Medical and Dental Consultants’ Association of Nigeria
Home - About us - Editorial board - Search - Ahead of print - Current issue - Archives - Submit article - Instructions - Subscribe - Advertise - Contacts - Login 
  Users Online: 1509   Home Print this page Email this page Small font sizeDefault font sizeIncrease font size

  Table of Contents 
Year : 2011  |  Volume : 14  |  Issue : 4  |  Page : 454-459

Serum creatine kinase and lactate dehydrogenase activities in patients with thyroid disorders

1 Department of Pathology, Faculty of Medical Sciences, The University of the West Indies, Mona, Kingston, West Indies
2 Department of Medicine, Faculty of Medical Sciences, The University of the West Indies, Mona, Kingston, West Indies
3 Health Policy Department, Independent Health Policy Consultant, Christiana, Manchester, Jamaica, West Indies
4 Department of Paraclinical Sciences, The University of the West Indies, St. Augustine, Trinidad and Tobago, West Indies

Date of Acceptance28-Aug-2011
Date of Web Publication12-Jan-2012

Correspondence Address:
D A McGrowder
Department of Pathology, The University of the West Indies, Mona, Kingston 6, Jamaica
West Indies
Login to access the Email id

Source of Support: None, Conflict of Interest: None

DOI: 10.4103/1119-3077.91755

Rights and Permissions

Background and Objectives: There is the recognition of a pattern of elevations of serum enzymes in hyperthyroid and hypothyroid patients. The aims of this study were to determine the activities of serum creatine kinase (CK) and lactate deydrogenase (LDH) in thyroid disorders, and to evaluate the relationship between CK, LDH and FT4, and TSH levels.
Materials and Methods: In this retrospective study, thyroid function tests, serum CK and LDH activities were obtained from the medical records of newly diagnosed hyperthyroid and hypothyroid patients attending the Endocrinology Clinic at the University Hospital of the West Indies from 2005- 2009.
Results: Elevation of CK activity was found in 5 patients (28%, 5/18) with overt hypothyroidism and in 12 patients (24.0%, 12/50) with subclinical hypothyroidism. The mean CK activity in subclinical hypothyroid patients was 179.80 ± 125.68 U/L compared with 389.901 ± 381.20 U/L in overt hypothyroid patients. The elevation of LDH activity was found in 6 patients (33.3%, 6/18) with overt hypothyroidism and in 37 patients (74.0%, 37/50) with subclinical hypothyroidism. In the hypothyroid patients, a positive correlation was found between CK activity and TSH (r = 0.292, P = 0.015), and a negative correlation between CK activity and FT4 (r = - 0.325, P = 0.007); and between FT4 and TSH (r = - 0.371, P = 0.002).
Conclusion: The significant elevation in serum CK and LDH activities indicates that these can be used as parameters for screening hypothyroid patients but not hyperthyroid patients.

Keywords: Hyperthyroidism, hypothyroidism, lactate dehydrogenase, serum creatine kinase

How to cite this article:
McGrowder D A, Fraser Y P, Gordon L, Crawford T V, Rawlins J M. Serum creatine kinase and lactate dehydrogenase activities in patients with thyroid disorders. Niger J Clin Pract 2011;14:454-9

How to cite this URL:
McGrowder D A, Fraser Y P, Gordon L, Crawford T V, Rawlins J M. Serum creatine kinase and lactate dehydrogenase activities in patients with thyroid disorders. Niger J Clin Pract [serial online] 2011 [cited 2022 May 18];14:454-9. Available from:

   Introduction Top

Overt abnormalities in thyroid function are common endocrine disorders affecting 5-10% of individuals over a lifespan. [1] Clinical symptoms and signs are often nonspecific, and the diagnosis and monitoring of therapy depends crucially on measurements of thyroid hormones (triiodothyronine, T 3 and thyroxine, T 4 ), and thyroid stimulating hormone (TSH) in blood. [2] Minor abnormalities in thyroid function with subclinical hypothyroidism or hyperthyroidism are even more common. [3],[4] Both subclinical hypothyroidism and hyperthyroidism are associated with an increase in risk of disease, [3],[4] as well as abnormalities in biochemical and physiologic measures that are often abnormal in patients with overt thyroid disease. [5]

