Urine Albumin 42.75 while fasting & exercising and holding starting on prescribed Lisinopril for now.

[Albuminian]

Hi! Male, 65, vegetarian 29yrs, 266 lbs and almost 100 lbs overweight. I eat all organically grown foods and drink only spring water. I commute by bike, and I also exercise by bike 1hr each day and at times 1 1/2 hrs a day. I'm just (at this point haven't told my GP I'm doing so... but only because I feel "borderline" yet) trying to hold taking Lisinopril 10mg a day so far. My Albumin Urine was 42.75 a month ago yet I was 64 hrs into a 72 hr fast -- "fasting"... a new thing I'm trying that's okay by my doctor, or he said, "You can do what you want.". Also at same lab my glucose was 94 and normal GFR at 78. I was also exercising while on my 3 day fast which I read in a medical journal that exercising can raise albumin "exercise induced proteinuria". My doctor said he would put the order in for a second lab but noted only to please me as it seemed he hadn't heard of that.

Sure enough, my next lab two days ago, almost a month later and not while fasting was 21.08, which is far better, but my GP made no comment and said it was high and that I still must start the Lisinopril. My bp in clinic has been great, around 120/80 many times, however I told my GP that at home, sometimes in the morning upon waking, about 4 times in 3 months, it's been at about 151/94. I'm still so far quietly holding the Lisinopril to honor my GP's (he's an internist) expertise and pride, yet I'm really trying to hang on with this and not have to take more pills if I can. Both my parents and two sisters all had or have high bp and take a med for it, yet all but one were sedentary (one sister goes on brisk walks) and not doing cardio exercise, a real workout like I do.

I also read that doctors will average the Urine Albumin lab over 3 months, then prescribe, but not with my doctor. 17 is the high end of normal Urine Albumin on their chart. I know I shouldn't have any protein leakage from my kidneys, but I cardio workout, except not now with below zero temps. In 2004 I was diagnosed "pre-diabetic" yet over the years my glucose max has been only a few times at 115 and once at 120. Once it's plus 25 degrees I'll resume my workouts. I don't own a car and also commuting by bike and using combined bike rack on city bus on extra long trips. I actually lost 21lbs averaging in past year and now keeping for several months at 15 pounds or more off. Last time after my fast I was even 29lbs less than I was a year ago when I was 287 - after the fast I was 257, yet now a month later and with below zero weather etc. at 266, so 21lbs less. Does anyone there know if Urine Albumin 21.08 is really bad, or any of the above conditions, thus I'm not in the category of trying 3 labs over 3 months? Also, should I even count the lab I had while fasting? Thanks for any input!

Hi Again!

Just joined this site. Please bear with me as often I forget things, like right now. I forgot to say I was also eating Atkins bars and other bars that have protein in them and wonder if that effected my Urine Albumin readings as with second lab I quit any protein bars. Also if tired while exercising on a long bike ride I'd take either an Atkins bar and/or a whole grain bar that had protein in it and sugar, and even sometimes a small piece of candy if I was feeling shaky and weak. Would that effect my first lab at 42.75 Urine Albumin too? Is it bad to eat maybe a low protein sweet bar and/or small piece of candy if I feel shaky and weak while on a long bike ride? It has helped me before. Also CT of my heart showed all arteries clear, and coratid ultrasound was all clear. A recent abdominal ultrasound showed kidneys and all are good... well except I was diagnosed with "NAFLD" a fatty liver disease, in 2002 and fat in my liver showed up. I am a vegetarian. Thanks!

[Bassetmommer NKF Ambassador]

yes you can edit your posts after you post them.Under more and the arrow there is an edit link. do your editing and then hit edit response.

[Albuminian in reply to Bassetmommer]

Hi Bassetmommer! Thanks and I found it and edited now!

[Dunsouth]

I would suggest getting in to see a nephrologist and finding an exercise option for cold weather. All in all readings under 100 are tolerable. Heck that's my goal. At the same time low dose lisinopril isn't so bad. If it helps keep the protein leakage down. Adjust calories, eat low sodium, and exercise at a level safe for you. Getting to a healthy weight with a whole food diet is going to make the biggest difference in overall health. IMO. Good luck and keep us posted.

[Albuminian in reply to Dunsouth]

Hi Dunsouth!

Thanks very much for taking your precious time to respond! Have you seen the side effects of Lisinopril (for me it's 10mg a day)? It's not good at all, but maybe you're not taking that med. Why did my Urine Albumin go from 42.75 when I was fasting and exercising down to to 21.08 when I was not fasting and not exercising? When I asked my GP for a second lab I wanted to be sure I wasn't engaging "exercise induced proteinuria". Also the evening before my 21.08 lab I foolishly forgot and had a Glucerna (sp?) no sugar bar with 6mg protein. Also before the 21.08 lab I had to (no choice) walk mostly up hill a mile and 300 ft up a steep climb through near knee deep snow all into the wind with below zero wind-chill... which to me means exercise, about 2 hrs before my second lab. Would that have raised my reading some so maybe I could have been even less than 21.08? Also my clinic's range is such 17 is the high end of normal. Your clinic has a different scale? You're over 100?

