What is the significance of recent elevated transaminases and creatine kinase (CK) levels, with a total CK of 335 U/L, which is higher than the normal range of 41-331 U/L, as reported by Lab Corporation (Lab Corp) on 05-06-2025?

From the Guidelines

Your lab results indicate mild transaminitis and a slightly high creatine kinase (CK) level, which could be caused by various factors, including recent physical activity, muscle injury, or certain medications, and I strongly recommend consulting with your healthcare provider for a thorough evaluation and guidance. The elevated CK level of 335 U/L (normal range 41-331 U/L) and transaminitis may resolve on their own with simple lifestyle modifications, but it is crucial to investigate further to rule out any underlying conditions that may require medical attention 1.

In the meantime, it is advisable to avoid alcohol, acetaminophen (Tylenol), and strenuous exercise for 1-2 weeks, then repeat the blood tests to see if levels normalize 1. Staying well-hydrated by drinking 8-10 glasses of water daily can also help. The liver enzyme elevation (transaminitis) might be related to the same factors as the elevated CK or could indicate mild liver stress. It is essential to inform your doctor about all medications you're taking, including over-the-counter drugs and supplements, as some can affect these lab values 1.

Some key points to consider:

• The elevated CK could result from recent intense physical activity, muscle injury, certain medications like statins, or other conditions 1.
• The liver enzyme elevation (transaminitis) might be related to the same factors or could indicate mild liver stress 1.
• These mild elevations often resolve with simple lifestyle modifications, but your doctor may want to investigate further if they persist or if you have symptoms like muscle pain, weakness, dark urine, or yellowing of the skin 1.
• It is crucial to consult with your healthcare provider to determine the cause of these elevations and to receive proper guidance on how to proceed 1.

From the Research

Elevated Transaminitis and Creatine Kinase

• The recent lab results showing elevated transaminitis and creatine kinase levels, with a total of 335 U/L and 41-331 U/L, respectively, may indicate muscle damage or liver injury 2, 3.
• A study published in the Journal of Clinical Rheumatology found that serum transaminases are frequently elevated at the time of diagnosis of idiopathic inflammatory myopathy and normalize with creatine kinase 2.
• Another study published in the American Journal of Cardiology discussed the value of liver function test and creatine phosphokinase monitoring with statin use, highlighting the potential risks of hepatotoxicity and skeletal muscle injury 4.
• Elevated creatine kinase and transaminases can also be seen in asymptomatic patients with X-linked spinal and bulbar muscular atrophy (SBMA) 3.
• A case study published in Pediatrics reported a 6-week-old male infant with complex glycerol kinase deficiency, presenting with persistent hyperbilirubinemia, hypertriglyceridemia, elevated creatine kinase levels, and transaminitis 5.

Potential Causes and Associations

• Elevated transaminitis and creatine kinase levels can be associated with various conditions, including muscle damage, liver injury, and certain genetic disorders 5, 2, 3.
• A study published in the Postgraduate Medical Journal emphasized the importance of careful history and clinical examination, along with interpretation of pattern of liver test abnormalities, to identify the type and etiology of liver disease 6.
• The correlation between creatine kinase and serum transaminases has been reported in several studies, highlighting the need for careful evaluation and monitoring of these laboratory changes 2, 3.