BG Medical Random Question Thread

[Milkster]

I've got a pretty serious case of type 2 diabetes which I have struggled to get under control for multiple years. I'm 49 and was initially diagnosed around 8 years ago. My A1C has fluctuated between 7-11 based on my meds and my attention to the disease/diet/exercise. I've also had blood pressure as high as 180/140 and never below 140/110 even on meds.

3 months ago we changed some meds. I changed my GLP1 from ozempic to monjaro, my blood pressure medicine to amlodipine. I also started being more consistent with my diet and exercise.

My blood pressure went down 40 points (160/120 > 120/80) and my weight went down 35 pounds in 3 months and my A1C hit 6.8 (under 7 for the first time in a long time). Also I had no nausea on the Monjaro, where I threw up multiple times a week on the Ozempic. It's the first time in like 5 years I've felt like I've made real progress in managing my diabetes and high blood pressure.

BUT I had an elevated CREAT (1.64) and BUN (28).

My PCP and I discussed it, I felt I might not be drinking enough water, so we decided to retest. I hydrated really well for 3 days, tested again. CREAT 1.79 and BUN 31.

I'm FREAKING out. I'm worried I've started down the path to progressive/permanent kidney damage and eventual need for stuff like dialysis.

I'm so mad at what I've done to myself, this was all self inflicted with Red Bulls, Milky Ways, and sitting on my ass playing video games through my 20s.

Anyone dealt with this before? My daughter is 6. I want to make it to her 25th birthday. Am I going to make it to October 5th, 2044. I'm so scared of letting her down.

3 days isn't that big of a gap to retest especially if you just recently increased physical activity and effort.

[kuronosan]

Ozempic is trash, it's ridiculous docs are still prescribing it.

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And yet you're still not a doctor.

My earnest advice would be to ask your doc about checking muscle markers too. Keep in mind that you might lose fat from GLPs but you can still lose muscle too, which can be harsh on your kidneys.

There's a number of reasons your kidney numbers go up. If all your numbers look better and you're hydrated it's not always your kidneys are ded, sometimes it's something else.

Also have to listen to Sal - kidneys can recover pretty quickly with hydration but running numbers over time is a better marker than running them 3 days apart. There isn't a significant difference in those two numbers depending on what your kidney numbers normally run. Run it again in a week or two and it's above 2.0? Then you might be looking at a trend.

[Yuri-G]

Ozempic is trash, it's ridiculous docs are still prescribing it.

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that's what a fattie would say

Spoiler: show

I jest, I was offered it (I'm "medically obese" but not that bad) and I turned it the fuck down. no thanks, I'll get there on my own

[Buffy]

And yet you're still not a doctor.

My earnest advice would be to ask your doc about checking muscle markers too. Keep in mind that you might lose fat from GLPs but you can still lose muscle too, which can be harsh on your kidneys.

There's a number of reasons your kidney numbers go up. If all your numbers look better and you're hydrated it's not always your kidneys are ded, sometimes it's something else.

Also have to listen to Sal - kidneys can recover pretty quickly with hydration but running numbers over time is a better marker than running them 3 days apart. There isn't a significant difference in those two numbers depending on what your kidney numbers normally run. Run it again in a week or two and it's above 2.0? Then you might be looking at a trend.

Thanks for responding Kuro, I was hoping you would weigh in. Most of my numbers are better. My triglycerides are better, my glucose was under 100 on the second test for the first time I've ever been tested. As I mentioned, my A1C and my blood pressure were both down, my weight was down 35 pounds in 3 months, best numbers I've ever had on any of those. I'm about 12 pounds from what my weight was when I graduated high school (which was also overweight despite playing sports every day).

If I hadn't had the kidney markers it would have been an unrestrained good visit. I was hoping my PCP would respond to my tests today, but alas. So hopefully Monday I can get some clarity from her on what she thinks the right next steps are.

Meanwhile I'm going to stick with what I've been doing the last three months. Daily walks, no carbs, no sugar, no caffeine. Just keep grinding it out.

[archibaldcrane]

that's what a fattie would say

Spoiler: show

I jest, I was offered it (I'm "medically obese" but not that bad) and I turned it the fuck down. no thanks, I'll get there on my own

You should absolutely take a GLP-1 med, just tirzepatide or retatrutide, not semaglutide.

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[Salodin]

Yeah, you're not gonna win a medal by losing weight slower, if you even do at all since we all know how successful most diets are. Literally could get glp medication for less money than what you'll be saving on eating less unhealthy food. And you'll be healthier and feel great for it.

