I have a lot of protein in my diet, and I used to have even more in there.
In July 2010, I decided to begin eating "cleaner" than I had before and began following a specific meal plan that my trainer had developed. I would have 2 "fat" days (with eggs, almonds, and peanut butter) followed by 1 "carb" day (with oatmeal, rice, and sweet potatoes). But everyday was a protein day. I had egg whites, chicken, and sometimes steak (on a "fat" day). Following this specific plan, I was able to push myself a bit further. I noticed that my weight was continuing to drop, even though I was consuming more calories. I looked leaner and felt stronger. I continued with this plan until mid-September when we went away on vacation.
After vacation, I was a little wishy-washy about getting back with the plan. I wasn't ambivalent about it and I didn't dislike it. I had some emotional stressors for a few weeks and a hectic schedule. I was able to be on-plan for most of the week but the weekends had a lot of cheat meals. With November, I was re-focused and able to be consistent. I was trying a plan that took out the carbs (temporarily), with whatever carbs I needed coming from the veggies in my diet. By the time of my annual physical at the beginning of December, I had my momentum going and was blazing ahead. I wasn't back to the point I had been at in September, but I was well on my way. My doctor was impressed with my maintained weight loss, happy with my BMI, and encouraging with my meal plan. She told me to keep doing what I was doing, until ....
She called me at home two days later with the results of my bloodwork. It's never good when your doctor calls you at home. The tests showed elevated creatinine levels. What's creatinine?
"Creatinine (from the Greek κρέας, flesh) is a break-down product of creatine phosphate in muscle, and is usually produced at a fairly constant rate by the body (depending on muscle mass). In chemical terms, creatinine is a spontaneously formed cyclic derivative of creatine. Creatinine is chiefly filtered out of the blood by the kidneys (glomerular filtration and proximal tubular secretion). There is little-to-no tubular reabsorption of creatinine. If the filtering of the kidney is deficient, creatinine blood levels rise. Therefore, creatinine levels in blood and urine may be used to calculate the creatinine clearance (CrCl), which reflects the glomerular filtration rate (GFR). The GFR is clinically important because it is a measurement of renal function." (Thanks, Wikipedia!)
Simply put, this blood test is a flag that there's a strain on my kidneys and they're not working as well as they should. Okay, so the doctor's concerned about my kidney functioning. She told me that my level was 1.18, but what does that mean?
"The typical human reference ranges for serum creatinine are 0.5 to 1.0 mg/dL (about 45-90 μmol/L) for women and 0.7 to 1.2 mg/dL (60-110 μmol/L) for men. While a baseline serum creatinine of 2.0 mg/dL (150 μmol/L) may indicate normal kidney function in a male body builder, a serum creatinine of 1.2 mg/dL (110 μmol/L) can indicate significant renal disease in an elderly female." (Thanks again, Wikipedia!)
So when my doctor told me that I had the kidney functioning of an elderly woman with renal disease, I freaked out a little bit. I thought I was healthy and doing great, the model patient. And now I'm a sickly old lady? What about the normal kidney function for a female body builder? Wouldn't that be an important detail to consider? I'm closer to that than to a geriatric grandma! Regardless, she wanted me to cut out the protein shakes, which she felt was contributing to this strain on my kidneys, and get retested in 4-6 weeks. Her hope was that the reduced protein would lead to lower creatinine levels.
But wait! I live on protein! What am I supposed to eat if I don't eat protein? How will I be able to continue with my fitness goals if I don't have the protein to fuel me? Answer: Eat more veggies as a substitution for the protein shakes. Fine, but I won't like it. Green beans aren't as yummy as chocolate shakes that taste like pudding (especially after the rest of the day is so restrictive).
But question! If creatinine levels are related to muscle (and I've got higher muscle mass than most ladies out there), and if it's released by muscles (and I did an intense total-body strength training session the day before the bloodwork), couldn't that explain my higher levels? The doctor agreed to a re-test a week later, with no protein shakes and no strength training in between. The result? 1.11! This was still higher than she would like, because I had apparently been lower before. So we negotiated that I could have one protein shake a day (if I had to), and I would go back for a re-test in about a month.
On Saturday, 1/8/2011, I headed back over to LabCorp for my bloodwork. I hadn't lifted since the previous Sunday and I'd had only one protein shake this entire time. I was ready to get this taken care of so I could put it behind me.
I then get a call from the doctor at 7pm on Tuesday night. Again, never a good thing when the doctor calls you at home, and so late in the evening, YIKES! My creatinine levels haven't gone down. In fact, they're up even higher! Reducing the protein hasn't made a difference (which frustrates me because I could have been having those yummy shakes all along - though I don't know if the level would have been even further elevated if the extra protein had been in there).
Given that my doctor doesn't know why my levels are elevated (with the protein reduction being ruled out), I've now been referred to a Nephrologist - a kidney specialist and not to be confused with a Phrenologist who interprets the bumps in your skull. My appointment is in two weeks, so I'm hoping to be a little bit closer to getting some answers then.
Trend of creatinine levels:
9/2007: 1.0
9/2008: 0.9
9/2009: Not noted on labwork, but nothing was flagged
12/2010: 1.18
12/2010: 1.11
1/2011: 1.21
Food Log:
- Breakfast
- 4 egg whites and 2 eggs with salsa
- Snack
- Artichoke hearts, peas, onions, and green beans (leftover veggies in the fridge) with Mrs. Dash and I Can't Believe It's Not Butter spray
- Tablespoon of peanut butter
- Dinner
- 4oz chicken
- Green beans
- 20g almonds
- Snack
- Tablespoon of peanut butter
Exercise:
- Time: 60 minutes
- Level: 1 minute at Level 1, 58 minutes at Level 4, 1 minute at Level 1
- Calories: 700+
Today's Weigh-In: 146.3
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