Low Phosphorus

[G-Ma]

Has anyone run into very low phos?  Mine came back less than one and my PTH bottomed out as well, so now they say stop binders, said have not had patients that were so faithful about binders and had this happen.  I have been "extremely" exhausted the last 2 weeks and now powers that be think this is the reason..red blood cells are good.  I work on watching everything I eat. The lab called them so I don't have anything in print yet.  Head nurse threw up her hands and said "go figure, this is all just a test anyway"..wow I felt good about that even through she was probably telling the truth.  I was just curious about this.

 

[jbeany]

Mine has been running low for a while.  I'm on a good binder, and I've been working hard on watching the phos in my diet.  I've been adjusting my binders accordingly - skipping them with low phos meals, taking half a binder with med phos meals, and only a full binder if I'm having something really high in phos, like a double serving of cheese.  I'm on Fosrenol, which comes in big, Tums like tablets, so it's easy to bite one in half, or even 1/4's if I need to.

It's nice to know I can add the cheese and milk back in my diet if I really want to.  I'm just staying away now because I know how much they make me gain weight.

[Romona]

Mine is low post transplant. I take phophorous three times a day. The last labs I had they told me to do the reverse of all I was told. Beans, low fat dairy, ect. After watching all of that for so long, it is hard to make myself eat it. I feel like I am being bad. 

[G-Ma]

Romona, I'm glad you are doing well post trans and don't feel bad about yourself.  I've done that for years thanks to some people in my life so please don't.   

Jbeany, thanks for letting me know what you are doing.  I think I'm going to talk to the Dr about trying to mix up my binders with the kind of food.  I HAD to take Fosrenol for 3 months and ohhhhh gawwwwdddd.  I've been back on Phoslo since that time, 3 before a meal and 1 before a snack or 2 if a chocolate snack, very seldom.  This may be a good idea.     

 

[Zach]

Mine came back less than one and my PTH bottomed out as well, so now they say stop binders, said have not had patients that were so faithful about binders and had this happen.

Please make sure your PTH doesn't go too low.



http://ihatedialysis.com/forum/index.php?topic=13528.msg234313#msg234313

[Rerun]

Go have a chocolate milk shake!  That is what I would do if my Phos was EVER too low which it never is.

                             

[G-Ma]

Thanks Rerun, I may just do that.
Thanks Zach for the link.  All the nurse said is my PTH is as low as my Phosphate, non existant.  Hope to find out more on Friday.  I don't know what to expect.

[RightSide]

Yes, my phosphorus actually dropped to around 1.6 last month.  My neph threatened to put me on phosphorus supplements if I don't get that number higher!

Like you, I follow the low-phosphorus regimen faithfully.  What it shows is that the regimen really does matter--if you don't cheat on it.

Part of it may also have to do with the type of dialyzer.  The one my center uses on me is the Baxter Xenium 210, which is claimed to be 82% as effective at filtering phosphates from the blood as it is with filtering urea!  The center chose it to help patients who are having trouble sticking to a low-phosphorus regimen get the phosphorus out of their blood.

But for those of us who take our binders and avoid high-phosphate foods, this dialyzer can really drive our blood phosphorus level down even further.

[G-Ma]

Thanks RightSide....so did you change how you ate after that or what did you do to come back up?  I ate 2 small steakburgers yesterday and yes....I went with my grandaughter and had a custard icecream thingy at a Rita's Place..it was very very good and I felt so guilty so today back on track...Dr wasn't in so will wait til next week to talk to him.  Thanks everyone.     

[RightSide]

Low phosphorus is not all that dangerous for renal patients--because as you say, it's not hard to correct.     My dietician told me to increase my protein intake, which is a good thing on hemodialysis anyway.  I'm not going to binge, just add a couple more ounces of protein here and there each day.

But paradoxically, too low a PTH level can be as dangerous (for different reasons) as too high a PTH level.  And even more strangely, a PTH level that would be perfectly acceptable for a healthy person is considered too low for us renal patients. 

Too low a PTH level has been implicated in something new--"adynamic bone disease."  This is a condition where our bones no longer replenish and reconstitute themselves as rapidly as they used to.

As a result, the "normal" range of PTH for renal patients like you and me has deliberately been set HIGHER than the normal range of PTH for healthy persons.