SHR # 2349 :: A Deep Dive Into Rhabdomyolysis

: Carl Lanore; 16 May 2019; 22 May 2019

Joe Cannon, MS, CSCS, NSCA-CPT

Rhabdomyolysis, or as its better known Rhabdo, is a very popular topic today. And that's NOT a good thing. It's evident that most people don't know about this condition brought upon by a very strenuous training session. On April 12th the internet went crazy searching for it's meaning when IFBB Pro Athlete Dana Linn Bailey posted on social media that she was hospitalized due to Rhabdo.

Joe Cannon is no stranger to Rhabdo. He wrote the first book about it over 10 years ago and since then has amassed a greater understanding of it than any clinician out there.

Rhabdo is no joke. But many athletes think it's a goal to reach with hoodies and t-shirts boasting "I Got Rhabdo" like its a good thing. If this interview makes you worry about the realities of getting Rhabdo, we've done our job. Don't be stupid.

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SHR # 2349 :: A Deep Dive Into Rhabdomyolysis

Show Notes:

[1:45] Joe was talking about rhabdomyolysis over 10 years ago.

The majority of trainers have not heard of rhabdo.
1 on 1 work with personal trainers seems to lead to a large amount of the reported cases of rhabdo.

[5:23] The “pride in rhabdo” moniker.

#rhabdo is insensitive, and rhabdo is not a laughing matter.
It is a life-threatening condition.

[7:10] Rhabdo can kill you spontaneously.

[7:55] It does not just affect the kidneys.

The liver, heart, and brain all take a shot as well.

[8:37] “Rhabdo is like pouring metabolic debris into your bloodstream.”

[11:22] There is no way to say “these are the things that cause rhabdo.”

The U.S. military are the only ones researching rhabdo.
Women report symptoms more often. This is probably because more women are training now than in the past; There is also the possibility that women are less likely to resist reporting of symptoms.

[15:00] Dark urine symptom.

A significant amount of people with rhabdo do not have dark urine.
Have you performed a new exercise that you do not routinely do? If so, are your muscles in pain when not being moved?
The best thing to do is to go to the hospital if you think that you have rhabdo.

[17:43] Creatine kinase as an indicator.

-5-7 times normal levels, as a general rule, indicate rhabdo in the general population.

- Hard working athletes do not follow this rule.

- Myoglobin in the urine is a better marker.

- Urine does not always change color.

- If your urine looks like cola, you have lost at least 3 ounces of muscle tissue.

[20:57] Does arachidonic acid promote rhabdo?

It is possibly, but Joe is not sure.
There are 3 types of rhabdo:
1. Traumatic- from instances of trauma such as a car wreck.
2. Non-traumatic- from drug use.
3. Exercise induced rhabdo.
NSAID’s in concert with training can promote rhabdo.
Could turmeric, fish oil, etc. also do this?
NSAID’s will reduce kidney function.
It is important to be wary of this if you have DOMS.

[27:30] Why don’t more bodybuilders get rhabdo?

Could drug use mitigate the risk?
There will probably never be research done on this topic.

Joe-cannon.com

Supplementclarity.com

[36:50] Does having rhabdo once increase the risk of reoccurrences?

Statistically speaking, yes.
Genetics play a role.
Phosphofructokinase deficiencies can also increase the risk.

[38:25] Sodium Bicarbonate as a prophylactic?

There is evidence that it does support the kidneys.
However, it doesn’t seem to work as well in cases of really bad kidney damage.
One could make a case for advocating a more “alkaline” diet.
Potassium is extremely important.

[42:23] When are the kidneys working the hardest?

When they are trying to blockade to keep electrolytes in the blood (low electrolyte balance).
Minerals are osmotically attracted to water, and for this reason excess water can dilute the mineral levels in your body.
It is a good idea to get your minerals from your diet.
Hyponatremia (water toxicity) can further progress rhabdomyolysis.

[46:58] Iron overload.