What Are the Causes of Elevated Muscle Enzymes?

According to the Muscular Dystrophy Association, elevated muscle enzymes are often seen, but the cause is often difficult to determine. Measuring muscle enzymes does not lead to a diagnosis, but it can help provide clues. Blood tests will be used to measure muscle enzymes so that the doctor can try to determine the cause of elevated muscle enzymes.

Enzyme Types

There are certain muscle enzymes that are often measured when a liver enzyme elevation is suspected. Doctors will draw blood to measure the level of ALT and AST. If these are elevated it often indicates that they are leaking from from a damaged muscle, or muscles, often indicating a neuromuscular disorder (a disorder that affects the nervous system and the muscles). According to the Muscular Dystrophy Association, doctors also often check the levels of creatine kinase, another muscle enzyme that is found in the skeletal muscles, heart and brain.


Certain types of hepatitis (viral infection that affects the liver), A, B and C, can cause elevated muscle enzymes. Autoimmune hepatitis and alcoholic hepatitis can also cause this condition. Several other medical conditions can also cause elevated muscle enzymes. According to Uptodate, these include hypothyroidism, cirrhosis, hemochromatosis, celiac disease, muscular dystrophy, cytomegalovirus, mononucleosis, liver cancer, Epstein-Barr Virus, liver cancer, an inflamed gallbladder, dermatomyositis and heart attack.

Other Causes

Trauma, medications, drugs and obesity can also cause elevated muscle enzymes. According to Uptodate, the medications that cause this condition include colchicine, nondepolarizing muscle relaxers with high doses of corticosteroids, antimalarials, niacin, penicillamine, fibrates, zidovudine and statins. Drugs that can cause elevated liver enzymes include cocaine and alcohol, particularly when they are abused.


Testing patients for elevated muscle enzymes helps doctors determine the cause and can help to evaluate muscle pain, weakness and inflammation. According to iVillage, testing can also be beneficial when monitoring how a patient is responding to therapy for certain diseases. Muscle enzyme tests are used to check the blood levels of muscle enzymes, particularly specific muscle enzymes.


According to iVillage, elevated muscle enzymes often indicate muscle tissue damage. This damage can be in one area of the body or in several areas. However, having elevated muscle enzymes does not always mean the patient is suffering from a disease or condition. Physical exertion can also cause muscle enzymes to be elevated. The doctor will use these results to aid in making a diagnosis.