Good news on my Liver Function tests!

saluki · July 2007

This has been the most nerve wracking month, wondering whether I was having elevated Liver enzymes from the cumulative effects of all the medications I've been on or whether I had liver or bone mets.

My liver enzymes have always been elevated and for me that was normal till June when suddenly they were up in multiples.

My Alkaline Phosphatase was 170 ------normal is U/L 33-130

AST was 63 ------normal is U/L 10-35

ALT was 102 -----normal is U/L 6-40

Don't know who was more concerned --the Oncologist who wanted them retaken immediately or my PCP who was freaking
about The ALT.

I didn't even consider the ALT since I was completely freaked with the Alkaline Phosphatase.

Well, I was so freaked I dumped all my meds cold turkey including Effexor XR----Not a bright move on my part but I was frantic. The only thing I stayed on was my BP med---Zestril (which can also affect liver enzymes.)

I stalled about retaking the tests, made appointments under
duress only to cancel them----I wanted all these meds out of my body before I retook the tests. So I stalled for about a month and had them retaken last Thursday. I got the results back today.

Look for yourselves.
Alkaline Phosphatase 134 ------- normal 33-130 U/L

AST 46 --------- normal 10-35 U/L

ALT 47 ----------normal 6-40 U/L

Guess the liver can heal itself when it's not constantly barraged with medications that are toxic to it.

I am so relieved. Now will be the search to control my medical conditions without the unwanted toxicity.

But for now I'm just going to enjoy the moment.

Susie

JoanofArdmore · July 2007

CONGRATULATIOND!!
Now are you going to go on and start taking all that garbage again?
I would get back on the Femara(!!!) and for the rest--SAM-E is looking really good.

I'm very glad things are muuuuuch better!
DEFINATELY enjoy the moment!!

saluki · July 2007

No one in this lifetime will ever put me on Effexor XR again or Nexium for that matter. I will go back on the Femara in another week and a half since that was the last med I stopped.

My Primary Care Phycisian has this notion of slowly reintroducing the meds one at a time and seeing which one is causing the most toxicity-----I DON'T THINK SO!!!!-----

I am also very concerned that with all this hoopla over my liver enzymes neither the PCP nor the Oncologist noted that
on the original lab the Bun/Creatinine ratio was 34 when normal is 6-22.

It went down to 20 on the repeat labs--- perfectly normal when the meds were discontinued. So, was this stuff causing kidney damage as well?

I think my Physiatrist (Pain management doctor) will be willing to work with me and the Sam-E as he is very inclined to think outside the box---- So that will be the next step.
They faxed the labs to him today.

djd · July 2007

Susie -

Thank goodness you have ruled out mets! Awesome news

You are a great role model of self-advocacy.

Good luck with the next step of your detective work

hugs,

LuAnnH · July 2007

Susie,

Did they do any scans? I would recommend them just to be 100%. I take nexium and that does not mess with my liver enzymes at all. Mine have always been in normal range. My kidney is another story. I am afraid to take some of my RA meds because the zometa I am on has been raising my creatine levels. The onc said to take it because we are watching the blood almost weekly, but I am too afraid to cause myself another issue.

LuAnn

wallan · July 2007

Good for you!!!

I have been on Effexor SR for years. The doc who originally described it used to take liver function tests to make sure it wasn't hurting my liver. I never had problems.

I did though have elevated liver tests after chemo in which the oncologist sent me for a liver ultrasound. But it wasn't anything. They came back down.

Good for you again..

Wendy A

saluki · July 2007

Quote:

Susie,

Did they do any scans? I would recommend them just to be 100%. I take nexium and that does not mess with my liver enzymes at all. Mine have always been in normal range. My kidney is another story. I am afraid to take some of my RA meds because the zometa I am on has been raising my creatine levels. The onc said to take it because we are watching the blood almost weekly, but I am too afraid to cause myself another issue.

LuAnn

LuAnn - My LEF's were up at my Dx and the breast surgeon
did not do surgery until my liver had two CAT scans and an ultrasound. I have Hemangeona's which are benign but
any radiology report always says on the last line --We can not rule out solitary metastasis. The only way they can
do that is to biopsey which they usually don't because Hemangeoma's bleed. On the beginning I was living from scan to scan absolutely crazed over my perpetually elevated liver enzymes and the perpetual scans---My onc was new and right out of school. When I couldn't take all the perpetual upheaval I changed to an Oncologist with some gray hair.

Looking through my records from 10 years before BC showed him I had a continual history of elevated liver enzymes (ptobably from a toxic auto immune reaction to Clinoril (an Nsaid). So he realized that was normal for me. So had they not come down I would have been scheduled for more liver scans.

