Elevated liver enzymes on Tamoxifen anyone?
I had labs drawn yesterday for my onc check up. Previous labs done were in December and they were fine. My AST and ALT are now elevated at 83 and 76, up from 36 and 32 in December. Of course, I am scared. I see the onc today but already had a heads up from the Nurse Practioner that he is going to recheck them in a week and see what happens before doing a liver ultrasound. I have been on Tamoxifen for 1 year. I hope it is the tamoxifen, but that really cuts down on years of meds available for ER+ and the ovaries would need to come out. I guess it is a small price to pay if he can tell me I am still NED. I did have a PET/CT in December that was negative and he told the NP he took great comfort in having that info. Well, I had inflammatory breast ca, so I have to get past the fact that 4 months is plenty of time for everything to rear its ugly head. Anyone else simiar? Thanks for responding.
Diane
Comments
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Diane
I was told from the get go that Tamox is known to raise those #'s.....I just did a 12 hr fasting blood draw and will see my doctor this coming week so will see what it has done to my numbers as Ive been on it over 2 years and had slightly high cholestrol to begin with.
Best wishes
Jule
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I had the same problem, but my liver enzymes were much higher than that - more like around 156 or something. My doctor ran some blood tests on me and we found out that I once had Hepatitis B and didn't even know it. Talked to my onc about it and she agreed that in my case the risk was not worth it. I seem to remember being told once that levels like yours aren't as bad - I had this problem with other meds over the years, too.
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Hi:
Don't have that problem yet, but I take a supplement, milk thistle, which is supposed to promote liver health. Good luck.
Peeps
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I was on tamox for 3 years until last month. Every six months my onc does blood work and my AST and ALT got higher each test. Onc says small % of women can get liver damage from tamox. She has switched me to an AI with 3 month Lupron shots to push me into menopause. You only have one liver...
MM
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So I saw my onc on Thursday and we are going to repeat the hepatic panel in 3 weeks. His thought is that it is probably 1 of 3 things, tamoxifen, ambien or fatty liver. If the enzymes are the same, I will stop the ambien and recheck after 2 weeks off ambien. If the enzymes go much higher, I will have a liver ultrasound, but he was quite encouraging that my negative PET is reassuring that this is a non-cancer thing. The other thing I realized is that I had what I think was food poisoning 2 weeks ago and that could certainly raise the liver enzymes as well. Thanks for the postivie thoughts.
Diane
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Diane - It is GREAT that it is a non-cancer thing
!! I think fatty liver is pretty common; especially if you have gained weight during treatment. I'm sure you are aware; but be careful coming off of ambien, make sure your doc gives you a clear plan to wean off of it, especially if you have been on it for any length of time. Age/menopaue-wise, are you close to being able to move from tamox to an AI? They are supposed to be easier on the liver.
Peeps - thanks for the advice on the milk-thistle. I am always looking for a natural way to combat the damage we suffer from all these chemicals. I want to beat the cancer AND be healthy once I am done with all of this.
Sending good thoughts and hugs,
MM
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I had my appt with primary care doc....she had ordered a 12 hr fasting blood draw to check things.....everything was really good, except(why does there always seem to be one of those?) my choloestrol has shot from 171 last August to 269 now....she put me on Lovstatin to see if we can get it down some....I also discussed the fact that tamox is know to raise this level and she said she read that but didnt realize how severly it can raise it.
She suggested have an intent conversation with my onco the end of this month about it to see what he says. She also faxed a copy of the report to him so he is aware of whats going on.
Will let you all know what onco says about this in a couple of weeks...I my appt for next week was changed to the 29th.
Hope everyone had a great mothers day!!!!
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I thought tamoxifen lowers cholesterol?
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MOTC
From my understanding it can go either way...mine chose to go to the high side.
There are lots of articles on the net that state it increases liver enzyme levels....some of them say it increases the good and some say the bad....I personally think it is individual as I eat very healthy so have no reason to have that high of level.
My onco even warned me that it could go either way so they would be watching my levels every 6 months.
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Interesting. Cholesterol also has a strong genetic component. Some people can lead very healthy lifestyles and still have elevated levels.
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MOTC-yes I know about the genetics too....the docs say that at my age I would have had issue with genetically risen cholestrol prior....
My boss is one of those people who are healthy in all aspects of his life and has had elevated levels for the past 10 yrs, but he said they have always been high, no one has worried about them until the last couple of years.....he was dx'd with protrate cancer about a year ago, so yes even healthy as a horse people do get ill.
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I'm so glad you asked this question, Diane. I just got back from a 3-month followup and my AST has gone from 18-22 range to 141. ALT from 32 to 66. I'm kinda worried, now, although my onc didn't say anything about it today.
I just put in a call to her. I've been on tamox for one year. Do I need I need to stop drinking wine altogether? I've gained about 10 pounds since last June, which is also very upsetting.
Those of you who have elevated AST, is there anything different in your diet that you think might contribute to the change?
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Just got off the phone with my oncologist. She was reviewing my records and is a little concerned about the AST and ALT. She asked if I drink alot so we talked about that. She recommended cutting back and then running another liver panel (I think that's what it's called) in one month. She said she's not too worried about the cancer spreading to my liver.
I'm quite relieved. Now, about the wine - I really do enjoy it, so this is going to be tough. Got any ideas for support?
