Why would AST and ALT go up during treament?

[luckyman316]

As many on here know, I'm on TAF through a clinical trial. For the past 6 months, my liver enzyes (ALT and AST) have stabilized into a normal range in the high 30s or low 40s. I got my tests back and my AST went up by almost 50pts and my ALT went up by like 15pts. I'm not doing anything different than what I did when I started this and I'm eating fairly healthy and have not had anything to drink with alcohol since I started this. Does anyone have explanations as to why this may happen? Naturally, I'm concerned. The only difference I've had was not taking any Vitamin D3 the past 2 weeks....

[needadvicewithhep]

No worries fingerd crossed ;)

Bear in mind yoga wont increase lean mass nor will hockey really compared to pumping iron.

But pumping iron is good as it keeps glycerol fat content down hence less chance of getting fatty liver disease and obviuosly the bone density element is important to.

I really do hope you get some luck

[SphereAj]

Thanks needadvicewithhelp for sharing

[needadvicewithhep]

Whilst i was on TAF i had an elevated ALT troughout the majority of it until the 2months prior to hbsag loss.

Also if your doing weight bearing exercise this may cause an elevation in ALT even more than hocky as weight bearing exercise will boost your metabolic rate for longer  whilst at rest more than hockey.
Just a thought. But in grand scheme of things 15points is minimal.

Just my opinion im not a doctor

[luckyman316]

Thanks for sharing, I'm praying that the elevated ALT is an early indication of potential hbsag loss. That would be be another blessing here and could be more proof that TAF is more of a cure than anything else. This would be the best case scenario for me (and I suspect this is actually what may be happening).

On that note, also thank you for the tip about working out. I am pretty active with hockey, which does have intense moments as well, as well as yoga and lots of walking. But if it's weight bearing exercise that did it, I'll be sure to not do much 4-5 days prior to my next test to see if there's a difference.

All's I know is that day by day, I've been feeling better and better and more stronger than I did when this all started for me. Crossing my fingers things are going in the right direction here!

[SphereAj]

Thanks BM2016
My Ultrasound was normal 6 months ago when sgpt sgot were 140 and 80 (before treatment started).

Now after 6 months on entecavir Viral load is less than 20 (base reading 6250 iu/ml) . HBsAg gone up to 2656 from base reading 1666.10iu/ml. And SGPT 50 SGOT 47.

[Bm2016]

Elevated liver enzymes is caused by inflammatory or injuries to liver, if you have liver biopsy, ultrasound or fibroscan result as normal, it could also mean while the drug can only suppress the hbv replication to a very low level, now the immuse system responding to the liver infection, and trying the resolve the virus, good luck!

[luckyman316]

I'll be thrilled if it's truing to resolve the virus! I had an ultrasound done this morning. They have always been coming back to me as normal, so I can't see how or why it would change within 6 months, especially since my habits are healthy.

[SphereAj]

My SGPT and SGOT was 140 and 80 respectively before starting entecavir in 3 months dropped to within normal range after 6 months it is 50 and 46 respectively. Why could this rise be?
I am taking vitamin d3 10000iu per say,  my levels went up from 10 to 66.5ng/ml in 5 months.

[stef2011]

vitamin d is known to normalize ast/alt, i reach very low alt when taking vit d, my lowest being 16 or 17 which i never reached in my life

[luckyman316]

Thanks, stef. I've already started the Vitamin D again since I got the call and partial results and will see how much a difference it makes between now and the next test, and I will continue my workouts as well.

[Aduiski]

your recent initiation of gym workout almost certainly caused this.

[luckyman316]

I'm wondering this as well. Though it would cause liver enzymes to go up? This makes no sense to me... especially since I never had a HUGE spike like this when playing ice hockey and going for a blood test the next day (maybe a minor spike but not this much). I'm going to have to see how this pans out and do what I normally do for the last 6 months these next 3 months.

[studyforhope]

There are two possibilities.
The first is that the medication is  causing an increased  vulnerability of the muscle tissue causing Alt spikes after  intense exercise.
The second one is a minor hepatic flare often seen in chronic hbv, in most patients.

[luckyman316]

I'm praying it's not a hepatic flare, because that typically doesn't happen to chronic Hep B patients on treatment (though it has been reported, I have not experienced any while on treatment for 2 years). This would be the worst case scenario for me, since my doctor would want to prescribe entecavir on top of the TAF and I just legit can't afford anything outside of my clinical trial due to major money issues at this time in my life.

[Royal36]

I think this Vit D3 has got so many impacts on our HBV 5mins ago i was reading on another post some one claiming his Hbsag went down almost by 50% after he started taking the Vit D3.