When a doctor tells you to check your "Enzyme Markers," you probably have a few questions in mind, right? "What are these enzymes?", "Why are they being checked?" Questions like that. Don't worry, it's very simple. Let's learn more about this today, just like talking to a friend.
So what are these enzyme markers?
Simply put, Enzyme Markers are a blood test that measures the levels of certain enzymes in your blood. These enzymes are usually found inside the cells of our bodies. However, when an organ in our body, such as the liver, heart, or muscles, is damaged, diseased, or injured, some of these enzymes leak from those damaged cells into the blood. It's like water leaking from a broken bottle.
Then, with this blood test, the doctor can see if the level of this enzyme in your blood is higher or lower than normal. Doctors sometimes call these "biomarkers." That is, a biological sign of a certain disease. This can give the doctor a clue as to whether there is something wrong inside your body.
Okay, so what are these "enzymes"?
We just talked about "enzyme markers." So what are these "enzymes"? Think of enzymes as proteins that are like little workers in our bodies. They help with other chemical processes in our bodies, and they speed up our metabolism. It's like someone who helps us digest food faster.
There are thousands of different enzymes in our bodies, each of which does a specific job. Here are a few examples:
- In the circulatory system: Helps with blood clotting.
- Digestive system: Helps digest the food we eat.
- Musculoskeletal system: Muscles help with function and movement.
- Nervous system: Helps the function of the brain, spinal cord, and nerves.
- Respiratory system: Helps with the breathing process.
- Urinary system: Helps remove waste from the body.
You see, enzymes play such an important role in our bodies!
Who needs this enzyme marker test?
There are a number of reasons why a doctor might order this test. The main ones are:
- Screenings: Sometimes, when you go for a routine physical examination, this test can be done to check for any internal problems, organ damage, or muscle fatigue, even if you don't have any symptoms.
- Diagnosis: If you have any symptoms, this test can help determine whether the cause is a specific disease or a heart problem.
- Monitoring the success of treatment: If you are taking medication for a certain disease, these enzyme tests are also done to see if the medication is working properly or if it is causing damage to another organ.
What types of enzyme marker tests are there?
Doctors use various enzyme marker tests to diagnose different diseases and their status. Here are some of the main types:
- Cardiac enzyme test: This checks for damage to the heart muscle.
- Creatinine phosphokinase (CPK) isoenzymes test: This tests for enzymes like `(CK-MB)` and `(CK-MM)`. This can also detect damage to the muscles, especially the heart and other muscles.
- Liver enzyme test: This test measures enzymes such as `(ALT)`, `(AST)`, `(Alkaline phosphatase)`, `(GGT)`, and `(5'-NT)` to get an idea of the condition of the liver.
Let's now look at each of these types in a little more detail.
What is a Cardiac Enzyme Test?
This is often done when a heart attack is suspected, or to check if the heart muscle has been damaged by another heart condition. It is also done to check how the heart is functioning after certain heart surgeries, such as coronary artery bypass grafting (CABG) or angioplasty.
When something is damaged in the heart, the heart releases a protein called troponin (cTn) and an enzyme called creatine phosphokinase (CPK) into the blood. In the past, the level of creatine phosphokinase (CPK) was the main test used to diagnose a heart attack. But now, if you suspect you may have a heart attack, doctors often do a troponin test to confirm the diagnosis. This is because the troponin enzyme is only found in the heart. That's why it's very specific.
Troponin levels in the blood can begin to rise within 12 hours of a heart attack. Elevated CPK levels can also indicate a condition called coronary artery disease, which is a blockage in the arteries that supply blood to the heart.
Normally, troponin levels in the blood are very low – about 0.02 nanograms per milliliter (0.02 ng/mL). Elevated levels of this cardiac enzyme in the blood mean that a heart attack is possible. The higher the value, the more damage has occurred to the heart.
Because enzyme levels change during a heart attack, your doctor may order several tests to measure your CPK and troponin levels every few hours.
Your doctor may order a cardiac enzyme test if you have any of these symptoms:
- Chest pain
- Dizziness
- Nausea
- Excessive sweating (Profuse sweating / Hyperhidrosis)
- Shortness of breath / Dyspnea
What is the CPK Isoenzymes Test?
This test looks for elevated levels of `(CPK)`. This indicates that tissue damage has occurred. When our muscles (including the heart muscle), brain, and lungs are damaged by disease or injury, these `(CPK)` isoenzymes are released into the blood. Isoenzymes are types of enzymes that are specific to certain organs or tissues.
For example:
- The heart-specific `(CK)` is `CK-MB` .
- The specific `(CK)` for skeletal muscles (such as the muscles of the arms) is `CK-MM` .
- Simply saying `(CK)` is the total amount of `(CK)` coming from all these places.
