My liver test results have been creeping up. Any else having their AST (SGOT) and ALT (SGPT) going up. I know these two test can relate to inflammation and muscle issues, but that is all I know about them.
My last AST was 46 and the ALT was 63.
Any input???
Those are still normal numbers. Norms are established by an entire population but interestingly, Men have higher numbers than women. Have never understood WHY they don’t have norms for each. That aside if they have been creeping up and not dropped during your routine blood work, its certainly something to watch. I’m sorry I don’t remeber what your med regime is, but if it were me I’d compare your numbers to when you take your meds. They will be higher right after you have taken meds and they can also be higher right before you take your meds if yur meds are pooping out some (or a lot) before you are due because as you noted they can be related to inflammaion. Converslet as some med are handled by your liver.kidneys those numbers will go up shortly after you have take them. If they are consistently high and you are taking MTX, a slight reduction will snap them to attention with out much effect to you. I just reduced for example from 1 mg/week MTX to .8mg/week because I was getting a bit anemic.
My liver is a little beat up from years of antidepressants and such. I took Serzone for years and it is hard on the liver. Finally switched off the serzone to remeron. Rheumy thinks those numbers are far enough out that he doesn’t want to try me on MTX.
I am on Humira EW.
when i was very sick in first few years mine got up over 200 each. I wasn’t allowed to take anti inflammatories anymore. I had to suffer with nothing. Over time once I started Stelara they went to normal along with sed rate. It can happen to us if the disease goes unchecked. Watch your diet and limit nsaids. Most doctors do not know they can cause liver damage, they think only kidney. If your goes up too high, it can mean your disease needs more addressing. Your are still reasonable. Just keep an eye with regular bloodwork.
Very true. What is scary is the fact the most Side effects that severely effect quality of life from medications PsA patients take aren’t Biologics or even MTX but are in fact NSAID’s. The safe alternative many of us are pointed to is acetaminophen (tylenol) which singularly causes even more damage to the population at large than do opiods. The single MOST dangerous medication to everyone is another OTC -Dextromethorphan (Delsym 12 hour, Robafen Cough, Robitussin Pediatric, Tussin Maximum Strength Cough, Cough DM ER, 12-Hour Cough Relief, Tussin Cough (DM only), Scot-Tussin Diabetes CF, Wal-Tussin Cough, Vicks DayQuil Cough) We tend to think that if its OTC its okay. NOTHING could be further from the truth.
what’s up with dextro? I take nyquil once in a while.
I had problems with my liver enzymes (ALT/AST) going up mildly a few times last year. I also have had a couple of kidney functions come back low which my Rheumy said was not related to the Methotrexate. My mtx was lowered after the first time, liver enzymes went back to normal. When they went up again after a couple of months at the reduced dose, I decided to discontinue the mtx as I also had several days a week of feeling pretty bad from it. My Rheumy was not happy about the decision, and told me to follow up with my regular doctor on the kidney function and call her if I decided to go back on the medication.
I had been taking nsaids (Aleve) for years prior to the Mtx, and wonder if that may have contributed to my enzymes creeping up as well. I know that mildly elevated enzymes aren’t supposed to be an issue, but I really don’t want to take a chance on blowing out my liver.
She said I can’t have the biologics because I had a melanoma diagnosis last October, and I have to wait until I’m clear 5 years. That limits the medications I can take, so I’m not on anything at the moment. For now, I’m feeling better without the Mtx, and at least have energy to do things again, albeit with a bit of discomfort. I use a cream called Penetrex to help with the stiffness and pain along with a bit of cbd oil and that’s about it.
Occasional use at recommended levels is not a problem. Mix even that with alcohol and bad things can happen. Its often been called the Poor mans PcP if you take much more than the recommended amount. Like any OTC medication risks are low if used occasionaly ANY medication can be a problem long term
I take very limited amounts of NSAIDs, minus the LD aspirin I have to take. I have started to occasionally ( one or two times a week) take the new Tylenol/Advil mix.
Doc has said my years of anti-depressants started my liver downhill. I understand they are hard on the liver and kidneys. I limit my intake of Tylenol anyway because of what it does to the body.
