I am Confused with the Testing I had Done & ADL & ast & GFR&Blood Urea Nitrogen

[chris0815]

I had a bunch of labs done recently and was left wondering what they are I am scared and the Dr just didn't explain things well. I has high sugar levels so she started me on a pill for that meta something, I am on a pain control program for chronic severe back pain and take 5 mg oxycodone daily 4x's I also am taking meds for high blood pressure, The first panel I had showed the high sugar this second test after starting the diabetic med this liver problem showed up, I started 5 days ago with burning itching pain that actually is bumpy rash like I covered it with neosporin and large bandaids I asked my Dr today what it was she said shingles " I about dropped my teeth I have never had anything like this how does this happen? and why is it causing such pain? I guess maybe I am not asking the right questions but I am miserable and it is very frustrating not to know what to do can you suggest anything? My test this time showed AST 164 ALT 188 GFR 71.8 glucose 115, and blood urea nitrogen 22 I don't understand these where do they come from what do they do? I need help I am on the verge of just giving up this pain is unbearable. Thank You
C. Smith
Langley,WA

[Tuckamore]

Sorry for the long post above... and then I forgot to address the Blood Urea Nitrogen level. This test is generally known as a BUN.  Again it is a Blood test to check the function of your kidneys.

The normal result is generally 6 - 20 mg/dL. As said earlier labs vary and the range may be a bit different with your lab. The good news is at 22mg/dL this would probably be considered normal.

All the Blood work that was done plays a part in the diagnosis of your kidney health.  They are all a piece of the puzzle!

My Best,
~Tuck

[Tuckamore]

Hello Chris,

Welcome to the Pain Management Community. I am glad that you found us and took the time to ask your questions and state your concerns. There are no experts here.... some of us have medical backgrounds but none of us are physicians.

I'll try to help you understand a bit better. In my opinion your physician or the nurse should have taken the time to explain all this to you. Don't ever be afraid to say, "I don't understand. Can you explain this to me." Sadly too often physicians take it for granted that we do understand..... or that we don't have any questions.

I'll think the medication that was ordered by your physician is Metformin. It is also known as Glucophage. It is an oral anti-diabetic drug. This medication helps reduce the Glucose (Sugar) in your system. I found contradicting information on the possible effects on the liver to ppl that take Metformin. Discuss your concerns with your physician.

Shingles is generally a very painful condition and I am sorry that you have it. My heart goes out to you. Shingles is caused by a virus known as varicella zoster virus or sometimes called herpes zoster. It is the same virus that causes Chicken Pox which you must have had as a child. It is unknown what causes this dormant virus to become active again. It seems to attack people when they develop a disease, are under stress, or when aging weakens the immune system. Some studies say that a medication can also "wake up" this virus...but all in all nothing there are not exact answers. The reactivated virus begins to multiply within the dorsal root ganglia (a section of a nerve), this causes damage and swelling to this area of the nerve. This damage to the nerve causes the first pains of shingles. The virus then moves along the nerve to the skin, damaging the nerve and causing swelling as it goes. When the virus finally reaches the skin, it causes the shingles rash. So what you are experiencing is nerve pain.... we all know how horrid nerve pain can be.

The normal range of values for AST (also called the SGOT) is from 5 to 40 units per liter of serum (the liquid part of the blood). Yours appears  elevated at 164.  The normal range of values for ALT ( also known as SGPT) is from 7 to 56 units per liter of serum.  Yours appears to be elevated at 188. These normal ranges can differ from lab to lab so I am not certain what values your lab uses. The ALT and AST are basically liver enzymes and elevation can indicate several things including liver disease or damage. It can also elevate when you have muscle damage. However the entire picture needs to be considered before you can determine why these enzymes are elevated and how significant the results and just what they mean... in other words only your physician can determine if there is cause for alarm. They are not extremely high.

GFR stands for glomerular filtration rate (of your kidneys)  and is the best test to measure your level of kidney function.  The higher the number the better in most cases. Yours is a bit low at 71 but again this all needs to be deciphered by your physician. Ask, ask ask questions!!

A Kidney Specialist is called a Nephrologist. If you haven't consulted one you might want to ..... or at the least discuss a referral with your physician.

So where to from here?? Don't give up!! That's never an answer though I can understand how severe pain can make you feel that way. You need good pain management for this acute Shingles. Your physician should be able to prescribe you something stronger right now that will not add to your kidney concerns. Be assertive and insist to be more comfortable.

Make a written list of questions to ask of your physician on your next appointment. If you don't have an appointment in the next few days call and make one. Explain your severe pain and request an appointment sooner then later.

Your BS is with in normal limits right now. I assume the Metformin may be responsible for that reduction.  

I hope something I have offered has been helpful. Please keep in touch and let us know how you are doing. I will look forward to your updates. You are not alone!! Hang in and be assertive. Best of luck!

Peace,
~Tuck