Re: CK blood test


"Bill" <xxx@xxxxx> wrote in message
news:3N2ye.194$Xp6.75@xxxxxxxxxxxxxxxxxxxxxxxxxxxxx
>
> "Sharon Hope" <shope@xxxxxxxx> wrote in message
> news:xJWdnd-d1M3hNFXfRVn-2g@xxxxxxxxxxxxxx
>>
>> "Bill" <xxx@xxxxx> wrote in message
>> news:EN%xe.152$Xp6.1@xxxxxxxxxxxxxxxxxxxxxxxxxxxxx
>>>
>>> "Sharon Hope" <shope@xxxxxxxx> wrote in message
>>> news:W9idnfLmY7EBHlXfRVn-pg@xxxxxxxxxxxxxx
>>>>
>>>> "Robert" <Robertitsme@xxxxxxxxxxx> wrote in message
>>>> news:FOednZk6qqRJz1XfRVn-qQ@xxxxxxxxxx
>>>>> http://jnnp.bmjjournals.com/cgi/content/full/68/6/750
>>>>>
>>>>> http://www.gpnotebook.co.uk/cache/-415956920.htm
>>>>>
>>>>> Being a doctor is hard and not as straight forward as some would have
>>>>> you
>>>>> believe.
>>>>>
>>>>> Statins are contra indicated in hypothyroidism which is what I presume
>>>>> you
>>>>> have based on your Super sensitive TSH which is low. Thyroid meds are
>>>>> based
>>>>> on TSH levels. Too low then meds are cut back and too high then meds
>>>>> are
>>>>> increased.
>>>>> Thyroid impacts metabolism. You know how people go on diets and they
>>>>> say to
>>>>> lose fat and not muscle? Muscle metabolism is involved in thyroid
>>>>> disorders
>>>>> as reflected by the CK or CPK which stands for creatine phosphokinase.
>>>>> It is
>>>>> an enzyme that is involved with high energy phosphorulation coupling
>>>>> reactions. ATP is the energy source of preference for aerobic use
>>>>> while
>>>>> creatine phosphate is the preferred source for anaerobic function.
>>>>>
>>>>> There are three different enzymes that we can test for. The one of use
>>>>> clinically is the CKMB fraction that is derived from heart generally
>>>>> and is
>>>>> used to check for heart attacks. The CKMM fraction is from
>>>>> conventional
>>>>> muscle and the CKBB fraction from brain.
>>>>>
>>>>> There are many, many reasons for CK elevations, from regular exercise
>>>>> to
>>>>> more severe disease.
>>>>>
>>>>> To blame everything on statins is just as dangerous and not blaming
>>>>> anything
>>>>> on statins.
>>>>>
>>>>>
>>>>
>>>> Yes, the doctors are supposed to look for "horses, not zebras" in
>>>> identifying the cause of a problem.
>>>>
>>>> In this case, the doctor should first ask, did you participate in an
>>>> ultra-marathon race immediately before the blood test?
>>>>
>>>> If not, the "horse" approach would be to ask:
>>>>
>>>> Is this patient taking a drug that has a known adverse effect of muscle
>>>> damage as identified by elevated CK? Yes? A statin? Then the most
>>>> likely cause is the statin.
>>>>
>>>
>>>
>>> I don't know if that is true or not true. What do you base that on? Do
>>> you know what % of people who are not on statins normally have high CK
>>> levels? Thanks.
>>>
>>
>> We know the "norms" from the CK Lab report.
>>
>
> That's not the point or addressing the question I asked. The question I'm
> trying to get an answer to is: If you took a random cross section of the
> population of non statin takers what is the liklihood that a person would
> show a high level of CK on this test. Or, to put it another way, what is
> the probability of a false positive on this test? Your claim that the most
> likely cause is a statin requires the false positive rate to be low.
>

I don't take random cross sections of anything. I work full time plus to
keep the family afloat, because one wage earner is now disabled from statin
adverse effects.

The most logical place to look for a sudden symptom that corresponds to the
most common known adverse effects of the drug the patient is taking is that
drug. This is not surprising.

