Blood work - Is this a concern?

ljs3000 · May 15th, 2008, 10:39 AM

This may not be the right area to post but I need some advice from someone in the medical field if possible. Had blood work done recently and some levels were slightly out of range. Since they are slightly out, I'm not too concerned but my doctor just referred me to a Nephrologist (kidney specialist).

Some background info on me. Male, 45, 185lbs, 5'10". Lift weights fairly hard 3 days a week, run/bike 2-3 days per week. Fairly lean body composition.

Supplements I take: whey protein (I probably take in 200-250 grams protein overall per day), creatine monohydrate on cycles of 5 weeks on/3 weeks off (I was off during these blood tests), shitload of vitamins everyday (multi, fish oil, glucosomine/chondr/msm, E, C, selenium, B complex, B12) and that's it. I have a pretty good diet of chicken, lean meats, brown rice, whole grains, pretty much all the right stuff you should be eating.

I'm also on high blood pressure medication (lotensin, 40 mg/day) which I've been on for at least 20 years. BP is controlled with this medication.

I drink about 1 gallon of liquid (mostly water) every day.

These are the levels out of range:

Urea Nitrogen (BUN): 28 and 29 - 2 different readings, range: 7-25 mg/dL
Creatinine: 1.32 and 1.39 - 2 different readings, range: 0.5-1.30 mg/dL
BUN/Creatinine ratio: 21 and 23 - 2 readings, range: 6-22

Both urea nitrogen and creatinine are waste products that the kidneys are supposed to process out of your system.

It seems like these numbers are just slightly out of range and if you read why these levels could be elevated, excessive protein intake could cause high Urea Nitrogen levels.

Also, I read on one medical website, that "muscular young or middle-aged adults may have more creatinine in their blood than the norm for the general population".

So should I be concerned here?

Thanks in advance.

Lou S.

**SAINT_X** · May 15th, 2008, 11:27 AM

I am in a very similar situation. Recently had a physical and the creatinin level cam back at like...1.32. My Doc cut me off of caffein, and any supplements, start drinking LOTS of water and retake the blood test. Which I just did last week ( expecting them back any time now ).
Very similar....no high bp though.

I'll keep you posted...

ljs3000 · May 15th, 2008, 12:14 PM

Thanks for the reply. I am thinking this is not an issue at all after what I've been reading. Here is a link to a very good article that addresses teenage weightlifters (which obviously I'm not), but I believe the same facts hold true for anybody training hard. Check this out...

John Berardi - Dear Mom and Dad

After reading this article, I'm really not happy with my doctor. I understand that he's doing the right thing by sending me to the kidney specialist but when he reviewed my results with me the first time and my creatinine and BUN levels were elevated, he asked me if I was taking creatine at the time since that could raise my blood creatinine level. I told him I was off at the time and he had me go take another blood test 2 weeks later. When the results came back, I get a call from the nurse who says the doc wants me to go to the kidney doc. I ask her what the new readings were (stated above), and they really aren't too high. I guess I'm pissed because I've been going to this doctor for like 13 years now and he didn't say anything about these elevated levels could be caused by excess protein intake or muscle protein metabolism.

I have an appt in 2 weeks with the kidney specialist so I'll see what he says then and report back here.

**JarheadRI** · May 15th, 2008, 12:23 PM

When I did my research on creatine use this came up as a potential issue. I believe the cretin is a by product of creatine and it could be caused from this. Did you tell your doctor you were using it? I usually only use creatine for 6 weeks and only like 2-3 times a year. I think you should go to the specialist and maybe cut back a bit on that and the protein. Another option is to drink a lot of lemonjuice/leomondae. It is supposed to help clean out the kidney. I also take a shot or pure lemon juice before I eat a heavy meal. This is supposedley supposed to stimulate the gall bladder and kidney to squeeze out the nasty bile ducts. Definately keep an eye on that level though as I believe it can effect your liver functions as well.

ljs3000 · May 15th, 2008, 12:34 PM

Yes, my doctor knows that I take creatine on cycles and said that 5 grams a day is not a problem. But at the time of the blood test (first one), I was off for about a week. He told me to get another blood test 2 weeks later so my system was fully rid of the creatine supplement, which I also did.

