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The basic metabolic panel or the BMP is arguably the most common lab that you're gonna get at your physician's office.
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But there seems like there's a lot on there, but it's really not that bad.
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Today we're gonna talk all about the BMP, how to interpret it, and how to interpret it in the athletic context.
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Let's get started.
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Welcome back everybody to the Building Lifelong Athletes podcast.
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Thanks so much for stopping by, I really appreciate it.
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For those of you who don't know me, my name is Jordan Rennke and I am a dual board certified physician in family and sports medicine.
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And the goal of this podcast is to keep you active and healthy for life through actionable, evidence informed education.
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Today we're talking all about the BMP or the basic metabolic panel.
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It's a very common lab work and we're gonna go through how to read it and talk all about it today, so let's dive in.
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First let's talk about why do we care about this, right?
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So this is a super commonly ordered test.
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As I mentioned before, maybe the most common thing because it's super, super prevalent.
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It is used for screening, monitoring, and diagnosing various conditions.
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It's also used to monitor the effectiveness of treatments or conditions, things like high blood pressure, we're looking at it, kidney disease, certain medications.
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We're gonna look at the side effects.
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So really this is a big one.
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We are ordering this for so many things.
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We do it for monitoring medications.
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We do it for so many things.
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So very, very common.
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Odds are if you've been to a doctor's office and got lab work, you've probably gotten a BMP.
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And so we're gonna break it down here and show the components of it first.
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So the components is, here is kind of what we're looking at.
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The basic metabolic panel.
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This is kind of just a generic one here.
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So it even says basic metabolic panel.
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There it is.
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As you can see, like most lab results, we have some sort of results.
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So this is what you personally had.
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So on the video version here, I'm kind of pointing to a column and then there's usually the units here and then there's a reference range.
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So reference range is pretty much what we expect to see, you know, for a general quote unquote normal person.
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That's what we're looking at.
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Here we can see there's glucose.
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So looking at your blood sugar.
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Then there's a couple things called the BUN and creatinine.
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We'll talk more about those.
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Those are definitely kidney markers.
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We have a couple computations here.
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We have EGFR and EGFR.
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We have those who are not African American, African American.
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Sometimes those are divided up in different calculations based off of different calculations based on race.
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Then we have this BUN/Cretinine ratio, which is once again looking at kidney markers.
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And then we also have electrolytes like sodium, potassium, chloride, carbon dioxide, and then calcium as well.
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So these are the main components of the BMP.
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Just that's a 30,000 foot view.
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We're going to dive into each, what each one of those means.
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But those are the main components of this basic metabolic panel.
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And some of them may have the EGFR listed right away.
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Some of them might not.
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Some might not have the ratios.
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That's okay.
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But going in there, let's dive into what they actually mean.
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So first and foremost, glucose.
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Obviously most people are familiar with what glucose is, right?
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Or sugar.
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So glucose is blood sugar.
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It's a critical indicator of how much glucose is going on in the body, which can be indicator for diabetes.
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And it can be very helpful as well.
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But it's most helpful when we're fasting.
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So if you don't get this fasting, if you're saying,
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"Hey, I've got this and I just ate," then we don't know necessarily what to make of it.
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You know, that's not the reason you order a BME typically.
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Although you can, because let's think about this.
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You can actually diagnose diabetes with fasting glucoses, right?
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So the other day, literally in my clinic, someone had two fasting BMPs with elevated blood sugars above 126.
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So we got to make the diagnosis of diabetes.
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And so you can do it for that.
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That's typically not the lone reason for it.
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But it's very helpful when it's fasting.
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And typically, we want to see that between 70 and 99.
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And, you know, less than 100 is ideal.
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That's, you know, once we're getting up 100, that's more of the pre-diabetes.
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And if we get in there, that's, you know, we don't want to be talking about it.
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We obviously have a deal of, like, the lower is probably better to an extent, but we don't get too low.