No rates of false positives are required at all. Once one cause is
eliminated, others are visited. Are you asking if a CK reading itself is
likely to be a false positive? If that were common, I would expect that
there would be a series of measurements made, or the measurement would not
be considered useful at all. Apparently doctors are encouraged to use it
with statin patients and with myopathy, so draw your own conclusions.

I am no an expert on anything medical, and would expect you to ask an expert
your question.

My comments spring from the observation that, despite the fact that the most
common adverse effects from statin drugs are well documented as muscle
damage, cognitive damage and nerve damage, many doctors faced with that
constellation of symptoms in a statin patient refuse to consider the drug
while they chase other possible or imagined causes, while all the while the
drug adverse effects are worsening and becoming more debilitating and
disabling.


>> If a drug is prescribed that has the adverse effects the patient is
>> presenting, regardless of the drug is a statin, that is the most likely
>> cause to investigate first. This per a presentation on Medical Ethics at
>> UCSD.
>>
>> Diagnosis can be challenging when it is an obscure but documented adverse
>> effect, and when it is an adverse effect of more than one drug the
>> patient is taking.
>>
>> In the case of statins, muscle pain and muscle damage with and without
>> elevated CK is the most common adverse effect. No mystery in muscle pain
>> with elevated CK while on statins or after statins.
>>
>>>
>>>> If no statin has been taken, and no other myotoxin, look for the next
>>>> most likely cause of the elevated CK.
>>>>
>>>>
>>>> If, by the way, the statin was discontinued due to muscle pain, expect
>>>> the muscle pain and damage to continue for months to years before
>>>> subsiding.
>>>
>>> Just the opposite is true. From
>>>
>>> http://medicine.ucsd.edu/SES/adverse_effects.htm
>>>
>>> "Although symptoms usually resolve on stopping the drug, for a
>>> proportion of those who have contacted us, muscle symptoms - pain or
>>> weakness - or peripheral neuropathy may persist when the drugs are
>>> discontinued."
>>>
>>
>> This is not binary, there is a range of recovery experiences.
>>
>
> I did not say it was. You claimed:
>
>
>>>> If, by the way, the statin was discontinued due to muscle pain, expect
>>>> the muscle pain and damage to continue for months to years before
>>>> subsiding.
>
> According to the what I cited. One should not "expect the muscle pain and
> damage to continue for months to years before subsiding." And there are
> many more references that say the muscle pains typically resolve upon
> discontinuing the statins.
>
> Therefore you were absolutely wrong.
>

Not so. You cited a website by the same researcher I cited. Knowledge is
gained over time.


>> In my husband's case, the CK continued to elevate, ramping up to the
>> threshold of rhabdo, for 12 full months off the statin before leveling
>> off and starting to subside.
>>
>
> I did not say it could not happen in an individual case.

I say it did indeed happen in this individual's case. And, I have observed
it myself, and I have the documented evidence.

>
>> Dr. Golomb, whose website you cite, presented at the International
>> Coenzyme Q10 Association conference this spring, and gave statistics on
>> the ranges (in months) of time (with a plus-or-minus factor of additional
>> montns) for two categories:
>>
>> 1) Time to start of recovery
>>
>> 2) Time to recover in full (or to the degree of recovery possible)
>>
>> These tables included the three most common statin adverse effects:
>>
>> a) Muscle Damage
>> b) Cognitive Damage
>> c) Nerve Damage
>>
>> In addition, she presented these numbers for the number of statin
>> exposures. i,e,, if a patient suffered an adverse effect on one statin,
>> halted the statin, recovered, then was started on a second statin. Also,
>> the same for a halt, recovery, then prescription for a third statin.
>>
>> Further, Dr. Golomb set the likelihood of experiencing the same adverse
>> effect on the second statin, if the statin is at the same effective
>> dosage in the 90-95% range.
>>
>
> None of which is relevent to the question.

