DMDs and Liver Enzymes

I've had blood work done three months in a row, and my ALT continues to be elevated.  At what point does this become "serious"?

Sherry

[Wobbly]

sorry, can't help... what does it say online??  

wobbly
dx

[essdipity]

I'm having the same results, which my PCP doesn't seem to think is significant. I too would like to know how high is too high.

ess

[sllowe]

It's good they are monitoring your levels with 3 month labs, but not good if your not getting any guidance where your med is concerned.

Interferons can cause changes in your blood and the most common you'll hear about are liver enzymes, WBC and thyroid.

With the liver enzymes, my doc said to me in the past something like, you'll know if your liver is affected because of jaundice.  That's not so reassuring is it?  Most of us want to know if there is a problem before the **** hits the fan or we turn yellow.

Standard protocol should be, stop the med for awhile, run the lab again while off and see if you return to normal (or average) range. Then have your labs run again once you are back on for a few months. That's what I did when my WBCs dropped down. And now, so far, so good.

Sounds to me they are not so concerned with elevated liver enzymes.  So, I'll add on to your question and ask - should they be? Is the answer to Sherry's question - when your jaundice?

Who wants to take a crack at this one? Quizzle Sticks?

-shell

[PastorDan]

Mildly elevated ALT, I've been told, is commonly a symptom of "fatty liver," a malady common among those of us who are too blessed, with plenty of food and rest, for our own good.  Worth looking into anyway, IMHO.

[Bob368]

It's not really at what level is serious, Now if your levels to start out with were 4x the high limit, then your doctor would have order additional test immediately. You have an elevated level and it keeps rising and not leveling off or dropping. If this continues your doctor will do a CT scan and/or an ultrasound of your liver. There are a number of conditions that cause elevation of ALT enzymes. As simply as eating fatty foods, to all types of hepatitis. Did your doctor check your AST level? ALT and AST ratio is useful in calculating any liver damage, unless it's do to cirrhosis or alcohol abuse. On your next appointment ask your doctor if they will do a "Liver Panel" or also known as "Liver Function Test" (LFT). It consist of 7 test from a sample of blood to see how the liver if functioning. I wish you the best, and i hope your ALT level comes down.

Take care,

Bob :)

[doublevision1]

Something like 3% of pts on Rebif will experience persistently elevated AST and ALT due to this medication, and ultimately discontinue due to the longer term risks to the liver (I don't know the rates for Avonex and Betaseron but I believe they are similar) .  I was in this bottom 3% and after two attempts, ruling out any other possible culprits (normal baseline, then no alcohol, supplements or any other medication for the trial run on Rebif), I went off Rebif at the advice of my neuro, who treated this all very seriously, and went on Copaxone June of 2008.  My liver enzymes promptly returned to normal, and I am tolerating this med well ; it has no neg effect on the liver.  Perhaps Copaxone is an option for you if your liver enzymes continue to escalate and interferon is proven to be the cause.  

[risnerrose]

Thaks everyone.  

Just want to mention that everything was normal when I began Betaseron.  The levels were elevated three months ago, and my GP has tested them once a month since.  

Another thing . . . I've been having the flu-like symptoms again.  Yuk!

Thanks again,

Sherry