Methotrexate - AST/ALT mildly elevated

pinkteapot
pinkteapot Member Posts: 48
edited 31. Jan 2020, 11:10 in Living with arthritis
Had my monthly blood test this morning, and the nurse wrote my last results from 31/12/19 in my booklet.

My AST/ALT has always been <25 - it's ranged from 7-23, bouncing around within that range since I started on MTX in May last year. I noticed that at the test in December it was 85. :shock:

Spoke to a GP and they said that's only classed as 'mildly elevated'. Under 50 is normal, 50-120 is mildly elevated, above that there's a problem. They'll look at the result from today's test - if it's the same as last time or has fallen then it's fine. If it increases again they'll talk to the rheumatologist.

Anyone else experienced this and had it be temporary?

I'm having a bit of a panic about the 'what if's'. :| My brain is running to having to stop methotrexate. I do have a love-hate relationship with it because I feel tired and down for 2 days after taking it, but my joints are amazing - no inflammation or pain since starting it, apart from a residual stiff finger from a previous flare.

I know I just have to wait and see, and hope today's bloods are OK. Nothing else I can do.

Keep any fingers you can crossed for me!

Comments

  • stickywicket
    stickywicket Member Posts: 26,023
    edited 30. Nov -1, 00:00
    I will. So often these things are just blips which soon sort themselves out. I hope yours does :D
    “There is always a well-known solution to every human problem - neat, plausible, and wrong.” H.L. Mencken
  • pinkteapot
    pinkteapot Member Posts: 48
    edited 30. Nov -1, 00:00
    Thanks! I didn't drink alcohol over Christmas but my diet was atrocious and I ate my body-weight in cheese, so maybe my liver just wasn't enjoying that... :lol:
  • trepolpen
    trepolpen Member Posts: 500
    edited 30. Nov -1, 00:00
    hi pinkteapot , I was on methotrexate for 18 years , in the early years I had problems with raised ALT , it got to 178 so had to stop the drug , when I went back on they put my folic acid up to six per week & this sorted the problem & on 25mg methotrexate my ALT was normal and back under 40

    you have to speak to your consultant or rheummy nurse
  • phoenixoxo
    phoenixoxo Member Posts: 625
    edited 30. Nov -1, 00:00
    Well, I haven't had any blips myself, but a friend did while on methotrexate tablets and they sorted themselves out, somehow. Good luck for your next lot of results. I'm crossing my toes :)
    PsA (psoriatic arthritis) and other things since 1990. Happy to help when I can :-)
  • dreamdaisy
    dreamdaisy Member Posts: 31,567
    edited 30. Nov -1, 00:00
    This has happened to me on a number of occasions, things have always settled down. This is why we have the regular tests as they can show potential problems before they happen. I must confess it's never bothered me but it helps being an old hand at the meds game.

    The best one was my ALT rising from 18 to over 600 in the space of a fortnight. I hadn't a clue 'cos I felt fine. During that time I learned that people with liver diseases have ALT readings in the thousands and are said to have a deranged liver, a terrific phrase. I merely have deranged joints. :roll: On that occasion enbrel was the culprit, I stopped the med and within a month all was back to normal.

    There is no point in saying don't worry or assume the worst because people naturally do and do; time spent playing this monstrous game is the best instruction for keeping things in proportion. Please let us know how you get on, I was on fortnightly bloods for years, what is your timetable? DD
    Have you got the despatches? No, I always walk like this. Eddie Braben
  • Springsoft54
    Springsoft54 Member Posts: 4
    edited 30. Nov -1, 00:00
    My recent experience on 20mg of methotrexate per week for over 20 years was good blood test numbers all the way along........but then.....
    I had some problems with reflux develop, so saw a gastroenterologist who did the usual endoscopy/colonoscopy examinations and also ordered a fibroscan. Kinda like an echo gram for the liver.
    Boom! Nearly maxed out on the hardness scale despite all the good blood test numbers. Diagnosis was that I was close to irreversible and potentially fatal liver damage.

    Much of this was my fault. I like single malt whiskeys from Islay in particular, and dark ales. Neither of which get on well will methotrexate being metabolised by the liver.

    Now off the alcohol and hoping for better test results at next scan in Feb 2020.

    Short advice is - whatever the bloods are like, still have a fibroscan because the bloods don’t tell you everything.
  • pinkteapot
    pinkteapot Member Posts: 48
    edited 30. Nov -1, 00:00
    Thanks, all! Well, latest result is in and it's back down to 17! They've no idea why it blipped in December.

    dreamdaisy - I'll be much more relaxed next time this happens. Just another aspect to life now to get used to! And I love 'deranged liver'. :lol:
  • dreamdaisy
    dreamdaisy Member Posts: 31,567
    edited 30. Nov -1, 00:00
    I reckon everyone's livers do this but we only find out because we have regular bloods done. I am pleased it's settled down again and I hope it stays that way. DD
    Have you got the despatches? No, I always walk like this. Eddie Braben
  • stickywicket
    stickywicket Member Posts: 26,023
    edited 30. Nov -1, 00:00
    I'm pleased all is well.

    If you really suspect your high-fat Christmas diet try it again and see what happens. A fun experiment, at least :wink:
    “There is always a well-known solution to every human problem - neat, plausible, and wrong.” H.L. Mencken
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