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Just had a patient in the hospital today who had a blood sugar of 25.
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And that's why I get admitted to CME is because that is very, very low and that can lead to issues.
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So this is kind of just a nice barometer of, "Hey, what is going on with glucose?"
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And we're not necessarily making changes all the time based off of this.
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But it's important, you know, as well.
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And then next, move on to the BUN or creatinine.
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So BUN is blood urea nitrogen.
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And blood urea nitrogen, essentially, this is indicative of how much urea nitrogen or a waste product is in the bloodstream.
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So usually it's broken down by the liver and that's how we get this BUN.
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So we kind of have this waste product.
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Normal range there is about 7 to 20.
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And then we have creatinine as well.
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So not to be confused with creatine, right?
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So we'll talk a little more about that later.
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But creatine is the supplement you take.
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Creatinine is the lab value that we can look at.
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So not to confuse that.
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Creatinine is a waste product filtered by the kidneys made by breaking down muscle and protein.
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And you can see elevated levels with kidney dysfunction.
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And you also have this ratio we talked about, right?
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The BUN to creatinine ratio that we saw up there can provide additional clues about underlying conditions.
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Things we can kind of determine between what we call prerenal and postrenal or intrarenal causes of kidney dysfunction.
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So if you have an acute kidney injury, you can sometimes look at that and say,
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"Hey, that may point towards prerenal, meaning maybe dehydration, something like that."
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Regardless, if your BUN to creatinine ratio is very elevated, you shouldn't be interpreting any of these on your own.
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This is just to kind of help you understand.
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This is never to say, "Hey, you should take this as advice."
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But just understanding.
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And normal ranges for the BUN is typically around 7 to 20 milligrams per deciliter.
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And creatinine is about 0.6 to 1.2 milligrams per deciliter.
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And that is going to depend on also where you get that reference range.
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Some people stop at 1.1.
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Others I've seen up to 1.3.
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As we mentioned, most labs kind of variable there.
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But that's the general range about 0.6 to 1.2.
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And then we also have the glomerular filtration rate, which this is a calculation to determine how well the kidneys are filtering things.
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This calculation is based on age, creatinine, sex, and race.
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And so we expect it to be way higher in younger and healthy people.
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However, anything less than 60 usually requires a workup and could be a sign for something called chronic kidney disease.
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And so if you're less than 60, you want to get it checked out.
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And you should be, you know, higher than younger you are.
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And we'll talk more about those kind of how this is abnormal in a bit and what to think about that.
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Next, moving on to calcium.
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Calcium is super important.
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We hear about it all the time for bone health.
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But it's really important for muscle contractions, nerve signaling, stabilizing the cells, blood clotting, lots of different things that is important for.
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Also can help assess the parathyroid gland function.
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And medications, diuretic medications, steroids can all affect calcium.
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And our normal range is about 8.5 to 10.2.
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Next, moving on to what we call our electrolytes, right?
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You can't go on today to any sort of person on YouTube or marketing and they're talking about their, "I need my electrolyte drink, right?
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I'm replacing my electrolytes."
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That's probably a whole other podcast, whether that's actually worth it or not.
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But today we're going to talk about what those electrolytes actually are and what they mean by that.
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First, we have sodium.
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So sodium is super important because it maintains the fluid balance for our body and is crucial for nerve and muscle function.
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So a lot of times if your sodium is off, we don't love that.
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The normal range is about 135 to about 145.
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And both hypernatremia and hyponatremia are problematic.
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So hyper is when you have too much, hypo is when you're too low and have too little.
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And they can have serious complications, including confusion, seizures, and a coma.
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So we care about this.
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Also this week, as in the hospital, I'm taking care of the inpatient team.
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We had a person down there, 119 was their sodium.
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So very low.
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And we got to work on slowly bringing that back up.
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But we care a lot about sodium, has a lot of impact on the body.
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Next, we're talking about potassium, which is essential for heart and muscle function.