Both subclinical hyperthyroidism and hypothyroidism are increasingly being recognized as having significant health implications with subclinical hypothyroidism more common than subclinical hyperthyroidism. [6] Subclinical hypothyroidism is defined by the finding of elevated serum TSH concentrations associated with normal free thyroid hormone levels (FT 4 and FT 3 ). [7] The prevalence of this condition is higher in women than men and increases with age, reaching a peak of 21% in women and 16% in men over 74 years of age. [8],[9]

The serum creatine kinase (CK) activity in healthy individuals depends on age, race, lean body mass and physical activity. [10] It has since become an important clinical marker for muscle damage. Musculoskeletal disorders often accompany thyroid dysfunction. The association of myopathy with both myxedema and thyrotoxicosis is well known. [11] Concentrations of CK in serum are often increased in patients with primary hypothyroidism, [12],[13] but evidence for any change in thyrotoxicosis is conflicting. Some authors [14] reported normal and others subnormal [15] CK activity. Furthermore only a few studies have investigated serum lactate dehydrogenase (LDH) activity in patients with thyroid dysfunction. [16],[17]

In recent years studies have been conducted to establish a relationship of CK activity in thyroid diseases. [18] However, no correlation has been consistently described between CK activity and circulating concentrations of either T 3 , T 4 , or TSH. [19],[20],[21] The aims of this study were to determine serum activities of CK and LDH in overt and subclinical hypothyroidism, and also in overt and subclinical hyperthyroidism; to evaluate the relationship between FT 4 , and TSH levels and the degree of skeletal muscle involvement in these thyroid disorders, as determined by serum CK activity in these thyroid dysfunctions.

   Materials and Methods Top

This is a retrospective study where information was extracted from the medical records of newly diagnosed hypothyroidism or hyperthyroidism patients attending the Endocrinology Clinic at the University Hospital of the West Indies from 2005-2009.

Exclusion criteria were previous use of L-thyroxine or antithyroid medication and thyroidectomy. Also, patients with risk factors for having high CK activity were excluded: recent fall, intoxication, intramuscular injection, seizure, stroke, surgery, excessive physical exercise, and certain medications (antiarrhythmics, b-blockers, lithium, fibrates, phenothiazines, steroids and statins). We included 18 patients (14 females, 4 males) with overt hypothyroidism; 50 patients (34 females, 16 male) with subclinical hypothyroidism; 31 patients (26 females, 5 males) with overt hyperthyroidism; 61 patients (46 females, 15 male) with subclinical hyperthyroidism, and 99 controls (healthy persons who did their annual routine tests; 64 females and 25 males) in the study. Serum levels of TSH and FT 4 were measured by radioimmunoassay on AXSYM System (Abbott Laboratories, Abbott Park, USA); serum CK and LDH activities were determined using an automated analyzer (c8000, Abbott Architect, Abbot Park, Illinois, USA) in all subjects.

The patients in the study were classified into one of the following four groups based on their thyroid function tests These were (1) overt thyrotoxicosis defined as a TSH level of less than 0.40 mU/L (normal, 0.4 - 4.0 mU/L) with an elevated FT 4 concentration (normal, 0.8 - 1.9 ng/dL); (2) subclinical hyperthyroidism defined as a TSH level of less than 0.40 mU/L with a normal FT 4 concentration; (3) subclinical hypothyroidism defined as a TSH level of more than 4.0 mU/L and less than 20 mU/L with a normal FT 4 concentration; and (4) overt hypothyroidism was defined as a TSH level of 20 mU/L or more or a TSH level of more than 4.0 mU/L with an FT4 concentration below normal. [22]

Chi-square was used to examine non-metric variables. A P-value < 0.05 (two-tailed) was used to establish statistical significance. Statistical analyses were carried out using linear regression analysis.

   Results Top

Patient groups (overt hypothyroidism and subclinical hypothyroidism; overt hyperthyroidism and subclinical hyperthyroidism) and control groups were similar in regard to age (60.67 ± 17.96 and 59.16 ± 21.16; 58.38 ± 18.33 and 58.65 ± 17.91 years) and 52.75 ± 16.44 years, respectively; and gender (16/4 and 34/16; 26/5 and 46/15) and 64/25, female/male, respectively.

