Rhabdomyolysis is a condition that certainly threatens health and is often associated with hospitalization. It can be caused by intense physical effort, but not only. A marker of rhabdomyolysis is the level of CPK or enzyme (creatine kinase CK or CPK) occurring mainly in muscles, heart and brain. 

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An elevated CPK level indicates muscle damage. Normal value is 55-170 j / L for men and 30-135 j / L for women. Muscle disintegration usually occurs after road or industrial accidents (mechanical damage, crushing), poisoning with drugs. It may be due to the use of excess alcohol, cocaine, heroin, amphetamine, hyperthermia and burns, hypothermia and frostbite limb. Few people realize that carelessly overused medicines, eg from the group of non-steroidal anti-inflammatory drugs (NSAIDs) can be dangerous to health, sometimes even for life (effect on the kidneys). 


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Case report A 45-year-old male complained of fatigue and extensive body ache. He was diagnosed with acute decay of striated muscles. Symptoms began on the fourth day of the simultaneous use of diclofenac and pantoprazole. The patient used diclofenac 50 mg tablets once a day for 1 month and pantoprazole 40 mg once a day (only the previous week). Diclofenac sodium was used for headaches and pantoprazole for heartburn. As a result of drug administration, the concentration of creatine kinase increased to 3114 IU / L (some give the limit of 170, and 190 units per liter). 

Do bodybuilders and other athletes reach for diclofenac sodium? Of course. For example, the use of drugs in football has been monitored since the 2002 FIFA World Cup. Physicians employed in football teams were asked to provide information on prescribed medicines for each player 72 hours before each match. 69% of adult male players reported the use of drugs, with more than half of the players using non-steroidal anti-inflammatory drugs (NSAIDs). 43.3% of young footballers (teenagers) and 54.5% of adult men used NSAIDs at least once in the course of the game. In popular events such as Marathon in Bonn 2009, Marathon in Berlin in 2010 and Ultramarathon El Andalus from 47 to 61% of athletes used NSAIDs or other painkillers. 

Bodybuilders may suffer from heartburn due to the use of oral SAA, e.g. anapolon, winstrol or oral-turinabol, and a specific high-protein diet (usually based on white and red meat). It has been shown that a large intake of fresh red meat is more than tripling the risk of esophageal adenocarcinoma. People who consumed the most processed meat were exposed to 4.67 times higher risk of oesophagitis caused by abnormal regression of acid gastric contents into the esophagus. In combating heartburn, it is important to eliminate from the diet products that increase the symptoms of the disease, such as coffee, tea, alcohol, chocolate, carbonated drinks, fatty and spicy foods. 

The conclusion should be taken with caution when reaching for NSAIDs and funds for heartburn. This combination can damage the muscles and damage the kidneys. 


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