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Normal range is about 3.5 to 5.0.
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And once again, both hypo or hyper can be a problem and can lead to cardiac arrhythmias or abnormal heart rhythm.
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So that's why we care about our potassium.
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We've gone to our chloride.
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Chloride kind of helps maintain fluid and is part of our acid-base balance.
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And acid-base is essentially your body should maintain a very tight pH.
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So the pH is how acidic or basic your blood is.
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And your body is very good at measuring that and adjusting accordingly and appropriately to maintain a very narrow range.
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And chloride plays a role in that as well.
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So the normal range is about 96 to 106.
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You know, it's often looked at in conjunction with sodium in maintaining osmotic pressure and for acid-base balance, like I mentioned.
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Very seldomly used in isolation.
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Like all the time, you will see slightly abnormal chlorides.
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And you go, okay, cool.
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That's great.
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That's why you look at the bigger picture of things.
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Very rarely someone look at isolated things.
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What is that looking at?
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Next, we move on to the carbon dioxide.
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It showed carbon dioxide/bicarbonate in those countries interchangeably.
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And this is, once again, something involved in the pH balance.
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Normal is about 22 to 28.
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And it's a key component of buffering, kind of your body uses, long story short, your body uses carbon dioxide or CO2.
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And then these kind of, you have acid and bases in there, bicarbonate and carbon dioxide.
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Those, you use those two where carbon dioxide is typically more acidic, bicarbonate is more basic.
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And your body kind of fluctuates those things by either breathing faster or hanging on to more bicarbonate.
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You kind of get, you can balance your pH once again.
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And so we are looking at these in conjunction with everything.
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It's kind of that buffering system.
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And so overall, those are the general components of the BMP.
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Not too crazy, not a whole lot, but you know, there's enough where it's kind of confusing.
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There's quite a few things.
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And so next I want to move on to how to interpret the BMP results.
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So normal ranges, as I mentioned before, the specific reference ranges are highly variable between laboratories.
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And keep in mind that these ranges might differ based on things like age, sex, health conditions, underlying, you know,
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medical conditions, and it's once again reinforcing the importance of personalized interpretation by a healthcare provider.
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This is not, I'm not your doctor.
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This is not me saying advice or what you should do, but just understanding there.
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And when we have deviations, we can definitely have problems or, you know,
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if we are not in that reference range, and reference range can be arbitrary,
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but if we're way off, we can lead issues. Like glucose, for example, if we're very high or low,
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very high levels may indicate diabetes, while low levels could suggest hypoglycemia, which can be dangerous.
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And honestly, maybe more dangerous than diabetes in the short term.
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So that's why we care about that a lot.
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An abnormal calcium, calcium is an issue. High calcium could indicate potentially parahyperthyroidism,
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where low levels might indicate something like a vitamin D deficiency or magnesium deficiency.
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And these are much more nuanced conversations.
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Calcium is not just like, oh, that's a very normal easy one.
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There's a whole lot going on there.
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Once you start talking about thyroid, parathyroid, all that stuff, it gets very complicated.
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That's more nuanced, but just worth noting that abnormal calcium
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also can affect cardiac arrhythmias as well.
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And so we want to stabilize. We take extra calcium and kind of quote,
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"stabilize the membrane" to make sure we have solid electricity conducting through our heart cells.
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But once again, 20,000 foot view, calcium important for that.
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Next, talking about electrolyte imbalance and sodium, we care about this a lot.
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As I mentioned before, hyponatremia going too low, or hyper, both are not good.
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We don't like that. When we're hypernatremia, we tend to think that, hey, we've lost free water.
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Because in our body, if we think about it, the blood specifically, we have a mix of water and solutes.
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And specifically sodium is one of them.
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And if you lose actual water, then you're left with just the sodium in there.
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So it seems higher. So you have a hypernatremia.
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So that's dehydration or water loss.