Elevation of CK activity was found in 5 patients (28%, 5/18) with overt hypothyroidism and in 12 patients (24.0%, 12/50) with subclinical hypothyroidism. The mean CK activity in subclinical hypothyroid patients was 179.80 ± 125.68 U/L compared with 389.901 ± 381.20 U/L in overt hypothyroid patients [Table 1]; while values for patients with overt and subclinical hyperthyroidism was 88.37 ± 69.22 U/L and 105.98 ± 57.00 U/L respectively [Table 2].
Table 1: Comparison of FT4, TSH, CK, and LDH levels between controls, overt and subclinical hypothyroid patients

Click here to view
Table 2: Comparison of FT4, TSH, CK, and LDH levels between controls, overt and subclinical hyperthyroid patients

Click here to view

Elevation of LDH activity was found in 6 patients (33.3%, 6/18) with overt hypothyroidism and in 37 patients (74.0%, 37/50) with subclinical hypothyroidism. The mean LDH activity in subclinical hypothyroid patients was 340.38 ± 153.38 compared with 421.00 ± 203.91 U/L in overt hypothyroid patients [Table 1]; while values for patients with overt and subclinical hyperthyroidism were 233.80 ± 77.37 U/L and 227.81 ± 54.99 U/L respectively [Table 2].

In the hypothyroid patients, a positive correlation was found between CK activity and TSH levels (r = 0.292, p = 0.015), and a negative correlation between CK activity and FT 4 concentration (r = - 0.325, P = 0.007); and between FT 4 concentration and TSH levels (r = - 0.371, P = 0.002). No significant correlations were found between FT 4 concentration and LDH activity (P = 0.836), between TSH levels and LDH activity (P = 0.714), between CK and LDH activities (P = 0.133).

There was statistically significant difference in CK and LDH activities in patients with overt hypothyroidism and the control, and subclinical hypothyroidism and the control [Table 1]. Although a statistically significant elevation of FT 4 concentration was found in patients with overt hyperthyroidism when compared with the subclinical hyperthyroidism patients (P = 0.0001); no statistical difference was found for TSH, CK, and LDH [Table 2].

In the hyperthyroid patients compared with the control group, CK activity was found not to be statistically significant in the subclinical and the control (P = 0.326), and the overt and the control group (P = 0.147). However, significant statistical differences in levels were found in FT 4 , TSH and LDH activity between the subclinical and the control; and the overt hyperthyroidism and the control group [Table 2]. However, no statistical correlation was found between FT 4 and TSH (P = 0.128), CK and FT 4 (P = 0.120) and LDH and FT 4 (P = 0.545) in hyperthyroid patients; a positive correlation existed between CK and LDH activities (r = 0.341, P = 0.021). A significant statistical difference was found among the means of CK activity for the hyperthyroid and hypothyroid patients, and control group [Table 3].
Table 3: Descriptive statistics of hyperthyroidism (subclinical and overt) and hypothyroidism (subclinical and overt) patients and control

Click here to view

   Discussion Top

The findings of this study confirm that elevated serum CK activity is frequently increased in hypothyroidism and decreased in hyperthyroidism. This study also indicates that CK activity correlates with the degrees of hypothyroidism and hyperthyroidism, as evident by the magnitude of the TSH. Elevated serum CK activity was observed in hypothyroid patients, and was higher in patients with overt hypothyroidism, and less so in subclinical hypothyroid patients. These findings are in accordance with those of other studies, which report a 43% to 97% elevation of serum CK activity in hypothyroidism: Beyer et al, 43% [22] Giampietro et al, 90% [19] and Soufir et al, [23] 97%. This is in contrast to the findings of Hartl et al, who found an elevation of CK activity in only 2 of 69 patients (3%), one with overt and one with subclinical hypothyroidism.­ [24] The finding of decreased CK activity in patients with hyperthyroidism compared with controls is in accordance with other studies. [14],[25]

In a few of the severely hypothyroid patients with TSH exceeding 40 mU/mL, the increase in serum CK activity was pronounced with CK values over 500 U/L. Unexpectedly, normal CK values was observed in older patients, despite marked overt hypothyroidism could presumably be related to inter-individual variations, [26] for example due to reduced muscle mass and lack of physical activity. Nonspecific muscle stiffness related to myalgia may be associated with serum muscle enzyme elevations. Skeletal muscle is affected more profoundly in patients with overt hypothyroidism, less so when subclinical hypothyroidism is present. [27] However, clinical muscular symptoms are not usually the chief complaint at presentation. More than 40% of patients with hypothyroidism also had neuromuscular complaints at the time of diagnosis. [28]

