If the creatine kinase is over 5000, it is possible that rhabdomyolysis or myocardial injury may have occurred, or it may be due to the presence of myocarditis or acute myocardial infarction. In addition to creatine kinase, for further diagnosis, patients are advised to combine creatine kinase isoenzyme and troponin I, or troponin T. Creatine kinase isoenzyme and troponin are relatively more specific for the diagnosis of myocarditis and myocardial infarction. First of all, if the patient has only a simple elevation of creatine kinase and is not accompanied by an elevation of creatine kinase isoenzyme as well as troponin. Myocarditis, or acute myocardial infarction, is not considered at this time. Secondly, if creatine kinase is elevated along with a doubling of creatine kinase isoenzyme and troponin, this may be considered as acute myocardial infarction or myocarditis. People with hypothyroidism may also have a severe elevation of creatine kinase, especially in patients with severe hypothyroidism.