New to Methotrexate - Concerns re Liver Function Test

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postal12
postal12 NonActiveMember5yrs Posts: 20
edited 23. Dec 2009, 15:40 in Living with Arthritis archive
Hi
I have had my first 2 week blood tests results and liver function test showed highs of 172 Alk Phos and 70 ALT/SGPT serum level. Is this usual after two weeks of Methotrexate 10 mg or should I be concerned about these high readings? I had headaches the first week and very severe headache the second week and have reduced dose from 4 to 3 tablets and no problems apart from slight diarrhoea - no sickness. My local Pharmacist is on Methotrexate and advised me not to handle tablets and mix in with food so that I can swallow them down quickly without touching my tongue. I take them one at a time in between a half spoonful of porridge and followed down with plenty of milk and water. I drink some milk before taking the medication. I know it is early days for me but wonder if this is stopping me getting nausea. Would appreciate advice on liver function test high readings please.
Thanks Angie

Comments

  • carob22
    carob22 Member Posts: 6
    edited 30. Nov -0001, 00:00
    Hi Angie
    I don't know much about high liver test results, but I do know that my GP said she would phone me any time there was something worrying about my results. If you are concerned, maybe you should phone your GP, or the Specialist Rheumy nurse. The MTX dose you are on is not very high, I am on 20 mg! Anyway, just wanted to say hang in there :)
    Caro[/img]
  • annie_mial
    annie_mial NonActiveMember5yrs Posts: 5,614
    edited 30. Nov -0001, 00:00
    I've been on MTX for seven weeks now and am being bumped up rather quickly to 20mg. I've had no problems so far (I take them with my evening meal on a Sunday). My doctor assured me that should any adverse results show on the blood tests, I would be contacted immediately. So far, so good.

    Annie
  • salamander
    salamander NonActiveMember5yrs Posts: 1,906
    edited 30. Nov -0001, 00:00
    Hi, I have had high liver results but nothing to do with methotrexate as haven't started it yet. I was reassured that they weren't high enough for them to worry about (my ALT was something like 52 though it was over 100 in the summer before I took any drugs at all.) I guess your rhuematologist is the one to talk to but imagine if they were worried they would adjust your meds. I hope you get the answers you need.
  • postal12
    postal12 NonActiveMember5yrs Posts: 20
    edited 30. Nov -0001, 00:00
    carob22 wrote:
    Hi Angie
    I don't know much about high liver test results, but I do know that my GP said she would phone me any time there was something worrying about my results. If you are concerned, maybe you should phone your GP, or the Specialist Rheumy nurse. The MTX dose you are on is not very high, I am on 20 mg! Anyway, just wanted to say hang in there :)
    Caro[/img]

    Hi Carol
    I have another blood test next Tuesday, so I guess that if the readings are still high, my Doctor or Rheumatologist will be in contact with me. It is scary the thought of being on a higher dose! Fortunately at the moment I am not too bad (mainly my wrists the worst problem). I was diagnosed RA/PA early, so hoping that if I can stick to the MTX that it may avoid it getting any worse. Hope so anyway!
    Best wishes
    Angie
  • postal12
    postal12 NonActiveMember5yrs Posts: 20
    edited 30. Nov -0001, 00:00
    sally36 wrote:
    Hi, I have had high liver results but nothing to do with methotrexate as haven't started it yet. I was reassured that they weren't high enough for them to worry about (my ALT was something like 52 though it was over 100 in the summer before I took any drugs at all.) I guess your rhuematologist is the one to talk to but imagine if they were worried they would adjust your meds. I hope you get the answers you need.

    Thanks Sally. Your comments are re-assuring. You will see my reply back to Carol, so fingers crossed results are better next week.
    Best wishes Angie
  • postal12
    postal12 NonActiveMember5yrs Posts: 20
    edited 30. Nov -0001, 00:00
    annie_mial wrote:
    I've been on MTX for seven weeks now and am being bumped up rather quickly to 20mg. I've had no problems so far (I take them with my evening meal on a Sunday). My doctor assured me that should any adverse results show on the blood tests, I would be contacted immediately. So far, so good.

