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bcadam82
03-16-2005, 09:52 PM
I recently had some bloodwork done and some results came out to be quite surprising, and now my doctor wants me to go see a Nefrologist. First off, I have never taken any steroid or pro-hormone...supplements are Protein, Creatine Estyl Etherate (4-5g per day), and now taking Ab-Solved.

Any feedback or opinions would be much appreciated. I had the blood work done 4 hours after I had finished working out (weight training), so not sure if that threw them off at all.

Age: 22
Height: 5'11"
Weight: 223
Bodyfat: 13-14%

The following were all high:

BUN - 37
Creatinine - 2.8
Albumin/Globulin Ratio - 2.1
Alkaline Phosphatase - 143
Mean Patelet Volume - 7.4 (this one was low)

The doctor was most concerned with my Creatinine levels.

Also my BUN/Creatinine Ratio was 13, which was within normal range, not sure if that means anything.

Anyway, any feedback would be appreciated, in regards to whetehr or not I should be concerened, if weight training effected this, if this is normal for a bodybuilder, etc. FYI, I had another test done today to make sure these were accurate and made sure not to workout prior, just in case it had affected the results.

Thanks.

erp7e
03-16-2005, 10:25 PM
Btw please always list units of blood values.

Did you tell your doc you were on creatine, or that you had just worked out? This information may have effected his decisions.

Creatine supplementation can elevate your urine creatinine, however this DOES NOT indicate a pathologic state. In other words, for a person on supplemental creatine, the creatinine measurement loses its diagnostic value.

Additionally, following exercise one can have any number of elevations in certain parameters indicating protein breakdown or a general stress response. This may have something to do with the high BUN, although I can't say definitively (assuming your units are mg/dL).

For example I did a study several years ago looking at CK levels post-exercise. If someone were to go to a doc after one of my sessions and get his/her CK level read, the doc would (out of context) of course suspect muscle necrosis or some other pathologic state.

Albumin/globulin ratio - don't see this one everyday. These are both proteins synthesized by the body, can't say I can interpret this ratio well. Don't know if this is looking at synthetic activity, hormone binding, nutritional state, etc.?

Alk phos is barely elevated - not too worried as an isolated figure.

Mean platelet volume - another obscure one. Don't know how to put it in context. Are your platelets themselves low?

Your last word on this should come from your doc, of course, not over the internet. But make sure you are supplying him with all the information.

bcadam82
03-16-2005, 10:35 PM
Sorry, yeah, units were mg/dl for the creatinine and BUN numbers. Yeah he is well aware that I am on creatine and also had worked out...but still was concerned. I guess I just wanted to put off my appointment with the nefrologist a couple of days until I got my new results back, but he was VERY against that, said i should be going RIGHT away.

erp7e
03-16-2005, 10:39 PM
If that's his feeling, then yes you should go. The nephrologist will know more about how to interpret your BUN/creatinine then your PCP and I combined multiplied several times over.

pizzaman
03-16-2005, 11:10 PM
erp,

If one knows they are going to have a blood test to check creatinine levels, how long would one need to stay off creatine in order for the body to return to natural levels?

WillBrink
03-16-2005, 11:54 PM
I recently had some bloodwork done and some results came out to be quite surprising, and now my doctor wants me to go see a Nefrologist. First off, I have never taken any steroid or pro-hormone...supplements are Protein, Creatine Estyl Etherate (4-5g per day), and now taking Ab-Solved.

Any feedback or opinions would be much appreciated. I had the blood work done 4 hours after I had finished working out (weight training), so not sure if that threw them off at all.

Age: 22
Height: 5'11"
Weight: 223
Bodyfat: 13-14%

The following were all high:

BUN - 37
Creatinine - 2.8
Albumin/Globulin Ratio - 2.1
Alkaline Phosphatase - 143
Mean Patelet Volume - 7.4 (this one was low)

The doctor was most concerned with my Creatinine levels.

Also my BUN/Creatinine Ratio was 13, which was within normal range, not sure if that means anything.

Anyway, any feedback would be appreciated, in regards to whetehr or not I should be concerened, if weight training effected this, if this is normal for a bodybuilder, etc. FYI, I had another test done today to make sure these were accurate and made sure not to workout prior, just in case it had affected the results.

