Hello all. Please, looking for yet more possible info here on my newely diagnosed AF. When I was in the hospital in early past November they were taking the usual blood tests especially since prescribing xarelto for me, along with my furosemide and metoprolol. Now since I'm home I had 2 more ordered blood tests ( I may have to keep getting them because of the meds). But I've just been alerted that my BUN level and BUN/Creatine levels are elevated. Furosemide is 40 mgs once a day, metoprolol is 75 mgs. twice a day, xarelto is 20 mgs. once a day. Could any of these be causing the increased kidney issues?? I tried to search and found a distinct posibility they may. My diet has for a long time always been high on the protein side because of my previous gym activity with pumping iron along with lots of veggies and complex carbs, and even though I'm now going through this stage in my life with AF and haven't been working out now for a few years (because of contracting covid at the gym) I still eat the same way. I plan on going back to the gym soon, but on a much easier workout load. Any info here appreciated. However, after these alerts, I admit I've cut back a bit on the protein. I usually used vanilla whey isolate in my morning coffee for a sweetener, and a scoop of it in my cereal bowl mixed in, really tasted good, I've now cut that out.
Yet more possible problems with AF wh... - Atrial Fibrillati...
Yet more possible problems with AF which may include meds
Sorry I am unable to give an opinion on your broad question re your blood picture and current medications which you use. For most of us it is a complex subject.I was interested in your comments about protein, use of whey powder and going to the gym. It seems that recommendations about protein intake vary from 0.75 g per kg body weight to 2g per kg body weight. I think that many gym goers consume more protein than necessary. 10 kg increase in muscle mass over the course of a year (very ambitious to say the least) requires an extra 30 g of protein per day if we assume complete bio availability. Many body builders and power lifters eat far more than this.
Iam now 70, I still work out. I went plant based about a year ago. I am eating less protein (about 70 g per day)but I have put on more muscle and lost fat. I nolonger use whey.
I come to think that I used to place too much emphasis on the need for protein.
Of course discuss with your doctor, but I really wouldn't be overly concerned about a high BUN based on a single blood test. I get that a lot. The reason isn't kidney disease or too much diet protein, but simply dehydration.
If I remember to hydrate prior to the blood draw. BUN and Creatine is always normal. The fact that you are now on Lasix, a diuretic, may also be contributing.
Of course, I cannot diagnose, only your doctor can, but certainly not Dr. Google who you have been consulting with. 😄
Jim
Hi Jim. Thanks so much. One of the reasons these meds are sometimes a double-edged sword, helping one thing but causing another. In this case Dr. Google has nothing to do with this, the papers that are given to you from the pharmacy when you pick up the medications are enough to show info and to alert.
I still wouldn't be overly concerned unless your doctor is. They are best for putting things in perspective, knowing your medical history.
Jim
Hi Jim. Again, thanks so much. I am just concerned because the nurse actually called me to let me know, even though I already knew by checking my latest results of the blood test by logging in to my patient portal to check on it. I just don't like to continue a medication knowing it's causing something else but at this stage of the game I guess I don't have much choice. They'll probably have to monitor me frequently.
I'm curious why you are on Lasix anyway? It's not a specific, a fib drug.
But going back to the test again, a sound medical principle is never make an important decision based on a single blood test. Always repeat the test. And if the office doesn't suggest it, you should.
And when you go in for the repeat test, make sure you are well hydrated, because again, dehydration is the cause of most abnormal BUN's.
Lastly, was the nurse relaying what the doctor said, or just giving you their own opinion? Because if it's the latter, do you want the doctors take.
Jim
Hi Jim. Again, thanks so much!! Well, it's a nurse that works with the doctor at the cardiac clinic. The explination for the water pill is because when I went into the hospital I had swelling in my left leg and foot and ankle, which wasn't getting any better, but not getting any worse. I was putting up with it for quite some time, actually for a few months. Only after I experienced some minor swelling which was now starting to affect my right foot did I decide to go to emergency Nov. 5th.. When I walked in, I told them that I could be suffering from a possible blood clot -which is what I thought I actually was suffering with, but tests while I was there showed no blood clot. The tests showed a quivering of my heart which was affecting the pumping, they said I was in AF, and I was retaining fluid because of it. They admitted me and I was in for a full week with tests. It was determined that I had the diastolic type of actual heart failure brought on by the AF which is where the "squeeze" of the heart is preserved, instead of the systolic type where the squeeze is suffering with reduced valve function. The diastolic type like I have means normal valve pressure, but the lower chambers of the heart are typically stretched which causes pumping all the blood out to be the problem. I must say that after administration of the furosemide, all swelling went away from very frequent bathroom trips, I believe it actually helped, which is why I guess I'm still on it.
