Creatine Kinase – A biomarker for muscle damage
The Biomarker Handbook is a curated series that seeks to provide readers with insights on each biomarker we cover in our blood test packages and its relation to our body.
Creatine Kinase (CK) is an enzyme that is released into the blood by different muscle tissues (skeletal, heart, brain and other muscle cells). It is normally present in very small amounts in our blood, but can increase to abnormal levels when there is presence of muscle damage.
Creatine Kinase is also known as Creatine Phosphokinase (CPK).
Importance of tracking Creatine Kinase
This biomarker assesses the presence of heart muscle damage (such as a heart attack), skeletal muscle damage (heavy lifting or workouts, muscle injury, or drug induced – particularly lipid lowering statin drugs), and muscle disease (myopathy such as muscular dystrophy, myositis).
CK is known as a non-specific biomarker for muscle damage, whereas the MB iso-type of CK (called CKMB) is more specific for heart muscle. These biomarkers (CK and CKMB) are the most commonly ordered. CK is primarily used to screen and monitor for the aforementioned conditions. CKMB is ordered specifically when a heart attack is suspected.
The National Institute of Health recommends that 35 millions Americans should be taking statins (lipid lowering drugs) and more than that actually do. One well established side effect of statins is muscle pain, and CK is a great biomarker for these people to monitor for drug induced muscle damage.
Signs and symptoms to watch out for
In using CK to screen for skeletal muscle disease or injury, you should be aware of non-specific symptoms such as muscle aches or pains, weakness, which depend on the condition causing the elevated CK.
If CK is caused by a stroke or brain damage, look out for signs and symptoms of confusion, loss of consciousness, slurred speech, change in vision, muscle stiffness/ aches/ pains, paralysis, sudden weakness in one side of the body, which should alert you to call an ambulance immediately.
Another common usage of CK is to diagnose a heart attack. Classic symptoms of acute myocardial infarction are chest pain and difficulty breathing. Call an ambulance if you suspect a heart attack with these symptoms:
- Tightness or pressure in the chest
- Pain in the chest radiating to the jaw or left arm
- Shortness of breath
- Sweating profusely
- Lightheadedness, dizziness, anxiety
- Fast heart rate
Ways to balance these levels
A diet high in creatine is not shown to increase your CK levels as your body won’t produce more CK unless it is needed. To have a healthy diet to prevent cardiovascular disease (heart attack, strokes that increase your CK), we do recommend a heart-friendly diet. Mayo clinic published an article with 8 steps to reduce heart disease:
- Control your protion size
- Eat more vegetables and fruits
- Select whole grains
- Eat less unhealthy fats
- Choose low-fat protein sources
- Limit your sodium intake
- Plan ahead: create daily menus
- Allow yourself an occasional treat
When to see a doctor?
Anyone displaying the symptoms of heart disease such as chest pain, tightness in the chest, shortness of breath and nausea should consult a doctor immediately. These are clear symptoms that the patient has high levels of creatine kinase.
Equally urgent, when symptoms or signs of a stroke appear you should seek immediate medical help (slurred speech, sudden weakness on one side of body, facial droop, changed vision). This can also cause an elevated CK.
Associated blood tests
CK is usually elevated in a heart attack or muscle damage, and your doctor may follow up with the more specific CKMB (heart muscle specific) or Troponin-I and T.
If there are suspicions of a heart attack or stroke, you will benefit from screening for major risk factors of cardiovascular disease if you haven’t already, including but not limited to a full lipid profile (cholesterol levels), diabetic profile (blood sugar or HbA1c), hsCRP (looking at the inflammation or stickiness of your blood vessels), homocysteine, because there are many ways you can improve these risk factors by diet, exercise, and medications. Talk to your doctor about it if any of these are abnormal. Monitor your blood pressure and weight levels.
High levels of CK indicates heart disease, stroke or muscle damage. And a simple blood test called CK can check for and monitor your levels for diagnosis and recovery.
Typically used to screen for heart muscle damage (heart attack), skeletal muscle damage (drug induced by statins or muscle disorders), and less often used to see if you suffered brain damage (stroke).
Elevated CK is not something that should be taken lightly. If you have been doing strenuous exercise within three days prior to blood taking, then it would be prudent to repeat the blood test under resting conditions (three days minimum) to see if CK normalised. Any presence of the above symptoms to indicate heart attack or stroke, then see your doctor immediately.
If you want to learn more about creatine kinase, read our lifestyle article by clicking here!
Interested in other biomarkers? Check out the rest of The Biomarker Handbook.
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