Please answer (APAP and elevated ALTs)

[terminator02]

I'm in my 30s and do not drink but abuse percocet on and off throughout the year.  My enzymes have never been elevated but now they are.  I take 1300mg APAP (20mg oxycodone) at once and then 975mg APAP 4 hours later and then that is it for the day.  I repeat this for 2 weeks and then go anywhere from 2 weeks to 3 months off.  No alcohol ever used in conjunction and rarely alcohol when not taking APAP.  I quit using the painkillers 10 days before my test.  My ALTs were 59.  Which is slightly elevated. My doctor doesn't know I take the dose as I do and attributed this to my change in weight over the last year.  So I am going to diet down and stop taking the medicine. How long should it take for my enzymes to return to normal?  I would have thought 10 days would be enough as I don't think I am taking THAT much over recommended values; but do realize it is not advisable.  How concerned should I be here? i can only imagine what my enzyme readings are for the weeks that I am taking the medication if they are 59 10 days off and with me taking milk thistle and eating better.  Thanks in advance.

[ill13632]

I am taking NAC at high doses I think it's good and I'm feeling better.  I think it's insanity to wait 2 months to treat a level of 80/250.  I may have had millions of liver cells die already because of this terrible hospital
I only took high doses of glutamine,

[NT77]

Again, it depends on the individual liver. For a liver of 'average strength', AST of 59 is not that 'abnormal'. General consensus is that it should be below 40. Also, your liver, just like you, doesn't heal as fast as it used to when you were in your 20s. If you're otherwise healthy, it's more then likely it's gonna recover. You will know in 2 months. In the mean time, overdosing on anything (even milk thistle) will not help the recovery at all. Neither will worrying about it.

Please let me know the new numbers in 2 months, I would really like to hear them.

[ill13632]

Percocet comes in 5mg doses that I was taking every 4 hours.  so it's not possible that my 80/250 levels were from Percocet.  maybe my levels shot up so high because of methenamine/sodium salicylate or the surgery/anesthesia?

[terminator02]

Thanks for the response.  How "abnormal" is a level of 59?  This is about 2 weeks after I ingested the last of the APAP?  I am hoping it was still recovering and takes longer than 2 weeks.  I am getting rechecked in 2 months.  

[NT77]

There's no definitive answer to your questions.

Try looking at it this way: your liver has to break apart every toxin you put into your system. It particularly doesn't like breaking apart paracetamol, and to a lesser degree oxycodone. But it also doesn't like breaking apart traces of pesticides that are on the fruit and vegetables in supermarkets. And many other things.

Every liver in the world has a limit on how many toxins it can process. Some people reach that limit early, some late, and some never. It really depends on your individual liver, and health of your other organs.

Good news: liver, of all the organs, has a greatest tendency to repair itself.