Elevated “CK” or Creatine Kinase Level?  In African Americans, This May NOT be a Problem

Creatine kinase (CK) is a chemical/enzyme that exists in human muscle cells, heart cells, and also small amounts can be found in brain cells. Body cells can release creatine kinase (CK) into your bloodstream when they’re damaged or related to normal cell recycling. Many Black men have been told by their doctors they have a substantially “elevated CK level.”   Most are perplexed by the high readings and unfortunately, many medical providers are at a loss when asked to explain the problem. 

What many medical providers don’t know is African Americans tend to have significantly higher baseline CK levels. Essentially, Black Americans can have dramatically higher CK blood levels with Black men having the highest levels.

Research Confirmed: Higher CK in Blacks

A large study done at Vanderbilt University revealed consistently higher CK levels in African Americans with substantially even higher levels in Black men.  Because CK is generally released from the muscle, many believed that the increased muscle mass seen in African American men explained the difference, but after further analysis, the muscle mass explanation didn’t explain the significant difference. 

Normally when you see elevated creatine kinase (CK) levels in the blood, it can be associated with strenuous exercise, excessive alcohol use, some medications, toxins/poisons, and particularly after a heart attack. CK levels are frequently drawn on patients when they go to the emergency department with chest pain presumed to be heart-related.  An elevated CK level in these situations can suggest heart muscle damage that can lead to a heart attack.

Some have seen the CK level be elevated in people taking statin medications. Others find that the elevated CK levels were associated with undiagnosed rheumatologic disorders (called idiopathic inflammatory myopathy).

Higher CK Normal Range in Black Men & Women

The important message is the significantly higher “normal range” for both African American men and women. The table below from research at the University of Pittsburg suggests these different parameters.  Essentially, if an African American man has no muscle aches and pains and a normal physical exam, their CK level can be as high as 1200 IU/L, which is twice as high as a White man.

Higher CK in Blacks
Moghadam-Kia S, Oddis CV, Aggarwal R. Approach to asymptomatic creatine kinase elevation. Cleve Clin J Med. 2016 Jan;83(1):37-42

In all humans, the creatinine kinase (CK) levels decrease with age and this decrease is likely related to loss of muscle mass consistent with aging.

The graph below shows the dramatically different range and distribution of CK levels by race/ethnicity with Black men and women being substantially higher than all other groups.

Higher CK in Blacks
George, Michael D. MDa,*; McGill, Neilia-Kay MDa; Baker, Joshua F. MD, MSCEa,b,c. Creatine kinase in the U.S. population: Impact of demographics, comorbidities, and body composition on the normal range. Medicine: August 2016 – Volume 95 – Issue 33 – p e4344 doi: 10.1097/MD.0000000000004344

The authors reported the following:

“The most notable factor that contributed to higher CK levels was Black race. Previous studies suggested that racial differences in CK may not be due to differences in height, weight, or body mass, but did not evaluate other body composition measures. This study evaluating BMI, waist circumference, and arm circumference, provides additional evidence that racial differences are not explained by differences in muscle mass. Higher CK levels among black individuals might instead be due to differential production or clearance of CK.”

George, Michael D. MDa,*; McGill, Neilia-Kay MDa; Baker, Joshua F. MD, MSCEa,b,c. Creatine kinase in the U.S. population: Impact of demographics, comorbidities, and body composition on the normal range. Medicine: August 2016 – Volume 95 – Issue 33 – p e4344 doi: 10.1097/MD.0000000000004344

High Creatine Kinase in Blacks

Essentially the authors suggest a fundamental difference in either the production of creatinine kinase or its destruction in African Americans . . . and the difference is significant!

The differences in creatinine kinase levels in African Americans have been known for over 40 years, but adjustments in the “normal range” used by laboratories have not been implemented.   When these so called lab “abnormalities” are seen, medical providers begin a range of investigations as well as suggest interventions to patients that imply that something is wrong or abnormal when in reality they simply seeing a normal variant.

Appropriate knowledge of these important differences in the care of African Americans can lead to improved care and much less worry on the part of the patient and provider.