    Annie

    Hi Annie
    I hope they dont increase my MTX as I do feel the body needs to get used to it for awhile before any changes. I have been diagnosed early with RA/PA so hoping that 3-4 tablets will curb it from getting too bad. Time will tell! I am surprised they are increasing your medication so quickly as I believe it takes quite a few weeks before you notice any difference with your joints etc.
    Best wishes Angie
  • salamander
    salamander NonActiveMember5yrs Posts: 1,906
    edited 30. Nov -0001, 00:00
    postal12 wrote:
    sally36 wrote:
    Hi, I have had high liver results but nothing to do with methotrexate as haven't started it yet. I was reassured that they weren't high enough for them to worry about (my ALT was something like 52 though it was over 100 in the summer before I took any drugs at all.) I guess your rhuematologist is the one to talk to but imagine if they were worried they would adjust your meds. I hope you get the answers you need.

    Thanks Sally. Your comments are re-assuring. You will see my reply back to Carol, so fingers crossed results are better next week.
    Best wishes Angie

    good luck with it all. I know how worrying these test results can be. I hate the way my life seems to be taken over with hosp visits, drugs, life adjustments etc, as I am in early stages like you. Hope it will all settle down for us both!
    X
  • postal12
    postal12 NonActiveMember5yrs Posts: 20
    edited 30. Nov -0001, 00:00
    sally36 wrote:
    postal12 wrote:
    sally36 wrote:
    Hi, I have had high liver results but nothing to do with methotrexate as haven't started it yet. I was reassured that they weren't high enough for them to worry about (my ALT was something like 52 though it was over 100 in the summer before I took any drugs at all.) I guess your rhuematologist is the one to talk to but imagine if they were worried they would adjust your meds. I hope you get the answers you need.

    Thanks Sally. Your comments are re-assuring. You will see my reply back to Carol, so fingers crossed results are better next week.
    Best wishes Angie

    good luck with it all. I know how worrying these test results can be. I hate the way my life seems to be taken over with hosp visits, drugs, life adjustments etc, as I am in early stages like you. Hope it will all settle down for us both!
    X

    I know what you mean! Two of my Xmas presents this year are a magic can opener and jar/bottle opener. I guess we cannot drink much over Xmas either - fortunately I have never drunk a lot anyway. My joints seized up overnight towards end August. First blood test did not show up RA/PA but the second one did.
    Best wishes Angie x
  • salamander
    salamander NonActiveMember5yrs Posts: 1,906
    edited 30. Nov -0001, 00:00
    postal12 wrote:
    sally36 wrote:
    postal12 wrote:

    Thanks Sally. Your comments are re-assuring. You will see my reply back to Carol, so fingers crossed results are better next week.
    Best wishes Angie

    good luck with it all. I know how worrying these test results can be. I hate the way my life seems to be taken over with hosp visits, drugs, life adjustments etc, as I am in early stages like you. Hope it will all settle down for us both!
    X

    I know what you mean! Two of my Xmas presents this year are a magic can opener and jar/bottle opener. I guess we cannot drink much over Xmas either - fortunately I have never drunk a lot anyway. My joints seized up overnight towards end August. First blood test did not show up RA/PA but the second one did.
    Best wishes Angie x

    I siezed up beginning of August, it's taken a while for a diagnosis as they thought it might have been viral arthritis. Sadly not. I am not too bad most days but am on steroids (starting mtx in Jan) though today I am really bad, fingers feel wooden, achy wrists and sore feet. Don't know if it is the cold or what. Like you, I am not much of a drinker but I was told by the rheum nurse yesterday I could have no more than six units a week and none on the mtx day or the day after. She said it is unrealistic to ban alcohol altogether so I've opted to take mtx on a Monday which at leat means I can have a drink on the weekends if I like.
    Is the mtx working for you?
    Sally x
  • postal12
    postal12 NonActiveMember5yrs Posts: 20
    edited 30. Nov -0001, 00:00
    sally36 wrote:
    postal12 wrote:
    sally36 wrote:

    good luck with it all. I know how worrying these test results can be. I hate the way my life seems to be taken over with hosp visits, drugs, life adjustments etc, as I am in early stages like you. Hope it will all settle down for us both!
    X

    I know what you mean! Two of my Xmas presents this year are a magic can opener and jar/bottle opener. I guess we cannot drink much over Xmas either - fortunately I have never drunk a lot anyway. My joints seized up overnight towards end August. First blood test did not show up RA/PA but the second one did.
    Best wishes Angie x

    I siezed up beginning of August, it's taken a while for a diagnosis as they thought it might have been viral arthritis. Sadly not. I am not too bad most days but am on steroids (starting mtx in Jan) though today I am really bad, fingers feel wooden, achy wrists and sore feet. Don't know if it is the cold or what. Like you, I am not much of a drinker but I was told by the rheum nurse yesterday I could have no more than six units a week and none on the mtx day or the day after. She said it is unrealistic to ban alcohol altogether so I've opted to take mtx on a Monday which at leat means I can have a drink on the weekends if I like.
    Is the mtx working for you?
    Sally x