Thanks.

Not sure why you would be using that form of creatine considering what we have been saying about it, but that's not your question. I have seen this issue with people and their docs many times. The creatine section does mention this, and the new report I did on creatine goes into more depth on the issue of creatine and effects on creatinine. You might want to refer to those sources. The bottom line here is, go off creatine and take a week off from working out and retest. You should find, unless you have a legit kidney issue, your enzymes and creatinine are back to normal.

bcadam82
03-17-2005, 06:56 AM
Thanks for all the info guys. Will, I got a tub of 1000g of the CEE back in the fall at a crazy price from a very reputable site. The cost was 10 bucks more than regular creatine, so I figured I'd give it a shot. I find the creatine to be fine and definitely don't have ANY bloating from this creatine, which is good. Regardless, although there may be no difference between this stuff and monohydrate, since I have it, I figure I may as well use it...no harm in it, so why not, ya know?

By the way Will, NOT sorry to say, but I am abandoning the east coast man. I graduate Boston College in May and then I'm off to Los Angeles to embrace some warm weather...I've been a New Englander all my life...ready for some palm trees :)

WillBrink
03-17-2005, 02:57 PM
Thanks for all the info guys. Will, I got a tub of 1000g of the CEE back in the fall at a crazy price from a very reputable site. The cost was 10 bucks more than regular creatine, so I figured I'd give it a shot. I find the creatine to be fine and definitely don't have ANY bloating from this creatine, which is good. Regardless, although there may be no difference between this stuff and monohydrate, since I have it, I figure I may as well use it...no harm in it, so why not, ya know?

By the way Will, NOT sorry to say, but I am abandoning the east coast man. I graduate Boston College in May and then I'm off to Los Angeles to embrace some warm weather...I've been a New Englander all my life...ready for some palm trees :)

Dude, take me with you!

bcadam82
03-17-2005, 08:20 PM
Will man, you should make the move if you can dude. I was out there last week, and damn man, it was so nice to get out of this awful winter weather we've been having...plus, nothing like parking under a palm tree man...just a major calming feeling there. Any particular reason you've stayed in the Boston area for so long? Work related? Or you just like it here maybe?

By the way, went to the naphrologist today. I had my blood work redone yesterday, made sure not to work out before hand, and all my blood work came back completely normal, BUN was SLIGHTLY high at 28mg/dL, but nothing to worry about. Creatinine was down to 1.2mg/dL. I attributed the results to having not worked out for the past 24 hours, but my doctor felt it was a faulty test (the 1st time around, not this new one). Anyway, she wanted to retest me just to make sure everything was OK, although again, I had worked out this morning. I suspected that is what threw it off from my readings and from what you said...she STRONGLY disagreed, thinking i was COMPLETELY wrong, so I'm interested to see how these new results come in...if I am right and all the numbers are out of whack again, or if she is right and the first test was faulty. Either way, she had no concerns about me having any kidney problems.

WillBrink
03-17-2005, 08:36 PM
Will man, you should make the move if you can dude. I was out there last week, and damn man, it was so nice to get out of this awful winter weather we've been having...plus, nothing like parking under a palm tree man...just a major calming feeling there. Any particular reason you've stayed in the Boston area for so long? Work related? Or you just like it here maybe?

By the way, went to the naphrologist today. I had my blood work redone yesterday, made sure not to work out before hand, and all my blood work came back completely normal, BUN was SLIGHTLY high at 28mg/dL, but nothing to worry about. Creatinine was down to 1.2mg/dL. I attributed the results to having not worked out for the past 24 hours, but my doctor felt it was a faulty test (the 1st time around, not this new one). Anyway, she wanted to retest me just to make sure everything was OK, although again, I had worked out this morning. I suspected that is what threw it off from my readings and from what you said...she STRONGLY disagreed, thinking i was COMPLETELY wrong, so I'm interested to see how these new results come in...if I am right and all the numbers are out of whack again, or if she is right and the first test was faulty. Either way, she had no concerns about me having any kidney problems.