African Americans Need to Walk More! More Daily Steps Tied to Better Overall Health

Regular exercise has always been associated with better health. Still, with newer smartphones, watches, and “wearables,” we can now measure more accurately how much walking and exercise we get in a day. Unfortunately, we in the Black community do not get near enough exercise or even simple walking.

A study done at Rutgers University showed that the percentage of Blacks achieving physical activity guidelines was low and continued to decrease further with age. The highest amount of exercise was seen in the youngest in our community and started to decrease steadily from age 15 to age 65 and beyond.

Single Black Men Exercise the Most

Black men of all ages exercised significantly more than Black women. The researchers attributed this difference in gender to several factors, including neighborhood safety, child-rearing responsibilities, concerns about personal appearance, and other cultural dynamics.  

Black men that were “never married” exercised more than “married men.” In contrast, women who were “married/living with a partner” exercised more than “never married” and “no longer married” women. Go figure that out!

Employment is Good for Your Health

Unsurprisingly, “employed” people were more physically active across all demographics. Arising in the morning with a purpose and the activities inherent in being employed is good for your health. Walking is a big part of being employed with steps being counted associated with parking, job duties, breaks, socialization, and more while at work.

Education & Money is Good for Your Health

Also not surprising was the data that showed higher education and income are associated with more exercise and better health.

Increasing Your Daily Steps is a Great Start!

A study published this week showed that getting 9800 steps in a day was associated with a dramatically lower risk for dementia and getting as low as 3800 steps still showed a 25% reduction in risk. Most smartphones have a “steps counter” that is free and already measuring your steps (whether you know it or not). Take a look and see where you stand (or step).

Let’s Get Started!

It’s time to start benefiting from health research and incorporating more exercise in the form of walking into our daily routine. Married men need to get off of the couch and represent! Black women of all ages and social engagement need to know that their mental and physical health depends on their activity level . . . and there should be no excuses.

Low Potassium and African Americans

Potassium doesn’t get enough credit as a very beneficial nutrient to good health and potassium deficiency (low potassium) has been directly related to high blood pressure, heart problems, diabetes, muscle weakness, fatigue and much more.

Multiple studies have confirmed that African Americans are much more likely to lack potassium and low potassium can be linked to higher blood pressures, diabetes and a number of other health problems that impact the Black community.

As much as high sodium (“salt”) can be a problem, low potassium can also be a problem . . . a big problem. Potassium is an essential mineral that has many functions in your body. For example, it is central to muscle contraction, it maintains healthy nerve function, and regulates water balance in your body. With all of those essential functions, it is a wonder that so many people, including African Americans are low in potassium. 

Curiously, low potassium has also been linked as a diabetes risk in African Americans. A large study at John Hopkins found that African Americans with lower potassium levels had a higher risk for diabetes.  The author said “”we now know lower serum potassium is an independent risk factor for diabetes and that African-Americans have, on average, lower potassium levels than whites.” 

Previous studies have also found that lower potassium was directly linked to higher blood sugar levels. The higher the blood sugar, the higher the risk for diabetes . . . and high blood pressure. Yet another study found that taking a potassium supplement directly lowered the blood pressure of Black patients. Lowering your blood pressure reduces your risk of heart disease and stroke.

The CDC says that increasing your potassium intake can reduce your risk of heart disease and stroke by lowering blood pressure. Conversely, consuming too little potassium (and too much sodium) can increase your risk of heart disease and stroke.

Foods that are rich in potassium include beans, leafy green vegetables (greens, spinach, etc.), potatoes, sweet potatoes, yams, squash, beets, broccoli, and bananas.

Low Potassium, African Americans

It is important to note that salt-substitutes are generally swapping potassium for sodium so using them in moderation can also be a benefit.

Always check with your doctor before changing your potassium intake because people with kidney problems, heart problems, or take certain medications may make things worse if their body has trouble processing the increased potassium. People on dialysis or have poor kidney function, for example, have to be vigilant about not getting too much potassium (as well as protein and sodium), and are frequent prescribed a low potassium diet.

Sequence Multivitamins for African Americans were formulated to replace science-confirmed vitamin and mineral deficiencies seen in our community . . . AND has added POTASSIUM.