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And then hypo is when we're having low sodium.
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That can be kind of sensitive to think about it, like dilute it out.
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If you've diluted out your sodium by things like heart failure, kidney disease,
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what's called SIADH is kind of another symptom that you're holding on water.
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And so when you have too much fluid in your blood, essentially it's diluting out the sodium.
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So that's what we call hyponatremia.
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And that's a very simplified version.
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These are literally like days of lectures in medical school.
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But it's important to know that it's very, very important for the balance of the cells,
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for the oncotic pressures, things going in and out of your bloodstream, all that stuff.
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So we care a lot about it because if it's not corrected in a timely fashion,
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you can have lots of neurologic issues in terms of like worry about comas,
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or if you're corrected too fast, stroke.
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So if your sodium is drastically off, please do not manage that on your own.
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Please seek help on that.
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Next, moving on to potassium.
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Potassium, we have kind of hyperkalemia, hypokalemia,
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and both of these can lead to fatal arrhythmia.
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So we care a lot about potassium with the, when we're talking about the heart.
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Chloride, like we mentioned before, important in our acid-base balance.
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You know, an abnormality usually isn't indicated in overall acid-base disturbance.
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Like if you say, oh no, like my chloride's off, my acid-base is off,
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no, that's a whole different thing.
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Talk about pH and VBGs and labs that we don't talk about here.
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But if you are elevated to hyperkalemia, have elevated chloride,
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a lot of times it's a sign of dehydration potentially.
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It could be things from like GI loss or kidney disease as well.
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And if you're low, sometimes it can also be from diarrhea or vomiting as well.
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And once again, these are always taken in context of everything.
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So I'm not just saying look at a number, that's kind of what we're looking at there.
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Next, moving on to B1 creatinine.
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And if you have an elevated B1 creatinine,
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that may suggest that we're having some impaired kidney function or potentially dehydration.
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If it's elevated, when you think could there be a problem with the actual kidney itself?
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Do we have an acute kidney injury?
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Was there decreased blood flow there from like shock or dehydration?
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Did we have a GI bleed?
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Or sometimes you can also just when you have elevated BUN,
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you can have a really high protein diet or creatinine
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because creatinine is a breakdown product of a protein and BUN essentially is as well.
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And so if you have a high protein diet, you may have an elevated BUN or creatinine.
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We'll talk about that more in a little bit there.
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And if you have a low creatinine or BUN, sometimes you can say either like overhydration is an idea,
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not that common, but a lot of times we're very low creatinine.
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It's kind of talking about malnutrition or you're under muscled.
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So if you have no muscle, then your creatinine is very low.
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So sometimes we'll see, you know, little old ladies in the hospital
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and their creatinine is like 0.3 and we're like, oh, their kidneys will see so good.
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It's like, well, that's not necessarily the case.
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It's just that they have no muscle mass really and so their numbers are lower.
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And so that's kind of the general, just once again, 20,000 foot overview of, you know,
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when we have these things, how are we kind of interpreting them and what abnormal ones can go.
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And next I want to talk about factors that affect BMP results.
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And so diet is always important. We think about that high sodium diets can shockingly lead to high sodium,
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but it's not that easy, right? It's not like your body's very, very,
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very good at maintaining its proper balance of things.
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I'm just going to throw that out there. So if you intake more sodium,
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most likely what you're going to do is your body's going to adjust, maybe add an additional water.
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They say, you know, if you drink, you know, or consume sodium, you hold on water more,
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you gain weight. That's probably what your body's going to do more than rather just get a higher sodium number.
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So you're very, very intuitive, but it can happen. Additionally, potassium diets,
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low in potassium can lead to shockingly lower potassium levels.
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And so it's efficient in all the things.
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And once again, that's not very common to see people who are hypokalemic just from their diet alone.
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A lot of times it's from medication wise. And as we mentioned before, diet can affect glucose,
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whether from a diabetes perspective, if you're in a high carbohydrate meal, that can happen.
