Worried - elevated liver function tests
I am freaking out once again. This is why I hate having bloodwork done. This is the 3d time my liver function tests have been elevated. Can Femara cause elevated liver enzymes? I am also having muscle issues/pain from overuse during the holidays and suspected LE. Can muscle problems raise LFT's? I so hate this worrying. My PCP recommends I retest in a month. Anyone have this happen with blood tests?
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Femara
PRECAUTIONS: Before taking letrozole, tell your doctor or pharmacist if you are allergic to it; or to anastrozole; or if you have any other allergies.Before using this medication, tell your doctor or pharmacist your medical history, especially of: high blood fats (cholesterol), bone problems (such as osteopenia, osteoporosis), stroke or blood clots, heart disease (such as chest pain, heart attack, heart failure), high blood pressure, kidney problems, liver problems.
Liz...This is what i found out for you.
Im also on Femara.
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Liz
Femara did increase my liver enzymes, Medication can definitely do that. If it is medication induced it is usually going to affect your AST more than the ALT. Also try some liver cleanse before next blood draw like milk thistle. Vitamins and supplements can also impact Liver enzymes, for example one night I had 2 glasses of wine and melatonin to help me sleep. Next day my Liver enzymes were doubled. My ONC said get off the Melatonin, it is a known problem for liver enzymes I did and my LE's returned to normal.
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I make sure I take anastrazole after having bloodwork done. Found this out by accident. I had done the first bloodwork fasting, then they needed to redo after my checkup. Guess what....one of my liver enzymes was seriously elevated.
So I do all bloodwork fasting now, just to be sure. Hoping this is the case with you. Good luck.
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Thanks Ladies, I will be taking milk thistle regularly before my next bloodwork in 30 days. Both my LFT's were minimally elevated, ALT more than AST but neither were double the upper limit of normal. I was wondering if muscle damage/inflammation/soreness could have affected my LFT tests. I say this because I overused my BC side over the holidays (had BLMX/ALND and rads) and had a lot of pain and aching in my arm (was thinking it might be LE). When I googled elevated LFT's and muscle damage/inflammation, some articles came up talking about AST and ALT also being in your muscles as well as the liver. I wonder if there could be a connection there. I hate getting bloodwork because I freak out everytime something isn't normal, thinking it is a recurrence.
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I know that my enzymes went way up (more than double the top of normal) shortly after I began working with a personal trainer and I'm pretty sure it was because I was so sore I could barely walk! Strenuous exercise can cause a rise in liver enzymes.
The important thing is that they come back down again. When mine are high (and they been high numerous times) I always have follow up tests -- usually a week later, then a month after that, and so far they have always come down nicely. I bet yours will too.
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Revkat, thanks for sharing that info with me. I didn't exercise for more than a month during the holidays and on New Years day my arm started aching due to overuse (shopping/cleaning/wrapping/carrying bags/cooking for family) and also hopping into a 105 degrees hot tub on New Years eve. I started working out again on the Monday after the holidays plus started doing my exercises (which I had stopped for quite some time) on my problem bc side shoulder (frozen shoulder twice) . I was in a lot of pain when I had my bloodwork done on that Friday.
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Liz, I hope you are posting in the LE section about our arm. You need to see a lymphedema therapist.
I had my bloodwork done the day after I ran 12 miles and my AST was elevated. It reacts to muscle damage as well. In your case, since it keeps happening and it isn't just one test, I would be concerned about the Femera. Can you talk to your onc? You might want to stop the femera for a period of time before the retest, but only under your onc's supervision.
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Hi Member,
Yes, I have been posting in the LE thread and am on a waiting list at Hopkins for an appointment with an LE specialist. I was thinking that Femara or maybe Fosomax could be the culprit. I am at 4 and a half years on an AI so I think it would be okay to take a small break from both medications. My PCP wants to retest in 30 days - I am thinking about stopping both Femara and Fosomax one week before I have the retest. I was also thinking about taking Milk Thistle but have heard it may have estrogenic properties so I am a little nervous about going that route. I have also read about SAMe for the liver but have to do more research on that one. I do find it unusual that both times that my LFT's were elevated I was having problems with frozen shoulder and had a lot of muscle inflammation at the time the tests were taken. The times that my LFT's were normal I was not having PT on my shoulder or experiencing any pain. May be a coincidence but does make me wonder. Plus I did read on a muscular distrophy site that our muscles contain AST and ALT and muscle inflammation/damage can elevate them.
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so glad I found this thread. My ALT was elevated at the end of Dec - just took the 2nd test today so hoping for results tomorrow. From my onc's nurse - elevated is a sign of possible met to bone BUT almost always accompanied by bone (not muscle) pain. From my gp - he sees it elevated due to gallbladder so asked about indigestion...none. I had to put it totally out of my mind - which worked well until they stuck the needle in today.
I did fast since they were checking my cholesterol...it does help knowing someone else understands the stress. BTW, I'm about 9 months on Femera, just finished my nipple recon so hadn't been excercising.
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I found another culprit that could have caused my minimally elevated enzymes. I had forgotten that I take Zantac every morning and have been for months due to acid reflux. When I googled Zantac and elevated liver enzymes, all kind of stuff came up. Seems that is one of the side effects of Zantac and Tagament. I just threw my Zantac in the trash. I also decided to take SAM-e instead of milk thistle because not only is it good for liver detoxification, it is good for arthritis and overall well-being. I could sure use some of that right now. Also, I am starting to think that chemo can really do some damage to our bodies long term. I know that my LFT's were slightly elevated during chemo and have been at least twice since completing chemo. I also think that the aromatase inhibitors wreak havoc on our bodies. I wouldn't give up either one but just saying they could be the culprits as well.
rseaw22, good luck with the results of your tests and keep us posted.
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Finally the results: so after much chasing, I finally had a conversation with my onc. My level is the same (124) which is borderline. 6 months ago it was 107 - so we will test in 4 months and see what time does. She said in reviewing my chart - the outstanding issue was I've gained 15lbs in a year...and a total of 30 lbs in 2. (oddly totally corresponding with Tamoxofin/Femera). While my bp, cholesterol and all other stats are great - the weight gain is going to cause health issues....so I cussed a bit and am angry at myself, cancer, and the cure - It's the first I have cried in a while and I can't tell you how frustrated I am with this. But when I am doing throwing my fit - I will commit to 60 days of pure effort. And if nothing changes - I am eating a doughnut and crying again. I know there is a bigger picture - but today I can only handle a small step.
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I'm breathing a sigh of relief this morning as I just received the results of my recent liver function tests which are now normal. My previous numbers for alt and ast were 165 and 111 after completion of chemotherapy and a year of Herceptin for her2 positive breast cancer. When i saw these high numbers I thought ... this is it. My onc sent me for an immediate liver scan which ruled out mets. My primary sent me to a liver specialist who mentioned it might be a fatty liver, told me to loose 12 lbs and come back for a follow up appointment. I was embarrassed not to have lost the weight so I just went for the blood work and rescheduled my appointment for a later date. Although I plan on loosing the extra 35lbs I've been carrying around, in a way I'm glad I didn't loose it before my most recent lab work. I now believe the elevated numbers were due to the treatments. Now... Time to hit the gym, planning on being around for awhile! -
Great, Donna! -
My liver enzymes have skyrocketed since Sept ALT from 14 to 253 and AST from 26 to 140. Onc has ordered an early scan. Pray it's the meds.
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