In February of 2014, I went to see my family physician for an annual exam. It was a routine physical exam, typical questions about my general health, “excuse my cold hands and cough”, and an order for the usual blood tests. This blood work included a Complete Blood Count (CBC), Comprehensive Metabolic Panel, Lipid Panel, Thyroid Stimulating Hormone (TSH), and Vitamin D. A week later, I received my results in the mail. Along with all the numbers, it read:
“Liver enzyme slightly elevated. Will do Hepatitis panel…please make follow up appointment with me. If negative will need to follow up for possible fatty liver.”
The liver enzyme that was elevated was Aspartate Aminotransferase (AST). So now I had Hepatitis? And how dare you say I have a fatty liver! I had never received abnormal blood work before so of course, I started researching liver enzymes online to understand what the possible causes are for elevated levels.
At the time, I was training hard for an upcoming half marathon and a 10-miler. My weekly mileage was higher than ever and I was doing regular speed work at the track. I had recently read an article in Runner’s World (RW) about interpreting blood test results so I wondered if these findings were caused by my training. It is true that an elevated AST level can indicate liver damage but it can also suggest myocardial damage, pancreatitis, and skeletal muscle damage. Considering my overall health, the likelihood that I did have some skeletal muscle damage, and the recent RW article that I had read, I felt that the additional testing my doctor was recommending was not necessary. I told him I believed my abnormal results were due to my current training and I suggested doing the Comprehensive Metabolic Panel again after recovering from my upcoming races. Then, if the results were still abnormal, I would go for more testing as he suggested. My physician agreed. Four months later, my results were within normal ranges.
I share this experience with fellow runners for two reasons. First, I think it is important to take responsibility for our own health by questioning and, if necessary, challenging our healthcare providers. As patients, we should all understand the purpose and implications of the care we receive. Second, running directly impacts our health. Most often, it affects our health in a positive way but sometimes, as in my case, it can cause certain issues. Therefore, as runners, we should include “running” as part of our medical history when discussing our health with our physicians and making healthcare decisions. My doctor knew I was active and ran regularly but when the test results came back abnormal, “routine” guided his decisions. Hopefully this short article, along with the RW article (click on link above), will increase your awareness of how running may affect your blood test results and remind you to discuss this with your healthcare providers, who are more likely used to dealing with patients with hepatitis and fatty livers.
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