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So I just diet. That's much more nuanced. I didn't want to open the can of worms on all those things,
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but just understanding you can make some differences there.
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But once again, your body is very intuitive and can usually fix it for you.
14:11.700 --> 14:14.500
Moving on to exercise, exercise definitely can affect things.
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Acute exercise can certainly change values. Specifically,
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I'm going to kind of walk through what the general trend is.
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So if you exercise, your sodium could increase or decrease depending on,
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you know, how much you sweat or anything like that. Potassium maybe changes a little bit,
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most likely increases. Glucose could be either. Usually acutely during exercise though,
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your glucose goes up, whereas after it might go down a little bit.
14:33.600 --> 14:37.900
Creatinine BUN most likely increases. Your GFR may decrease with that.
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Chloride usually no real change and then carbon dioxide or bicarb decreases.
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And so this is just acute exercise.
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So if you said, hey, I just got back from the lab, you know,
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I was working out and then you go to the lab to get some blood drawn,
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you may see some changes there. Just something to consider as well.
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Then there's medications. There are lots of medications. So many to include here
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because that is a pharmacology class.
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But some of the most common medications we have that cause electrolyte abnormalities are
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diuretics, most likely to affect these electrolytes.
15:05.600 --> 15:08.200
ACE inhibitors, which are like high blood pressure medications,
15:08.200 --> 15:11.800
ending in an ill like lisinopril. These may mess with your potassium.
15:11.800 --> 15:16.400
And then SSRIs, medications for anxiety depression can also affect sodium as well
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and have lots of other issues as well.
15:18.900 --> 15:22.600
And finally, hydration, dehydration can lead to elevated B-win and creatinine levels,
15:22.600 --> 15:24.800
like we mentioned before. And so yeah,
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the things you eat and the things you drink can play an impact on what is going on with your BMP.
15:29.500 --> 15:33.600
And now I want to specifically talk about our everyday athlete specific considerations here.
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So what I mean is like people who work out don't have to be lead athletes,
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but want to talk about what at Lab Down Mallard we can see or expect in these people.
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So this is me in primary care as a sports doc. A lot of times this is, you know, my passion.
15:44.700 --> 15:46.900
This is what I am. This is what I'm looking for.
15:46.900 --> 15:50.100
But if you're your primary care doctor may or may not understand these things,
15:50.100 --> 15:53.500
and that's not a knock to them. Like I'm a nerd. I do additional research.
15:53.500 --> 15:55.100
I'm a sports medicine doctor. I have additional training.
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So these things are kind of my alley, but your general primary doc might not have this.
15:58.500 --> 16:01.900
So this is kind of the caveat to the athletes out there who are saying,
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hey, your blood results might be a little different. Here's why.
16:04.700 --> 16:07.900
So we'll dive into it here. First, for endurance running,
16:07.900 --> 16:12.000
this is more like in a race. Like if you are drinking so much water
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and just pounding it and you might have something called hyponatremia,
16:14.600 --> 16:18.400
once again, too low sodium. This is usually the person who's never run a marathon before
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and they're, you know, running a four to five hour marathon,
16:22.000 --> 16:26.000
stopping drinking water at every stop. That's not ideal and can lead to,
16:26.000 --> 16:29.500
like we talked before, neurologic issues, but usually we just treat with fluid restrictions
16:29.500 --> 16:32.400
and monitoring and don't usually have to do something called hypertonic saline,
16:32.400 --> 16:35.000
which is like a really concentrated form of salt.
16:35.000 --> 16:38.700
And so we don't necessarily do that, but it can, if you drink too much water,
16:38.700 --> 16:41.700
can mess you up. But for most people that's more acutely,
16:41.700 --> 16:44.000
like if you're running a marathon, don't just like to drink to thirst.