Some patients with primary hypothyroidism may have a marked myopathy, [29] with associated histological changes in muscle cells. [11] It is widely suggested that this increase results from leakage of the enzyme from muscle cells, [30] perhaps related to the subnormal body temperature accompanying primary hypothyroidism. [31] The increase may also reflect a decrease in enzyme clearance. [32]

Various mechanisms have been proposed as causing elevated CK activity in hypothyroidism, although these mechanisms may have varying influence at different stages of the disease.­ [19],[20] The hypo-metabolic state of hypothyroidism can cause a reduction in glycolysis and oxidative phosphorylations and thus reducing adenosine triphosphate (ATP) concentrations beyond a critical limit. The alteration in sarcolemmal membranes can cause increased cell permeability and the leakage of CK from cells. [33],[34] Another possibility is reduced turnover of CK because of hypothyroidism, allowing serum activities to rise generating a marked release of CK through the altered sarcolemnal membranes. [31]

Our finding of lower CK activity in hyperthyroidism, is in accordance with other reports [14],[25] and suggests that in the hypermetabolic state there may be increased enzyme degradation which may have contributed to these low CK activity. That the muscle cell is less permeable than normal to efflux of CK in hyperthyroidism is unlikely, although possibly in these circumstances the muscle cell might reflect loss of muscle bulk. [25]

A key finding in the study is significant inverse correlation in hypothyroid patients between serum CK and TSH (P < 0.001), regardless of whether FT 4 concentrations were normal (P < 0.01) or decreased (P < 0.01). The elevated CK activity in subclinical hypothyroid patients might be explained by the fact that just as the pituitary gland releases TSH in response to suboptimal levels of thyroid hormones, the muscles probably respond by releasing CK into the circulation. [22] Further, the results of this study are in accordance with others [22],[35],[36] as we found that the severity of hypothyroidism to correlate with the elevation of serum CK activities: however, still others have not found such a relationship [23],[24],[28] or have found a reciprocal relationship.­ [37] These conflicting results may depend more on the degree of clinical manifestations of hypothyroidism, rather than on the amount of elevation of serum markers.

Hypothyroid patients have increased activity of creatine kinase that is mostly due to increased CK-MM as CK isoenzyme analysis in six cases of primary hypothyroidism showed only the MM isoenzyme to be present in four patients, and MM with a trace of MB in the other two. [38] These findings also confirm previous studies that indicated skeletal muscle to be the major source of the increased plasma CK activity. [39],[40]

Studies have shown that LDH activity was increased and decreased in the hypo- and hyperthyroid states, respectively.­ [16],[17] The study found increase in LDH activity in patients with hypothyroidism which correlates with the degree of hypothyroidsm. LDH activity have been reported to be increased in primary hypothyroidism [41],[42] and in one study, 37% of hypothyroid patients had elevated LDH. [39] In another study of six untreated primary hypothyroid patients, LDH activities from 473 to 1885 U/L [38] was reported; and in a latter study 27 of 45 hypothyroid patients had elevated total LDH levels. [43] Further isoenzme analysis showed a normal pattern of LDH isozyme in 12 patients, while in the remaining ten, three showed increased LDH 1 levels, one showed an increased lactate dehydrogenase isozyme 3 level (LDH 3 ), and six showed elevated lactate dehydrogenase isozyme 5 (LDH 5 ) levels. [43] Studies of LDH isozymes in myxedema heart disease have shown that LDH isozyme 1 (LDH 1 ) may be elevated in this disorder and gradually fade with thyroid replacement therapy. [44] The elevations of LDH levels could reflect increased release and/or decreased clearance from the liver. [45] In addition, lactate dehydrogenase values were inversely related to both the thyroxine and triiodothyronine concentrations. The finding of the latter study differ from others in that the LDH levels was statistically significantly higher than the control group in both patients with subclinical and over hyperthyroidism as significant number of these patients had normal LDH. Strasberg reported no association of hyperthyroidism with elevated levels of the LDH isozyme. [46]

   Conclusion Top

The study found an inverse relation in the serum levels of FT 4 concentration and serum CK activity in thyroid diseases; and between FT 4 concentration and LDH activity in hypothyroidism. In hypothyroid patients with decrease in serum FT 4 concentration, there is a significant increase in CK and LDH activities, which indicates that these can be used as parameters for screening hypothyroid patients and to lesser extent hyperthyroid patients.

