Apollo 13 calling lab gurus...

[gauf]

Hey guys,

Wondering if anyone can tell me why my LFTs' don't seem to want to improve much over time. Shouldn't they look better by now?  Staying right around upper limit. UND <5 at 12 weeks.  I started tox 5/08.

          1/08     4/08      5/08     6/08   7/08   7/08   8/08   9/08  10/08 11/08 12/08 1/09
AST      96        65         66       55       41     41      45      43     39      41     36     41
ALT       73        47        69        62       41     39      38      35     35      28     34     39
Glucos  72        82         90       93      100    133      77     101    80     66     71    77    


"Houston, we seem to be experiencing some shakes and shutters up here, over..."

" Roger that 13, doesn't sound like an instumentation problem after all...."

"...got that right Houston.."

[Kristina538]

I had <15IU 4weeks and UND at 24 weeks (G3) on 6 month tx (finished December08).  My ALT/AST only went down to 46/38 at week 2 and then starting rising; remained around the 50 mark from about week 4.   I've only been post tx 3 weeks so can't give you any post tx outcomes.

My nurse said it "might be as good as it gets with early cirrhosis" or "could be a gliche" (I dismissed both her comments as I knew other cirrhotics whose ALTs had become normal,  although on the monotherapy in '94 I did come down to ALT of 13 throughout tx and relapsed - my liver was obviously in much better condition).

Two other explanations I found were (1) specialist said that hyperthyroid can increase ALT (?) and (2) the pegasys itself is being processed by the liver and in a percentage of patients it causes a rise in LFT's; as long as it's not twice the baseline value  (my nurse said twice the upper limit of normal), and the other LFT's are okay,  there is no concern;   I can't find the link but I think it's on the Pegasys site or Janice and Friends;  someone may be able to assist.   My week 24 EOT ALT/AST was 50/60.    

I did a really good hunt of this site and there doesn't seem to be a huge correlation between relapse and high ALT's, although, obviously I came across relapsers and SVR's (which drove me nuts which the mix of genotypes and fibrosis stages so I stopped hunting).   To my non-medical eye your ALT/AST's are looking good;  I was told that after tx, the ALT may readjust to being off the meds, all going well.

[Bill1028]

They may never go down due to the amount of damage that we have with cirrhosis.  My last round of 76 weeks, they only got down to 40 to 50.

[FlGuy]

Two times treating for a total of 70 weeks; AST/ALT never in normal range.  Just take your meds, that's your part.  Almost time to think about crawling out of the LEM, guy.

[portann]

What other meds are you taking? I think even Tylenol can increase your LFT's.

I have similar concerns but in re-reading previous, informative threads, I remain insecure and  wish my danged numbers would drop into the teens.

In fact, when my nurse comments on how well I'm doing, I say jokingly I'd rather not be doing so well, if only my ALT would drop below twenty. It's not a joke, though.