16:44.000 --> 16:46.600
Don't just keep pounding water. That's like my biggest recommendation,
16:46.600 --> 16:49.800
but just something to keep your heads down. But usually just endurance training in general,
16:49.800 --> 16:52.500
shouldn't lead to hyponatremia. It's only for over drinking.
16:52.500 --> 16:54.800
From an acute exercise perspective,
16:54.800 --> 16:57.800
we would expect to see a rise in creatinine due to using more muscles, right?
16:57.800 --> 16:59.300
So we're using more muscles, they're breaking down,
16:59.300 --> 17:03.000
so we're going to have more creatinine and probably going to see an increase in BUN as well.
17:03.000 --> 17:06.900
And may see some other electrolyte abnormalities like we mentioned a little previously.
17:06.900 --> 17:11.000
Now I want to talk about well-muscled individuals. So people who are jacked,
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what's going on here? Well, if they have increased muscle or they're consuming lots of protein,
17:15.300 --> 17:20.600
increased protein intake leads to protein metabolism breakdown and it produces urea or the BUN
17:20.600 --> 17:24.300
and it'll show up as elevated BUN. So it doesn't mean that something's wrong necessarily,
17:24.300 --> 17:26.800
just that we have to explore more. So funny story,
17:26.800 --> 17:30.900
actually, I got labs from one of my one of my doctors a couple years ago
17:30.900 --> 17:34.000
and then she's looking like, do you just eat a lot of protein? I'm like, yeah, I do.
17:34.000 --> 17:38.400
And so that's what happened. So if you have an elevated BUN can be because of that.
17:38.400 --> 17:42.500
Once again, I'm not gonna say, oh, that's it. That's no problem. My creatinine or BUN is elevated because of that.
17:42.500 --> 17:44.800
No, we'll explain a little further here.
17:44.800 --> 17:49.100
And so now I want to dive right in and talk about the kidney considerations for athletes.
17:49.100 --> 17:53.900
And so as we talked about a little bit before, muscle mass and creatinine are related.
17:53.900 --> 17:57.200
So as one goes up, so the other. So the if you have a higher muscle mass,
17:57.200 --> 18:00.900
so you're bigger, more jacked, you're probably going to have a higher creatinine value.
18:00.900 --> 18:05.100
And it's not uncommon to see someone who's well-muscled to have a creatinine of 1.1 to 1.3,
18:05.100 --> 18:10.600
kind of in that area. That is not atypical. However, though, because of calculations,
18:10.600 --> 18:12.400
we know that GFR is based off of creatinine, right?
18:12.400 --> 18:17.100
So your filtration rate equation does take into consideration your creatinine.
18:17.100 --> 18:20.800
And if your creatinine is way high, then your GFR is actually probably going to be lower.
18:20.800 --> 18:24.900
And then it's going to look like, oh gosh, you've got a low GFR, your kidneys are failing.
18:24.900 --> 18:29.000
Is it time to panic? You know, this is the classic one that happens is someone who works out a lot,
18:29.000 --> 18:32.100
has a lot of muscle, comes to the doctor, right? Get the test and they say,
18:32.100 --> 18:35.100
"Hey, your creatinine is high. I'm worried about your kidneys. What's going on?"
18:35.100 --> 18:38.400
And everyone panics. So I'm going to kind of walk you through what we think about there.
18:38.400 --> 18:41.300
But real quick, I also want to talk about creatine supplementation.
18:41.300 --> 18:44.600
We know that taking creatine can increase creatinine levels.
18:44.600 --> 18:47.200
So creatine gets converted to creatinine in the body.
18:47.200 --> 18:50.700
So it will look like you have a really high creatinine. Once again, that can be a scary thing.
18:50.700 --> 18:55.100
When you're saying, "Hey, I have a high creatinine. That might indicate that my kidneys aren't working well.
18:55.100 --> 18:58.500
Well, what do we do?" Well, now let's talk about some of the nuance behind that.