   Acknowledgement Top

Appreciation is hereby extended to Mr. Paul Bourne for assisting with the statistical analysis of the data.

   References Top

1.Vanderpump MP, Tunbridge WM. The epidemiology of thyroid diseases. In: Bravermann LE, Utiger RD, editors. Werner and Ingbar's the thyroid: A fundamental and clinical text. Philadelphia: Lippincott-Raven Publishers; 2000. p. 467-73.  Back to cited text no. 1
2.Jarlov AE, Nygaard B, Hegedus L, Hartling SG, Hansen JM. Observer variation in the clinical and laboratory evaluation of patients with thyroid dysfunction and goiter. Thyroid 1998;8:393-8.  Back to cited text no. 2
3.Ross DS. Subclinical hypothyroidism. In: Bravermann LE, Utiger RD, editors. Werner and Ingbar's the thyroid: A fundamental and clinical text. Philadelphia: Lippincott-Raven Publishers; 2000. p. 1001-6.  Back to cited text no. 3
4.Ladenson PW, Singer PA, Ain KB, Bagchi N, Bigos ST, Levy EG, et al. American Thyroid Association guidelines for detection of thyroid dysfunction. Arch Intern Med 2000;160:1573-5.  Back to cited text no. 4
5.Monzani F, Caraccio N, Siciliano G, Manca L, Murri L, Ferrannini E. Clinical and biochemical features of muscle dysfunction in subclinical hypothyroidism. J Clin Endocrinol Metab 1997;82:3315-8.  Back to cited text no. 5
6.Gillett M. Subclinical Hypothyroidism: Subclinical thyroid disease: Scientific Review and Guidelines for Diagnosis and Management. JAMA 2004;291:228-38.   Back to cited text no. 6
7.Bigos ST, Ridgway EC, Kourides IA, Maloof F. Spectrum of pituitary alterations with mild and severe thyroid impairment. J Clin Endocrinol Metab 1978;46:317-25.  Back to cited text no. 7
8.Sawin CT, Castelli WP, Hershman JM, McNamara P, Bacharach P. The aging thyroid: Thyroid deficiency in the Framingham study. Arch Intern Med 1985;145:1386-8.  Back to cited text no. 8
9.Canaris GJ, Manowitz NR, Mayor G, Ridgway EC. The Colorado thyroid disease prevalence study. Arch Intern Med 2000;160:526-34.  Back to cited text no. 9
10.Meltezer HY. Factors affecting creatine phosphokinase levels in the general population: The role of race, activity and age. Clin Chem Acta 1971;33:165-72.  Back to cited text no. 10
11.Rainsay I. Thyroid disease and muscle dysfunction. London: Heinemann Medical Books Ltd; 1974.  Back to cited text no. 11
12.Graig FA, Ross G. Serum Creatine-phoaphokinase in thyroid disease. Metabolism 1963;12;57-9.  Back to cited text no. 12
13.Griffiths PD. Creatine-phosphokinase levels in hypothyroidism. Lancet 1963;1:894.   Back to cited text no. 13
14.Aquaron R, Boeuf G, Codacciona JL. Serum creatinine in thyroid disorders. Ann Endocrinol 1971;32:142-56.  Back to cited text no. 14
15.Graig FA, Smith JC. Serum creatine phosphokinase activity in altered thyroid states. J Clin Endacrinol Metab 1965;25:723-31.  Back to cited text no. 15