    They also thought mine was a viral or reactive arthritis first but sadly like you, it wasnt. I had swollen feet and 1 hand to start with(happened one after another) and could not bend legs in the night. Legs and feet Ok at the moment. Hands and wrists worst and get very weak and hurt to write or type. Cold seems to be affecting mine. I took the fourth dose of MTX yesterday and had slight nausea but no headaches. 3 tablets obviously agrees with me more than 4. I had a steroid injection on 9 September but I guess that would have worn off by now. I take my MTX on a Wednesday with breakfast as we are less busy mid week and then I am also OK at the weekend.

    Keep in touch as we seem to be at a similar stage.
    Best wishes Angiex
  • margaretschild
    margaretschild NonActiveMember5yrs Posts: 197
    edited 30. Nov -0001, 00:00
    Hi All,

    Just wanted to say when I was taking MXT and my results were only slightly high my GP called me in straight away.

    My consultant ok, it was his registrar really, but she rang me once as well. Proving that they do actually read the results even if we mortals think they don't. Lol
  • postal12
    postal12 NonActiveMember5yrs Posts: 20
    edited 30. Nov -0001, 00:00
    Hi All,

    Just wanted to say when I was taking MXT and my results were only slightly high my GP called me in straight away.

    My consultant ok, it was his registrar really, but she rang me once as well. Proving that they do actually read the results even if we mortals think they don't. Lol

    Thanks Margaret. I have another blood test on Tuesday, so hope that my high liver results may have gone down. I daresay if they are high again, I will receive a call from someone! I am not sure if it is normal for the readings to be high when you first go on MTX. If anyone can enlighten me, that would be great.
    Best wishes Angiex
  • salamander
    salamander NonActiveMember5yrs Posts: 1,906
    edited 30. Nov -0001, 00:00
    sent you a pm Angie, too hard to find the threads!
    Sally
  • vezmac
    vezmac NonActiveMember5yrs Posts: 2
    edited 30. Nov -0001, 00:00
    Hi guys, I've just been reading through your replies and I have to say they have settled my mind a bit, I was diagnosed beginning of December and am so scared to say the least. I have been suffering chronic symptoms for nearly a year now with my gp doing very little to help. The rhumatologist has said she wants to start me on methotrexate beginning of January but everything I have read on it has scared me senseless. Is it really as bad as it reads.....please help, I would really appreciate it

    Verity xx
  • salamander
    salamander NonActiveMember5yrs Posts: 1,906
    edited 30. Nov -0001, 00:00
    vezmac wrote:
    Hi guys, I've just been reading through your replies and I have to say they have settled my mind a bit, I was diagnosed beginning of December and am so scared to say the least. I have been suffering chronic symptoms for nearly a year now with my gp doing very little to help. The rhumatologist has said she wants to start me on methotrexate beginning of January but everything I have read on it has scared me senseless. Is it really as bad as it reads.....please help, I would really appreciate it

    Verity xx

    Verity, I was diagnosed about the same time as you after suffering symptoms (which hospitalised me for 2 weeks) for 5 months. I too was terrified of mtx but, having met the rheum nurse and talked it through, have decided to give it a go. I start beginning January too. It was the fear of doing permanent damage to my joints that decided it for me even though I didn't feel that bad at the time. Ironically, the day after my appointment I had a bad flare up and realised I had done the right thing. I don't know what it is like or how it will affect me but feel I am the one in control of this and will stop the drugs if need be. Seeing as we will be starting at the same time (if you decide to) let's keep in touch. You can send a private message any time or post here. We can compare notes!
    Sally
  • postal12
    postal12 NonActiveMember5yrs Posts: 20
    edited 30. Nov -0001, 00:00
    vezmac wrote:
    Hi guys, I've just been reading through your replies and I have to say they have settled my mind a bit, I was diagnosed beginning of December and am so scared to say the least. I have been suffering chronic symptoms for nearly a year now with my gp doing very little to help. The rhumatologist has said she wants to start me on methotrexate beginning of January but everything I have read on it has scared me senseless. Is it really as bad as it reads.....please help, I would really appreciate it

