Liver Enzymes elevated a bit...

LeesaD

Saw my MO Tuesday for check up and bloodwork. First time we've gone six months between bloodwork and appts. I always stress about the tumor markers. TM's ended up being all good... but my AST and ALT elevated a bit. AST is 112 (normal is 10-40). And ALT is 61 (normal is 10-45). My ALP is good and lowest end of normal and Bilirubin normal as well. All other bloodwork is perfect. I've reviewed all my results from the past 2 1/2 years and enzymes were only elevated one other time and that was the one day I was admitted to hospital with severe sepsis from port infection and they said to me either you are a heavy drinker (I don't drink at all) or you've taken alot of Tylenol the past week which was the case as I thought I had the flu and not sepsis so had been taking a lot of Tylenol to keep fever down. Enzymes returned to normal within a week.

So of course I'm concerned as my bloodwork has usually been spot on with what my body is going through. The one difference from last bloodwork six months ago is I had started a clinical trial the day after my last labs in January. It's an aspirin for breast cancer trial where I'm taking either 300 mg of aspirin per day or a placebo. My MO and PCP said they don't think aspirin can cause elevated liver enzymes. I did some research and I found a few sites that says regular aspirin or salicylates can cause elevated liver enzymes. Also I asked if exercise can cause elevated enzymes as I had done a two mile run literally an hour before the bloodwork and also my muscles had been severely sore from a new workout I started a few days prior. MO said no also. Again I did some research and found AST is not only found in liver but also muscle and an elevated AST could possibly indicate muscle injury.

Maybe I'm grasping at straws a bit but just wondering if either of these two things could possibly cause the elevations and not my worst case scenario where of course my mind runs too.I was sent for an abdominal ultrasound yesterday and MO just called and said the ultrasound is good and no issues showing. I repeat bloodwork next Thursday and he's going to run some additional labs as well. Doctor and trial coordinator said stop taking the trial pills for seven days anyway as I'm having another test next week that could involve bleeding so if I am on the aspirin I would have to be off it for a week prior. So for my bloodwork next week I will be off the trial medication for a week.

I don't know. I guess I'm just thinking out loud. Any insights would be greatly appreciated. Only meds I’m on are Anastrozole and Vit D and the trial pill daily.

wallycat

Have you started any new supplements? My twin had elevated liver markers with a new supplement; stopped it and everything came back to normal. She's never been dx with cancer.

LeesaD

Wallycat- No new supplements. I take just anastrozole and vitamin D and the trial pill.

letsgogolf

LeesaD... I know you mentioned that you only take a few meds but I thought I would mention that my husband had been on Lipitor for a couple of years when very suddenly his liver enzymes shot way up. I think there are several drugs that can cause a spike. Not sure about aspirin, anastrozole and vitamin D but definitely worth checking out.

Anonymous

My liver enzymes go up and down. I had borderline elevations at least one time; one time my MO had me retest in 2 weeks and they were fine. I think we sometimes just catch our bodies at these "moments" where our bodies are seeking homeostasis, trying to balance everything, and you might have just had your blood taken during one of those times. I know that pain relievers like the ones you mentioned can elevate, and intense exercise can also elevate.

I bet you're okay, retest and eliminate all the things you thought might have skewed results perhaps a few days before you retest, and see what happens.

Claire in AZ

KBeee

A lot of exercise can cause a spike in liver enzymes. Hoping they return to normal this time.

LeesaD

Thank you all for your input. So appreciated. Abdominal ultrasound was good. Repeat bloodwork and some additional labs being done this morning. We shall see.

LeesaD

Update- repeat bloodwork taken 9 days after first is perfect. Enzymes back down way into normal ranges. My AST went from 112 down to 22 and ALT went from 61 back down to 19. I had stopped the trial drug and exercise for seven days prior to the repeat bloodwork so one of them had to be the cause I would think of the elevations. I’m going back on trial drug and I’ll have my PCP
re test the enzymes in six weeks and if they’re elevated then I think that is the culprit. My MO says he doesn’t think either one is the cause but he’s happy everything is back to normal.

wallycat

Excellent news. I'm shocked they would not suspect medication as a cause with such dramatic results. I guess your "experiment" to re-introduce and recheck will be telling.