Depending on your symptoms, diagnosis, or risk factors, your doctor may order this (CPK) isoenzyme test to check for conditions such as:
- Heart attack
- Stroke
- Brain tumor
- Muscular dystrophy (a disease that weakens muscles)
- Dermatomyositis (a disease of the skin and muscles)
- Inclusion body myositis (a disease that causes muscle weakness)
- Polymyositis (a muscle disease)
- Malignant hyperthermia (a condition in which a person develops a high fever in response to anesthesia during surgery)
What is a Liver Enzyme Test?
When our liver is damaged by some disease or injury, the liver releases various enzymes into the blood. Two of the most well-known of these enzymes are alanine aminotransferase (ALT) and aspartate aminotransferase (AST). The enzyme ALT is mainly produced in the liver. Aspartate aminotransferase (AST) is produced in the liver, heart, kidneys, brain, and muscles.
A liver enzyme test looks for elevated levels of these enzymes. If they are elevated, it could be due to a condition such as:
- Blocked bile duct
- Celiac disease (an allergy to gluten)
- Cirrhosis of the liver
- Fatty liver disease or alcohol-related liver disease
- Hemochromatosis (excess iron in the blood)
- Hepatitis A, hepatitis B and hepatitis C
- Liver cancer
- Mononucleosis (a disease that causes swollen glands)
- Wilson disease (excessive copper deposition in the bone)
Remember, elevated enzyme levels alone do not necessarily mean you have a disease. Your doctor will compare these with your symptoms and other test results to reach a conclusion.
How should I prepare for an enzyme marker test?
If you're going to have a blood test, keeping these few things in mind can make the process easier:
- Drink plenty of water: Drink plenty of water before donating blood. This will help the blood flow through the veins better, making it easier to collect blood.
- Avoid nicotine: If you smoke (including vaping), avoid it before donating blood. Nicotine causes blood vessels to constrict, making it difficult to draw blood from a constricted vein.
- Tell us if you are afraid: If you have a fear of needles (Trypanophobia) or a fear of seeing blood (Hemophobia), tell your doctor or the person who is drawing your blood beforehand. They can help you make the process of drawing blood more comfortable.
Do I need to fast before an enzyme marker test?
Your doctor will tell you whether you need to fast (except for water). In most cases, you don't need to. Especially since cardiac enzyme tests are done in an emergency, like a heart attack, you won't be expected to fast during that time.
What happens when an enzyme marker test is done?
This is just a very simple blood test. Depending on your situation, this test can be done in a doctor's office, a blood testing lab, or a hospital. A phlebotomist (a person specially trained to draw blood) or another healthcare professional will draw your blood. This process only takes a few minutes.
What should I expect after an enzyme marker test?
It's best to keep the plaster on the site of the blood draw for about two to four hours to reduce the risk of infection. The area where the needle was inserted may be slightly swollen and bruised. This will go away in a few days.
You can reduce bruising or discomfort by doing these things:
- Wrap an ice pack in a piece of cloth and place it on top of the plaster.
- Take an over-the-counter pain reliever.
- Do not lift weights or do strenuous exercise for 24 hours after donating blood.
What are the risks of an enzyme marker test?
Blood tests are relatively low-risk procedures. Some people may experience low blood pressure (hypotension) when they have blood drawn. This can make you feel dizzy or nauseous. If you feel unwell or faint, tell your doctor or the person taking the blood immediately. They can help you by making you lie down or doing other things.
When will I receive the test results?
In an emergency, for example if a heart attack is suspected, the results are available very quickly. Otherwise, it may take several days for the doctor to receive the results from the lab.
Your doctor will discuss the results with you. You may need to have more tests to either diagnose a specific problem or to make sure there is no problem. Depending on the nature of the problem, you may have several enzyme marker tests over a period of hours or days.
What should I ask my doctor?
You can ask the doctor questions like these:
- Why do I need to do this enzyme marker test?
- Do I need to fast, stop smoking, or stop taking medications before the test?
- When will I receive the test results?
- Should I be worried about the test results?
- Will I have to do more tests?
- How often will I need to have this enzyme marker test?
Finally, what to remember (Take-Home Message)
An enzyme marker test is a test that provides important information about the function of our organs, the status of diseases, and treatment. If you have certain symptoms, a doctor may order this test to diagnose a disease or to confirm that there is no such disease.
A cardiac enzyme test assesses the damage to the heart after a heart attack. A phosphokinase (CPK) test looks for muscle-related diseases. A liver enzyme test assesses liver function. Ask your doctor any questions or concerns you may have about this test or its results. Don't worry, your doctor is there to help you.
` Enzymes, enzyme tests, blood tests, heart disease, liver disease, muscle disease, diagnosis
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