Could Kidney Function Affect My Cholesterol Levels? Is It Wise to Delay Accutane?
I have some concerns regarding my high cholesterol in relation to my upcoming Accutane treatment and whether kidney issues might be contributing factors. I’m a 27-year-old female, weighing 183 lbs and standing 5'7". I have been prescribed 100mg of Spironolactone to manage acne for the past five years, along with Junel Fe 1.5/30 birth control for ten years. I don’t use any recreational drugs and consume alcohol infrequently. With Accutane set to commence next week, I find myself apprehensive due to recent blood and urine test outcomes that reflect elevated cholesterol levels and other anomalies that could point to kidney dysfunction. I could use some insights into interpreting these test results and determining whether it’s prudent to begin Accutane, given its potential to raise cholesterol levels further. Unfortunately, I am unable to consult my primary care physician regarding these findings before my appointment with the dermatologist. My latest test results showcase several irregular indicators: * **Lipid Profile:** * Cholesterol: Elevated at 210 mg/dL * LDL Cholesterol: High at 130 mg/dL * Non-HDL Cholesterol: Increased at 154 mg/dL * **Metabolic Panel:** * Low CO2: 17 mmol/L * Anion Gap: High at 20 mmol/L * **Urine Tests:** * Microalbumin: Elevated at 19.1 mg/L Earlier blood tests have shown consistently high LDL levels as well: 126 in 2022 and 120 in 2023, while my triglycerides have remained in the normal range. Additionally, my A1c test from January returned normal, suggesting that diabetes isn’t a factor here. In the past five years, I've gained approximately 30 lbs, attributed primarily to an unhealthy diet and insufficient physical activity. Recently, I have improved my eating habits and started running between 3 to 5 miles several times weekly. However, I had hoped my latest LDL reading would be lower than in 2023, but instead, it has risen to the highest it has ever been. I aim to lose about 20-30 lbs, yet my weight has stagnated over the past year. I’m curious about the possibility that my elevated cholesterol may stem from kidney issues rather than solely from dietary habits. My research indicates that the combination of low CO2, high anion gap, and increased microalbumin could suggest metabolic acidosis linked to kidney function. The only previous kidney-related issue I’ve had was with kidney stones in 2021, which were confirmed through imaging and passed without intervention. I’ve also experienced sporadic kidney pain since then, which I believed might be related to stones (although this pain resolved on its own). Occasionally, I notice swelling around my eyes, a symptom I've read could be associated with nephrotic syndrome. I'm eager to receive guidance regarding my next steps, any additional tests I should consider, and overall advice on this situation. Thank you in advance for your input!
Answers (1)
4/4/2025, 12:10:52 AM
OpenHealth AI
Main Points: Elevated cholesterol can indeed be related to kidney function, and starting Accutane with existing concerns about cholesterol and kidney health requires careful consideration. It's crucial to monitor your symptoms and test results.
Explanation: Your test results showing elevated cholesterol levels could be influenced by several factors, including your kidney function. Impaired kidney function can lead to abnormal lipid profiles. The elevated microalbumin in your urine is an important indicator, suggesting some level of kidney stress or damage, which could potentially be impacting your cholesterol levels. Other tests, like low CO2 and high anion gap, may suggest metabolic issues, possibly related to your kidneys.
Starting Accutane carries a risk of further increasing cholesterol levels. Given your current health situation, it's wise to consider these risks seriously.
Next Steps:
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Monitor Symptoms: Keep an eye on any worsening symptoms such as fatigue, swelling (especially around your eyes), or significant changes in urination. These can provide insights into your kidney health.
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Consider Delaying Accutane: While you're scheduled to start next week, it may be prudent to postpone until you can discuss your concerns with a healthcare provider. Accutane can exacerbate cholesterol levels, and it’s essential to address your current health status first.
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Lifestyle Adjustments: Continue improving your diet and exercise routine, focusing on heart-healthy foods (fruits, vegetables, whole grains, healthy fats) and maintaining regular physical activity.
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Stay Informed: Document your symptoms, lifestyle changes, and any other related changes you observe in your health. This information will be valuable for your upcoming consultations.
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Follow Up on Tests: When possible, request a detailed discussion about your lab results with your primary care physician or a nephrologist. Additional tests—such as kidney function tests (creatinine, BUN), and possibly a referral to a specialist—may be warranted to further evaluate your kidney health and cholesterol management.
Always prioritize your health and make sure to communicate all these concerns clearly if you see your dermatologist or any other healthcare provider.
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