Elevated LFTs : Tomorrow is my last day... - Advanced Prostate...

Advanced Prostate Cancer

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Elevated LFTs

Milkweed profile image
7 Replies

Tomorrow is my last day of IMRT, with high-dose Brachytherapy scheduled to follow starting next week. But on pre-op labs my LFTs hav risen dramatically over the past 3 months, up 4-7x from normal baseline. I did not have visceral mets on any of several staging scan types. I am asymptomatic as far as the liver goes. The rest of the labs look great- CBC, Bun and Creatinine, Calcium and Alk Phos, electrolytes, testosterone (total) is 24. Most recent PSA 0.25 at the beginning of IMRT. I am taking Lupron, Bicalutamide, Tamsulosin, a multi-strain probiotic and B-complex vitamin supplement, turmeric, and vitamin D3 at 5000 IU/day, all started at diagnosis in late January. Reading, it looks like several of these could, if rarely, cause hepatotoxicity. Reading I also learned of grapefruit juice possibly interfering with Bicalutamide metabolism in the liver and I drink an unusually large amount of fresh grapefruit juice, have for a long time simply because I like it.. Anyone think the grapefruit-bicalutamide combo or something else I am taking could cause such marked liver enzyme rise, and if so is this typically reversible? Or does this seem more like a sign of liver mets?

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Milkweed profile image
Milkweed
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tango65 profile image
tango65

Some info about bicalutamide and liver toxicity:

livertox.nih.gov/Bicalutami...

and about grapefruit and interactions with medicines:

ncbi.nlm.nih.gov/pmc/articl...

and about bicalutamide and drug interactions

pdr.net/drug-summary/Casode...

Longterm101 profile image
Longterm101

Good luck. Where are u being treated?

How many sessions of IMRT did you have?

Milkweed profile image
Milkweed in reply to Longterm101

Salt Lake City, Gamma West. 28 sessions.

Longterm101 profile image
Longterm101 in reply to Milkweed

Stay healthy !!

Tall_Allen profile image
Tall_Allen

Maybe try cutting out all supplements and grapefruit juice and retest after giving time for washout.

j-o-h-n profile image
j-o-h-n

I was always told to never drink grapefruit juice with meds... (and never ever eat the pits)...

Good Luck, Good Health Good Humor.

j-o-h-n Thursday 05/09/2019 11:53 AM DST

Stelle profile image
Stelle

Get off the biculutamide and Lupron NOW and change to Enzalutamide (Xtandi) TODAY! Ask your oncologist why you are not on it. It is now within the Standard of Care. It is very successful relatively new drug. My PSA has been no more than 0.14 for the last 15 months. You may not be getting it because the annual cost is about $130k/yr. If you are in the US Medicare and most private insurance will cover it.

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