Taking a lot of protein (whether by supplement or by food), is not a problem and the excess levels in the blood can be a by-product of the protein intake and just plain muscle protein metabolism (hard weight training sessions).

Thanks for the tips on the lemon juice and stuff.

**helpmespock** · May 15th, 2008, 02:15 PM

CHIIIIIIILLLLLOUT!!!!!!!

Hi I am a board certified ER doc and have been in practice for 12 years. i have been bodybuilding for 23. You have nothing to worry about and seeing a kidney specialist is ridiculous. It is well established in the literature that muscular people will have higher bun and cr levels. My creatinine is never less then about 1.4. You should be concerned if you had a cr of 0.8 like most of society. IT WOULD MEAN YOU AREN'T DOING MUCH IN THE GYM! after a good squat day in the gym your bun (which varies much more then cr) should be like 30, or apparently you wussed out. It has nothing to do with taking creatine....CREATININE and CREATINE are two different things.

don't be offended...my shouting is really out of frustration for how little most docs know about bodybuilding, steroids, and physiology in general. i had a friend who was cycling some deca and test, at the end of a 3 months cycle his ast/alt were slightly up.....GO FIGURE! the enzymes are INDUCED by roids so its typical to have slight elevations while on, and for about 2-4 weeks after. well my friend didn't believe me and took his docs advice for the kidney specialist consult ( i know why not a liver specialist?) well thats a long story and really another silly answer, needless to say the viral hepatitis panels (which i recommended as well since he was a paramedic) were negative, as were his liver biopsy ct scan and ultrasound....so after a 10,000.00 work up the kidney specialist figured it out...."oh don't roids induce those enzymes...."

bottom line you got no worries. if your CR goes above 1.6 and you are not built like Jay Cutler i would get concerned. 1.3, 1.4, 1.5 no worries.

**wildstang** · May 15th, 2008, 03:59 PM

i will lean more towards helpmespocks advice. your ranges arent out of wack enough to be worried over. everybodys levels will be slightly different then others. what catches my eye is your on blood pressure meds.
what you have listed for activity is sufficient to have eliminated most problems of needing help controlling your pressure. but obviously theres more to it underlying your health issues. during this boloodworkup did they test cholesterol values?
im just a little suprised someone as active as you have listed would need bp pills.

ljs3000 · May 15th, 2008, 04:56 PM

Quote:

Originally Posted by helpmespock

CHIIIIIIILLLLLOUT!!!!!!!

Hi I am a board certified ER doc and have been in practice for 12 years. i have been bodybuilding for 23. You have nothing to worry about and seeing a kidney specialist is ridiculous. It is well established in the literature that muscular people will have higher bun and cr levels. My creatinine is never less then about 1.4. You should be concerned if you had a cr of 0.8 like most of society. IT WOULD MEAN YOU AREN'T DOING MUCH IN THE GYM! after a good squat day in the gym your bun (which varies much more then cr) should be like 30, or apparently you wussed out. It has nothing to do with taking creatine....CREATININE and CREATINE are two different things.

don't be offended...my shouting is really out of frustration for how little most docs know about bodybuilding, steroids, and physiology in general. i had a friend who was cycling some deca and test, at the end of a 3 months cycle his ast/alt were slightly up.....GO FIGURE! the enzymes are INDUCED by roids so its typical to have slight elevations while on, and for about 2-4 weeks after. well my friend didn't believe me and took his docs advice for the kidney specialist consult ( i know why not a liver specialist?) well thats a long story and really another silly answer, needless to say the viral hepatitis panels (which i recommended as well since he was a paramedic) were negative, as were his liver biopsy ct scan and ultrasound....so after a 10,000.00 work up the kidney specialist figured it out...."oh don't roids induce those enzymes...."

bottom line you got no worries. if your CR goes above 1.6 and you are not built like Jay Cutler i would get concerned. 1.3, 1.4, 1.5 no worries.