once the fluid retention has gone down it may be time to change the dosage of furosemide. I have had fluid retention a couple of times - don't have it constantly. Had slight retention shown in swelling in one leg back in November and prescribed 40mg Furosemide. It worked really well and a couple of weeks ago called the surgery and asked if I could lower the dose and they said yes - for the present time either take a furosemide every other day or cut them in half and take every day and then go onto 20mg if necessary after seeing the GP. Once I finish this pack of tablets I will go back to see the GP and wonder if he will stop the tablets again.
Hi Desanthony. Thanks much for the reply. I'll mention this at my next visit in about 3 weeks. Does your weight still fluctuate a bit? And, did or are you restricting fluids? They wanted to restrict me to about 50 to 64 ounces of fluid a day while taking Fursomide, but I was getting too dried out, so I'm trying to drink a bit more normal.
Due to bladder and prostate problems I regulate fluid intake - have been drinking decaff coffee and tea since about 2007. I don't drink anything after 6pm and try and drink most of my fluid intake in the morning having only about 2 drinks in the afternoon sometimes 3 including my last one at 6pm. Drink very little alcohol at most half a glass of wine now and again. In the evenings when sat in front of the TV I raise my legs. This seems to help. Can't say much about weight fluctuation as I have a problem with my teeth which means I can eat few things more solid than cheese. Have a dental appointment on 3 Jan when I hope I can sort this out. My weight has gone down during this time but that all started about 2 months before I got the swelling attributed to fluid retention. I do exercise a lot going to the gym at least every other day and believe this helps too.
Hi again Jim, I see you are from the US, I'm here in Pennsylvania, I also question prescriptions, I was actually butting heads with some of the doctors while I was admitted in the hospital, nothing really serious but just general thoughts on lifestyle in general pertaining to food, certain supplements, and things like that. I dislike being "talked down to" by some of them pushing their ways as to "do it my way or take the highway" type attitude that some of them have.
gbn: Hi again Jim, I see you are from the US
-------------
Guilty as charged 
Lifestyle, diet and supplements aren't really taught much in med school so a lot of the times a waste of time talking to them about it. As to the "my way or the highway" docs, fortunately at least with Medicare, I can choose my own docs and change quite easily if things don't mesh.
Jim
Hi Jim. Same here, picked plan N for my medicare so I could do the same. This much I can say, I'm no fan of "procedures", If condition can be helped with medication, I'm willing to try it. When you mentioned that you also had some elevated kidney numbers, did the docs call you to tell you, or did you find out on your own with you reading the results? AF is one thing, but to have a kidney issue on top of it isn't good. Funny thing about my heart fluttering like the hospital said, I never felt it, I had no idea, only real symptom I had was just feeling a bit more tired, I just chalked it up to not being in the gym for so long. I'm going to make sure though that I'm more hydrated for my next blood test, much appreciated info. Any other tips as I struggle through this, please, please pass them on.----------------Mike
Actually, the doctor skipped right over the abnormal BUN. When I pointed it out to him, he said I was probably just dehydrated. So apparently, he needs as lot more than an abnormal BUN to be concerned.
As I mentioned to another member in this thread, for about $50 you can order your own CMP (comprehensive metabolic panel) from Quest or LabCorp, depending on the state, no prescription needed. If you do, just make sure you hydrate the day before and day of and maybe have something like Gatorade as well. That will give you your BUN when hydrated. Or, of course you can wait until your next scheduled test with your doctor. Just keep in mind that since you're on Lasix, an elevated BUN may be normal -- hydration or not -- I really don't know, but in any event, nothing to worry about unless your doctor is concerned.
Jim
Jim, thanks so much again. Really, really appreciate this. I know about the Quest labs, I also am a member of Life Extension, they have a whole slew of blood tests that can be ordered through them. I wish my next doctor visit was sooner, but I'll try to up-date any info on my end, should be an interesting conversation on next visit in about 3 weeks, I'll either reply here, or on a new thread here.
