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Dr. Singh
Dr. Singh, Doctor
Category: Health
Satisfied Customers: 6496
Experience:  MBBS. General Practitioner, experienced in hospital care and primary care.
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Hello, I am a 30 year old, 62 , 233lb male. I decided to go

Customer Question

Hello, I am a 30 year old, 6'2", 233lb male. I decided to go to the gym on Sat 9-26-10 and work out on one of the bicycle machines. I have not been to the gym or worked out in about 12 years. I worked out aggressively on the bike for about 45 minutes. Afterwards I was sore so I drank some water from the water fountain and went home. On Monday I noticed my quad muscles were really sore and stiff, and that my urine was dark brown. I went to the doctor and was admitted into the hospital with cpk levels over 20,000. It is now Fri 10-1-10 and I am still in the hospital with cpk levels still over 20,000. Blood test indicate that my kidneys and liver are functioning properly, ultrasound test indicate that my liver and other internal organs are fine, my urine is now the normal color and my quad muscles are no longer sore. So why are my cpk levels still over 20,000??????? What else could be wrong!! The doctor said that if cpk levels are over 20,000 the lab will only report it as being over 20,000 and not give an exact level. Is there a way to determine what my exact level is????
Submitted: 6 years ago.
Category: Health
Expert:  Dr. Singh replied 6 years ago.
Hello,
CPK or Creatine Phosphokinase is an enzyme that is normally present in large quantities in muscle cells. Whenever there is injury to muscle cells, CPK is released into the blood circulation from the injured muscle cells, and causes high levels in tests.

Since you had excessive exertion after a gap of many years, you may have had extensive injury to muscle cells in the limbs causing breakdown of muscle fibers (also called Rhabdomyolysis). This process also releases the protein myoglobin into the circulation causing dark urine.

The main concern with this condition is damage to kidneys due to excessive myoglobin. In your case, kidney function appears to be adequate and clearing of urine is a very good sign. So your prognosis is quite good. High CPK levels will not do any damage, but will return to baseline within few days. So CPK itself is not a major concern and there is no need to measure exact level of CPK. However your kidney function should be regularly monitored and you should be getting plenty of fluids.

You can read more here:
http://www.nlm.nih.gov/medlineplus/ency/article/000473.htm

Regards.
Customer: replied 6 years ago.

Should I be worried that the enzyme will damage the internal structure of my kidney? I was informed that the enzyme's molecules are quite large in comparision to the tube like structures in the kidney. I see that you said the levels would come down in a few days, I was in the hospital for five and my CPK levels are still above 20,000, the same as they were the day I arrived. Do you think that this is anything to worry about? Will I need to wait a few days longer?

Expert:  Dr. Singh replied 6 years ago.
CPK molecules are not large and would not damage the kidney tubules. Its the myoglobin molecules that can damage the kidneys, and cause dark urine at the same time. I think your condition has improved a lot and chances of any complications are low. So I would not worry too much about these levels.
Regards.
Dr. Singh and 3 other Health Specialists are ready to help you
Customer: replied 6 years ago.

Thank you for your time. The hospital doctors were giving me rushed answers. At times it seemed as though I might have to tie them down to get detailed answers. Again thank you

Expert:  Dr. Singh replied 6 years ago.
I can understand it can be difficult to get information while in hospital.
Let us know if you have any further questions.
All the best!

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