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[Dimmauk]

I stopped taking Glp1 because I was having back pains and I was tired of not sleeping because of acid reflux. I talked to a doctor and he said some people have had kidney issues because of the medication and not hydrating enough.

[Salodin]

If it was ozempic, I'd try the other ones. Ozempic saved many lives and opened Pandora's box with these meds, but it's the worst one of them all and they've come a long way in a short time. I'd order retatrutide myself online, or if that makes you uneasy then ask the doctor for mounjaro instead of ozempic.

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[kuronosan]

Thanks for responding Kuro, I was hoping you would weigh in. Most of my numbers are better. My triglycerides are better, my glucose was under 100 on the second test for the first time I've ever been tested. As I mentioned, my A1C and my blood pressure were both down, my weight was down 35 pounds in 3 months, best numbers I've ever had on any of those. I'm about 12 pounds from what my weight was when I graduated high school (which was also overweight despite playing sports every day).

If I hadn't had the kidney markers it would have been an unrestrained good visit. I was hoping my PCP would respond to my tests today, but alas. So hopefully Monday I can get some clarity from her on what she thinks the right next steps are.

Meanwhile I'm going to stick with what I've been doing the last three months. Daily walks, no carbs, no sugar, no caffeine. Just keep grinding it out.

Just stay hydrated. That's the most important thing. Unless your numbers are going through the roof or you're retaining water keep in mind you're going to be constantly losing water as your body loses weight, especially if you're not eating as much.

Ozempic/Wegovy is the easiest to get approved when it comes to GLPs but frankly tirzep is better (though more hurdles to get approved and expensive as hell out of pocket without a voucher) in almost every way.

[archibaldcrane]

Ozempic/Wegovy is the easiest to get approved when it comes to GLPs but frankly tirzep is better (though more hurdles to get approved and expensive as hell out of pocket without a voucher) in almost every way.

Or

Just buy it, fuck the gatekeepers and save a ton of money while gaining much greater control

http://peptidesforcheap.substack.com...loss-drugs-285

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[Buffy]

Doctor responded. Blood in my urine. Recommend seeing a urologist. Recommend a renal ultrasound.

Man I’m in a bad headspace.

[Salodin]

God gave you two for a reason. Keep us updated!

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[Buffy]

I've got a pretty serious case of type 2 diabetes which I have struggled to get under control for multiple years. I'm 49 and was initially diagnosed around 8 years ago. My A1C has fluctuated between 7-11 based on my meds and my attention to the disease/diet/exercise. I've also had blood pressure as high as 180/140 and never below 140/110 even on meds.

3 months ago we changed some meds. I changed my GLP1 from ozempic to monjaro, my blood pressure medicine to amlodipine. I also started being more consistent with my diet and exercise.

My blood pressure went down 40 points (160/120 > 120/80) and my weight went down 35 pounds in 3 months and my A1C hit 6.8 (under 7 for the first time in a long time). Also I had no nausea on the Monjaro, where I threw up multiple times a week on the Ozempic. It's the first time in like 5 years I've felt like I've made real progress in managing my diabetes and high blood pressure.

BUT I had an elevated CREAT (1.64) and BUN (28).

My PCP and I discussed it, I felt I might not be drinking enough water, so we decided to retest. I hydrated really well for 3 days, tested again. CREAT 1.79 and BUN 31.

I'm FREAKING out. I'm worried I've started down the path to progressive/permanent kidney damage and eventual need for stuff like dialysis.

I'm so mad at what I've done to myself, this was all self inflicted with Red Bulls, Milky Ways, and sitting on my ass playing video games through my 20s.

Anyone dealt with this before? My daughter is 6. I want to make it to her 25th birthday. Am I going to make it to October 5th, 2044. I'm so scared of letting her down.

I wanted to reply here since Salodin asked to be updated.

The last 6 weeks have been a real mixed bag.

After the truly distressing kidney results above, my PCP adjusted my meds twice. The result of those adjustments led to improvement in CREAT, EGFR and BUN (EGFR and BUN returned to the normal range, last CREAT score was 1.34, just above the "normal range of 1.27). All of that is good.