I don't think I could stand living in LA. Check out San Diago if you can. I like that much more myself. If I had had a reason to move to the left coast, I might have, but nothing ever came up. I have been looking at southern FL, where I do have work related stuff and friends, so that is possible at some point. Let us know how the blood work goes.

erp7e
03-18-2005, 09:10 PM
bcadam: well there's your answer then. Like I said, I think it could be part of a generalized stress response. If the nephrologist isn't worried neither should you be.

Btw Boston is too damn cold. My brother goes to Northeastern U and is soon graduating and moving to SF. We're from Florida so basically he's had enough.

In June I am moving to hot and sunny Houston...should be nice.

erp7e
03-18-2005, 09:18 PM
Pizza - I'm not sure, this is an interesting question. Surely it depends on many factors, including the person's lean body mass, total body water, degree of creatine saturation, kidneys' glomerular filtration rate, etc. Maybe Will has a better answer but I would ballpark it at 30 days or so after your last day of taking creatine.

erp7e
03-18-2005, 09:19 PM
Also realize that if you have a lot of muscle mass your creatinine will be falsely elevated - this happens even when not taking supplemental creatine.

The point is - everything in context. If medicine were so simple as to say, your lab value is x so you must have condition y, then we sure as hell wouldn't have to invest a decade of our time and six figures worth of debt to start figuring it out.

bcadam82
03-18-2005, 09:23 PM
Hey, so big problem again...my dcotor insisted i get retested the other day RIGHT after i trained legs very heavy, and for the first time in a month. My values came up higher again. creatinine at 3.5. She thinks im going into kidney failure, but was completely unfamiliar with bodybuilding and what i was doing...even she admitted to being VERY confused as to what was going on. Anyway, she wants me in the hospital STAT, but i am very reluctant to go until i get one more test done NOT when im working out. Any thoughts?

WillBrink
03-18-2005, 09:25 PM
Pizza - I'm not sure, this is an interesting question. Surely it depends on many factors, including the person's lean body mass, total body water, degree of creatine saturation, kidneys' glomerular filtration rate, etc. Maybe Will has a better answer but I would ballpark it at 30 days or so after your last day of taking creatine.


30 days is what the studies found creatine levels were back to baseline, but I don't think anyone has looked at creatinine per say, so I don't know.My experience with others is that 2 weeks was enough time for creatinine to drop down to normal values, but that's guess work on my part.

erp7e
03-18-2005, 09:30 PM
Primary care docs have to stay on top of so much. It only follows that they can't know it all. This person, however well-intended, obviously is not very familiar with exercise physiology. I wouldn't go to the hospital (waste of money and resources for what's going on here)...I would simply consult the nephrologist on this. Give them a call if you can, since you just saw him. Most of them are quite familiar with how exercise and creatine use can spike creatinine.

bcadam82
03-19-2005, 01:46 AM
Well, I am not sure of the level of my nephrologist's information. Her plan as of now is to have me come back tomorrow (Saturday) after not having ingested Protein supplements or creatine and see what my levels are...I know for sure they will be normal. Then she wants me to do one more test just to make sure. Then she wants me to lift WITHOUT taking creatine to see where my levels are. I am VERY VERY frustrated. Basically, her concern is that she says they have NEVER seen levels as high as mine. My Creatinine levels have ranged from 2.8-3.2 after workouts...and have been around 1.2 when not working out (which is fine). She thinks I could have some sort of muscle myopothy and wants to run more tests this week. She also thinks its possible I just have some sort of strange response to the creatine and that it raises my creatinine levels more than others. It's all jsut very frustrating, since while I know that she knows her stuff, I feel in some ways she doesn't...I don't know...it's all just really annoying, since I was brought in today with the idea that I had kindey failure...and then they realized that DEFINITELY was not the case and released me from the hospital...again, this is definitely just a pain, and most likely a big waste of my time.

erp7e
03-19-2005, 02:15 AM
OK, wasn't sure if you were talking about:

A) your original doc/primary care doc.

B) your nephrologist.

In your story it wasn't clear which was which.

Anyway, I would follow the nephrologist's recs on this. If it were your primary care doc, that's one thing, but I would listen to the nephro about your kidneys, no question.

