Len A. said:Had a company physical the other day. Sample of urine
required, Doctor told me that a trace amount of blood came
up on the test strip. Just so happens I had increased my
mileage that previous week from 30 to over 40 miles.
Question .... should I worry about this or is this normal
for this amount of running?
This is a great example of "ask a dumb question
inappropriately, get a problematic answer".
There is no justification for doing any urine testing on
anyone of any age in the absence of symptoms (unless
pregnant). It has been reviewed many times in many ways at a
wide range of age groups, and every time, the answer comes
up the same, either
1) insufficient evidence to show benefit from screening
urine tests, or more often,
2) clear evidence that screening urine tests cause harm
Harm how? Harm by suggesting disease when there is none.
This is likely, though not certainly, to be the case here.
Follow along: test urine (without justification), get
positive worrisome result, wonder whether disease exists, do
big workup investigation, such as painful scopes up urethra
which cost a hell of a lot of money and can cause harm
(infection, trauma, etc.), or do dye test already mentioned
which involves xray radiation exposure and the dye is kidney
toxic, and so forth.
Don't believe me? Check an authority you might believe more
than me, the United States Preventive Services Task Force,
which makes recommendations on screening tests in
asymptomatic persons and then gives the evidence which
supports the recommendations.
No value screening for bladder cancer with urine dipstick:
hstat.nlm.nih.govscreenOpen ↗
/Browse/s/47208/cmd/HF/action/GetText?IHR=CH17
No value to screening for bacteria with urinalysis (unless
pregnant): ahrq.govuspsbact.htmOpen ↗
Now you and your real doctor (rather than your "company
physical" employer will have to puzzle over what to do with
a potentially meaningful but probably meaningless test
result. As another respondent already effectively and
accurately pointed out, the test result could mean disease,
and more likely it could mean nothing bad at all, such as
all the usual running-related reasons for a little blood in
the urine.
Sorry you will now have to deal with whether and how to
figure it out.
Best regards, -- Josh Steinberg MD, Syracuse, who doesn't
know everything, but is up on what preventive and screening
measures are appropriate