anyone else have "low anion gap" in bloodwork on a regular basis?

[Kendo]

Hi everyone,
I'm in early stages of probable Sjogren's and am starting to have more issues. For at least three years now I've always had a low anion gap in my bloodwork. It doesn't get measured at family doc, just at ER when I'm there. Docs just dismiss it and it doesn't seem to just be a lab error as I've read in my research.

I've had protein in my urine several times and am now suffering from swollen eyelids when I first wake up in the morning. The swelling disappears in about five minutes once I'm upright. I've had more problems with swollen ankles too.

Anyone with renal tubular acidosis who remembers how they were first picked up by the doctors? This keeps coming up when I look at my symptoms. I have a calcium disorder that requires large doses of calcium and Vitamin D and am waiting (many more months!) for a specialist visit out of town. Too much calcium can cause kidney problems but I've read Sjogren's can affect them too. I'm getting tired of telling my family doc what to order!

My family doc visit is next week and I'll ask for an increased  thyroid dose as having a TSH of 3.91 seems high for someone suffering various hypothyroid symptoms. It really is such a balancing act with this disease.

Thanks for any help you wonderful people can give me.
Kendo

[irish]

I don't have RTA, but I am wondering if they are checking your potassium levels?? These can get quite low and cause weakness with the RTA.

Also, there are other kidney issues that can show up besides the RTA so I would keep reminding your doc about this. I know that it is a worry for you and actually it is something that we should all keep in the back of our mind.

We all need to make sure that we have kidney function tests done periodically. Are they checking your BUN/Creatinine levels??? There are a lot of blood tests that can get a little screwy with the kidneys and I don't remember what most of them are anymore.

If you could find some info and print it for your GP it would maybe help. Have you done a search on this site concerning kidney function, etc??? THere was a gal on here about a year or so ago who had stage 3 kidney failure and was having testing and preparation for possible kidney transplant. Sjogrens doesn't cause nearly as many kidney issues as the lupus, but even a few people with problems is way too many.

Maybe someone else can remember who that was. I can't even remember if she ended up having the transplant. Good luck to you and hope your docs get you some answers. Irish

[Kendo]

Thanks for the informative post, Irish. I went to family doc Monday and she ran bloodwork, chest xray and EKG. The EKG was abnormal and said I had a possible infarct! I was sent straight to emergency where they ran another EKG, chest xrays, blood and urine tests. The hospital EKG was still abnormal too but no heart attack and bloods for the heart attack markers were negative.

I still had the low anion gap and potassium at the low end of the range (always just below normal or at low end yet I drink tons of milk and eat bananas and oranges daily). Kidney function was okay and so I ended up with a chest CT with contrast dye that showed a possible lung clot. I was given heparin and sent home.

The next day a pulmonary radiologist read my scan and said "No clot" so we now have no diagnosis at all. I'm waiting on pulmonary function tests and a referral to a respirologist. Looks like it is still Sjogren's related. I have mild asthma but when ER did a pre and post inhaler test, my lung function was the same. I am dizzy and breathless on exertion so am taking it easy and ordering Christmas gifts online this year.

I'll head to my naturopath next week for ideas how to decrease the fluid in lungs, eyelids, and feet. Still sounds like kidneys or heart, says my walking partner who is a nurse. It is no wonder people with Sjogren's end up seeing so many kinds of doctors!
Kendo