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  1. #1
    RX MEMBER Flex500's Avatar
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    Question My Blood Panel-Creatinine and BUN freak out by doc

    Hey Dr Nathan

    Since I have gotten bigger my creatinine and bun has slowly increased over the years. Five years ago I had a creatinine of 1.9 and BUN of 25. I did the whole lower the protein to 100 grams a day, didn't workout for two weeks, stopped all creatine and two weeks later it was 1.5 and 19 did the 24 hour urine and a kidney ultrasound and all was fine.

    Overall my creatinine stays around 1.5-1.8 and seems to depend on my overall training intensity/volume, protein intake/diet, and creatine intake. BUN is usually 19-24 seems to depend highly on my protein intake and hydration level.

    So now I go to this new doc and he is FREAKING OUT. My overall bloodwork is....


    Weight: 251
    Blood Pressure: 119/78

    sodium 138
    potassium 4.6
    chloride 100
    CO2 30
    anion GAP 8
    Glucose 82

    BUN 23
    Creatinine 1.69

    Calcium 9.8
    Cholesterol 176
    HDL 48
    LDL 89
    Triglyceride 190

    billirubin 0.9
    total protein 7.6
    albumin 4.7
    alk phos 63
    ast 24
    alt 30
    TSH 2.12
    Free T4 1.1


    What are your overall thoughts? I made an appointment with a nephrologist to get 24 hour urine and ultrasound again. I have been steroid free for 15 months.

    What are your general thoughts on my creatinine and BUN? What are normal values you see for people my size and larger? Should I just stop the creatine completely (which seems to make it drop 15% or so)? I take about 25-30 grams of creatine a week, eat around 250-300 grams of protein a day.

    Just interested in any general thoughts? I'm tired of being stressed out about this...
    Last edited by Dr. Joel Nathan; 02-11-2013 at 12:20 PM. Reason: correcting the color of text.

  2. #2
    RX MEMBER Flex500's Avatar
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    Guys I'm sorry I have no idea whhy the formatting of my thread looks like that with the black and white...sorry I know it's not easy on the eyes!

  3. #3
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    This is a good read on creatinine and BUN levels in blood work...

    http://www.johnberardi.com/articles/nutrition/dear.htm

  4. #4
    RX MEMBER BigJD69's Avatar
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    Your blood levels look good, I have Type 2 Diabetes and my glucose was as high as 124 if I remember correctly. Your kidneys are working over time, how high is your protein in take on a daily basis??? They told me that if I didn't get my BGL in control, that it would eventually take a toll on my kidneys!

  5. #5
    STRONGMAN Bryan Hildebrand's Avatar
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    if its high, but hasnt changed, why the concern.

    find a new doctor who is accustomed to working with athletes.

  6. #6
    Team Provo, Chem Moderator Provo82's Avatar
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    although your numbers do look really high like you said previously when they were that high the protein urine test indicated that you were fine. i guess to err on the side of caution you could go through the motions of the protein urine test and ultrasound again. your blood pressure being good is also a good sign for your kidneys. ive had doctors freak out on me over a 1.35 creatinine once for me it was simply a hydration issue but as ive read youve already explored that and you are a heavier bodybuilder than myself. please keep us posted with what happens here. i feel your pain with the doctors giving you anxiety over this as ive been there multiple times.

  7. #7
    RX MEMBER Flex500's Avatar
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    UPDATE....

    So I dug up past creatinine bloodwork from back in 2006 forward. I usually get bloodwork done 1-2 times a year and these are the numbers I found for creatinine and BUN...

    1.72 17
    1.59 19
    1.62 17
    1.59 20
    1.91 22
    1.49 17
    1.69 23


    As I also mentioned in the past I did have an ultrasound, 24 hour urine screen etc. and all normal.

    So I made an appointment with a specialist for nov 10 this year. In the meantime I called my primary doc and ask if I could do a urine test (not 24 hour just one time thing), ultrasound, and another blood test.

    So before the next blood test I went on a 50 gram a day protein diet, lowered calories to 1,000 a day for a week and went on a juice fast. The only protein I ate was from pea and other "green protein".

    Creatinine 1.35
    BUN 12
    ultrasound- A-OK
    Pee pee test- A-OK

    The other thing we looked at was cystatin C. This is becoming the new test of choice for people like me..and it was 100% normal.

    The doc seemed totally satisfied and said I could cancel the appointment with the specialist. I am keeping it however "just because" but am no longer in the slightest bit worried.



    The other key point is my doctor did actually apologize. He said one of the big things now is to "look at the whole clinical picture". He said if he woudl have done that and just not freaked out he would have realized there was a 99.9999999% chance everything was 100% fine. His words were "You don't have full blown, dialysis type kidney failure and have perfect glucose, perfect blood pressure, perfect lipid, perfect liver function, perfect blood counts, etc. etc." He went on to say when he has seen patients with all out kidney failure there are MASSIVE issues with bloodwork. Not just one random number a little off. He actually pointed me to this study...

    http://cjasn.asnjournals.org/content/3/2/348.full


    so I am relaxed and it appears all is well. Also...interesting timing but there were so many false positives the lab my doc used changed the reference range from .5-1.2 to .5-1.5 for creatinine and there is even a footnote saying "often proportionate to overall muscle mass" or something like that. Thought that was interesting too.
    Last edited by Flex500; 09-08-2011 at 01:51 PM.

