Home Talk Live Lori Contests Nutrition Homegrown Training Galleries Muscle Scoop Die Welt About Us		< previous more Q&A >     Questions & Answers CASE #4 "The Case of Cigarette Smoking, Valium Taking Tired Person" Hello Dr. David Ores, I saw your email address on the internet at femalemuscle and I have a question for you and I really hope you can give me some advise. I am a women bodybuilder from Holland. I have been very very busy for the last 8 months with training, competing, guest performances, seminars etc. etc. I really love to do all those things, but the last 4 months my energy is gone. I have had a blood test and I found out that my CK level is (instead 70-100) 1067. My own doctor can not help me otherwise than saying I have to quit training for at least 4 weeks. My question is: is that the right decision and is it good to continue cardio? Are there any supplements I have to take to fasten that process? How do I prevent that this is happening again; I mean 2 months training and 1 week off? I really hope that you can give me an answer. Thank you very much in advance. Apple in Holland Dear Apple, What is your age, ht and wt? Do you use steroids? that would increase your CK values... which can damage your kidneys... which you need to live. That may be why your energy is lower. Also, do you have depression or anxiety or "stress".... low energy may be a sign of these syndromes. Also, what are your Thyroid levels? How is your sleeping? Any insomnia? Do you also have to work at a job? Or just train full time? Yours, Dr Ores Dear Dr. Dave, What is your age ht and wt? (45 years, 1.74 m and 86 kg) do you use steroids? (yes, stopped 6 weeks ago) Also, do you have depression or anxiety or "stress".... low energy may be a sign of these syndromes. (no I don't, just feel bad because I have no energy) What are your Thyroid levels? (don't know, but the doctor said they where fine) How is your sleeping? (bad since a couple of years, I use temazepan 10 mg) do you also have to work at a job? or just train? ( work in a large gym and help people with their training and nutrition, besides that I am a personal trainer) Yours, Apple in Holland Dear Apple, Your low energy may be related to steroid withdrawal. for how many years did you use these medications? Why did you stop? Was there a problem or concern? How often do you use temazepan? This medication is like valium. It can keep you tired / sleepy most of the day. Trouble sleeping can be a sign of anxiety disorder and or depression. Depression does not necessarily mean you feel "sad". It can be a cause of tiredness, anxiety and sleep difficulties. Do you have any brothers or sisters? Do you have any relatives with mood disorder? Insomnia? Addiction problems? Crazy question. Do you smoke tobacco? Do you drink alcohol? When was your last CK test? Is it time to check again? Does your 24 hour urine have any protein in it? If so, how many grams? Your doctor can check this for you. Yours in Health, Dr. Dave Dear Dr. Dave, Your low energy may be related to steroid withdrawal. for how many years did you use these medications? Why did you stop? Was there a problem or concern? ANS. For several years now with a lot of 'clean'periods. There never were problems. I stopped because I don't have a competition this year. How often do you use temazepan ? This med is like valium. It can keep you tired most of the day. ANS. Every day. Trouble sleeping can be a sign of anxiety disorder and or depression. Depression does not necessarily mean you feel "sad". It can be a cause of tiredness, anxiety and sleep difficulties. Do you have any brothers or sisters? ANS. Yes, 1 sister and 2 brothers. Any relatives with mood disorder? Or Insomnia? ANS. No Addiction problems? ANS. No Crazy question. Do you smoke tobacco? ANS. Yes, 15 cigarettes a day (I know it is still to much) Do you drink alcohol? ANS. No When was your last CK test? ANS. 2 weeks ago Is it time to check again? ANS. after another 2 weeks I think Does your 24 hour urine have any protein in it? how many grams? Your doctor can check this for you. ANS. Have no idea, ask for it next test. Thank you very much for your answers, but I have the feeling it is only guessing. I don't train for 4 weeks and after that I will take an other blood test and hopefully the level went down. Thank you so much for now. Regards, Apple in Holland Dear Apple in Holland, OK. Good luck. PS The carbon dioxide and many other deadly poisons in the tobacco smoke are probably a bad idea. Have you smoked more than 10 years? You may have lung disease. In any case, if you have any regard for your health you need to stop smoking. Nic patches work well. Nicotine addiction also causes anxiety, mood problems, tiredness and trouble sleeping. I suggest to use nicotine patches and perhaps a small dose welbutrin to stop smoking. Also, there are much better (and safer) medications for anxiety / insomnia than Valium types drugs. Valium type drugs don¹t work for very long and are addictive. They can also be a cause for depression / withdrawal syndromes. Also, my suggestions aren't exactly guesses...... but by e- mail, it's the best I can do. I often need to ask a lot of questions to figure out what is going on. Since you¹re 45, have your doctor perform all the proper health / cancer screening for your age. Cholesterol, Chest x-ray, Gyn exam, mammogram, colon exam (flex sig) for polyps or cancer to name a few. Also, please share these suggestions with your local Doctor and he or she may be able to help you better. Good luck and good health to you.       Dr. Ores is a General Practitioner who practices medicine on the Lower East Side of Manhattan in New York City and is also the host of "Medically Incorrect with David J. Ores, MD" on Monday nights (10pm) on the Time Warner Cable Network in Manhattan/MNN channel. Please feel free to e-mail him any questions you might have about health, fitness, wellness or the health sciences in general to david.ores@verizon.net. Thank you and good health! To go to his site click here .   Selected questions and answers from "Ask Dr. Dave" may be posted here by femalemuscle.com without last names or email addresses. Please include your first name, place of residence, height and weight.