Re: CK blood test

I have never seen you post anything approaching 80+ pages of published
journal articles backing your opinions.

For backup to mine see:
http://www.freewebs.com/stopped_our_statins/StatinFAQ_031305wTOCv4.pdf


"listener" <listener@xxxxxxxxxx> wrote in message
news:Xns96896CB7A6125some1outthere@xxxxxxxxxxxxxxxxx
> "Bill" <xxx@xxxxx> wrote in
> news:MZ7ye.153$LK5.85@xxxxxxxxxxxxxxxxxxxxxxxxxx:
>
>>
>> "Sharon Hope" <shope@xxxxxxxx> wrote in message
>> news:uuudndUjpebdUFXfRVn-2g@xxxxxxxxxxxxxx
>>>
>>> "Bill" <xxx@xxxxx> wrote in message
>>> news:3N2ye.194$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.
>>>
>>
>> Which has no relevance to anything being discussed here.
>>
>>> 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.
>>>
>>
>> You claimed:
>>
>> " 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 am asking you to support YOUR claim. Why could not the most likely
>> cause be a false positive due to something else?
>>
>>
>>> 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.
>>>
>>>
>>
>> Which has nothing to do with the question which is why could not the
>> most most likely source be a false positive due to something else?
>>
>>>>> 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.
>>>
>>>
>>
>> The fact that I cited the same website was to show that even people
>> you trust disagree with with you. What does "Knowledge is gained over
>> time" have to do with anything. Again why should one
>>
>> "expect the muscle pain and damage to continue for months to years
>> before subsiding"
>>
>>
>>
>>>>> 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.
>>>
>>
>>
>> So what? I agree with this. That fact that you have documented it has
>> no relevance to this discussion.
>>
>>>>
>>>>> 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)
>>>
>>
>> I will accept that if you present evidence of it - not your
>> recollection of it. It is not consitent with her website which says
>> that "symptoms usually resolve upon stopping the drug" This does not
>> imply to most people months or years. (Unless you mean 0 to 2 months
>> and 0 years) Otherwise please provide some evidence of your claim that
>> I can see. What is a typical time for resolution of symptoms?
>>
>>> 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.
>>>
>>
>> What do you mean by that?
>>
>> Bill
>>
>>>>
>>>> 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
>>>>>>>>>
>
>
> Bill,
>
> Here again, we enter the sci.med.cardiology Twilight Zone. The dialogue
> above has taken place so many times. Sharon makes a claim, someone
> questions it, she's offended that someone had the balls to question it
> ("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"), she makes an attempt to defend her statements,
> someone questions her attempts, she feigns ingorance ("I am no an expert
> on anything medical"), she changes the subject, she blames doctors, she
> blames pharma, (now she blames Journals!) she blames us for being
> insensitive and eventually you'll be dismissed with an online diagnosis
> of statin-induced aggression and the thread will end!
>
> All because you've politely asked her to back up some of her claims.
> There's simply no reasoning with her and the others. This Chung-like
> behavoir is more in need of a psychologist than a gp.
>
> L.


.

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