OK, so the blood results are back. I must admit when I first saw some of the values I was a little startled to say the least (namely the CK [creatinine kinase], AST and ALT values)! My result is shown with the reference range in brackets. The starred results are the ones that are out of range.
HAEMATOLOGY
HAEMOGLOBIN, 16.0 g/dL (13.0 - 17.0)
HCT, 0.456 (0.37 - 0.50)
RED CELL COUNT, 5.48 x10^12/L (4.40 - 5.80)
MCV, 83.2 fL (80 - 99)
MCH, 29.2 pg (26.0 - 33.5)
MCHC, *35.1 g/dL (30 - 35)
RDW, 12.5 (11.5 - 15.0)
PLATELET COUNT, *132 x10^9/L (150 - 400)
MPV, 12.2 fL (7 - 13)
WHITE CELL COUNT, 4.49 x10^9/L (3.0 - 10.0)
Neutrophils, 2.66 x10^9/L (2.0 - 7.5)
Lymphocytes, *1.29 x10^9/L (1.5 - 4.0)
Monocytes, 0.40 x10^9/L (0.2 - 1.0)
Eosinophils, 0.12 x10^9/L (0.0 - 0.4)
Basophils, 0.02 x10^9/L (0.0 - 0.1)
Normal RBC and WBC populations. Platelets decreased
ESR, 5 mm/hr (1 - 5)
BIOCHEMISTRY
SODIUM, 143 mmol/L (135 - 145)
POTASSIUM, 4.2 mmol/L (3.5 - 5.1)
CHLORIDE, 105 mmol/L (98 - 107)
BICARBONATE, 29 mmol/l (22 - 29)
UREA, *8.8 mmol/L (1.7 - 8.3)
CREATININE, *119 umol/L (66 - 112)
estimated GFR, 64
For UK guidelines:www.renal.org/CKDguide/ckd.html
BILIRUBIN, 13 umol/L (0 - 20)
ALKALINE PHOSPHATASE, 81 IU/L (40 - 129)
ASPARTATE TRANSFERASE, *400 IU/L (0 - 37)
ALANINE TRANSFERASE, *129 IU/L (10 - 50)
LDH, *1013 IU/L (240 - 480) Result confirmed
CK, *16782 IU/L (38 - 204) Result confirmed
GAMMA GT, 25 IU/L (9 - 40)
TOTAL PROTEIN, 78 g/L (63 - 83)
ALBUMIN, *51 g/L (34 - 50)
GLOBULIN, 27 g/L (19 - 35)
CALCIUM, 2.35 mmol/L (2.15 - 2.55)
Corrected Calcium, 2.20 mmol/L (2.15 - 2.55)
PHOSPHATE, 1.06 mmol/L (0.87 - 1.45)
URIC ACID, *263 umol/L (266 - 474)
FASTING BLOOD GLUCOSE, 4.6 mmol/L (3.9 - 5.8)
FASTING TRIGLYCERIDES, 1.5 mmol/L (< 2.3)
FASTING CHOLESTEROL, 4.9 mmol/L (Optimum <5.0)
HDL CHOLESTEROL, 1.3 mmol/L (0.9 - 1.5)
HDL % of total, 27% (20 and over)
LDL CHOLESTEROL, 2.9 mmol/L (Up to 3.0)
IRON, 27.0 umol/L (10.6 - 28.3)
T.I.B.C, 56 umol/L (41 - 77)
IRON SATURATION, 48% (20 - 55)
ENDOCRINOLOGY
THYROID PROFILE 1
THYROID STIMULATING HORMONE, 3.28 mIU/L (0.27 - 4.20)
FREE THYROXINE, 19.6 pmol/l (12.0 - 22.0)
TESTOSTERONE, 16.1 nmol/L (9.90 - 27.80)
17-Beta OESTRADIOL, 115 pmol/L (44 - 146)
Looking through these results the most concerning result was the CK levels (as well as AST and ALT levels) - of almost 17,000 IU/L - as much as a marathon runner would get - I reall must have pushed it at the gym (hopefully assuming that's what it is - read on)!
Speaking to Dr Harry Rashid at The Doctor Ltd (a service that provides confidential blood testing), he suspects the condition I have is termed Exertional Rhabdomyolysis or Exercise Induced Rhabdomyolysis.
CK (Creatine Kinase) is an enzyme predominately found in muscle and released into the blood when the muscle is injured or inflamed. Exercise also has this effect on muscle in causing microscopic tearing of the muscle fibres and is part of an adaptation process that leads to greater strength and size once the muscles recover (ie the whole point of weight training and getting bigger/stronger). This is why we get DOMS (Delayed Onset Muscle Soreness) after a heavy training session.
The golden question is that when do DOMS stop and Rhabdomyolysis start. In reality they are basically opposite ends of the same spectrum/process.
During rhabdomyolysis, the contents of skeletal muscle cells are dumped into the blood stream. The two most important factors are creatine kinase, CK (a muscle enzyme,), and myoglobin (a muscle protein). Extremely elevated concentrations of CK in the blood confirms the diagnosis, however, it is the presence of myoglobin in the urine that generally alerts the athlete that something is really wrong, causing them to seek medical attention. When myoglobin appears in the urine, the urine color changes to a dark brown/red.
So, the diagnosis of rhabdomyolysis focuses on 3 details:
# muscle pain
# elevated levels of creatine kinase (CK) in the blood
# myoglobin in the urine
At the most you have 2 out 3 of those (pain and high CK levels). You do not have a muscle wasting condition/illness. With time, i.e. over the next week, your levels will return to normal.
The above has occurred due to the way you pushed your body this week especially doing an exercise you are not used to (legs) combined with an endurance session of rowing.
Here is a link to a general overview of the condition which you may find useful:
http://www.med.umich.edu/1libr/aha/aha_rhabdomy_crs.htm
So, I've booked some further tests at the doctors to see if these values go down as the aching legs "go away". Until then - no gym, no additional protein, and no creatine supplements. This raises a good point that if I hadn't of had my blood work done prior to the steroid usage I would have been in a real pickle when if I would have have the blood work done after the steroid usage ... as we wouldn't have been able to know what was caused by the steroids and what issues I had previously. Anyway, until we can get the bottom of the levels above, the steroid cycle is going to have to be pushed back (assuming this is just regular muscle break down after a hard work out).
Some other useful links are as follows:
http://www.musculardevelopment.com/content/view/1270/51/
http://www.ergo-log.com/creatinekinaserecord.html
http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=164338#B5
http://bmb.oxfordjournals.org/cgi/content/abstract/81-82/1/209
http://www.labtestsonline.org.uk/understanding/analytes/ldh/test.html