Never seen values that high? That's a crock. I'm only a fourth year medical student and I've seen creatinine values 2 or 3 times higher than that! Granted, those people were essentially on the way to the morgue, but come on...never? There's no way that person could make it through med school, residency, a nephrology fellowship, and practice for however many years, and never see a creatinine above 3.2! So maybe she's lying to you to make you take this seriously, I don't know.

bcadam82
03-19-2005, 02:20 AM
Yeah I swear man, she told me point blank she had never seen values that high...said she'd have to report how high my values were.

erp7e
03-19-2005, 02:24 AM
OK, and report to who? Oh I'm sorry I missed out on the National Creatinine Reporting Database (yeah right). This is starting to sound like Mark McGwire's steroid testimony.

bcadam82
03-19-2005, 02:46 AM
Maybe I'm really wasting my time here. Question, if i lift and then don't take creatine (having not taken creatine for about 4-5 days) will my creatinine levels be way down? if so, that'll answer all of her questions right there, and Ill be free and clear from her and my own doctor's constant baggering. She wants to see what happens if i lift without taking creatine.

And yeah, i totally don't want to keep doing all these tests...she thinks i may have Muscle Myopothy...which I looked up, and that appeasrs to be a disorder where you break down muscle and lose it...well OBVIOUSLY that isnt the case if i keep getting bigger.

erp7e
03-19-2005, 02:53 AM
I was beginning to feel the same. But let me try to help you out:

If you read my other posts above, creatinine may also be elevated due to training (even w/o the creatine supplementation). A more useful test for your esteemed group of physicians would be on a non-training day.

Best of luck.

bcadam82
03-19-2005, 02:54 AM
OK, in that case I am going to do the test tomorrow (non training day), and if it comes up normal I think I'm just gonna forget about all this stuff and let it go. I'll report back with test results tomorrow. Thanks for all your help guys.

Also, like i said, Doctor thinks I may have Muscle Myopathy and/or McCardle's Syndrome...this is crazy guys.

bcadam82
03-19-2005, 08:56 PM
Wow, so now I've wasted tons of time listening to the doctors, who at one point thought my kidney's were failing. My BUN today came in at 23 mg/dl. My Creatinine came in at 1.1 mg/dl. Now they want me to do one final test. Workout on Monday without taking creatinine, and then take blood. I feel like a guinea pig as opposed to a patient. This REALLY shows how the medical community is way behind the times on this stuff IMO. Especially since we are talking about a kidney specialist.

bcadam82
03-22-2005, 01:15 AM
I took my blood test today about 4 hours after working out as instructed (since that was the length of time I used in all the other tests - which was a coincidence). I didn't take any creatine for hte past few days so they want to see what my numbers are now. Big question though, they have told me not to take creatine...now THAT seems a little drastic. At this point I am confused as to what to believe. They said that numbers that high (2.8 mg/dl creatinine) after a workout is trouble. The test today is to see whether i get up there without taking the creatine. Could any of this be as a result of me taking CEE? Or would this happen with regular monohydrate? Or is all this irrelevant and is the nephrologist and PCP both off base. The nephrologist hasn't said to stay off creatine yet, she said to stay off it till i talk to her, but I think that implies she doesnt want me taking it any longer either. I read the creatine report Will, but I never saw any specific numbers given for creatinine levels, so I am unsure of whether my nubmers are too high. My PCP actually want to document my case since he says hes never seen or read about anything like it.

Any thoughts on this? Do I need to stop taking creatine for my own health? Is it posing a risk to me? Or do I need to switch back to Monohydrate? OR can I just keep doing what I'm doing and leave it be. Thanks a bunch.

Also Will, if you think this could be cause of concern, do you think you could name perhaps another nephrologist in the Boston area who has better experience with bodybuilders or at least is someone you know and trust?