18:58.500 --> 19:01.500
One thing we can do is we can get something called the cystatin C.
19:01.500 --> 19:06.200
And a cystatin C is a protein in the body made by pretty much all your cells.
19:06.200 --> 19:09.600
And it's freely filtered in the kidney. Freely filtered means it just kind of goes through.
19:09.600 --> 19:12.700
We should understand that. It doesn't get absorbed necessarily as much.
19:12.700 --> 19:16.200
And it's not affected by muscle mass or creatinine or creatinine intake.
19:16.200 --> 19:19.600
So not affected by muscle mass or creatinine intake.
19:19.600 --> 19:27.000
So we can use a slightly different calculator that uses cystatin C instead of creatinine to estimate our GFR.
19:27.000 --> 19:35.600
So once again, we are using cystatin C to then calculate our glomerular filtration rate or marker of our kidney function instead of creatinine number.
19:35.600 --> 19:39.100
So that's kind of helpful. We're going to kind of take out creatinine so that we can see,
19:39.100 --> 19:46.600
"Hey, is it actually because the creatinine is elevated and because we're having a lot of muscle or we're taking creatine or have a lot of protein intake?"
19:46.600 --> 19:50.400
That's one thing we can think about. And then we use the cystatin C kind of in place of that.
19:50.400 --> 19:56.500
It's not perfect though. It can still be affected by things like steroids, you know, how much fat tissue you have, inflammation and thyroid dysfunction.
19:56.500 --> 20:04.600
However, though, if your GFR is low and you're a very fit person or very pretty jacked, it may be worth looking into getting a cystatin C.
20:04.600 --> 20:09.200
And once again, this is not formal medical advice, but I have seen this quite frequently where we freak out.
20:09.200 --> 20:13.300
You know, they get a referral to the nephrologist. They say, "You go to the kidney doctor. You go to the kidney doctor.
20:13.300 --> 20:15.900
They do a cystatin C and they're like, "Oh, you're good. Don't worry about it."
20:15.900 --> 20:19.600
And so that's just something we have to think about. And this is kind of my framework.
20:19.600 --> 20:23.800
I want to say, you know, what do you do, you know, if you're one of those people whose labs are normal?
20:23.800 --> 20:31.400
First, don't panic. You know, for me, typically, unless I have an enormously like life-threatening situation lab,
20:31.400 --> 20:35.400
I'm not, you know, you're not going to send you the ER. A lot of times I'll say, "Hey, you know, this is a little up.
20:35.400 --> 20:39.800
Let's take a look. Let's repeat those labs." And so it's very common to see lab errors with some of the BMPs.
20:39.800 --> 20:43.700
And even then specifically, I'll see potassium things that, you know, a little up there, 5.3.
20:43.700 --> 20:46.500
I'm like, "Ah, I'm not sure if I believe that." And then recheck it, it's normal.
20:46.500 --> 20:49.800
And so a lot of times we recheck lab. That's my general rule of thumb is if you don't like it,
20:49.800 --> 20:54.600
recheck it because you want to verify it. And then also evaluate whether, you know,
20:54.600 --> 20:57.500
you set yourself up for success or not for that lab draw.
20:57.500 --> 21:01.600
So were you adequately hydrated? Were you dehydrated? That might affect things.
21:01.600 --> 21:05.200
Did you recently work out? As we mentioned, a workout might affect some of those numbers.
21:05.200 --> 21:09.000
Are you taking a creatine supplement? That's also good to know. If you are, then I probably say,
21:09.000 --> 21:12.400
"Hey, let's stay off creatine for a couple days before getting a lab test."
21:12.400 --> 21:16.100
I think that's probably a reasonable idea. I think if you're going to go get that measured,
21:16.100 --> 21:19.300
you know, taking a few days off your creatine supplement is not going to ruin your gains.
21:19.300 --> 21:21.900
I promise you that. I promise you, you can take some time off
21:21.900 --> 21:27.000
and then start back up after you get the labs and kind of help you get a more neutral look at things.