Hi Jim. Here's something else. I may post this question on the site. It seems that in the first few weeks of taking the furosemide, it helped with the water weight, as I am supposed to weigh myself daily at a certain time. But now, it seems like my weight is creeping back up a bit, I know to cut back on sodium in foods while on this, maybe I'm just slipping back eating more, or could it be something else?
I find your response about dehydration very interesting. My GP usually gives me the form for a full blood count and CKD annually. These require starvation after midnight. I live in South Africa and my local path lab. sample taking depot opens at 7.30pm, and as I take 'starving' very seriously. it often means nothing passes my lips for 12 hours. After the last test she said my kidney function was reduced, and I have visions of being on dialysis some time soon. She has never mentioned dehydration to me. I'm due to go again next month, so I will ensure I drink water during the starvation period. What indication do electrolytes have regarding kidneys. I had a test a couple of months ago and that was normal ?
Unfortunately, doctors don't always convey instructions clearly. I've never seen the word "starvation" used, however if I did, I would ask about drinking water. All I know is that simple dehydration is a very common cause of an abnormal BUN reading. I don't know if normal electrolytes rule out kidney dysfunction, but I wouldn't really worry about your kidneys based on a single abnormal BUN, especially if you were dehydrated.
Jim
Thank you - 'starved' is the normal terminology used here especially if the analysis is includes cholesterol etc., always 'nothing after midnight'. I've even been cagey about brushing my teeth,! but of course it makes sense to drink plain water, I'll just confirm it next time.
In the US they use the word "fasting".
I read your response with interest, since I always have a high BUN showing on my yearly Medicare wellness exam. It seems I mistakenly thought that, in addition to not eating for 12 hours prior to the blood test, it included no water either! The nurse taking my bloodwork commented that my veins (and skin on hands) seemed dehydrated -- that's when I told her I didn't have water for 12 hours; she said it affects blood tests. What a dummy I was -- live and learn!
Yes, live and learn Since you live in the US, depending on state regulations, you can order your own Comprehensive Metabolic Panel (CMP) from Quest or Labcorp for about $50 if you don't want to wait for your yearly wellness exam. Just make sure to hydrate well the day before and up to the test. I find the on demand lab services a great resource when I want to track certain metrics more than my doctor does. Given what you said, I'd bet your BUN will be just fine.
Jim
Thanks -- I didn't know that about Quest or Labcorp. Will definitely look into those in the future if I'm worried about certain test numbers. Stay well!
Glad there's two of us !!!!
hi I take furosemide, 40mg once a day and docs say I have to have regular blood tests. Something about kidney function and potassium. I’d ask your gp or cardiologist about it to be sure. If you have Arrythmia nurses you could ask them.
I complained to my GP about my feet becoming swollen as the day progresses (they are fine when I get up, but when I start walking or sitting they gradually start to swell.)She prescribed 2,5mg Indpamide daily, which made a small difference. When I went to the Cardiologist he said 'No that's the wrong one', and prescribed what he called a potassium sparing diuretic - Spironolactone 12.5mg daily. This made no difference, The GP doubled it to a whole 25mg tablet per day, which makes it worse - it certainly does not increase my urine output ! When I saw the Cardio a couple of months ago I told him these things don't work, I don't have to run to the loo frequently and my feet are still swollen!, and he said that they do other things! I should have said you prescribed them for my swollen feet, and they don't work for that - but I wasn't thinking. What neither of them believe and they do not take me seriously, is that if I have an anti-biotic for something else, my feet do not swell' All the Cardio could say, was 'You don't have an infection'. The GP does not want to increase the dose to protect the kidneys. I'm better off not taking the wretched things ! I see the GP next month and see if there's another one I can take. When I read about these diuretics they all seem to involve salt consumption. I hardly touch salt, never cook with it or add it to food, all I have is what I consume in the small amount of bread and wholewheat biscuits I eat.
Hi pusillanimous. I too am restricted with salt. Were you prescribed compression socks? These help a bit.
I haven't been yet, but I will ask - they could be a bit uncomfortable on hot Summer days in South Africa, but anything would be better than these disgusting pig's trotters !!!!
Hi pusillanimous. Actually they're quite thin, but I must say, get ready for a workout putting them on and taking them off, it's tough, but they help.