Low Potassium, African Americans

Vitamin D Deficiency is Associated with Stroke Risk in African Americans

Recent studies have found a correlation between vitamin D deficiency and stroke risk as well as stroke severity. A study just published found that people with the highest vitamin D levels had fewer strokes and if they had a stroke, it was less severe.  People with low vitamin D levels had more strokes with more severe symptoms. 

As you know, we get most of our vitamin D from the sun, but urban living, colder/cloudy weather, and lactose intolerance (so we can’t drink “Vitamin D Milk”) have all resulted in wide-spread African American vitamin D deficiency.

African Americans Have Low Vitamin D Levels

Four of five African Americans have low levels of vitamin D, and we also have the highest rates of heart attack, stroke, and circulation problems. Risk factors for low vitamin D levels include older age, darker complexion, obesity, and limited sun exposure.

Studies have shown that hemorrhagic stroke patients (those strokes caused by a bleed rather than a blood clot) often suffer from low vitamin D levels. Another study suggested that putting stroke victims on vitamin D helped their recovery somewhat.

Biologically, vitamin D reduces total cholesterol and fat in blood as well as improves inflammation which helps your blood vessels stay healthy.

A Direct Effect Has Not Been Shown

To be clear, there has yet to be a study that showed taking a vitamin D supplement led to fewer strokes. These research studies are only able to find correlations and from these associations, they “suppose” that raising your vitamin D level will lead to better health.  Some researchers believe that poor health leads to low vitamin D levels and that is the reason sicker people have low vitamin D. 

Vitamin D levels have been positively associated with improved cardiovascular health, especially with reduction of stroke risk. Until the controversy is settled, everyone agrees that leaving a low vitamin D alone is not a reasonable option. 

Vitamin D is best increased through natural means . . .  sun exposure, a healthy diet, etc. Foods high in vitamin D include salmon, herring/sardines, cod liver oil, tuna, mushrooms, and fortified beverages (milk, orange juice, and cereal).

Good Vitamin D Levels Help in COVID Patients

Another study looked at COVID patients and vitamin D deficiency and found COVD illness directly related to vitamin D level.  COVID-19 is greatly associated with increased stroke and heart attacks so having a normal vitamin D level was somewhat protective against severe COVID disease.  Obviously the absolute best way to avoid COVID-19 is through getting an approved vaccination.

Sequence Multivitamins for African Americans have a science-based formula to best replace deficiencies in the Black community. Go to SequenceVitamin.com for more information on the multivitamin that is best for you.

Multivitamins May Help African Americans Avoid Alzheimer’s Dementia

A new study is showing benefit from taking a multivitamin once a day in slowing the progression of dementia in older individuals.  It has long been known that vitamin D deficiency is directly linked to Alzheimer’s Dementia and African Americans have the highest rate of vitamin D deficiency as well as Alzheimer’s Disease and some have called it a “silent epidemic.”

Research suggests that Alzheimer’s disease may be two to three times higher in older African Americans when compared to Whites. Studies also show that the disease progresses much more slowly in African Americans and people with it live significantly longer.  These curious facts lead doctors to think that the cause for the mental decline may be different.

Alzheimer’s occurs in African Americans at a comparatively younger age and robs too many older adults of their independence, dignity, and resources.  It has been linked to hypertension (high blood pressure), depression, diabetes, smoking, and some genetic factors.  In fact, the risk for Alzheimer’s Disease is 44 percent higher if you have a close relative with dementia.

There are also studies that show a higher consumption of fruits and vegetables, taking cholesterol-lowering medicine, and high social engagement may help ward off dementia.  A Mayo Clinic article addresses the connection between vitamin deficiency and dementia and given the widespread deficiencies we see in the Black community, there is certainly no harm in taking the right amount of vitamin D. 

The article also outlines that the National Institutes of Health recommends adults age 70 and younger need 600 international units (IU) of vitamin D daily, and adults over age 70 need 800 IU daily.  These recommendations are too low for African Americans who need much higher doses to achieve normal vitamin D levels.

Sequence Multivitamins for African Americans contains a much higher amount of vitamin D more closely aligned with what the Black community needs. Sequence also replaces deficiencies in vitamin C, potassium, magnesium and zinc that are widespread in the Black community.  Go to SequenceVitamin.com or purchase the multivitamin for men over 50 at Amazon or the women over 50 on Amazon here.