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Serum enzymes in hypothyroidism

J R Burnett1, M J Crooke, J W Delahunt

  • 1Division of Chemical Pathology, Wellington Hospital.

The New Zealand Medical Journal
|September 14, 1994
PubMed
Summary

Unexplained high serum enzyme levels, including creatine kinase (CK), aspartate aminotransferase (AST), and lactate dehydrogenase (LD), can indicate hypothyroidism. L-thyroxine (T4) replacement therapy rapidly normalized these enzyme levels in three patients.

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Area of Science:

  • Biochemistry
  • Endocrinology
  • Clinical Diagnostics

Background:

  • Serum enzyme elevations are common laboratory findings.
  • These elevations are often investigated for liver or cardiac dysfunction.
  • Non-organ-specific enzyme elevations can indicate systemic conditions.

Purpose of the Study:

  • To highlight hypothyroidism as a cause of unexplained elevated serum enzyme levels.
  • To present cases where hypothyroidism was diagnosed through elevated muscle enzymes.
  • To emphasize the importance of considering hypothyroidism in differential diagnoses.

Main Methods:

  • Retrospective review of three patients with unexplained elevated serum enzymes.
  • Analysis of serum creatine kinase (CK), aspartate aminotransferase (AST), and lactate dehydrogenase (LD) levels.
  • Monitoring enzyme levels before and after L-thyroxine (T4) replacement therapy.

Main Results:

  • Patients presented with markedly elevated CK (>2000 U/L), AST (>90 U/L), and LD (>300 U/L).
  • CK isoenzyme analysis indicated skeletal muscle origin.
  • Thyroid function tests confirmed primary hypothyroidism, and enzyme levels normalized with T4 therapy.

Conclusions:

  • Elevated serum muscle enzymes, particularly CK, can be a manifestation of hypothyroidism.
  • Hypothyroidism should be suspected in patients with persistent, unexplained elevations in serum muscle enzymes.
  • Serum enzymes are not always organ-specific and can reflect broader systemic dysfunction.

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