Elevated CPK

Hi Doctor,

My wife, 29 yrs old has been experiencing some minor muscle weakness.  She is a hair stylist, so standing on her feet multiple hours a day is normal.  Her legs are often restless, and her hands sometimes bother her, typically like a carpal tunnel sensation.  Anyway, she finally went to the doctor yesterday (04/26/10), as kind of a physical exam, and the muscle weakness was not even a topic of conversation.  It was more of a hormonal related visit.  With that being said, they took 5 vials of blood work to make sure everything was okay, and the results came back and they noticed her cpk was 1400.  Obviously, the doc was concerned and wants to test it again tomorrow.  My wife is now kind of worried.  My wife and I have been on a pretty vigorous exercise routine for the past week and I'm curious as to know if you think this exercise could be related to the elevation of cpf?  Please let me know.  Thank you!!

Ben

[Philip D Parks, MD, MPH, MOccH, FACOEM]

Hello,

A couple questions about your posting.

1. What type of vigorous exercise have you been engaged in over the last week?
2. What was the repeat CPK level?
3. How did the other laboratory values turn out? Was anything else abnormal?
4. Does your wife have any joint pain?
5. Does your wife have a history of hypothyroidism (thyroid gland is under active)?
6. What do you mean when you say that "her legs are often restless"?

~•~ Dr. Parks

This answer is not intended as and does not substitute for medical advice. The information presented in this posting is for patients’ education only. As always, I encourage you to see your personal physician for further evaluation of your individual case.

[DrOHS]

Hi, First I would like to let you know that there are three CPK isoenzymes present in the body. CPK-1 found mostly in the brain and lungs and higher than normal level is associated with the pathology of brain and lungs. Similarly, higher CPK-2 level is associated with heart pathology. Most relevant CPK level according to your wife's clinical history is CPK-3 that is associated with muscle inflammation or injury. Additionally, certain medications also interfere with the final test results. I think there may be a muscle injury or loss (after vigourous exercises) or atrophy in your wife's case that is causing all the restless symptoms & higher CPK level and needs to be evaluated thoroughly. Treatment depends upon treating the specific medical condition. Additionally, I don't think that this medical condition is related to her job profile apart from standing for long hours that may aggravate pressure on leg muscles. She may also require rest for few days to recover completely. Thank you.

[bscott1983]

Thanks for the replies!!

First, for 6 days leading up to her first test, we worked out about an hour and a half each day with a trainer...pushing our limits (free weights, machines, cardio, etc.).  This isn't the first time she's ever worked out, just the first time in 6 months.  Next, the repeat CPK level was 1100, so a 300 drop in two days.  Her other lab values turned out perfectly normal, except her ANA test came back positive.  In regards to joint pain, none of which is severe, she does have some hip, knee, wrist pain, which again, we've always associated with her job.  Hypothyroidism actually runs in her family, however, she has had her thyroid checked several times, and it always comes back perfectly normal.  When I say her legs are restless, I mean that her legs are quite sensitive.  I can sometimes touch them, or lightly rub them and it's somewhat painful for her.  

One thing also that I think may be worth mentioning, is that she was sick (sinus infection type, cough, runny nose, sore throat, etc.) for like 2 weeks leading up to her appointment.  She didn't take any medicine throughout this process, but she couldn't seem to kick it.  Not even sure if she is yet 100% better.  Just wondering your thoughts, to see if this sickness would increase her levels??  Anyway, she has an appointment on May 13th with a rheumatologist.  Any advice would be of extreme help.  Thank You!!

Ben