I know what you mean about the Zometa--people always talk of the risk of Jaw Necrosis but no one mentions the possible damage to the Kidneys. Its a hard choice you have to make between getting relief for the RA, maybe stopping it from progressing and not giving an additional burden to your kidneys. Talk about a balancing act; But if you are not getting enough pain relief with your current regimen, you may have to consider it. If, your onc is doing frequent labs
they should be able to catch and reverse potential problems.

I can certainly see why you wouldn't want to open up another can of worms.

I'm not sure that one drug would have been responsible for that degree of elevation in my liver enzymes but rather the cumulative effect of all of them together.

I know I'm going to have to go back on one that is likely
to affect my liver enzymes. Between the RSD and all the Musculoskeletal issues from Femara they will have to put me on something to get some relief. So I guess the three month panic will go on. But at least it's great to know that this month all the worry was unwarranted.

Susie

sahalie · July 2007

Susie that's great news about your enzyme levels.

LuAnnH · July 2007

ah hah....I knew I was missing something. Guess we will just play the guessing game with these meds....ugh

either way, glad its good news for you.

LuAnn

Anonymous · July 2007

Susie, all that worrying it's a wonder you're not in the nut house. Oh, sorry, I was thinking about myself...not so strong of a person.

Bless your pea-picking heart. I'm soooo happy your LE's have come down.
Shirley

Anonymous · July 2007

LuAnn, you look soooooo purtty with that baby. Aren't they sweet! Enjoy being able to rock him and hold him and change his poopy diapers and all that start cuz, as you know, they grow up to fast. My little two year old grandson peed in the potty at day care ALL DAY yesterday..didn't wet his pants once. That means HE'S growing up.
Shirley

LizM · July 2007

Susie, I am so happy to hear that your LFT's went down. I have been following your threads about this as my AST and ALT have been mildly elevated off and on since I finished chemo 16 months ago along with my WBC which has been below normal. I am not surprised with all the meds you have been taking that it has had an affect on your liver. I am also glad to see that it doesn't take long for the liver to heal itself. Keep us posted as you reintroduce your meds as I would like to know if Femara is one of the culprits. I am on Arimidex and before I started taking it my LFT's were normal and 6 months later they were mildly elevated. I have been doing a lot of reading on good foods and supplements for the liver and have been trying to add them to my diet. I found the below info last night which I thought was interesting. It is mostly talking about alcohol use and the liver but I think the suggestions would apply to medications.

http://www.webmd.com/content/pages/9/1685_52366

THE THREE-STEP OVERHAUL

Your liver may be the picture of health (which is still pretty disgusting). Or it may look like Keith Richards'. Either way, giving it this makeover won't hurt, and it may heal.

* 1. Drop alpha-lipoic acid. It's not a hallucinogen; it's an antioxidant that turns up the production of glutathione, your liver's head janitor. Glutathione latches on to toxic gunk and makes it water-soluble enough to be flushed out through your kidneys. "We give patients who overdose on Tylenol a drug that stimulates glutathione production. It's the quickest way to rid the liver of toxins," says Savant Mehta, MD, director of the liver-transplant program at the University of Massachusetts. For maximum liver scrubbing, take a 50-milligram alpha-lipoic acid tablet (sold in drugstores) twice a day.

* 2. Swallow some milk thistle. Popular in Germany -- a country that's tough on livers -- the herb milk thistle is loaded with the compound silymarin. One research review published in the American Journal of Gastroenterology concluded that silymarin may help heal liver damage caused by excessive alcohol consumption, infection with viral hepatitis, or exposure to certain toxic chemicals. "About half the patients in my clinic are taking it, but its efficacy remains to be proved," says Dr. Mehta. If you want to give it a try, check your local health-food store for Thisylin by Nature's Way ($23 for 60 capsules); it's the brand used in most clinical studies.

* 3. Down a protein shake. Muscleheads know that guzzling protein drinks may help build bigger biceps. But how about building a really buff liver? According to a study review published in Nutrition, when rats were given a protein supplement, their damaged livers started regenerating faster than those of rats not given the supplement. "The thinking is that this would also apply to humans," says Harihara Mehendale, PhD, a University of Louisiana professor of toxicology. Look for powders that get their protein from whey (not soy) and that list the essential amino acid glutamine as one of the ingredients.

-------

I am taking milk thistle and just switched brands to Thisylin so I am glad they mentioned it. I had also read about glutathione and glutamine and drink a whey protein shake each morning. However, I had not heard about alpha-lapoic acid. Does anyone here take this supplement?

Rosemary44 · July 2007

* 1. Drop alpha-lipoic acid.

When I first read this, I almost fell over. Not ALA! Then I read on, whew. It's good to know it does some other good that I wasn't aware of. I guess I'm forgetting the jargon of the 60's.