Obviously, if the time before there is any recovery at all from statin
muscle damage is measured in MONTHS, that would be precisely relevant to the
question of how long it typically takes for muscle pain begins to lessen.
(that is after discontinuing the statin, of course)

Oftentimes, not always, CK elevation correlates to muscle pain.

This, again, is the START of recovery, there is another entire chart, also
measured in MONTHS (plus-or-minus some number of MONTHS) before the muscle
pain resolves.

If that is not relevant to the question, you didn't ask clearly enough.


>
>>>
>>>
>>>
>>>
>>>>CK elevation can continue to climb for a full year before leveling off
>>>>and then subsiding.
>>>>
>>>> In some cases, the statin muscle damage exists without the elevated CK.
>>>>
>>>> In many cases, some level of statin-induced muscle dysfunction is
>>>> permanent.
>>>>
>>>
>>> I don't think there has been any documented case of permanent muscle
>>> damage without elevated CK levels. Do you have any evidence that such
>>> cases exist?
>>>
>>
>> That was the previous paragraph, the statement "In many cases, some level
>> of statin-induced muscle dysfunction is permanent" was independent. No,
>> I have not seen the breakdown of the cases of permanent muscle damage
>> with vs without elevated CK. The answer to this would be in one of the
>> many statin adverse effects studies awaiting publication.
>>
>
> Such a case may or may not exist in studies awaiting publication. But I
> have been though some of the previous studies and have not found one. I
> don't think you can cite one either.
>
> Do you know about when the adverse effects studies will be published?

When the journal editorial board is ready to publish a study that might not
please their statin pharmco advertizers.

>
> Bill
>
>>> Bill
>>>
>>>>> "Ben" <organ@xxxxxxxx> wrote in message
>>>>> news:da9db30o1c@xxxxxxxxxxxxxxxxxxxxx
>>>>>> Hi Everyone
>>>>>>
>>>>>> I had full blood work done a few weeks ago and most of the result was
>>>>>> very
>>>>>> good. Especially the cholesterol. but two readings were out of the
>>>>>> normal
>>>>>> limits. And that is STSH 0.08, that is for the thyroid. which is not
>>>>> working
>>>>>> well due that I am on Amiodarone and also the CK 390. Now the
>>>>>> cardiologist
>>>>>> reduce my thyroid medication, but said nothing about the CK.
>>>>>> My question is, are the two related, what is CK reading anyway?
>>>>>> Your input would be appreciated
>>>>>> Ben
>>>>>>
>>>>>>
>>>>>>
>>>>>
>>>>>
>>>>
>>>>
>>>
>>>
>>
>>
>
>


.

Relevant Pages

  • Re: aggressive statin treatment may affect mitochondrial volume
    ... >> 1- Muscle adverse effects (myopathy, myositis, muscle wasting, ... >> mitochondrial damage, cellular mitochondrial respiratory damage, ... >> all three categories of statin adverse effects - an entire constellation ...
    (sci.med.cardiology)
  • Re: CK blood test
    ... >> cause is a statin requires the false positive rate to be low. ... >>> In the case of statins, muscle pain and muscle damage with and without ... >>> adverse effects studies awaiting publication. ...
    (sci.med.cardiology)
  • Re: Cholesterol Levels Are Falling, But Red Flags Are Rising
    ... Does it make me a 'statin disliker' to find that his NP ... >>massive chronic excruciating muscle pain, muscle wasting, ... >>apparently due to demyelination of the nerves by the Lipitor. ... >>cleverly kept ignorant of these adverse effects. ...
    (sci.med.cardiology)
  • Re: Outcomes in 45 patients with statin-associated myopathy
    ... >>> statin muscle problems only 45 were proven. ... > "Patients with statin-associated myopathy experienced full resolution of ... muscle damage and pain, to the degree that medical intervention was needed - ...
    (sci.med.cardiology)
  • Re: Additional Info. about statins
    ... > It addresses Frequently Asked Questions on Statin Adverse Effects. ... > with muscle rigor, severe gout upon exertion due to massive releases of uric ... >> a case of Rhabdomyolysis in a patient with a non-elevated CK level? ...
    (sci.med.cardiology)
Loading