Thanks for this response. From what little I read today on the web, I didn't think I really had any problem. And your response helps immensely. My biggest gripe was that my doctor of 13 years couldn't tell me that it's based on my diet and lifting routine. I will see him Monday and see what he has to say about all this now that I've done MY research.

ljs3000 · May 15th, 2008, 05:19 PM

Quote:

Originally Posted by wildstang

i will lean more towards helpmespocks advice. your ranges arent out of wack enough to be worried over. everybodys levels will be slightly different then others. what catches my eye is your on blood pressure meds.
what you have listed for activity is sufficient to have eliminated most problems of needing help controlling your pressure. but obviously theres more to it underlying your health issues. during this boloodworkup did they test cholesterol values?
im just a little suprised someone as active as you have listed would need bp pills.

Unfortunately, high BP runs in my family. I was diagnosed at around 25 and have been taking meds ever since. It's controlled fairly well with the meds. Part of the problem is that I'm a type A hyper type of person and work in a fairly high stress job which certainly doesn't help my situation.

**helpmespock** · May 16th, 2008, 03:21 AM

Quote:

Originally Posted by wildstang

i will lean more towards helpmespocks advice. your ranges arent out of wack enough to be worried over. everybodys levels will be slightly different then others. what catches my eye is your on blood pressure meds.
what you have listed for activity is sufficient to have eliminated most problems of needing help controlling your pressure. but obviously theres more to it underlying your health issues. during this boloodworkup did they test cholesterol values?
im just a little suprised someone as active as you have listed would need bp pills.

good post wildstang. I totally missed the bp meds line. i suspected after rechecking that it was a genetic thing since the man started at age 25. thats pretty unusual and typically occurs with strong family history for it. I am assuming ljs, that you were fully worked up for the cause of your htn, including renal ultrasounds and an evaluation for renal artery stenosis? It would be very rare for a doc to Rx bp meds at 25 without a full workup. So i have to qualify not worryinng about the kidneys, assuming you did have them checked years ago, and they are not the cause of your htn. also i am assuming you have no other condition, particularily diabetes...i'm interested in your response, so if you prefer to comment privately just pm me, otherwise 'll look for it here.

cheers,
Sean

ljs3000 · May 16th, 2008, 09:02 AM

Sean,

When I was first diagnosed with htn, I don't recall going through a big battery of tests. I was a lot bulkier at the time so I tried trimming down which didn't help much. Both my grandmothers had htn and my cousin had it since he was a baby. I believe it just runs in the family. Docs first prescribed lopressor which I believe slows your heart rate down and it just made me tired as hell. Then went on to some beta blockers and finally ended up on ACE inhibitors (lotensin) which has been working fairly well.

I have no other medical condition and my sugar levels have always been well within range. no issues there.

I have the basic physicals every year and blood work every 6 months since I'm on BP meds. I have my blood work results from the last 4 years and in each case the BUN and CR levels have been at the higher end of the range. I have been weightlifting consistently for over 20 years. This is also what is silly to me. If my CR level has been, let's say 1.29-1.30 the last 3 checks and now it's as high as 1.39, big friggin deal. Same is true for BUN levels, always been at the higher end. Over the last 1 1/2 years, I have raised the intensity level of my workouts quite a bit.

A year ago doc sent me for a chest x-ray (routine, no problem req'd this), results came back and said my heart was enlarged (another common condition for runners and weightlifters). Scared the living crap out of me until I went and had a stress test and ultrasound and they said I was absolutely fine and nothing was abnormal.

Now over the last couple of years, my cholestorol (sp?) has been on the high end of the range as well (~180-200). Doc comes in with his sheet of what I should and shouldn't be eating. I proceed to both laugh and get pissed at the same time since I eat better than anyone I know. High protein, low fat, whole grains, low refined sugar, etc, etc, etc. At one time he even suggested putting me on chol meds and I flat out told him no freakin way was I taking that crap with all the bad things I've heard about chol meds. Anyway, it's within range just at the high end.

Thanks a lot for your help with this.

Lou S.