Why did my doctor not then change his mind about the Lisinopril, or say it was "exercise induced proteinuria" as I'd found in that medical journal? You're saying I should at 65 exercise less? At first my GP said keep up my 45 min biking exercise to lose weight. It wasn't working at 45 and as time passed he said up it to at least one hour. I realized that 1 hr wasn't making me lose weight, I'd just get hungrier and eat more. I then decided I had to drive myself to exhaustion instead of just being winded and tired after my rides. I then upped it to 1 1/2 hrs a day or at least alternating with 1 hr. I haven't done the 1 1/2 hr ride in a long time. I'll climb the fire escape for indoor exercise during this Alberta Clipper. You mention "exercise at a level safe for you". Is that 1 1/2 hr driving myself too much and causing the protein to leak? Also, you think I shouldn't go the route, or try to suggest to my GP, doing a 3 month average, a lab a month, before prescribing the Lisinopril? Isn't that what most GP's do first? Does my kidneys leaking protein mean that's permanent damage? At least my GP hasn't started me on insulin yet. I was diagnosed pre-diabetic in 2004. He said I can't control my lipids by exercise. I never disagree with him but was surprised he said that. In fact I'm wondering if I might make him angry if I schedule to see a nephrologist. I think I need a referral from him but not sure. It's just that I'm at this juncture now and making myself feel stressed about it. If you don't have time for all this I fully understand.

Top of the Day!

[Bassetmommer NKF Ambassador in reply to Albuminian]

You got a lot going on here. Yes, exercising can cause more protein to be extruded.

found a lot of informaiton out there on this but here is one source: davita.com/education/kidney...

However, the bigger concern I have is where you say you are worried about upsetting your doctor by requesting to see a nephrologist. Wow, big indicator that this is not a person you want on your medical team. They should be working for you, with you and making recommendations for the optimal healthy outcome.

You have very good questions here and your doctor should be supplying you with options for your daily living which includes medications. Its all up to you in the end. But if you are worried about putting your doctor off....well maybe rethink that choice first.

[Bet117 NKF Ambassador in reply to Bassetmommer]

Love to see your blog!

[Dunsouth in reply to Albuminian]

Certainly not saying less exercise. If anything more exercise and adjusting your diet to hit a healthy weight. Calories in vs out. Just saying that you should exercise in a way that is safe for your current level of health. Typically the best results come from a mixed array of exercise. Lifting weights, mixed with cardio for example. I absolutely agree with Bassetmommer about your doctor. If you are worried about his reaction I would look for somebody you feel more comfortable with. I understand in Canada that may be more challenging vs here in the states. Still...I would look around if other options are available in your area. Anything under 100 would be great for me as I was at 12000 just a few months ago. I am on Lisinopril now and know many others whom are as well with little to no side effects. It is overly prescribed here for sure. I know many whom take it for BP and yet still eat fast food and high sodium literally everyday. Their doctors tell them they need it and don't even discuss the horrid eating habits. Pretty typical now days. To treat my case required chemo and steroids that have led to numbers under 200 and hopefully reducing by my next check. Cause was never found, but the cure has included meds, lots of high intensity exercise, and a very healthy diet with occasional splurges to maintain normalcy on some level. You are concerned about what you are eating and exercise causing this problem. I am no doctor, but from what I have learned in my own case it is very unlikely that the small amount of protein is due to eating protein and exercise. For exercise induced to even be considered (only as it has been explained to me) it must be very high intensity and often with dehydration. In other words in pretty hard core athletes more so than general public doing mild exercises. All in all you should work to get to a healthy weight via appropriate diet and exercise and find a doctor you are comfortable with. Then, you can continue to monitor you protein levels and see where they go. We monitored mine for some time while in the thousands to make sure it was going to continue to worsen. If no underlying cause is found it sometimes goes away without treatment. However, you don't want it to run rampant as permanent and substantial damage can occur. One question for your Doc might be the range of + or - on the test. You could be scoring the same every time with only the margin of error being the difference. Your loss is at a very low level right now. So stay positive and make sure you and the doctor are on the same page or find one who is. Good luck!

[Albuminian in reply to Dunsouth]

Hi Dunsouth! Wow, great advice! If you don't have time for this I fully understand. I just remember top of the normal Albumin range is 17 in my lab results. Then how did I go from 42.75 while fasting and exercising down to 21.08 not fasting or exercising? I must have done something to cause the 42.75 with GFR 78 and Glucose 94 while fasting. Then a month later, just to please me, my GP ordered another lab and Albumin was 21.08, so if not that exercised induced theory at my average workout level, then it was just my system roller coastering? I say average level workout and you mention athletes, but what about someone with a 65 yr old metabolism, might it take less exertion etc to cause the albumin to rise? I also have fatty liver and overweight, 5'9" and 261 but down from 286 a yr ago (I don't know my BMI and read that's more important than weight) but weight roller coastering. I actually have NAFLD but my GP keeps referring to my having a drinking problem and I don't, I never drink alcohol at all. Thanks for your input!

Carpe Diem!

[Bet117 NKF Ambassador in reply to Albuminian]

Agree with Bassetmommer.

You can't worry about offending your doctor, if they are on your team, they will work together toward keeping you as healthy as possible!

Advocate for yourself and see the nephrologist; specialized expertise may be comforting and eye opening!

Stay strong and keep in touch!