21:27.000 --> 21:30.200
And then if anything's off that day, you know, then repeat the labs, right?
21:30.200 --> 21:32.600
It might be worth the repeat it as well with asystatin C.
21:32.600 --> 21:36.400
So if you're saying, "Hey, I did work out. I didn't really drink as much as I wanted to.
21:36.400 --> 21:39.400
So cool, let's repeat those." And then maybe on top of that, you know,
21:39.400 --> 21:42.200
if you're already fit and you think you have a decent amount of muscle,
21:42.200 --> 21:43.900
then it may be worth to get the asystatin C as well.
21:43.900 --> 21:45.900
And then you take a look at those, re-evaluate,
21:45.900 --> 21:49.100
and then you can kind of have the next round of labs if you need to get it again
21:49.100 --> 21:50.500
or need to get further things there.
21:50.500 --> 21:54.200
So I want to say, you know, a lot of times, don't jump the conclusions that your kidneys are dying.
21:54.200 --> 21:56.900
A lot of times that's the thing I see online is that, "Oh my gosh,
21:56.900 --> 21:58.700
my doctor sent me to the nephrologist, the kidney doctor,
21:58.700 --> 22:01.900
because my kidneys are dying and I shouldn't eat protein and protein is bad for my kidneys."
22:01.900 --> 22:05.200
And as you can see, it's a lot more nuanced than that and there are other ways to look at it.
22:05.200 --> 22:09.300
So I definitely don't want to say, what I don't want to say is, "Oh my, creatinine's elevated."
22:09.300 --> 22:13.600
It's not a big deal. Like, I got a lot of muscle. Like, my creatinine's at 1.5, no big deal.
22:13.600 --> 22:17.800
Like, no, that's not what I'm saying. You know, upper limit normal is like 1.2, 1.3.
22:17.800 --> 22:19.800
Once they're creeping up in 1.5,
22:19.800 --> 22:22.500
I don't know if there's a level of jackness that would get you up to that high.
22:22.500 --> 22:25.400
So I definitely don't want you to be like, "Whatever, I'm good."
22:25.400 --> 22:28.500
But it's a consideration that if it's high, then maybe check those other things.
22:28.500 --> 22:33.200
And so overall, I think the BMP is one of the most common labs we're going to get
22:33.200 --> 22:35.100
and we're going to see it everywhere if you get it.
22:35.100 --> 22:39.200
It's commonly affected by lifestyle changes, specifically exercise can happen.
22:39.200 --> 22:41.500
Creatinine and GFR aren't perfect, as we learned.
22:41.500 --> 22:44.900
And if you're well-muscled, you may have some abnormalities that require further workup,
22:44.900 --> 22:46.300
things like getting a cystatin C.
22:46.300 --> 22:49.500
And so that's kind of the takeaway here is that your BMP,
22:49.500 --> 22:52.400
looking at your electrolytes, looking at your sugar, looking at your calcium,
22:52.400 --> 22:54.900
looking at your kidney function, that's the general gist of that.
22:54.900 --> 22:57.600
And it can be affected by exercising. And so I just want to mention that.
22:57.600 --> 23:00.500
And so that's going to do it for today. Thank you so much for stopping by.
23:00.500 --> 23:03.100
I really appreciate it. If you found today's episode helpful,
23:03.100 --> 23:06.300
and it would mean the world to me if you left a five-star review on your podcast,
23:06.300 --> 23:09.400
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23:09.400 --> 23:11.500
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23:11.500 --> 23:14.600
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23:14.600 --> 23:17.100
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23:17.100 --> 23:18.900
but I promise I'll never spam you because I hate spam.
23:18.900 --> 23:21.800
So that's it for today. Thanks so much. Now get off your phone.
23:21.800 --> 23:25.900
Go be active. Have a good rest of your day. We'll see you next time.
