Can you all weigh in here please? Liver Enzymes

mmm5

Hi all-

Just wanted to put this question out for all. I am 6 months done with chemo, 1 more Herceptin treatment left. I know there are many conversations about LE's but wanted to get an opinion.

 Ever since I went on the AI's and Clodranate (pill form of Zometa, am in the Bisphos trial) I have had elevated enzymes. Not high at all Normal is under 40 (alt) and I hovered around 44. 2 weeks ago I was in for blood work and they had risen to 78! My Onc was not concerned and told me not to take Melatonin and not have a glass of wine before coming. Had them done again yesterday and had dropped back down to 48 but still above normal. The dropping seems to indicate not to worry about Liver Mets but am still worried about liver, any suggestions, insight, or comments would be greatly appreciated. Is carrying around a 48 ALT going to harm my liver long term? And, Do you all have elevated ALT's more from Bisphos, AI's (i am on Femara) or Herceptin. I am guessing it is a combo of all 3.

What about liver mets, would they drop back down if it was a met?

TenderIsOurMight

I had mild elevations of my ALT during the first year during and post chemo, mmm5. One time they'd be up slightly, then not the next. We checked quite carefully for a source but did not isolate one (although I have chronic right upper quadrant pain which I think may cause some elevation from time to time).

A pattern is what is looked for, and one with a tendency of rising. Like your doctor said, cutting back on supplements and wine is wise to just rid your system of extra agents. Many non-cancer patients have transient elevations of the liver enzymes, and there is a protocol or workup if they persist which your oncologist will know.

After a year or so, my LFT's stayed in the normal range. I try to stay away from fat in my diet, keep my cholesterol normal by diet and a Lipitor. Fatty liver is very common and can be asymptomatic: just results from poor metabolism of one's fat, added to a genetic predisposition of elevated triglycerides and cholesterol. But it too can raise LFT's.

Can't tell you about liver mets. Perhaps someone else will stroll by.

Hope this helps a little and that you get some reassurance and rest. It's a struggle when these blood levels raise their head some. 

Best,

Tender 

weety

This is an old post, but I'm bringing it up again since I'm having a liver enzyme problem as well.  (mmm5, why doesn't it surprise me that I found one of your posts that relates to my situation again!)   

My ALT started out pretty much on the low normal side (17) before chemo and only went up to 20 during chemo.  The problem is, is it still going up!  It was 20 a  couple months after finishing chemo, then 2 months later 22 and now today (after another month) its up to 26.  It's not the number I'm so worried about (anything under about 50 is still normal)--it's the upward trend that is making me nervous.  I'm still on hercepitn.  Does anyone know if herceptin can cause ALT to become elevated?  I haven't had any alcoholic drinks or any other known liver stressor that I can think of.  Ladies, any insights??

Just when I thought I was having a couple months of "smooth sailing" this showed up. . . I swear, if it's not one thing, it's another. . . SIGH. . .

mmm5

You know I have been through this many times. Even as recently as 3 months ago mine had gone up to 48 I freaked. However I went off all meds for 3 days and retested and it went back to normal. I went off my hormone meds, I was also on lexapro as well. Your liver works hard on Herceptin, if you even have an advil the night before it will make the liver respond with higher enzymes, you are totally in normal range and on meds so don't worry!

weety

Thanks mmm5 for seeing my post and replying.  I guess I wouldn't be so worried if the numbers were bouncing around--it's the consistent climbing that has me nervous.  Why would my liver enzymes be goiing up now during herceptin only, but during chemo they were stayed pretty consistent?  I did start taking femara and zoloft, but just a couple weeks ago.  That doesn't explain why the numbers started going up in the first place.  I don't take ipuprofen anymore--I try to use aspirin if I have any aches or pains now, because of those studies that came out about aspirin and recurrence decrease.  So, I'm not sure what it could be.

mmm5

its all the drugs ..trust me!

When you have them retested they will probably continue to climb with the zoloft and Femara mine sure did! 

rhonda35

I was on herceptin and all   the other stuff.......I HAD VERY HIGH ENZYMES UNTIL I HAD TO STOP MY TAXOL...AND IT WAS AII DUE TO THE STEROIDS I TOOK WITH THE CHEMO...I STILL HAVE HIGH ENZYMES TODAY BECAUSE MY LIVER BECAME FATTY AND I AM 4 YEARS OUT...ITS THE MEDS

weety

Thanks, Rhonda.