  8. #8
    RX MEMBER BigJD69's Avatar
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    Quote Originally Posted by Flex500 View Post
    UPDATE....

    So I dug up past creatinine bloodwork from back in 2006 forward. I usually get bloodwork done 1-2 times a year and these are the numbers I found for creatinine and BUN...

    1.72 17
    1.59 19
    1.62 17
    1.59 20
    1.91 22
    1.49 17
    1.69 23


    As I also mentioned in the past I did have an ultrasound, 24 hour urine screen etc. and all normal.

    So I made an appointment with a specialist for nov 10 this year. In the meantime I called my primary doc and ask if I could do a urine test (not 24 hour just one time thing), ultrasound, and another blood test.

    So before the next blood test I went on a 50 gram a day protein diet, lowered calories to 1,000 a day for a week and went on a juice fast. The only protein I ate was from pea and other "green protein".

    Creatinine 1.35
    BUN 12
    ultrasound- A-OK
    Pee pee test- A-OK

    The other thing we looked at was cystatin C. This is becoming the new test of choice for people like me..and it was 100% normal.

    The doc seemed totally satisfied and said I could cancel the appointment with the specialist. I am keeping it however "just because" but am no longer in the slightest bit worried.



    The other key point is my doctor did actually apologize. He said one of the big things now is to "look at the whole clinical picture". He said if he woudl have done that and just not freaked out he would have realized there was a 99.9999999% chance everything was 100% fine. His words were "You don't have full blown, dialysis type kidney failure and have perfect glucose, perfect blood pressure, perfect lipid, perfect liver function, perfect blood counts, etc. etc." He went on to say when he has seen patients with all out kidney failure there are MASSIVE issues with bloodwork. Not just one random number a little off. He actually pointed me to this study...

    http://cjasn.asnjournals.org/content/3/2/348.full


    so I am relaxed and it appears all is well. Also...interesting timing but there were so many false positives the lab my doc used changed the reference range from .5-1.2 to .5-1.5 for creatinine and there is even a footnote saying "often proportionate to overall muscle mass" or something like that. Thought that was interesting too.
    When I got the results of my urine tests back several months ago and it said that I was in the beginning stages of kidney distress it scared the Shit out of me, but since my Diabetes is under control I am Fine!

  9. #9
    RX MEMBER Flex500's Avatar
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    Quote Originally Posted by BigJD69 View Post
    When I got the results of my urine tests back several months ago and it said that I was in the beginning stages of kidney distress it scared the Shit out of me, but since my Diabetes is under control I am Fine!

    That's good to hear man!

  10. #10
    Hormone Replacement Therapy M.D. Dr. Joel Nathan's Avatar
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    Default Elavted Creatine

    If you have an above average of muscle mass, your creatinine will be higher than normal. You got an ultratsound that was normal.

    Ask you doc to recheck your values 2-3 times / year to see your trends.
    Last edited by Dr. Joel Nathan; 02-28-2013 at 02:10 PM.

  11. #11
    RX MEMBER surfline's Avatar
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    My blood tests:
    12/2008 ................. Urea 42.21 mg / dl
    Creatinine 1.39 mg / dl


    10/2009.................creatinina 1.4 mg / dl


    01/2013.................uréia 65 mg / dl
    creatinine 1.61 mg / dl

    My doctor recommended that I seek a nephrologist. With these results need to worry?

  12. #12
    Hormone Replacement Therapy M.D. Dr. Joel Nathan's Avatar
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    Keep on following the blood work, Flex.
    Last edited by Dr. Joel Nathan; 02-05-2013 at 02:26 PM.

  13. #13
    Hormone Replacement Therapy M.D. Dr. Joel Nathan's Avatar
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    Dear Surfline,
    Your creatinine is ok. The BUN is high. If you're on a high protein diet, your BUN could rise. Also if you are dehydrated, the BUN/Creatinine ratio is high like yours is. At 27 years old these values should all be in the normal range. Talk with your health care provider to give you the necessary referrals to get your kidneys checked.

  14. #14
    RX MEMBER surfline's Avatar
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    OK! The story is this: I started doing work with a doctor hormonal modulator. He asked a slew of blood tests, before anything. Then I discovered that creatinine and urea values ​​were outside. My doctor referred to a nephrologist, which already have an appointment. My doctor said already talking twice to take water, and reduce a little protein in my diet. Reduce Protein is needed? This is my doubt!

  15. #15
    Hormone Replacement Therapy M.D. Dr. Joel Nathan's Avatar
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    It is a standard recommendation to take in 1gm protein per day/kg of body weight. This would make the typical 70KG person have a protein intake to 70gm/ day. This is much less than that that bodybuilders take per day.

    Protein increases the pressure within the kidney blood vessels. This causes renal (kidney) hypertension that diminishes renal function.

    Your doc is right to recommend increasing your fluid intake. The goal is 1 gallon per day or so.

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