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Tacrolemus and liver transplant

im post Tx 1.5 years    I was healing fine after Tx now my kidneys are taxed pretty bad down to 50   They were up around 70 than slowly went back down.  I’m on 4 mg tacrolemus and 750 cellcept. Yet I can’t lower my tac yet.  Any suggestions.  I eat healthy hydrate and exercise

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  • Wish I had a good answer for you but I don't but keep on things can get better.

  • I believe you are using your EGFR numbers.

    I would have to ask about your nutrition - I will explain.  Potassium can get out of whack depending on your body.  So eating healthy is obviously a requirement for us, which you do.  But also are you fosuing on micronutrition?  I only eat certain vegetables and all the big K foods are not in my diet.  It is a challenge as many healthy foods are not tailored to our needs.  

    I was on Veltassa (none of my docs knew what it was at first) which assists with keeping K levels in check.  I then quit taking it and used only diet, problem gone and CKD numbers doing better.

    USDA Website and google is how I created my Food List and that is generally what I eat.  Tacro is rough tho.  I am doing all I can to stay ahead of the CKD curve as I would prefer no more new organs.  

    • Hi Jeff thank you could you go into what k foods are specifically I’m thinking keratin  vita k where and how do I do this.  Great info this may be the problem hopefully 

      • A place to start:

        This is not set up great but get out a pen and paper or cell phone and scroll, and look at it 100 times, serious here.   For instance - I eat asparagus a lot, but I love all veggies.  But I do not eat things I like:  avacados, tomatos, potatoes. Yes, I eat an Apple a day but not a banana.


        Then I went here because I am a little over the top committed to all of my nutrition now.  Low/No sugar, specific carbs, watching K,  SODIUM.  It is more confusing but I also choose meats based on protein/sodium value.  Again, I am pretty focused but I had one Tx, almost another, and I will do anything to keep what I currently have lol. Site is search based so no easy but a lot of info.

        And I am just going to assume you and all other readers look at every label of every thing you put in your body.  You can have your cheat items, just mark them as such and have them in your diet in that capacity.  I also eliminated sodium (as low as possible) so I read less labels.  No cans are in my diet currently.  

        And while on my bandwagon - the gym, a walk, anything moving.  


        • Sorry,  what specific carbs?   TY 

        • Jeff , thank you so much... I appreciate your focus. It helps me. Do a reality check on myself and diet.   Exercise I have down.  I go to the gym about 5 to 6 times a week .  Just need to adapt some of your wise recommendations and no I don’t don’t want to go under the knife again and will learn to adapt better eating habits.  Thank you 

          • Of course.

            The other points I neglected:  Protein, Protein, Protein (all sources).  And you may find, as I did, that your palate will adapt and change as your diet does.  My treats are all pretty healthy and they feel like it so I do not miss many foods.  


            • Thank you so much

  • Some people just have a harder time lowering their levels while others need to take a lot more medicaiton to achieve an acceptable level. I've gone down to as low as 0.5mg twice a day of Tacrolimus and I'm currently at 1mg and 1.5mg. If you're already eating healthy, exercising, and drinking enough fluids then you may not be able to do much else. You could take your medications with food so that it's easier for your body to absorb them rather than with an empty stomach. 

    • How long ago was your transplant ?    I know during the crisis of liver failure my kidneys were put in the position of taking over a lot of functions the liver could not do on top of all the drugs they were giving me to keep alive. My kidneys almost failed than. So bouncing back was a problem although for a while they did it’s only within the last month they took a dive 

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