you take control and feel your best!

Understanding your kidneys

First, let’s take a look at your kidneys and their function. Your kidneys – small, bean-shaped organs – play a vital role in overall health. Most people have two kidneys -- located on either side of the lower back -- but it is possible to live with only one functioning kidney.

So, what do kidneys do exactly? Let’s take a look at their functions:

Filtration of Waste Products: One of the primary functions of your kidneys is to filter waste products and toxins from your blood. Every day, your blood circulates through the kidneys, where tiny structures called nephrons filter out waste material, excess water, and toxins. These waste products are then eliminated from your body through urine.

Regulating Fluid and Electrolyte Balance: Kidneys are crucial in maintaining fluid and electrolyte balance in your body. They carefully regulate the amount of water and salt reabsorbed into the bloodstream, ensuring that your body maintains optimal hydration levels. The kidneys also control your levels of other electrolytes, such as potassium, sodium, and calcium, essential for various bodily functions.

Maintaining pH Balance: Maintaining the proper pH balance in your body is crucial for overall health. Kidneys control the levels of acids and bases in the blood and keep these levels within a narrow range. Too much acidity or alkalinity can disrupt various bodily functions, so the kidneys keep that balance in check.

Blood Pressure Regulation: Kidneys play a vital role in regulating blood pressure. They produce a hormone called renin, which helps control blood pressure by constricting or dilating blood vessels. Additionally, the kidneys regulate your blood volume by adjusting the amount of water and salt retained or excreted.

Red Blood Cell Production: The kidneys produce a hormone called erythropoietin, which stimulates the bone marrow to produce red blood cells. These cells carry oxygen to various organs and tissues, ensuring proper oxygenation and overall health.

Vitamin D Activation: Vitamin D is essential for calcium absorption throughout your organ systems and supports strong bones and teeth, muscle function, and hormonal balance. The kidneys play a role in converting inactive vitamin D into its active form.

Detoxification: Along with filtering waste products, the kidneys also help eliminate various drugs, chemicals, and foreign substances from your body. This detoxification process is vital in maintaining a healthy and functioning system.

Signs and symptoms of kidney dysfunction

When the kidneys are not functioning properly -- known as renal dysfunction --  it can lead to various signs and symptoms. Awareness of the signs of kidney dysfunction is essential because early detection and treatment can help prevent further damage and potential complications. Here are some common signs and symptoms of kidney dysfunction:

Changes in Urination: One of the earliest signs of kidney dysfunction is changes in urination patterns. You may notice more frequent urination, especially at night (nocturia), decreased urine output, or urgency to urinate. Your urine might also appear foamy or bubbly due to the presence of protein, which is usually filtered by the kidneys.

Swelling and Fluid Retention: Kidney dysfunction can cause you to retain excess fluids, leading to swelling in your hands, feet, ankles, or face. This condition is known as edema and results from the kidneys’ decreased ability to remove waste products and excess fluid from your body.

Fatigue and Weakness: When your kidneys are not functioning correctly, there is a build-up of toxins and waste products in the bloodstream. This can cause anemia, a condition characterized by decreased red blood cells. As a result, you may feel tired or weak and have difficulty concentrating.

Shortness of Breath: Kidney dysfunction can disrupt the balance of fluids and electrolytes in your body, leading to fluid accumulation in the lungs. This fluid build-up can result in shortness of breath or difficulty breathing, even with minimal exertion.

Persistent Hypertension: The kidneys play an essential role in regulating blood pressure. When kidney dysfunction occurs, it can lead to uncontrolled or persistent hypertension (high blood pressure). Monitoring your blood pressure regularly is crucial, as high blood pressure can further damage the kidneys and other organs.

Changes in Appetite and Taste: Kidney dysfunction can cause a loss of appetite or a metallic taste in the mouth. As waste products build up in your body, it can affect your sense of taste, leading to a change in food preferences or aversion to certain foods.

Muscle Cramps and Restless Legs Syndrome: Imbalances in electrolyte levels, specifically potassium and calcium, can occur when your kidneys are not functioning correctly. This can lead to muscle cramps, especially in your legs, and Restless Legs Syndrome (RLS), causing an uncontrollable urge to move your legs.

It is important to note that the signs and symptoms of kidney dysfunction vary depending on the severity of the condition and the underlying cause. If you experience any of these symptoms, it is crucial to consult a healthcare professional who can perform the necessary tests to diagnose and manage kidney dysfunction effectively.

How is kidney dysfunction diagnosed?

