Runners and Doctors - know your body!

I recently had some routine blood work done and the results were scary! I always had high creatine levels, but the doctor pushed if off on dehydration. This time, my level was elevated to the point that indicates Stage 3 Kidney Disease! Of course I’m not buying this. I am a runner, in perfect health, feeling great so I investigated.

The common causes of high creatine and kidney function are diabetes, hypertension; I don’t have any of these. So on I went to research the possibilities. In doing so I found multiple test results that can test abnormal for athletes and be misinterpreted to mean we have a problem!

Of course I’m not suggesting if any of your labs or test results are off that you should ignore them and chalk it up to being an athlete. That would be extremely irresponsible! But, you can relax, investigate and retest before jumping into a panic.

Let me first start with the variables that our athleticism can affect tests and give an incorrect reading. These are general guidelines and do not necessarily pertain to all athletes.

  • The length and level of intensity of an activity affects tests.

  • The frequency of your training and the pre and post hydration.

  • Timing is everything! Results vary according to when you get tested. Tests done after a strenuous run or hard workout may affect the outcome. This also pertains to being tested after an event such as a marathon or triathlon.

  • The level of fitness affects your heart rate. Athletes tend to have slower heart rates which can be misinterpretated by someone not familiar with the runner’s physiology. To calculate you training heart rates click here.

  • Blood pressure in athletes tends to be lower.

  • Athletes have more muscle mass and less fat than an average person in their age group.

  • Athletes often push themselves to a points that stress the body and can affect tests if done immediately afterwards.

  • Regular distance running can cause changes to commonly measured blood values.

Here are some the tests that can be off simply because we are athletes

  • EKG/EEG – If tested after a marathon, creatine phosphokinase (CPK)levels can indicate a false heart attack.

  • A general heart examination on a runner can alarm a doctor if he isn’t aware that a healthy person who has been running for years can produce minor electrical changes in the heart, sometimes producing arrhythmia.

  • Running can also alter your heart rate, making it much slower than a physician may be use to.

  • Liver Function – The enzyme, aspartate aminotransferase (AST) is elevated after a hard run and will affect liver-function tests.

  • Kidney/Renal Tests – Bun/Creatine levels can be elevated simply due to the fact that you are an athlete who has more muscle mass. If you are tested after a run you may be dehydrated which will also show false results.

  • Cholestrol – Most cholesterol test these days are broken down in HDL(bad) and LDL (good) otherwise, athletes have such high ‘good’ cholesterol that it throws the total number into a high bracket.

  • Iron levels of an athlete after a workout can show anemia simply because running causes your blood volume to increase, enabling the heart to send more blood to the muscles during a workout. Since not every athlete produces enough red blood cells to keep up with this change, a result can indicate lower than normal hemoglobin levels (how much iron is in red blood cells) which lead the doctor to diagnose anemia.

What to do?

  • Keep in mind that even though strenuous training may cause false results, any indicators of a problem or possible problem should be followed up on and discussed with your doctor. Don’t ignore recommendations for repeating a test or for further evaluation.

  • First, research doctors. This is your health and your body. People shop around for cars, appliances etc. so why not the most important connection to your health?

  • Ask other athletes for recommendations of physicians they have used and trust.

  • If you can find a sports doctor or primary care physician that is an athlete him/herself that is helpful.

  • Look at the doctor’s reputation as well as his or her lifestyle. Are they health conscious, fit, open to ‘new ideas?’

  • Notify the physician of the fact that you are an athlete. Make it clear that you are not a weekend warrior, but participate in regular, strenuous activities.

  • Don’t make assumptions and ask questions. This is your body. Don’t just take a prescription until you know exactly what it is for, the side effects and if there are any other alternatives.

  • Get a second opinion if you don’t like what you hear or disagree with the diagnosis.

Runners…yes we ARE different…and proud of it!

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