3 Reasons Why Hardcore Lifters Need a Routine Check-Up

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I get it – you’re generally healthy, wait times are often long, and nobody welcomes added expense. Who would want to go to the doctor anyway?

Bodybuilders and fitness enthusiasts thrive on routine. They follow often-strict diet plans. They train regularly, in a premeditated manner. They structure their days of rest and repair. They do not, however, routinely visit the doctor. This has been my experience.

Despite all of the reasons that people may avoid getting regular check-ups, I encourage readers to make it a part of their routine in order to simply address issues that when properly assessed and treated can insure longevity in the activities that we most enjoy. In that spirit, I’ll attempt to construct an argument for regularly seeking medical care…

Do You Even Doctor?

High Blood PressureRoutine check-ups provide assessment of basic vital signs

I commonly encounter athletes with high blood pressure – hypertension.

Termed “the silent killer”, high blood pressure, if left unchecked, can persist for years without symptoms before leading to a plethora of problems including kidney damage, eye abnormalities, heart attacks, strokes, and more. Blood pressure problems are easily diagnosed and often simply treated.

Routine check-ups provide comprehensive physical examinations that are capable of detecting subtle signs of disease

Often health complications manifest as a constellation of physical exam findings that can, to an untrained individual, be difficult to appreciate.

Whether through the detection of a heart murmur, atypical lung sounds, a suspicious skin rash, abnormal tendon reflexes, palpation of a mass, or any number of physical exam findings, a clinician’s exam contributes an important piece of the health evaluation.

Routine check-ups provide assessment of basic lab work

While active individuals who eat well are perhaps less likely to encounter laboratory abnormalities than the less health-conscious population, I’ve found many athletes to be surprised by their results. Do not, however, allow for the fear of potential surprise prevent you from undergoing testing.

Basic blood work offers a general screen for common conditions and it allows for identification of certain disorders for which some individuals might have a genetic propensity. Though subject to the discretion of your physician, some frequently ordered tests include a complete blood count, a comprehensive metabolic panel, a lipid panel, a vitamin D level, and perhaps hormone panels.

You Are NOT the Average Patient

In addition to mounting what is hopefully a persuasive argument to encourage regular visits to your physician, I also want to make you aware of some examples of situations in which athletes need to be evaluated as the unique patient population that they represent.

I have witnessed erroneous interpretation of clinical presentations and lab results by many care providers who are perhaps less familiar with some of the nuances that can be encountered in particularly active individuals like the readers of this article.

Obesity

BMI for Bodybuilders – Obese or “A Beast?”

Once such example of potential misinterpretation is in the calculation of body mass index (BMI).

BMI is often calculated during physician visits by plugging height and weight measurements into a computer. The resulting number can be very misleading, particularly if you have a muscular build as this type of calculation cannot account for the proportion of lean body tissue.

During one of my routine checkups, and as the care provider’s eyes were fixed on the computer screen in front of him, I was told that I should watch my weight because my BMI indicated that I was nearly obese. This was during a time when I was preparing for a physique competition and was around 5% body fat – something that I was regularly measuring throughout the course of the competition preparation.

This is an example of a situation in which the care provider’s brain was on autopilot – relying on a computer screen readout instead of paying attention to the patient.

Making Gains and High Creatinine Levels

Similar to BMI, several lab test results might be read as abnormal in the athletic population when in fact they should be entirely unconcerning when interpreted with context. Creatinine, an indicator of kidney function, is one such example. If you are supplementing with creatine, your creatinine level will be high.

If the physician is not informed of your creatine supplementation, he or she might think that you are experiencing kidney failure. Elevated creatinine is, however, a completely normal and expected result of supplementation since creatinine is just a byproduct of creatine.

I liken this to a gum ball machine. With lab work, the physician is only looking at what comes out of the machine. If he doesn’t know that 2 quarters instead of 1 were inserted into the machine, he might think that the machine is broken when 2 gum balls come out, though it is actually functioning properly.

For this reason, be sure to inform your physician if you are taking a creatine supplement. It should be additionally noted that there is ZERO scientific literature suggesting that creatine (a compound that is both produced by our bodies and found in our food) is in any way harmful to the kidneys or any other organ in a healthy population despite what some misinformed individuals might say.

No, Bro, You Do Not Have Hepatitis

Measurement of amino-transferase enzymes (AST and ALT) also commonly leads to misinterpretation in athletes. These labs are often ordered as part of a hepatic (liver) panel. As a result, when some providers find elevated values, they assume that there is a problem with the patient’s liver, such as hepatitis.

Surprisingly, however, many providers forget that these enzymes are found not only within the liver, but also in muscle tissue. Just as the enzymes can be released from liver cells in cases of liver inflammation, so too can they be released when there is muscle inflammation, as in after an intense workout.

The above examples are meant only to serve as illustrations to highlight the importance of conveying details of your lifestyle to your physician. When equipped with the appropriate information, most medical practitioners have the clinical acumen to properly diagnose and direct care. If you want to be certain that your physician will recognize your active lifestyle and consider the unique implications of this, you could always start the visit by asking him or her, “Do you even lift?”

Call your physician. If you don’t have one, get one. The investment is small but as in all things related to health, it’s the consistency in investment that leads to great long-term payoff.

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Name: Jeremy Girmann

Bio: Jeremy Girmann is a physician with particular interest in exercise, nutrition, and musculoskeletal medicine. He has committed himself to delivering healthcare through primary emphasis of lifestyle intervention. Whether bearing a stethoscope or squat bar, Dr. Girmann aims to educate others, empowering them to achieve their desired health and fitness goals.