When it comes to diagnosing kidney dysfunction, your healthcare professional will utilize a variety of tests and examinations to assess the condition of your kidneys accurately. Here are some common methods used in the diagnosis of kidney dysfunction:

Physical Examination: During a physical examination, your healthcare provider will look for signs and symptoms of kidney dysfunction. This may include swelling of the ankles or legs, high blood pressure, or abnormal heart sounds.

Urine Tests: Urinalysis is a crucial diagnostic tool for kidney dysfunction. It helps assess the presence of various substances such as protein, blood, or glucose in your urine. These abnormalities can indicate kidney damage or disease.

Blood Tests: Renal function studies include blood tests that provide valuable information about your kidney function. Two common blood tests for kidney dysfunction diagnosis are blood urea nitrogen (BUN) and creatinine tests. Increased levels of these substances in the blood indicate impaired kidney function.

Imaging Tests: Imaging tests such as ultrasound, CT scan, or MRI may be performed to get a detailed view of your kidneys. These tests can detect any structural abnormalities, tumors, or blockages in the urinary system that may be causing kidney dysfunction.

Biopsy: In some cases, a kidney biopsy may be necessary to confirm the diagnosis and determine the underlying cause of your kidney dysfunction. A small tissue sample is taken from your kidney and examined under a microscope to assess any damage or abnormalities.

Glomerular Filtration Rate: Glomerular filtration rate (GFR) measures kidney function in patients, estimating how efficiently your kidneys are filtering waste products from the blood. It is determined through a blood test and is considered one of the most reliable indicators of kidney health.

Free T3

Free T3 is a hormone produced by the thyroid gland. Levels of this fluctuate when individuals have an under or overactive thyroid gland.


Thyroid-stimulating hormone, TSH, is the hormone responsible for controlling hormone production by the thyroid gland. The hormone TSH is considered the most sensitive marker for screening for thyroid diseases and conditions. Our thyroid panel is ideal for TSH testing at home and will tell you how your levels compare to normal TSH levels.

TPO Antibodies

Thyroid peroxidase antibodies are antibodies that can bind to thyroid enzymes, suppressing thyroid function. They are elevated in a condition called Hashimoto's disease, which is the most common type of hypothyroidism in the USA.

Free T4

Free T4 is the predominant hormone produced by the thyroid gland. Levels fluctuate when individuals have an under or overactive thyroid gland. Testing your free T4 with this thyroid function test lets you see if your thyroid hormone production is at a normal level.

Reverse T3


RT3 is a metabolite of T4. Typically, when T4 loses an atom of iodine—a process known as monodeiodination—it becomes (T3), the active thyroid hormone.The body also converts T4 into rT3, which is an inactive form of T3 that is incapable of the metabolic activity that is normally carried out by T3.

Vitamin D


Some observational studies have found low blood levels of vitamin D in patients with hypothyroidism and Hashimoto’s as well as hyperthyroidism due to Gravesʼ disease. It is not clear from these studies if low vitamin D is a cause, a consequence or an innocent bystander in the development of these common thyroid conditions.

The link between hypothyroidism and kidney dysfunction

Hypothyroidism, an underactive thyroid, is a condition where your thyroid gland does not produce enough thyroid hormones necessary for various bodily functions. While most people are aware of how hypothyroidism impacts metabolism, energy levels, and weight gain, you may not know how hypothyroidism can affect your kidneys.

The prevalence of kidney disease in people with hypothyroidism is relatively high. Thyroid hormones play a crucial role in maintaining kidney function. When these hormones are deficient due to hypothyroidism, it can lead to several kidney-related complications, including:

Decreased Renal Blood: Thyroid hormones play a significant role in regulating blood flow to your kidneys. When thyroid hormone levels are low, there is a reduction in renal plasma flow. This can result in impaired kidney function and reduced filtration of waste products from the bloodstream.

Decreased Glomerular Filtration Rate: As described earlier, the glomerular filtration rate measures how efficiently your kidneys filter waste from the blood. Hypothyroidism can decrease your GFR, resulting in the build-up of waste products and toxins in your body.

Electrolyte Imbalances: Thyroid hormones help regulate your levels of electrolytes like sodium and potassium. When you’re hypothyroid, electrolyte imbalances can occur, leading to symptoms such as muscle weakness, fatigue, and irregular heart rhythms.

Fluid Retention: Hypothyroidism can cause fluid retention in your body, leading to swelling and edema. This can put extra strain on your kidneys and reduce kidney function.

Increased Cholesterol Levels: Hypothyroidism is often associated with high cholesterol levels. Elevated cholesterol can lead to the development of atherosclerosis, a condition characterized by the narrowing and hardening of the arteries. The reduced blood flow to your kidneys caused by atherosclerosis can impair kidney function.

