Today I am going to have a look look at the following paper: 

Liu, M., Zhang, Y., Ye, Z., Yang, S., Zhou, C., He, P., Zhang, Y., Hou, F.F. and Qin, X. (2023). Inflammatory Bowel Disease With Chronic Kidney Disease and Acute Kidney Injury. American Journal of Preventive Medicine, [online] 65(6), pp.1103–1112. doi:https://doi.org/10.1016/j.amepre.2023.08.008.

With my ongoing gut and according to my bloodwork kidney issues this paper came up in my research. As always please not I am no longer a scientific researcher and am outside of my area of expertise, this is just what I can tell from a look at the paper and knowledge I have left from 12 years ago when I was in science, I am not a medical doctor and this is not medical advice.  

Summary:

• Study analysed data from UK Biobank to assess the risk of chronic kidney disease (CKD) and acute kidney injury (AKI) in individuals with inflammatory bowel disease (IBD).

• Participants with IBD had a significantly higher risk of CKD and AKI compared to those without IBD.

• The study highlights the importance of monitoring kidney function in patients with IBD.

This study provides valuable insights into the association between IBD and kidney diseases, emphasizing the need for proactive monitoring in clinical practice.

Detailed Summary:

- Individuals with inflammatory bowel disease (IBD), including ulcerative colitis (UC) and Crohn's disease (CD), are at a higher risk of developing chronic kidney disease (CKD) and acute kidney injury (AKI).

- Potential mechanisms contributing to the increased risk include electrolyte abnormalities due to intestinal inflammation, dysbiosis leading to uremic toxins, and immune system alterations promoting renal disease progression.

- The association between IBD and kidney issues is independent of genetic risks of kidney diseases, and the risk is higher in younger participants compared to older individuals, highlighting the importance of monitoring kidney function in patients with IBD.

Creatinine gone back up

Frustratingly my blood test came back at 6pm on a Friday, because of course it did. And it also showed that my creatinine has gone back up to where it was when I was unwell with the infection. This might help me get some more tests at least but does suggest that my kidney function could be impaired.  

I am not a doctor so I will try and not spend the weekend guessing everything that could be going on. I personally still think it could be linked to the underlying gut issue, not through dehydration as I am drinking well and not going that often but because papers that I will try and summarise (in another post) suggest that IBD / gut issues can link to kidney damage. Though the decline since Feb suggests it is something acute that has caused the decreased kidney function. It is also the decline, well increase in number but decrease in function, that suggests it is nothing to do with the carnivore diet. I say this because a high meat diet is known to increase creatinine levels. 

Will update once I have spoken to the doctors. Hopefully my Op in June can still go ahead and hopefully we can get my a settled tummy and back to 100%. 

Antibiotics can lead to IBD?

I am hoping to start doing some short posts (and maybe some longer ones) looking at various aspects of science. I do aim to look at running and carnivore papers (not that such a thing would ever get any funding) but at the moment I am researching a lot into my gut issues and potential causes. 

The reason that this article actually caught my attention is because I generally have to stop taking antibiotics due to the severe stomach cramps and diarrhoea that it causes, I might in fact cover a paper next that shows antibiotic use can trigger flare ups. Anyway.

Not say I have IBD, though as discussed before many of the symptoms line up (for a mild case at least) and during that I came across a podcast about a research paper on antibiotic use and its potential link to IBD. 

Faye, A.S., Allin, K.H., Iversen, A.T., Agrawal, M., Faith, J., Colombel, J.-F. and Jess, T. (2023). Antibiotic use as a risk factor for inflammatory bowel disease across the ages: a population-based cohort study. Gut, [online] 72(4), pp.663–670. doi:https://doi.org/10.1136/gutjnl-2022-327845.

The basic conclusion of this study is that "Antibiotic exposure is associated with an increased risk of IBD, and was highest among individuals aged 40 years and older. This risk increased with cumulative antibiotic exposure.."

So there you go, there is a chance that taking antibiotics increases your risk of developing IBD. Of course you should take any medication you are advised to take and this information is me sharing the research and should not be considered medical advice. 

ibd, medical, paper, antibiotics, Crohn's, runner, gut, diarrhoea, stomach cramps,

Lots going on and not enough running

I have had a lot going on recently, none of which I think is diet related. I don't want to share all of them but here goes. The GP has said they could point towards IBD, though it would be relatively mild for IBD based off my research. 