Yes, I take it. It's suppose to help vitamin C stay in the body longer and do what C does best and regenerate antioxidants. I'm sure it's taken for other reasons, but now we know it helps the liver.

Susie, that's really good news for you. After all you've been through, it's about time things are going your way. On to finding the culprit.

JoanofArdmore · July 2007

Liz, I take ALA.It is something Gary Null recommends.I read it a couple of years ago, and have been taking it ever since.
I dont know if he mentioned liver function, I'm sort of disinterested in this.(Everything I take, or dont take is for my liver, so I'm doing the best I can..)
Gary advised it for general health, and vigor, along with Acetyl L-Carnitine, which I also take.These are his top 2 picks.
(Of course Gary is ALL about eating right.)

saluki · July 2007

Every day Liz, for years 300mg a day--- Although recently, I switched to Life extensions "R"-Dihydro- Lipoic Acid and the other one I take is Acetyl L Caritine and Lipoic acid from Source naturals. I wasn't taking it for liver health but to help with my neurologic problems---which is the main reason
I wind up on so many off label medicines. Real guinea pig am I. LOL

Been also taking the Natures way Thisilyn for years.

The only new addition is the Sam-e

The protein shake sounds interesting. I used to take one bit I got concerned about the Soy. Maybe I'll look into it again. Glutamine here I come.

I've been using iherb.com for the supplements. They seem to be reasonable in cost and have allot of info.

I used to belong to LEF but the $75 membership was prohibitive for the privilege of the January sales

I guess all I need now is some radishes and beets. LOL

Just my own suspicion but I think had I discontinued the Femara and not taken my Zestril those readings may have been even lower.----But then I'm not aiming for a stroke------

Catherine · July 2007

I also had good luck with Milk Thistle. I had high liver enzyme levels four years ago. Surprisingly the Milk Thistle worked great and very quickly. My husband just recommended this to his mother. I am convinced that my levels were elevated by Tylenol.

Catherine

saluki · July 2007

Catherine---Everyone's been frustrated with me; Asking me, why I've been holding back on my pain medicine as well? Very simple -It has Tylenol in it!

With my apparent Keith Richards liver.(LOL) That's the last thing I need.
Well I need them, but, I'm apprehensive about taking them---another item to discuss with pain management.

That is going to be a real brain storming appointment.

SoCalLisa · July 2007

My liver docs told me that tylenol is dose specific for toxicity and it is the painkiller of choice for liver problems.. but to keep it under 4 gms..under 2 is best for my liver problems..no aspirin or NSAIDS...

saluki · July 2007

That's the problem Lisa --the cumulative toxicity. I'm already taking meds that affect the liver that I have no choice about continuing. I'm not allowed NSAIDS at all---already had Toxic reactions, nor the COX2's and I'm allergic to Sulfa.

No-- one, or two, painkillers containing the Tylenol is not going to be a problem for me, but the amount that would be needed to give me relief for the day is quite another matter; Especially when considered with other meds that have liver toxicity associated with them.

It is very easy if your are badly arthritic to pop 2 extra
strength tylenol at a time. At 500mg a pill 4 pills in a day would hit your two grams which may be fine if you are not getting other meds that affect the liver.

4 doses of two would be 4 grams and could start being toxic. I don't think I've ever had a bottle of Tylenol in the house that wasn't Extra Strength.

These LFT's have taught me valuable lessons about my body, about medications and about my Doctors. Mind you, I could have done without all the angst.

Anonymous · July 2007

Susie, so what are you going to do for the pain. Bless your heart. I've been downing Tylenol because of some strange cold I got from somewhere (doc at a walk in clinic said it was a summer cold..had a fever for over a week).
Fever is good to fight the virus, but I was miserable and took Tylenol. My LF so far has been good. But when I take those pills I do think about my liver because I take other things that can affect the liver.

I hope you can find only ONE culprit. And not the femera!
Shirley

Catherine · July 2007

Now I try to stay away from Tylenol, but I have problems every once in a while with arthritis pains (I think). It's not bad enough to see a doctor, but I have painful elbow problems on occasion. It's very annoying, but a lot of people have things much worse.

My MIL is going to try Milk Thistle as she's had similar liver enzyme problems. I have a feeling that it's quite common.

Catherine

saluki · July 2007

A friend of mine had a PCP that was convinced he was an alcoholic since his LFT's were off the map.

I knew his habits, and that he always got a vicious headache after drinking even a gin and tonic unless it was Premium Gin.

I asked him if he was downing Tylenol to deal with the headaches----You bet!! -4 pills at a time----

Mystery solved---No more Tylenol for him and his LFT's are back to normal----Mind you he still has a beer or rum and coke a few times a week!

Good news on my Liver Function tests!

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