I they just ankle high? I know when my late husband had a DVT he had a knee high stocking, and he had to lie still on the bed and I had the job of putting the thing on him !!!!
They are knee-high for me.
if your blood pressure is under control, why is the need for Metaprolol?
Did you have A/F prior to the use of Metaprolol?
Like others on this forum, I am not a doctor. Whatever is shared is based on our understanding of our own experiences. I see you are taking a high dosage of metoprolol. Along with a handful of others who have expressed similar concerns, I have been questioning the effects I may or may not have suffered with metoprolol. If you look online, there are several reports that say metoprolol can cause arrhythmia. My cardiologist said that was not a problem, but my experience makes me question that.
My concern is that a few months after starting metoprolol 100 mgs three years ago for blood pressure, I first developed Afib. I was on that dosage for 2 years, (approx.) and my Afib became increasingly frequent. A year ago, I was reduced to 25 mgs and made important changes in diet, exercise and weight reduction. For nine months, I had no Afib (it had gotten to every 10 days). Three months ago, I was increased to 50 mgs. and have had 5 Afib episodes since. (2 possibly due to Covid) I have now ( on my own) gone back to the 25 mgs to see whether it reduces or eliminates the Afib occurrences. My suspicion is that it may make my heart less stable and more vulnerable to the stomach gas and sleep apnea that are my Afib triggers. My anecdotal pseudo-science should not be a guide to your medications, but you might question your doctor if Afib becomes more frequent. I don't know the answer.
I'm sorry I have no information about your kidney question.
Fibnum
Hi fibnum. For me, the Metoprolol was prescribed primarily for keeping the heart rate a bit lower due to AF. It's interesting that it may actually cause AF.
I certainly am not able to demonstrate that it causes Afib, but am trying to get a sense whether, for me, it makes my heart more susceptible to Afib.
I just suggest asking your doctor more about it if your Afib becomes more frequent or persists despite medications.
There are conflicting opinions about it. I will post on the forum whether cutting my dose coincides with reduced Afib over the next 6 months.
Hi
Metoprolol is banned from my list of negative meds.
Twice its made me breathless, fatigue and no energy with 24-hr heart monitor showing pauses in night.
Low dose 47mg didn't show in 2008 but doubled it did.
A stroke in 2019 due to AF undiagnosed and within 4 days due to a carotid arteries scan of Papillary cancer biopsied later. Offered Metoprolol I said no but somehow a West clinic during a home shift hadn't put the alert so I was overrode by giving me 3 x 47mg a day.
The amount you take is wrong. Also although the world uses it for stroke patients it is wrong for AFers and most Cardiologist change it to low dose Bisoprolol.
Research question whether Betablockers are the best entry for Afers. If you have asthma Metoprolol should not be given.
The other meds I am not familiar with.
At 2 years 3 months I saw a private cardiologist who promptly put me on CCB Calcium Channel Blocker, Diltiazem. Although 180mg (1/2 dose) took me down 105bpm to 51 this was twinked to 125mg AM. Bisoprolol BB Betablocker reduced from 10mg to 2.5mg PM (separate these).
I am proud of a 110-130. /. 69. and 88-96 H/R day but since reducing weight on sour dough bread and A2 milk now 60s day and my forever 47avge night bpm.
I still remain in AF but it is controlled from rapid, persistent ....
As damage to my heart shows up on ECHOs I cannot have a cardioversion, ablation or anti-arrhythmic drugs.
I cannot feel the irregularity of my heart and I have lost the sweating, no energy, breathless, fatigue is so much less. I do sleep when I want to during the day at home.
You are at the beginning of your journey. Your triggers need monitoring and you are on an anti-co.agulant, important.
When first introduction to high H/Rate, I was given a CCB my life continuing would be different.
I'm still hoping for my heart to go back to normal one day!
Best wishes for 2024 from NZ.
cheers JOY. 74. (NZ)
when I was first diagnosed with af I was given low dose bisoprolol. 2,5mg once a day alongside apixaban. No problems for 5 yrs the. Wham crazy afib. They I teased my dose to 10 mg twice a day and I felt like the walking dead, dragging others behind me. If metoprolol is the same type of med it could be that. I reduced my dose myself and told the docs afterwards. You’ve only just been diagnosed so maybe make yourself a list of questions. Tbh it depends who I see whether they listen or not. Goood luck and hope you get sorted soon xx
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