An aximum scan picked up three cancerous lymph nodes in my pelvic area. I got a 3 month injection of Lupron on 5/18 and started 1000 mg generic Zytiga on 5/26. A blood test on 6/21 showed very elevated liver enzymes; ast was 130 and alt was 215, so I was taken off Zytiga. A week later my enzymes were back to normal; ast was 17 and alt was 36. My MO put me back on 500 mg Zytiga and will continue to monitor liver function weekly. My MO said that I was one of the unlucky 6% that have liver issues. Has anyone else had this problem with Zytiga? Otherwise, side effects from lupron and Zytiga are minimal with mild hot flashes and afternoon fatigue. I also am on day 6 of 25 days of radiation to all pelvic lymph nodes. I think I’m beginning to feel a little more fatigued from the radiation. Hopefully I can tolerate the reduced Zytiga. My testosterone is non detectable and psa is 0.4, down from 1.9 when I started treatments. Thanks for reading!
Liver problems with Zytiga - Advanced Prostate...
Liver problems with Zytiga
Zytiga can be tough on some livers. 1000 mg made my enzymes skyrocket. I reduced to 750 mg without much improvement. At 500 mg my liver enzymes went back to normal. I also supplemented with European Milk Thistle and dandelion root, which seem to help the liver.
When I first went on 1000 mg Zytiga along with Lupron I had elevated liver enzymes. I then stopped taking it for about 2 months while remaining on Lupron after which my liver readings were back to normal. I then started back on Lupron at half the normal dosage. My liver readings remained normal and the dosage went back to 1000 mg. All was well until I stopped taking it as part of my ADT vacation six months later.
We don’t know exactly why this all occurred but I remember seeing an article referring to a similar experience while on initially on Casodex for 2 weeks before going on Lupron and Zytiga, which was the case for me. The article attributed the liver problem to Casodex rather than on Zytiga. I’ll try to find the article.
I was in Zytiga (1000 mg) for a year or so. I guess I was on the lucky side...no issues with liver. Urologist required that I have blood tested each 2 weeks. After about 3 months of that with no issues, I went to a 3 month test to coincide with PSA check. Only pain was to wallet.
It's not too common. When I started Zytiga, I asked my doctor about it and he said it does happen but he has not seen it yet. I asked him how many patients he currently has on Zytiga and he said "about 2 dozen".
In many cases lowering the dose solves the problem and is still effective.
Wishing you the best.
I was initially on 1000 mg of Zyteiga plus a three month eligard shot. I had lots of qol issues so I went off zyteiga. Fast forward a few months and my new mo had me on250mg of Zyteiga plus Orgovyx. Shortly thereafter I had a heart attack and he took me off Zyteiga completely because it is hard on the heart. Come to find out that 250 mg with food is just as effective as1000 mg without food.
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I had a liver problem with Zytiga where my numbers went to 1500 and 3000. Stopped immediately and took a couple of months for levels to get back to normal. MO did not put me back on Zytiga and Lupron has been working good. Low testosterone and negligible PSA. With less severe reactions I hear lower doses have no liver effects but keep taking blood tests to verify. I hope the lower dose works for you. I did have 40 RTs where fatigue got a little worse towards the end. Exercise is key.
I had the same liver issues. Reduced it to 750/day then settled on 500/day. Been on that dose 2 1/2 yrs. Your numbers look good.
I had similar situation on Zytiga as liver could not tolerate it. Now it’s Lupron every 3 mos as my T level is at castrations level. I cannot emphasize how much you need to exercise and eat healthy to combat the disease. I drag myself up to get off the mat each day and exercise as unfortunately our disease takes no time off. Working out with free weights just trying to maintain muscle mass in hopes of looking like Nal at a later age! Ha ha!!!
Are you on any statins or any other meds that may affect the liver? Keith had an issue and the oncologist didn't think to look at his other medications and see if there were any interactions. . .
Just atorvastatin
Statins can affect your liver. Before altering Zytiga, talk to your doctor about the interactions between the two. There may be another statin or other healthy ways to deal with cholesterol. Keith went off them during chemo because his numbers were rising. He gave his liver a rest and then started them back again. Luckily he's had no problems with Zytiga and statins. Personally, I won't take statins. . .but that's just me.
Good treatment plan. Radiation generally gives some level of fatigue but is temporary. 👍👍🙏💕
Finally some good news! My liver seems to be tolerating the 500 mg level of Zytiga! Also, 9 out of 25 radiation treatments finished.
I convinced my MO to start me on 750 Mg. Zytiga & I immediately started taking the European Milk Thistle & Dandelion Root.. (My MO said there was no "study" that indicated it would help) But I tolerated the Zytiga fine & had no elevated liver readings so after 2 months we upped the Zitiga to the full dose of 1000 (body had a chance to adjust to it) & I still have good liver readings & low PSA.. Yeah..!! And I continue to take my Milk Thistle.. Good Luck..
Elevated liver enzymes
Advice on radiation treatment?
SIGNIFICANT METS PROGRESSION DESPITE LOW PSA, LOW ALP, LOW CALCIUM WITH LUPRON/ZYTIGA TREATMENT
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