January 9, 2009
Other
Question from Canada:
What, if any, relationship would a severely elevated CPK level have with type 1 diabetes?
Awhile back (at age 20 or 21), I was admitted to the Emergency Room due to cardiac arrhythmia (sinus tachycardia and acute severe hypertension). My blood sugar was 8 mmol/L [145 mg/dl]. My thyroid levels were elevated due to Hashimoto’s thyroiditis of an 11 year duration and fluctuating levels. I was told to adjust (lower) my replacement hormone. All other tests were normal (no diabetes complications) other than an elevated CPK (creatine phosphokinase). Cardiac source was ruled out.
I was told that I must have “exercised” too much, but I had done NO exercise in the past month. I had no injuries or trauma. I was not taking statins or other medications. I suspect I did already have celiac disease at that point, but it was undiagnosed.
Is there a relationship between type 1, Hashimoto’s, or celiac with severely elevated CPK? The doctor was dumbfounded and had no idea what was wrong with me. Could hyperthyroidism cause significant muscle breakdown? Or, was it caused by my undiagnosed celiac? Should I be concerned that I have “markers” for autoimmune muscle tissue damage?
I’ve never felt well for the past nine years and I am at a loss.
Answer:
CPK is a clinical laboratory test used to look for muscle breakdown. In the presence of low thyroid hormone levels, the turnover of CPK is slow and leads to an accumulation of the enzyme without true pathology. People with type 1 diabetes have an increased risk for hypothyroidism, therefore, the connection between an elevated CPK and diabetes is through the thyroid condition. It should also be mentioned that patients who are on a statin drug for treatment of elevated cholesterol can have a side effect of the medicine to cause marked muscle pain and discomfort. CPK levels are also elevated in this scenario. I bring this up because many people with type 1 diabetes are also on statins to control cholesterol levels. The difference between the former and latter scenario is that statins are usually associated with marked symptoms whereas the CPK level is elevated with thyroid disease without marked pain.
JTL