Thanks for updating us and so happy you can relax.

LeesaD

Thanks wallycat! I’m so relieved. And yes I don’t understand how my oncologist and my PCP don’t think there is any correlation 🙄 as both of them kind of dismissed me when I asked if it could be the trial drug or the exercise and both said nope. And it’s not even like the enzymes were just a little lower, they were drastically back down to completely normal range with 7 days of no trial drug and no exercise. It’s ok for now.... will see what happens with the results in six weeks. Rught now I’m all good and so relieved all is back to normal.

KBeee

Great news!!!! The explanation, "it couldn't be the drug" gets really old to us cancer patients......seriously......acknowledge that teh drugs can have side effects...even unexpected ones.

Artista928

mine go up and down. Mine though is due to non alcoholic fatty liver where a diet change helps.

MamaOz

hi leesa. What is the trial pill? Were you having issues? And hows the prolia treating you. Im still holding out. But my joints are not doing so well

Marina

LeesaD

Hi Mamaoz, I started a clinical trial in January called the ABC trial (aspirin for breast cancer) to see if aspirin as an anti inflammatory can help prevent recurrence. I’m either on daily 300 mgs of aspirin or a placebo🤷‍♀️. My liver enzymes were out of whack at my blood work a couple of weeks ago. I had to stop the trial pill for 7 days anyway in case it’s aspirin as I needed to have a thyroid biopsy (all good) and they repeated bloodwork same day as biopsy and everything was back to normal and enzymes way back down to normal range. Could be a coincidence but who knows. I went back on the trial and I’ll have blood work repeated in six weeks.

Prolia still ok Had my 4th shot last week and still haven’t had any side effects. Not sure if it’s doing anything to build my bones yet as the anastrozole seems to have put me in full blown osteoporosis per my last bone density test that I had in January when I had been on the anastrozole for 16 months. My endocrinologist is holding out hope the Prolia will kick in eventually. He’ll do another bone density in January.

My joints a little achy too but better since I started brand name Arimidex. Im sorry you’re feeling the same. Hope you are well otherwise!!

wallan

Hi Leesa:

My liver enzymes have been slightly elevated for months now. My GP is not concerned; says we will retest in a year. I have read that Arimidex can cause your liver enzymes to be elevated. I did get an ultrasound and it was normal.

So... hugs to you.

wallan

Artista928

Tamoxifen can cause liver enzymes to be elevated.

Palesa2018

This thread has been so helpful and encouraging. I have been losing my mind from fear. For the first time last week my liver enzymes are high. ALT 51 and AST 34 which is borderline. They had been tracking very low before. I am of course worried and stressed out about it. The only thing different in the last few months has been increased and intense exercise. I have also been on Tamoxifen for almost a year. I am going for a CT of chest amd abdomen on Wednesday. I have moments of being ok and moments of complete fear.

I hope everyone here is doing well.

Anonymous

Intense exercise can cause elevated liver enzymes. I too, am a very physically active person, and my enzymes are sometimes slightly elevated, which makes me crazy with fear although so far my MO doesn't ever hyperventilate about them. I have a check up this Monday with a new MO, and I'm sweating what the CBC results will be when I get there.

See the middle of the linked article for what strenuous exercise can do.

http://blog.insidetracker.com/muscle-damange-to-blame-for-elevated-liver-enzymes

Palesa2018

Thank you Claireinaz. I get the result of the ct scan today and while I am hopeful that it is all good my anxiety levels are through the roof. Waiting through the weekend has been torture. I have been through all my other check ups this last week and every was good.

Take care

LeesaD

Palesa2018- please let us know how your results were. Hoping all is good 🙏

Palesa2018

Hi, the CT scan of chest and abdomen results were clear, no change since my last CT a year ago. What a relief! So I am attributing the change in enzyme levels to exercise because that is the only thing that I changed drastically. MO says nothing to worry about, she was just being cautious.

Thank you for the thoughts and support.

KBeee

Great news!