16.Griffiths PD. Serum enzymes in diseases of the thyroid gland. J Clin Pathol 1965;18:660-3.  Back to cited text no. 16
17.Roti E, Bandini P, Robuschi G, Emanuele R, Bolognesi R, Ciarlini E, et al. Serum concentrations of myoglobin, creatine kinase, lactate dehydrogenase and cardiac isoenzymes in euthyroid, hypothyroid and hyperthyroid subjects. Ric Clin Lab 1980;10:609-17.  Back to cited text no. 17
18.Finsterer J. Stellberger C, Grossege C, Koroiss A. Hypothyroid Myopathy with unusually high serum creatine kinase. Hormone Res 1999;52:205-8.  Back to cited text no. 18
19.Giampietro O, Clerico A, Buzzigoli G, Del Chicca MG, Boni C, Carpi A. Detection of hypothyroid myopathy by measurements of various serum muscle markers - Myoglobin, creatine kinase, lactate dehydrogenase and their isoenzymes. Horm Res 1984;19:232-42.  Back to cited text no. 19
20.Monforte R, Fernández-Sola J, Casademont J, Vernet M, Grau JM, Urbano-Marquez A. Miopatia hipotiroidea: Estudio prospectivo clínico e histológico de 19 pacientes. Med Clin (Bare) 1990;95:126-9.  Back to cited text no. 20
21.Del Palacio A, Truea JL, Cabello A, Gutiérrez E, Moya I, Fernández Miranda C, et al. Miopatia hipotiroidea: Estudio clínico-patológico de 20 casos. Ann Med Intern (Madrid) 1990;7:115-9.  Back to cited text no. 21
22.Beyer IW, Karmali R, DeMeester-Mirkine N, Cogan E, Fuss MJ. Serum creatine kinase levels in overt and subclinical hypothyroidism. Thyroid 1998;8:1029-31.  Back to cited text no. 22
23.Soufir JC, Zbranca TE, Bernheim R, Perlemuter L, Hazard J. Assay of serum creatine phosphokinase in primary hypothyroidism: Comparison with other thyroid gland function tests in 32 cases: Values of isoenzyme study. Nouv Presse Med 1975;4:3055-9.  Back to cited text no. 23
24.Hartl E, Finstere J, Grossegger C, Kroiss A, Stöllberger C. Relationship between thyroid function and skeletal muscle involvement in subclinical and overt hypothyroidism. Endocrinologist 2001;11:217-21.  Back to cited text no. 24
25.Doran GB. Serum enzyme disturbances in thyrotoxicosis and myxoedema. JR Soc Med 1978;71:189-94.  Back to cited text no. 25
26.Staub JJ, Althaus BU, Engler H, Ryff AS, Trabucco P, Marquardt K, et al. Spectrum of subclinical and overt hypothyroidism: Effect on thyrotropin, prolactin and thyroid reserve, and metabolic impact on peripheral target tissues. Am J Med 1992;92:631-42.  Back to cited text no. 26
27.Hekimsoy Z, Oktem IK. Serum creatine kinase levels in overt and subclinical hypothyroidism. Endocr Res 2005;31:171-5.  Back to cited text no. 27
28.Duyff RF, Van den Bosch JV, Laman DM, van Loon BJ, Linssen WH. Neuromuscular findings in thyroid dysfunction: A prospective clinical and electrodiagnostic study. J Neurol Neurosurg Psychiatry 2000;68:750-5.  Back to cited text no. 28
29.Mace BE, Mallya RK, Staifurth JS. Severe myxoedema presenting with chrondrocalcinosis and polymyositis. JR Soc Med 1980;73:887-8.  Back to cited text no. 29
