Liver Disorders Community
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Avatar universal

How likely is it that TB meds cause hepititis or liver issues??

Hi all!
I'm a recently diagnosed active TB patient (back in April) now it's June and I have been on and off TB meds (RIFAMPIN, Ethambutol, Isonazid, and PZA). I don't have any previous liver issues that I know of My Liver enzymes have been 5x higher than normal & for the 3rd time they have had to stop my meds (1st time had Nausea/V & malaise that triggered to stop+ high LFTs). The last time it took 2 weeks for my LFTs (AST & ALTs) to come back down to where they could restart my meds. My doc is trying to figure out which meds have been harming me & has canceled out INH (Isonazid) since that's one of the ones that seems to raise my liver enzymes. But yesterday the results were high again with just taking RIFAMPIN, Etham., & PZA(PZA for only 1day!!). Now they're thinking it's either the PZA or RIFAMPIN, but not sure yet. Would anyone know what other options I have (and are they worse or better on the body's systems) since my body keeps refusing these meds?
My most recent X-RAY 2 days ago looked clear and they are finally doing another AFB (sputum test) again. I've never had any TB symptoms but my original culture was positive. I still have my doubts of even having TB thlough but I guess at some point I must have.
I'm just very scarred of developing long term liver issues from these meds and of course death! And I'm afraid of also possibly developing a resistance to the meds since I've had to stop my meds for about a total of 3-4 weeks since I started back in April (it's June 18 now). If anyone knows any info please inform!! I'm desperate and scarred and have read some terrifying stories of people dying from these meds (even just for latent TB treatment) after just a few months of taking them!
Thank you in advance!!!
4 Responses
Avatar universal
I am really sorry I can't answer any of your questions. If your doctor is having trouble figuring this out, we certainly won't be able to offer much help as we are just patients. I hope that you are working with an infectious disease doctor who knows hep C as well as TB. Or, at least an infectious disease doc in conjunction with a hepatologist. I wish you the very best and hope you get your answers soon.
Avatar universal
TB can affect your liver directly or indirectly, via your treatment medications. Please discuss your blood testing schedule with your doctor just to be sure everyone is on the same page, TB or meds. Several weeks at a moderately elevated liver enzyme levels will not cause any long term problems. But making sure that this is the case is essential. Hope that your treatments resolve your TB and your liver remains in great shape!
Avatar universal
Thank you for your response guys. Recently they stopped my meds again (4th time): was on Ethambutol and Levaquin (Levofoxacin) but again, just a few mins ago my PHN called me and informed me my liver enzymes are up AGAIN!!! Nothing seems to work for me! They now want me to see my primary care DR. to see if there's possibly another underlying cause that may be causing my LFT's to rise frequently (they base this on that Levaquin shouldn't affect the liver, yet I looked it up on my drug guide book and it does have Hepatotoxicity as an adverse effect as well as causing AST, ALTs to rise under lab considerations). This is all just very frustrating and I just don't see the end of this TB treatment, unfortunately! :(
Does anyone have any tips or advice? Thanks in advance!!
Avatar universal
It is a good idea for your primary to double-check your liver's current status before proceeding. This shouldn't take too long and, if your primary feels he or she isn't versed well enough in liver issues, get a referral to a good GI doctor. If they get started soon, it should only take several weeks. Otherwise, all this start and stop will lead you no where except to frustration.

Once your baseline liver condition has been determined, then a confident judgement can be made as whether or not the small elevations are tolerable for the limited duration of the TB treatments. Small elevations aren't dangerous for short periods. It takes a long time to cause real liver damage. But only a good liver doctor armed with the relevant data should be making that kind of call.
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