The changes in my meds however has led to reduced sleep and increased blood pressure that I've struggled to get under control despite good diet/exercise. I've also lost another 5-7 pounds over the last 6 weeks and am down over 40 pounds now since March. The kidney doctor has prescribed additional blood pressure meds (started yesterday) and recommended I restart using my cPap. He feels one of the reasons my blood pressure is high - especially in the morning when it should be low - is my body is "panicking" while sleeping cause I can't get enough air.

I've struggled to get good sleep with the cpap despite using it for more than a year. I stopped using it in May in agreement with my sleep doctor to see how my sleep apnea responded to the weight loss. We had a follow up appointment scheduled for November. Now that appointment is today. During our last appointment the doctor had suggested a surgical implant since I had struggled with the cpap machine so much. I had demurred, but am now going to push for that solution because right now I see the biggest long term risk to my health as my stubbornly high blood pressure, so I need to address the sleep issue asap.

At the same time, one of the tests I took while adjusting my meds above with my PCP was a urine test that showed blood in the urine, which didn't surprise me much since I had reported a change in the color of my urine several weeks before that test.

That led to referrals to a urologist and a nephrologist (kidney doctor, covered above on the cpap/blood pressure topic). From the urologist I got a kidney ultrasound (normal), then a kidney CT with contrast. The kidney CT with contrast has revealed a simply massive kidney stone that will not come out naturally so it needs to come out surgically. I'm hoping to schedule that surgery to occur in the next 1-2 weeks. I'm expecting a scheduling call today or tomorrow if the surgeon's scheduler calls me.

In summary: I need surgery, which isn't awesome but should address the blood in my urine and some physical discomfort I'm experiencing. My blood pressure is a disaster but I'm trying to get that under control with meds/diet/exercise/weight loss/sleep doctor. My weight and blood sugar appear to be on track for another reasonable A1C score next time I test and I'm real proud of my diet. IF the surgery addresses the blood and I can fix the blood pressure issue I should see most/all of my scores return to normal ranges.

[Salodin]

Man, hopefully the invader in your kidneys is the real culprit behind so many of your health issues. Fortunately you're at least making progress in your health journey, instead of wallowing in the dark over what's wrong. Hard to fathom they didn't notice this gigantic kidney stone before, feel like that could have been an easy find considering you've had urine issues for awhile. Whatevs, at least you're on the way to better health.

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[Byrthnoth]

Yeah, I wouldn't make big moves on anything else until the kidney stone is handled.

[Buffy]

Kidney stone surgery was successful. Self-removing the stint was, uh, a life experience.

Doctor wants me eating less "animal based protein" so I've started learning about things like Tempeh and Seitan. Edamame is going to feature prominently in my future too.

I go for blood tests today (2 weeks after surgery, 1 week after stint removal) to see what's going on with my kidneys.

My weight journey continues. I was 198 pounds on the scale this morning. That's my first time being under 200 pounds since high school (graduated in '94). My max was 280, I was 245 or so when I started the Monjaro in April.

[Salodin]

Niceee

Isn't it so weird being at your "high school" weight or lower as an old man? Once I hit that weight on reta it took me a moment to internalize it cause man, life is weird yo

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[Julian]

I had a small stone last year, was on vacation in the west coast when I got the WORST imaginable pain I've ever had in my entire life, felt like I was dying / almost went to the ER. (Managed with some urgent cares... though it was not a fun day at all. Yay American health care keeping people out of the ER at all costs...)

Got a CT scan when I got home, they confirmed the stone, but said it was up to me whether to do the surgery to remove it or not. (It was borderline around the max size to come out on its own) The pain had subsided (and never came back, maybe I had two and passed one..?), but I do get some light testicular pain every so often (one of the bad pain symptoms I had) that I've just been "treating" with flowmax. (like, once every 1-3 months maybe, though it could all be in my head I don't fucking know)

Got an appointment in two weeks to xray, see how its changed, and then make a decision from there. I'm near my family OOP this year so I think I might bite the bullet and do it, but, uh, not looking forward to it at all...

edit: Also weighed myself at 198 last week, first time below 200 since.. high school as well. Though I don't think I ever went over 245-250 at most. Feels great!

[Buffy]

Niceee

Isn't it so weird being at your "high school" weight or lower as an old man?
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Honestly it's been such a white whale for me for so long it doesn't feel real.

[Melena]

I hit 209.9 yesterday (210.1 this morning, but that is on me for my dinner choice) and I don't remember the last time I was technically below 210.

My high school graduation weight was 214, and that was thanks to my badminton coach (who also coached our varsity soccer team) emphasizing cardio during practice and would run us into the ground.

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