30.Klein I, Mantell P, Parker M, Levey GS. Resolution of abnormal muscle enzyme studies in hypothyroidism. Am J Med Sci 1980;279:159-62.  Back to cited text no. 30
31.O'Malley BP, Davies TJ, Rosenthal FD. Effects of rest, exercise and warming on serum creatine kinase levels in primary hypothyroidism. Clin Sci 1981;60:595-7.  Back to cited text no. 31
32.Karlsberg RP, Roberts B. Effect of altered thyroid function on plasma creatine kinase clearance in the dog. Am J Phyiol 1978;235:E614-8.  Back to cited text no. 32
33.Robinson JM, Wilkinson JH. Effect of energy-rich compounds on release of intracellular enzymes from human leukocytes and rat lymphocytes. Clin Chem 1974;20:1331-6.  Back to cited text no. 33
34.Robinson JM, Wilkinson JH, Johnson KP. Factors affecting the release of haemoglobin and enzymes from human erythrocytes. Ann Clin Biochem 1974;12:58-65.  Back to cited text no. 34
35.Khaleeli AA, Griffith DG, Edwards RH. The clinical presentation of hypothyroid myopathy and its relationship to abnormalities in structure and function of skeletal muscle. Clin Endocrinol 1983;19:365-76.  Back to cited text no. 35
36.Khaleeli AA, Edwards RH. Effect of treatment on skeletal muscle dysfunction in hypothyroidism. Clin Sci 1984;66:63-8.  Back to cited text no. 36
37.Myamoto T, Nagasak A, Kato K, Masunaga R, Kotake M, Kawabe T. Immunoreactive creatine kinase isoenzyme concentrations during treatment of hypothyroid patients. Eur J Clin Chem Clin Biochem 1994;32:578-93.  Back to cited text no. 37
38.Goldman J, Mats R, Mortimer R, Freeman R. High elevations of creatine phosphokinase in hypothyroidism. J Am Med Assoc 1977;238:325-6.  Back to cited text no. 38
39.Doran GR, Wilkinson JH. The origin of the elevated activities of creatine kinase and other enzymes in the sera of patients with myxoedema. Clin Chim Acta 1975;62:203-11.   Back to cited text no. 39
40.Goto I. Serum creatine phosphokinase isozymesin hypothyroidism, convulsion, myocardial infarction and other diseases. Clin Chirn Acta 1974;52:27-30.  Back to cited text no. 40
41.Griffiths D. Serum enzymes in diseases of the thyroid gland. J Gun Patliol 1965;18:660-3.  Back to cited text no. 41
42.Fleisher GA, McConahey WM, Pankow M. Serum creatine kinase, lactic dehydrogenase and glutamic-oxaloacetic transaminase in thyroid diseases and pregnancy. Mayo Clin Proc 1965;40:300-11.  Back to cited text no. 42
43.Strasberg GD. Hypothyroidism and Isozyme Elevations. Arch Intern Med 1984;144:1313.   Back to cited text no. 43
44.Tajiri J, Higashi K, Morita M, Sato T. Lactate dehydrogenase isozyme and hypothyroidism. Arch Intern Med 1985;145:1929-30.  Back to cited text no. 44
45.Klein I, Levey GS. Unusual manifestations of hypothyroidism. Arch Intern Med 1984;144:123-8.   Back to cited text no. 45
46.Strasberg GD. Lactate dehydrogenase isozyme. Arch Intern Med 1983;143:2023.  Back to cited text no. 46