• Low Folate - Post supplementation is fine however this can be a sign of IBD

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• Calprotectin - Had the Campylobacter infection, Calprotectin was through the roof and do still have regular diarrhoea, great fun with running. Note studies have shown a max calprotectin score of 1200 for infections, my score was 1700.

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• Fatigue - I am falling asleep during the day, I will sit on the sofa during my lunch break or to watch TV and then wake up an hour later. I also have less energy and enthusiasm for my hobbies and am struggling to concentrate on complex tasks. 

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Skin - I have patches of dry and itchy skin. The worst is under my left eye, it is red, sore and getting gradually worse. There is also a patch that comes and goes between 2 of my fingers.  

Muscle Cramping - I take an electrolyte supplement for running, if I forget to take this on a single day I will get cramping in my calf overnight. 

Diarrhoea - I experience a loose bowel movement at least once or twice most days. It is generally in the evenings or early morning and comes shortly after some severe fatigue / tiredness and the feeling of nausea. Running, something I enjoy, is also a trigger.

Stomach Cramping - The Diarrhoea is often accompanied with stomach cramps, with pain being in the lower right hand side of my chest.

Yes I am speaking to doctors about all of this.  

An Easy parkrun and ongoing issues

So there have been some positives over the last few weeks, I am back running and strength training consistently but I am also far away from where I want to be. With a week long holiday coming and then hopefully my operation my return to fitness might be a longer journey that I had hoped for. 

On the plus side I am back off dairy but I really haven't fancies burgers since my infection, and burgers were my staple meal. Whilst I still seem to have fitness I was only able to do a very badly paced 20 minutes at parkrun and not sure I could go much quicker. At least a minute of that is the weight I have put on from the dairy but hey ho. 

My goals now are to stay as fit as I can and get to the bottom of my health issues. I am still fatigued and still having regular bowel issues. I am going to push for a follow up calprotectin test as the last one was through the roof and from speaking to a doctor earlier in the week a lot of my other symptoms like the low folate I had, the electrolyte issues, fatigue and obviously the bowel issues could be explained by IBD of some description. 

I don't want it to be IBD but at the same time a diagnosis and explanation would be great. So for now I am accepting the place I am in, attempting to work on various weaknesses and preparing for my holiday and op. Hopefully I can get lots of videos recorded on the holiday and in the post op recovery, videos that people will find interesting. I also plan on documenting any appointments etc. I have on my pathway to get back to full health. Whilst I still have belief in the Carnivore way of life modern medicine has its place and hopefully it can help me get to my full health and potential. 

My Video on having a 24 hour ECG

 

24 hour ECG, running, carnivore, NHS

Review of the Altra Escalante Racer

Shoe: Altra Escalante Racer

Reviewer:  Gary Manley, experienced runner, England Athletics Qualified Coach, Obsessed with running.

Date: April 2024

Summary: A lightweight, low stack racer with a wide forefoot. I personally love this as a training shoe and have run miles and miles getting through quite a few pairs. 

In a Nutshell:

• For runners who want zero drop, low stack and lightweight trainers than can be a traditional racing shoe or a daily trainer (at least for me coming from barefoot shoes). 
• But it is very low stack with good ground feel which some people might not like. If you are coming from barefoot these will give you a hint of cushioning to be able to push harder. If you are used to "normal" shoes then you might struggle. 

Upper:

Fit:

• Semi-form fitting: Generally, the upper offers a snug but comfortable wide fit, conforming to your foot without feeling restrictive. It's a good middle ground between a super-racing tight fit and a relaxed everyday trainer fit.
• True to size: The Escalante Racer fits true to size. I have wide feet and love the fit of the 8.5 in this trainer. In all other running shoe brands I am a 9.5 for the width, so for me anyone who says this show isn't wide enough is a real outlier.

 

Materials:

• Breathable mesh: The upper is primarily made of a thin, breathable mesh that allows for good ventilation and keeps your feet cool during runs. Note it does not keep your feet warm in the winter or dry in the rain, I mean you can't have it both ways but good to know for winter training. 
• Seamless construction: The use of minimal seams helps reduce irritation and potential hotspots, especially during long runs. I have worn this shoe racing 5k and 10k and on 13 miles long runs and have had no issues with comfort. 
  