**helpmespock** · May 17th, 2008, 03:20 PM

right on LJS! You are again showing a deeper understanding then your doc! chol meds are another of my pet peeves! they are extremely toxic to the liver, and are being pushed by the pharm companies big time...know why? they are damn expensive! It pisses me off how many gp's buy into this crap. Some slick salesman from Pfizer or whoever comes in the office with a bunch of food, stationary, pens and tickets to the lakers game, and suddenly the doc is pushin g their latest most expensive version of simvistatin. do you know that there has NEVER been a study done that has proven a reduction in mortality for MI patients as a result of taking these meds? Oh they have done a lot of them, yet they can't ever make the results say what they want. meanwhile cheaper drugs you never hear of actually DO reduce mortality....like HCTZ... have you ever heard a commercial for it? Nope...cause its cheap! drug companies can't make nothing off it...however, go turn your tv on for an hour and you got abpout a 75% chance of seeing a commercial for lipitor or zetia...expensive, toxic, and research proven NOT to work.....but pushed on the public like a panacea. what kills me is when docs are prescribing this for people with high normal(like yourself) or even normal chol levels....come on get a clue!

docs like this really embarass me. Keep doing your research bro. You are on the right track.

p.s. Lou ask your doctor if he has ruled out renal artery stenosis as a cause for your HTN. It probably isn't, but with BP problems at such a young age it should have been evaluated IMO.

ljs3000 · May 19th, 2008, 03:34 PM

Sean,

Just got back from the doc on a follow-up. I was ready with all my questions. Here's the way it went...

He asked if I made my appt with the Nephrologist. I had but I immediately asked him why I needed to see one. He proceeded to go through my blood levels. I stopped him and reminded him of my workout regimen and that I take in approx 250 grams of protein per day. I said, "aren't CR and BUN waste products of muscle/protein synthesis?". He responded yes, but but taking in too much protein is not good for your kidneys. Here we go again and I'm starting to get pissed. He said too much protein is not good for damaged kidneys and "we don't know" the effect that excess protein intake has on good kidneys. First part I can understand but second part is total BS.

He then explains to me that not only are my most recent CR (1.39) and BUN (32) levels high, but my eGFR is at 55. According to HIM, that's the real measure of kidney function and that's why he wants me to go to the kidney spec since they can do more thorough tests on my kidneys and do an ultrasound and may do a 24-hr urine test. He (the kidney doc) may also want me to go on a low protein diet or up my intake of liquids (quoting my doc).

Now that I had a chance to think about it and remember reading about this last week I am F---ING PISSED!!! eGFR is calculated from the CR level measured in your blood!!!!

While I was there I also told him that I kept my blood work results from the last 4 years and that my CR and BUN levels have always been on the high side. He said if they are high it's not a problem but if they go out of range, then it's a problem. Maybe he's just covering his ass and I can understand that but it seems to me he isn't knowledgeable on any of this.

So before I left, I asked about renal artery stenosis and if my htn could be caused by this. He said they will check all that at the kidney spec but if these blood levels were high back then (I'm assuming he means CR, BUN, eGFR), they would have had my kidneys checked at the time. Who the F--- knows if they even checked this crap 20 years ago.

So I will calm down, and go to the nephrologist (next Thurs) and have this battery of tests done but the first thing I am going to ask is why am I here just to see what the answer is. I plan to have a printout of my level of physical activity, diet, supplement intake and meds (just the BP med) in hand with me when i go.

I know it's better to be safe than sorry but the answers I'm getting seem like pure bullshit.

Thanks for listening to my ranting.

Lou S.

**SAINT_X** · May 19th, 2008, 05:34 PM

...very interesting.

Got my results back after 3 weeks of no supplements of any kind, no caffiene, and lots of water and the creatinin level was normal.

I am still curious about this though, as I don't feel I have a definitive answer to the source of this little alarm bell, or false alarm. Common sense leads me to lean towards pretty much doing what I always do just drink more water.

**helpmespock** · May 20th, 2008, 07:47 AM

Your gfr will be prone to the same calculation bias as creatinine and bun levels if you are overly muscular. The more muscular you are the more benign those numbers are. My numbers are similar to yours. I am white, 41, 5 feet 10 inches and 245-250 lbs at 12-14% body fat. I am not the least bit concerned. I am not sure how muscular you are, but if you are carrying a lot more muscle then the average guy, the numbers don't worry me. See what the kidney doc says. I would suggest you let him do most of the talikng initially, before you challenge anything. We doctors have frail egos, and many will get adverserial if they feel their expertise is being challenged. You should get everything off your chest, but let the doc give his speil first, that way he/she will be more likely to keep an open mind and actually listen to you.

good luck , keep me in the loop if you want

cheers,
Sean