I’m like you. Liver numbers up some, kidney numbers down some.
It seems like such a fine balance we walk with the medications out there. There is a lot of knowledge about them, but there is also a lot that is not known yet and it’s hard to know what the best solution is. I am probably too much of a minimal medication person, but also value the life-saving and quality of life aspects of them. It’s such a personal decision for each of us I think.
Gotcha. Thanks!
@tntlamb I was under the impression that Tylenol being a common source of medical problems is partially due to how available it is and is the most common med used (and one of the worst) to commit suicide via over dose. That puts the stats way up. We have a family member who has been an ER doctor for 30 years and acetaminophen OD is a horrible way to go and very common amongst young people. Also, we might all have differing thoughts on what is long term, occasional, low dose long term, high dose short term…so many language variables! I have been told to reach for acetaminophen 1000mg with a cup of coffee for pain relief instead of Celebrex whenever possible…and it works well for me! (occasionally)
In June 2009, an FDA advisory committee recommended elimination of prescription acetaminophen combination products because of the risk of hepatotoxicity associated with use of these medications It was often mixed with opiods. Funny thing happend after forks started complaining that their pain meds weren’t working. Aspirin once the darling of medications is rarely used anymore. In fact IF it were up for approval today most experts agree if in the unlikely event it were approved, it would be a class III prescription medication. Time changes a lot. ever hear of Darvon anymore. There is not a much gruesome death than suicide by Tylenol. BUT things changed in 2011.The maximum recommended dose for adults was lowered to 3,000 mg per day. This means 3 doses (6 pills) of extra strength or 4 1/2 doses (9 pills) of regular strength. Liver failure and deaths have been reported with doses of just a few extra pills. 4000 mg is considered VERY Dangerous especially over any length of time Prior to that 4000 mg was fine and dandy.
My Grandpa (the first registered Pharmacist in Montana back in 1910 would LOVE your doc. He patented a new medicine that was going to be Revolutionary. ANACIN. and you know for a time it was. Then along came Excedrin…
My last joint replacement I received ZERO narcotic Pain Meds. What I did get was IV Tylenol oh and after signing an AMA waiver i did get two doses of Torodol after PT “Choose Wisley” as to when was the advice. Not so long ago we had a lady here who had a prescription to self inject Torodol as often as Daily (I understand she has since passed with Kidney failure (blamed on Diabetes)
The problem as I see it is that a number of meds that were once Prescription (Ibuprofen and naproxen come to mind) eventually make it to the OTC market. Granted the DOSAGE they recommend is usually Half prescription strength. Experience Patients (like us)Know that and take extra (like you with tylenol) but many are lulled into the belief long term is okay because its OTC.
Predi is another one DosePaks (tapers) have been replaced by many ad growing number of Docs with 3 Day bursts. And may others have replaced Bursts with alternating patterns of low dose (5 - 7.5 mg daily)
Reference range for those tests are in the region of 50-55 from memory so don’t think yours are all that bad tbh.
I had a discussion with my GP about mine before when sometimes they would slightly go above the reference range and go reassure me he said when he sees patients with nasty conditions like liver cirrhosis etc, those values can be in the thousands so little bit of context can help 
Also worth remembering reference range is effectively an average so don’t be too concerned, just do what you can to help keep them low.
Several rheumatological conditions such as PSa increase your chances of metabolic disorders like diabetes and fatty liver. My GP also said conditions like fatty liver are very prevalent and a good proportion of the population will have elevated liver enzymes because of conditions like that. We just find out about them not often because of incidental findings through routine monitoring etc.
I remember mine being up at around 74 at one point. I told the GP I was concerned, and she said that they don’t get concerned until it’s in three figures - and normally over 200 at that. And they do tend to go up and down like a yo-yo, for no obvious reason. Mine was close to 60 just before Christmas, but down at 30 or so in February. I wasn’t worried at 60, but if you take a look at your regular blood tests, most things go up and down quite regularly - even the time of day makes a difference to some of the tests (although not liver, to my knowledge).