  [Table 1], [Table 2], [Table 3]

This article has been cited by
1 The effects of long-term thyroxine administration on hematological, biochemical and immunological features in sterlet sturgeon (Acipenser ruthenus)
Hamed Abdollahpour,Bahram Falahatkar,Glen Van Der Kraak
Aquaculture. 2021; : 737065
[Pubmed] | [DOI]
2 Thyroid Dysfunction and Dysmetabolic Syndrome: The Need for Enhanced Thyrovigilance Strategies
Sanjay Kalra,Sameer Aggarwal,Deepak Khandelwal,Pawel Grzmil
International Journal of Endocrinology. 2021; 2021: 1
[Pubmed] | [DOI]
3 The theory of endobiogeny: biological modeling using downstream physiologic output as inference of upstream global system regulation
Kamyar M. Hedayat
Journal of Complexity in Health Sciences. 2020; 3(1): 1
[Pubmed] | [DOI]
4 The Biochemical and Clinical Perspectives of Lactate Dehydrogenase: An Enzyme of Active Metabolism
Amjad A. Khan,Khaled S. Allemailem,Fahad A. Alhumaydhi,Sivakumar J.T. Gowder,Arshad H. Rahmani
Endocrine, Metabolic & Immune Disorders - Drug Targets. 2020; 20(6): 855
[Pubmed] | [DOI]
5 Analysis of metabolomics profile in hypothyroid patients before and after thyroid hormone replacement
C. Piras,M. Pibiri,V. P. Leoni,A. Balsamo,L. Tronci,N. Arisci,S. Mariotti,L. Atzori
Journal of Endocrinological Investigation. 2020;
[Pubmed] | [DOI]
6 Survey analysis of exercise participation and skeletal muscle symptoms in women with hypothyroidism
Gena Guerin,Ryan Gordon,Emily Layne Zumbro,Ann Amuta,Anthony Duplanty
Women & Health. 2020; : 1
[Pubmed] | [DOI]
7 Study of Serum Creatine Kinase and Lactate Dehydrogenase to Assess Muscular Involvement in Hypothyroidism
Reena R,Manjula KS,Priyadarshini KS,Usha SMR,HV Shetty
Indian journal of Medical Biochemistry. 2019; 23(2): 273
[Pubmed] | [DOI]
8 Assessment of serum irisin level in thyroid disorder
Mohamed R. Halawa,Mona M. Abdelsalam,Bassem M. Mostafa,Amira G. Ahmed
The Egyptian Journal of Internal Medicine. 2018; 30(4): 197
[Pubmed] | [DOI]
9 Assessing the impact of oral iodine supplementation on whole body iodine store, thyroid autoimmunity and serum biochemistry profile in women of childbearing age
Daie Saideh,Nourooz-Zadeh Sarmad,Javnsdoust Gharehbagh Farid,Soltani Fatemeh,Nourooz-Zadeh Jaffar
Journal of Nutrition & Intermediary Metabolism. 2018;
[Pubmed] | [DOI]
10 The association between irisin and muscle metabolism in different thyroid disorders
Ariadna Zybek-Kocik,Nadia Sawicka-Gutaj,Ewelina Szczepanek-Parulska,Miroslaw Andrusiewicz,Joanna Waligórska-Stachura,Piotr Bialas,Tomasz Krauze,Przemyslaw Guzik,Jerzy Skrobisz,Marek Ruchala
Clinical Endocrinology. 2017;
[Pubmed] | [DOI]
11 Linear Analysis of Autonomic Activity and Its Correlation with Creatine Kinase-MB in Overt Thyroid Dysfunctions
Manisha Mavai,Yogendra Raj Singh,R. C. Gupta,Sandeep K. Mathur,Bharti Bhandari
Indian Journal of Clinical Biochemistry. 2017;
[Pubmed] | [DOI]
Rekha Nanjundasetty Hemavathi,Anilkumar Hanumanthaiah
Journal of Evolution of Medical and Dental Sciences. 2016; 5(35): 2053
[Pubmed] | [DOI]
13 Creatine kinase serum activity in feline hyperthyroidism
Mauro José Lahm Cardoso,Fabiano Séllos Costa,Luciane Holsback,Thais Helena Constantino Patelli,Maíra Melussi,Ademir Zacarias Júnior,Rafael Fagnani
Ciência Rural. 2014; 44(12): 2236
[Pubmed] | [DOI]
14 Low serum creatine kinase activity is associated with worse outcome in critically ill patients
Lot Van de Moortel,Marijn M. Speeckaert,Tom Fiers,Sandra Oeyen,Johan Decruyenaere,Joris Delanghe
Journal of Critical Care. 2014;
[Pubmed] | [DOI]
15 Serum irisin levels and thyroid function—Newly discovered association
Marek Ruchala,Ariadna Zybek,Ewelina Szczepanek-Parulska
Peptides. 2014; 60: 51
[Pubmed] | [DOI]
16 The a' subunit of ß-conglycinin and the A1–5 subunits of glycinin are not essential for many hypolipidemic actions of dietary soy proteins in rats
Qixuan Chen,Carla Wood,Christine Gagnon,Elroy R. Cober,Judith A. Frégeau-Reid,Stephen Gleddie,Chao Wu Xiao
European Journal of Nutrition. 2013;
[Pubmed] | [DOI]
17 Endobiogeny: A Global Approach to Systems Biology (Part 2 of 2)
Jean-Claude Lapraz,Kamyar M Hedayat,Patrice Pauly
Global Advances in Health and Medicine. 2013; 2(2): 32
[Pubmed] | [DOI]


    Similar in PUBMED
   Search Pubmed for
   Search in Google Scholar for
 Related articles
    Access Statistics
    Email Alert *
    Add to My List *
* Registration required (free)  

  In this article
    Materials and Me...
    Article Tables

 Article Access Statistics
    PDF Downloaded1303    
    Comments [Add]    
    Cited by others 17    

Recommend this journal