  
  

Lockdown:

• Strategic overlays: Minimal overlays are strategically placed in the midfoot and heel area to provide lockdown and support without adding unnecessary bulk.
• Lace closure system: The standard lace closure system allows you to adjust the fit for a personalized feel.

Midsole:

The Altra Escalante Racer's midsole is designed to deliver a balance of responsiveness and cushioning for faster-paced runs. Here's a closer look at its key features:

• Altra EGO™ midsole foam: This is the core material of the midsole, known for being lightweight and responsive. It provides a good amount of energy return, propelling you forward with each stride. Compared to the standard Altra EGO™ found in some of their other shoes, the Escalante Racer's version is reported to be a touch firmer for a more performance-oriented feel.
• Lower stack height: The Escalante Racer boasts a lower stack height compared to some other Altra shoes. This lower stack height allows for a closer to the ground feel, which some runners prefer for better responsiveness and proprioception (awareness of your body's position).
• InnerFlex™ technology: These are strategically placed grooves that flex naturally with your foot during the gait cycle. This allows for a more natural and efficient foot strike, particularly beneficial for midfoot or forefoot strikers.
• Zero Drop Platform: A core feature of Altra shoes, the Escalante Racer maintains a zero-drop platform. This means the heel and forefoot are at the same height, promoting a more natural foot strike for some runners and a more balanced feel throughout the run. I love the ride of this trainer.

• Responsiveness over cushioning: While the Altra EGO™ foam offers some cushioning, the focus of the midsole is on responsiveness and a propulsive feel.
• Suitable for experienced runners: The lower stack height and firmer midsole might be more suited for experienced runners with good form who can handle a less cushioned shoe or those coming from a barefoot shoe background. Those who prioritize maximum cushioning might be better suited for a different Altra model.

Overall, the Altra Escalante Racer's midsole prioritizes a lightweight, responsive feel for faster runs. It achieves this with a lower stack height, a firmer version of Altra's EGO™ foam, and features that promote a natural foot strike.

Outsole:

The outsole of the Altra Escalante Racer is designed to be lightweight, flexible, and offer sufficient traction for road running. Here's a breakdown of its key characteristics:

• Material: It uses a strategic placement of rubber compounds for durability and flexibility. The forefoot uses a more flexible rubber compound to allow for natural toe-off and a smooth transition during your stride. 
• Traction: The outsole features a low-profile lug pattern. These lugs provide good grip on dry pavement and light rain. However, they may not be ideal for very loose surfaces like gravel or wet trails but they do grip better than the Altra Vanish Carbon or Tempos. 
• Durability: Generally, the outsole is considered durable enough for high mileage road running and in my experience they do last. I am a high mileage runner and these are some of the better lasting Altra's. 
• Flexibility: As mentioned earlier, the forefoot section of the outsole is designed to be flexible for a natural toe-off and efficient running form. This flexibility allows your foot to bend and move naturally during your gait cycle.

Here are some additional things to consider about the outsole:

• Not for off-road running: The low-profile lug pattern is not suitable for aggressive off-road running or very loose surfaces. That being said I have used them to good effect on my local parkruns summer route where a third of the route is on grass. 
• Balance of flexibility and durability: While the forefoot prioritizes flexibility, the outsole should offer enough durability for most road running needs. 

Overall, the outsole of the Altra Escalante Racer prioritizes a balance between flexibility for a natural running feel and durability for road running. If you need a shoe with super aggressive traction for off-road adventures, this outsole might not be the best choice. However, for most road runners seeking a lightweight, responsive shoe with a natural feel, the Escalante Racer's outsole should deliver a good experience.

Performance:

• This shoe is meant to be like a traditional racing flat. Having come from barefoot shoes I find this is great a a daily training shoe. It is great for building my foot strength and more durable than carbon racers but protects the feet more than traditional barefoot shoes. 
• I find this shoe works at all paces and have used it from 7 minute kilometre training runs through 18 minute parkruns. 

Overall:

• I do find one of my feet starts slapping the ground when I am wearing these and am tired. That being said this is probably the most comfortable shoe I have. It is durable, great for hot weather and suitable for fast and slow running. 

Additional Considerations:

• The new version of this shoe is supposed to come out later this year. So there could be good deals on these or the new version might be a big step up. 

Tags:

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