Re: CK blood test


"Jason" <jason@xxxxxxxxxx> wrote in message
news:jason-0407050940470001@xxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxx
> In article <3N2ye.194$Xp6.75@xxxxxxxxxxxxxxxxxxxxxxxxxx>, "Bill"
> <xxx@xxxxx> wrote:
>
> > "Sharon Hope" <shope@xxxxxxxx> wrote in message
> > news:xJWdnd-d1M3hNFXfRVn-2g@xxxxxxxxxxxxxx
> > >
> > > "Bill" <xxx@xxxxx> wrote in message
> > > news:EN%xe.152$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.
> >
> > > 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.
> >
> > > 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.
> >
> > > 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.
> >
> > >>
> > >>
> > >>
> > >>
> > >>>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?
> >
> > 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
>
> Ben,
> One of the problems is that many doctors (including my own doctor) do not
> conduct special blood tests (such as CK and liver enzyme) prior to
> prescribing statins. If this procedure became part of the protocals
> related to treatment for statin patients--it would solve many of the
> problems that you mentioned. Since those blood tests are not done by most
> doctors, it means that conducting those same tests after a patient
> develops muscle problems do not have hardly any validity.
> Jason
>

Jason as someone who does professionally performance of CK and all other
laboratory testing, one who is familiar with all if not most protocols
involving laboratory testing, I sincerely wish you the most rapid recovery
from your hardships.
I am pulling for you and others.
> --
> NEWSGROUP SUBSCRIBERS MOTTO
> We respect those subscribers that ask for advice or provide advice.
> We do NOT respect the subscribers that enjoy criticizing people.
>
>
>


.

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