    Verity xx
    Hi Verity. I was diagnosed with RA and PA in September following symptoms in August. I had swollen feet and 1 hand (1 at a time) and then all my joints seized up overnight. Was given a steroid injection in my bottom which helped and am now on Methotrexate. Like you I was petrified of going on this medication - I am never keen on taking anything. I started on 10 mg (4 tablets) and had severe headaches (worse the second week) and a numb feeling in my face (cheekbone up to eyes). My Doctor said I could reduce the dose to 3 tablets which I did and for the last 3 weeks I have generally been fine. Today is my medication day, so I may be tempting fate saying this! When my body has adjusted to MTX and I have a quiet day, I will try and increase back to 4 tablets. My liver reading was high two weeks ago and am waiting for the results of blood test I had yesterday. Fingers crossed all OK! At the moment I am happy to be on MTX and given time, hope it improves my joints - hands and wrists weak and difficult to write/type, otherwise not too bad at the moment. Take care and feel free to keep in touch with me. Best wishes Angiex
  • vezmac
    vezmac NonActiveMember5yrs Posts: 2
    edited 30. Nov -0001, 00:00
    sally36 wrote:
    vezmac wrote:
    Hi guys, I've just been reading through your replies and I have to say they have settled my mind a bit, I was diagnosed beginning of December and am so scared to say the least. I have been suffering chronic symptoms for nearly a year now with my gp doing very little to help. The rhumatologist has said she wants to start me on methotrexate beginning of January but everything I have read on it has scared me senseless. Is it really as bad as it reads.....please help, I would really appreciate it

    Verity xx

    Verity, I was diagnosed about the same time as you after suffering symptoms (which hospitalised me for 2 weeks) for 5 months. I too was terrified of mtx but, having met the rheum nurse and talked it through, have decided to give it a go. I start beginning January too. It was the fear of doing permanent damage to my joints that decided it for me even though I didn't feel that bad at the time. Ironically, the day after my appointment I had a bad flare up and realised I had done the right thing. I don't know what it is like or how it will affect me but feel I am the one in control of this and will stop the drugs if need be. Seeing as we will be starting at the same time (if you decide to) let's keep in touch. You can send a private message any time or post here. We can compare notes!
    Sally

    Sally,

    Thank you so much, I would love to keep i touch going through this. I am so frightened. I have only just got married and I think the shocker for me was the whole having children thing......I want to one day but dont want this t affect my chances. ALso I am scared its going to affect my job.....I'm really hoping it won't. Got my appointment on 4th January at 12 so will talk more to the nurse then and find out if my chest xray was ok, Meanwhile I'll just manage on the arcoxia, seem to be having one flare up after another at the moment.....its so draining....just want to sleep and hide in bed under my duvet.

    Verity xxx
  • salamander
    salamander NonActiveMember5yrs Posts: 1,906
    edited 30. Nov -0001, 00:00
    vezmac wrote:
    sally36 wrote:
    vezmac wrote:
    Hi guys, I've just been reading through your replies and I have to say they have settled my mind a bit, I was diagnosed beginning of December and am so scared to say the least. I have been suffering chronic symptoms for nearly a year now with my gp doing very little to help. The rhumatologist has said she wants to start me on methotrexate beginning of January but everything I have read on it has scared me senseless. Is it really as bad as it reads.....please help, I would really appreciate it

    Verity xx

    Verity, I was diagnosed about the same time as you after suffering symptoms (which hospitalised me for 2 weeks) for 5 months. I too was terrified of mtx but, having met the rheum nurse and talked it through, have decided to give it a go. I start beginning January too. It was the fear of doing permanent damage to my joints that decided it for me even though I didn't feel that bad at the time. Ironically, the day after my appointment I had a bad flare up and realised I had done the right thing. I don't know what it is like or how it will affect me but feel I am the one in control of this and will stop the drugs if need be. Seeing as we will be starting at the same time (if you decide to) let's keep in touch. You can send a private message any time or post here. We can compare notes!
    Sally

    Sally,

    Thank you so much, I would love to keep i touch going through this. I am so frightened. I have only just got married and I think the shocker for me was the whole having children thing......I want to one day but dont want this t affect my chances. ALso I am scared its going to affect my job.....I'm really hoping it won't. Got my appointment on 4th January at 12 so will talk more to the nurse then and find out if my chest xray was ok, Meanwhile I'll just manage on the arcoxia, seem to be having one flare up after another at the moment.....its so draining....just want to sleep and hide in bed under my duvet.

    Verity xxx

    Hi Verity, have sent you a PM in reply.
    S