Kidney diseases associated with hypothyroidism

Hypothyroidism is considered a risk factor for many kidney diseases. These include:

Chronic Kidney Disease (CKD): Previous studies have shown that individuals with untreated or poorly managed hypothyroidism are at an increased risk of becoming chronic kidney disease patients. The exact mechanism behind this association is still not fully understood, but it is believed that thyroid hormones play a role in maintaining proper kidney function.

Renal Failure: Hypothyroidism can contribute to the development of renal failure, a condition in which the kidneys can no longer filter waste products from the blood. Studies have shown hypothyroidism can lead to impaired kidney function, ultimately leading to renal failure.

Nephrotic Syndrome: Nephrotic syndrome is a condition characterized by excessive protein loss through the urine, resulting in low levels of proteins in the blood. Hypothyroidism has been associated with nephrotic syndrome, although the exact relationship between the two conditions is not yet fully understood.

Polycystic Kidney Disease (PKD): Polycystic kidney disease is an inherited disorder characterized by the growth of numerous cysts in the kidneys. Hypothyroidism is more prevalent in individuals with PKD compared to the general population. It is believed that hormonal imbalances associated with hypothyroidism may contribute to the development or progression of PKD.

Acute Kidney Injury (AKI): Hypothyroidism can also increase the risk of developing acute kidney injury. Acute kidney injury is a sudden loss of kidney function due to various factors such as infections, medications, or decreased blood flow to the kidneys.

Hashimoto’s and kidney function

Hashimoto’s thyroiditis, the autoimmune thyroid disease that is the cause of most cases of hypothyroidism in the U.S., also has implications for kidney health. Studies have shown that individuals with Hashimoto’s thyroiditis are at an increased risk of developing kidney problems, including chronic kidney disease (CKD).

One possible reason for this association is the presence of autoantibodies produced in Hashimoto’s thyroiditis. These thyroid antibodies, such as thyroid peroxidase (TPO) and thyroglobulin (TG), attack the thyroid and may contribute to kidney damage. They can infiltrate the renal tissue, leading to inflammation and kidney injury.

Some studies have also found a link between Hashimoto’s thyroiditis and a specific type of kidney disease called membranous nephropathy. Membranous nephropathy is characterized by the thickening of the glomerular basement membrane, which impairs kidney function. Research suggests that specific autoantibodies associated with Hashimoto’s thyroiditis might trigger this kidney condition.

How kidney disease affects thyroid function

Pre-existing Hashimoto’s or hypothyroidism in patients can affect kidney health, but the opposite is also true. Kidney disease can affect your thyroid function. One common condition that arises from kidney disease is known as “secondary hyperparathyroidism.” The parathyroid glands, small glands located near the thyroid gland, play a vital role in regulating calcium levels in your body. In kidney disease, there is a disturbance in the balance of minerals, including calcium and phosphorus. As a result, your parathyroid glands become overactive, increasing parathyroid hormone (PTH) levels. Elevated PTH levels, in turn, can affect the production and conversion of thyroid hormones, negatively affecting your thyroid function.

Another way kidney disease affects thyroid function is through the accumulation of uremic toxins in your body. In advanced stages of kidney disease, the kidneys cannot filter waste products effectively. Uremic toxins build up in the bloodstream, leading to a condition called “uremia.” These toxins can interfere with the conversion of thyroid hormones, affecting their availability and activity in your body.

How is kidney dysfunction treated?

Kidney dysfunction can have a significant impact on your overall health and well-being. It is essential to seek appropriate treatment to manage and potentially improve kidney function. Here are several approaches that healthcare professionals use to treat kidney dysfunction:

Medication: One of the primary ways to treat kidney dysfunction is through medication. Several drugs are used to treat kidney disease, and the treatment depends on the specific condition and symptoms. Some common medications include angiotensin-converting enzyme inhibitors (ACE inhibitors) and angiotensin receptor blockers (ARBs), which help to lower blood pressure and reduce protein loss in the urine. Diuretics may also be prescribed to help increase urine output and reduce fluid retention. Phosphate binders may be used to control the levels of phosphorus in the blood while erythropoiesis-stimulating agents (ESAs) are sometimes prescribed to stimulate the production of red blood cells in individuals with anemia. Additionally, corticosteroids may be used to reduce inflammation in the kidneys.

Lifestyle Changes: Adopting a healthy lifestyle can contribute to improved kidney function. This can include making dietary modifications, such as reducing sodium and protein intake, to ease the workload on the kidneys. Regular exercise and maintaining a healthy weight can also positively affect your kidney health.

Fluid Management: Managing fluid intake is crucial for individuals with compromised kidney function. Healthcare professionals may recommend limiting fluid intake to avoid excessive workload on your kidneys. This is especially important for individuals on dialysis, as excess fluid can lead to complications.

