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New bodybuilding record: creatine kinase level of one and a half million

Researchers at Columbia University in New York have measured the highest level of the enzyme creatine kinase (CK) ever found in an athlete, in a 25 year-old bodybuilder. The blood of the bodybuilder had a creatine kinase level of over one and a half million units per liter.

Creatine kinase [3D structure below] is the enzyme that creatine "recharges". The enzyme does a useful job, but doctors use the concentration of the enzyme in the blood as an indicator of muscle damage. If there are high concentrations of the enzyme in the blood, it means there are torn muscle tissues in the body, and they will leak their contents into the bloodstream.

New bodybuilding record: creatine kinase level of one and a half million
That the muscle tissue has torn is not such a problem, but the content of the muscle tissue can be a problem, especially the muscle protein myoglobin as it is poisonous to the kidneys. This is why rhabdomyolysis, the official name for the rapid breakdown of muscle tissue, can be fatal.

Doctors usually only encounter rhabdomyolysis in cases of strange poisoning, disasters or bombings where victims incur muscle damage as a result of explosions, buildings collapsing or being exposed to aggressive molecules. But a growing number of cases are occurring in the sports world, in particular marathon runners, triathletes, weightlifters or bodybuilders who have stretched their bodies beyond the limit. The concentration of creatine kinase, which is normally well below a thousand units per liter, can rise to 10,000 or even as high as 300,000 units per liter according to the literature.

And now we know, it can be as high as one and a half million units.

The bodybuilder with the extremely high creatine kinase level had admitted himself to the Accidents and Emergencies department after noticing his urine was dark and his left leg had swollen up. Two days before the man had trained his legs – and he'd done a heavy training. It was the first he'd done in six months because he was recovering from an operation on his left knee.

New bodybuilding record: creatine kinase level of one and a half million
Left you see some of the results of the man’s blood test. In the first blood test the man's CK level was 1,454,952. Four hours later it was 1,423,878. The doctors got the man to drink a lot and put him on a saline solution drip. Twelve hours later his CK had gone down to 321,244. On days 2, 3 and 5 his level went down further to 288,148, 191,196 and 52,476 respectively. At that point the doctors discharged the bodybuilder from hospital. In the days following his CK fell further.

As far as the doctors could tell, the bodybuilder was not using any substances – no drugs and no supplements. The only cause for his symptoms that they could think of was over-training.

If muscles haven't worked for a while they are more susceptible to muscle damage. If you start training slowly, and don't build up too fast you give your muscles a chance to make anticatabolic enzymes. These protect your muscles when you start training with heavy weights again.

Cases J. 2008 Sep 20;1(1):173.