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So, repeated the liver panel and the enzymes are not coming down. Have a CT of chest/abdomen and pelvis scheduled for Friday. Kinda freaked out but counting on it to be fatty liver. Argh!
Diane
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mmb1 I just was taken off Tamoxifen because cause of a enzyme I am lacking in the liver that makes it ineffective. I guess this is a new test that just came out. I was also put on Lupron and start Arimidex soon. How long did they say you will be on the shots and how often? Do you know if there are any major side effects like uterine cancer with Tamoxifen? I have had hot flashes and headaches also starting to get joint pain and can't sleep well. Is anyone else on Lupron experiencing these types of side effects. I don't know what t of think about this Lupron stuff.
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DianeE
How did your tests go on Friday? I saw my PCP today, repeated blood work and should hear next week. He's concerned, but will wait and see the results of today's test.
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Sunshine99
The results are back and it is indeed fatty liver. I will have the enzymes repeated in 2 months to keep an eye on it. I had a PET/CT in December and there was not fatty liver so the tamoxifen is contributing to it. I am also overweight, so I am working on that to do my part as well. Let me know how everything turns out for you.
Diane
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Diane, if you don't mind me asking, how much overweight are you? I'm 5"3 1/2" and weigh around 142. I'm about 14 pounds heavier than I was when I was going though chemo and would like to lose the weight.
Doc said if my enzymes were the same or down, we would just keep an eye on it. If they're higher, we'll do some more tests.
Are they doing anything for you in the meanwhile or are they going to wait for 2 months and see what happens?
Thanks so much for your reply
Sunshine
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Sunshine,
I am 50 pounds overweight. My onc very gingerly said, "you are probably going to have to work on that" to which I said, Yes I am. I did not have fatty liver on my December CT so they know the tamoxifen is adding to the condition, but losing weight would certainly decrease it. They are not going to do anything other than observe right now. I know I have to lose the weight. I am out of excuses and this is certainly a big reason to do it. I do not like the anxiety of scans only to find out a big cause is I am overweight. Argh!
Diane
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I haven't read back, but my liver was problematic and I had to have my gall bladder out
about a year after I started tamoxifen..
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Thanks, Diane
I know I need to get back to the gym, but my motivation is sorely lacking... I'll think good thoughts for you
SoCalLisa, was your liver problematic before the tamox? How did they discover you needed your gall bladder out? That doesn't sound like fun!
Sunshine
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yes- elevated liver enzymes this past month on annual bloodwork - did liver ultrasound and diagnosed with severe fatty liver - brought on by tamox - my liver held up thru chemo and rads and now the tamox is ravaging the liver - am on a tamox break until I get enzymes back into a normal range - went off of Femara because it shot my cholesterol to 367 (highest my internist has ever seen) and it crippled my joints. I know the difficult decision is coming - what to do??
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I know this is am older thread but hoping someone will respond. I've been on tamoxifen for 4 years and suddenly within a year my liver enzymes are getting out of the normal range. I'm getting really freaked out. I'm not a drinker and don't understand the sudden change. This past year the dosage is went from one 20g pill to 2-10 mg pills once daily. That's the only change. My enzymes took a big jump always in the low range then to 40 and 50. Anyone else have similar story?
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I know this is am older thread but hoping someone will respond. I've been on tamoxifen for 4 years and suddenly within a year my liver enzymes are getting out of the normal range. I'm getting really freaked out. I'm not a drinker and don't understand the sudden change. This past year the dosage is went from one 20g pill to 2-10 mg pills once daily. That's the only change. My enzymes took a big jump always in the low range then to 40 and 50. Anyone else have similar story?
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Also late to the thread. I've been on Tamoxifen for 10 months. My oncologist does not believe in scans or blood panels without symptoms warranting. I went for my yearly check up with PCP and today was told my liver enzymes up with AST at 60 and ALT at 69. It was 20 and 10 respectively before tamoxifen and at my last chemo in July 2014. I do not have a history of fatty liver. I shared the results with my oncologist who is recommending a recheck in 1 month. I'm wondering if I should push for an ultrasound or other imaging. Interested to hear other's experiences.
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I've been taking tamoxifen for a year and a half and now have high liver enzymes my Dr. is scheduling me for a hepatitis test, a liver function test, and an ultrasound oh no what now!
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Dear Kitten1966,
Welcome to the community. We are glad that you reached out to our members and sorry about the liver enzymes. We notice that this thread is about a year old without recent posts. You may want to start a new topic to elicit more responses. Take a look at this question on our main site about Tamoxifen and Liver Enzymes. Keep us posted. The Mods
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Dear Kitten, lots of other things can cause liver enzymes to be elevated. I found out that when I was taking aspirin and motrin to combat the joint pain I was having on Arimidex (not on it anymore) that can cause liver enzymes to rise. Also, tylenol and other OTC drugs can also cause them to go up temporarily.
Even a few glasses of wine the night before a test can skew the values. I'm betting you'll be fine and this is just part of our overall physiology of being human--up and down values in our CBCs. We are hyper-scrutinized by anyone medical because of our previous dx's, and that's why docs hyperventilate about every little aberration, which, btw, drives me crazy after a while. I just want to be treated normally!!!!!
Hugs
Claire
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