WillBrink
03-22-2005, 01:39 AM
I took my blood test today about 4 hours after working out as instructed (since that was the length of time I used in all the other tests - which was a coincidence). I didn't take any creatine for hte past few days so they want to see what my numbers are now. Big question though, they have told me not to take creatine...now THAT seems a little drastic. At this point I am confused as to what to believe. They said that numbers that high (2.8 mg/dl creatinine) after a workout is trouble. The test today is to see whether i get up there without taking the creatine. Could any of this be as a result of me taking CEE? Or would this happen with regular monohydrate? Or is all this irrelevant and is the nephrologist and PCP both off base. The nephrologist hasn't said to stay off creatine yet, she said to stay off it till i talk to her, but I think that implies she doesnt want me taking it any longer either. I read the creatine report Will, but I never saw any specific numbers given for creatinine levels, so I am unsure of whether my nubmers are too high. My PCP actually want to document my case since he says hes never seen or read about anything like it.

Any thoughts on this? Do I need to stop taking creatine for my own health? Is it posing a risk to me? Or do I need to switch back to Monohydrate? OR can I just keep doing what I'm doing and leave it be. Thanks a bunch.

Also Will, if you think this could be cause of concern, do you think you could name perhaps another nephrologist in the Boston area who has better experience with bodybuilders or at least is someone you know and trust?

To be honest, I gave you my opinions of exactly what I think is going on, directed you to specific material to read on the issue of creatine and creatinine, and gave advice what I thought you should do, and you seemed to brush over it if not outright ignore it. I think Erp is better suited to advise you at this point. Sorry, I don't know any nephrelogists around here, but it does sound like the one you are working with is doing what needs to be done even if she/he is not well aware of the effects of creatine on creatinine and heavy lifting on some enzymes.

bcadam82
03-22-2005, 02:53 AM
Sorry Will. I'll go read over everything closer. I had skimmed stuff; I'll check things over more carefully now.

Just read stuff I needed to read more carefully; again I apologize, i was just annoyed over the pressure I was getting from the doctors on this one.

Thanks again for all your help, and this board really is an invaluable tool in the quest for bodybuilding and nutritional knowledge. Thanks again.

erp7e
03-22-2005, 06:58 AM
I don't think creatinine levels would fluctuate that quickly due to creatine intake - in fact, I think this indicates that your CEE product is not saturating your muscles with creatine. I would strongly recommend you check out creatine monohydrate, mainly for greater effectiveness.

I DO think your fluctuating creatinine levels are due to working out prior to blood draws. It is a bit shocking that the nephrologist doesn't know this - he/she certainly knows far more about the kidneys than I ever will. This is third hand information here, though, and I can't say I know for sure what they are thinking.

You are absolutely dead-on about most docs not knowing much about exercise and nutrition. Most of what I know about the topic I learned during my undergrad work or reading/experience on my own, not in med school (although med school obviously gives you a much greater perspective on human physiological and biochemical processes, especially as related to when things go wrong). This knowledge gap is unfortunate - since docs are here to promote health, you would think exercise/nutrition would be included more in our curriculum.

WillBrink
03-22-2005, 03:03 PM
Sorry Will. I'll go read over everything closer. I had skimmed stuff; I'll check things over more carefully now.

Just read stuff I needed to read more carefully; again I apologize, i was just annoyed over the pressure I was getting from the doctors on this one.

Thanks again for all your help, and this board really is an invaluable tool in the quest for bodybuilding and nutritional knowledge. Thanks again.

No problem. Take a few steps back, read what I recommended, consider following what I recommended, and take it from there. If the doc thinks a person is close to kidney failure, then it's their job to move fast to find out what the problem is regardless if they know about the creatine and exercise connection to creatinine and some other enzymes. Now, if you had done what I recommended a week or so ago (stop using creatine, take a week off from training, and re test) you probably could have avoided all this. At least that's how it happended for all the other people who have had this issue. Even if a doc knows about the creatine / exercise connection to creatinine, they can't ignore abnormal lab results and will want to rule out other issues. That's their job, some do it well and some (too many in my opinion) don't. Your job is to be informed and help inform the doc with material, health history, etc, etc. I had a physical the other day. Doc found a small nodule on my thyroid. These are quite common (especially with people that have had high TSH and low thyroid output for some time as I have) but she wants to biopsy it. I gathered up all the info I could about the effects of TSH, etc on thyroid nodules, and she still wants to biopsy to "rule out" anything else, like thyroid cancer. I don't want to do it, but life is full of these fun little things, and her judgment is probably the right one. Me, i would rather take a "watch and see" with the nodule, but that's how it goes.