Dialysis: For individuals with severe kidney dysfunction, dialysis may be necessary to remove waste and excess fluid from your body artificially. There are two primary types of dialysis: hemodialysis and peritoneal dialysis. Hemodialysis involves filtering blood through a machine, while peritoneal dialysis uses the lining of the abdomen to filter waste. The choice of dialysis method depends on various factors and is determined in consultation with healthcare professionals.

Kidney Transplant: In some cases, a kidney transplant may be the most suitable treatment option. This involves surgically replacing your non-functioning kidney with a healthy kidney from a living or deceased donor. Kidney transplants offer long-term benefits and potential improvement in kidney function, but they require careful evaluation and compatibility testing.

Managing Underlying Conditions: Kidney dysfunction is often associated with underlying conditions such as diabetes, high blood pressure, or autoimmune disorders. Treating and managing these conditions is crucial for preventing further kidney damage and preserving your existing kidney function.

Regular Monitoring and Follow-up: If you have kidney dysfunction, you should undergo regular monitoring through blood tests, urine tests, and imaging studies to assess renal function and identify any potential complications. Regular follow-up appointments with healthcare professionals are essential for ongoing management and adjustment of your treatment plan.

What should hypothyroid patients do to maintain kidney health?

Hypothyroidism can significantly impact various organs and functions in your body, including your kidneys. Your kidneys play a crucial role in filtering waste products from the blood and maintaining fluid and electrolyte balance. When you are hypothyroid, taking steps to maintain healthy kidney function is essential. Here are some recommendations to keep in mind:

Optimally treat your hypothyroidism: It’s essential that your hypothyroidism be well-managed with thyroid hormone replacement therapy. Untreated or poorly treated hypothyroidism can increase the risk of kidney problems.

Follow a balanced diet: A healthy diet is essential for your general health, as well as your kidneys. You should focus on a balanced diet that includes fruits, vegetables, whole grains, lean proteins, and healthy fats. Avoiding excessive salt, sugar, and processed foods can also benefit kidney health.

Stay hydrated: Hypothyroid patients should drink an adequate amount of water to avoid renal dysfunction. Proper hydration helps to flush out toxins and waste products from your body. Aim to drink at least 8-10 glasses of water per day, or as recommended by your healthcare provider.

Control your blood pressure: Hypothyroidism can sometimes lead to high blood pressure, which can negatively affect your kidney health. You should monitor your blood pressure regularly and take steps to keep it within a healthy range. This may involve adopting a low-sodium diet, exercising regularly, and taking prescribed medications if necessary.

Limit your alcohol consumption: Excessive alcohol consumption can have detrimental effects on kidney health in patients with hypothyroidism. You should limit your alcohol intake or, in some cases, avoid it altogether. It is best to consult with a healthcare provider to determine the appropriate level of alcohol consumption based on your circumstances.

Maintain a healthy weight: Being overweight or obese can increase your risk of kidney disease and other health problems. You should strive to maintain a healthy weight through a combination of a balanced diet and regular exercise. This can help reduce the strain on your kidneys and improve their overall function.

Manage stress: Chronic stress can hurt kidney function. You should adopt stress-management techniques such as meditation, deep breathing exercises, or engaging in enjoyable activities.

Regularly monitor kidney function: Regular monitoring of kidney function through blood tests can help detect any early signs of kidney damage or dysfunction. You should work closely with your healthcare provider to schedule regular check-ups and discuss any concerns or symptoms that may arise.

A note from Paloma

While there is an association between hypothyroidism, Hashimoto’s, and kidney diseases, it does not mean that every individual with a thyroid condition will develop kidney problems. However, if you have hypothyroidism or Hashimoto’s, you should know the potential risks and ensure your condition is adequately managed. Regular check-ups, proper medication, and a healthy lifestyle can help minimize the chances of kidney complications associated with hypothyroidism.

Paloma Health can play a key role with easy at-home thyroid test kits, virtual visits with top thyroid practitioners, and dietary advice from our thyroid-savvy nutritionists. Learn more about how becoming a Paloma member can make all the difference in your health and life!

Vedrana Högqvist Tabor, Ph.D., contributed to this article.


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Mary Shomon

Patient Advocate

Mary Shomon is an internationally-recognized writer, award-winning patient advocate, health coach, and activist, and the New York Times bestselling author of 15 books on health and wellness, including the Thyroid Diet Revolution and Living Well With Hypothyroidism. On social media, Mary empowers and informs a community of more than a quarter million patients who have thyroid and hormonal health challenges.

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