Rising Liver Enzymes

[Mackeyandme]

On Zytiga, Prednisone and Lupron (standard plan). PSA has gone from 8.0 to undetectable within 3 months period but Liver Enzymes have started climbing over last 30 days. Any thoughts? Which is lesser poison, liver destruction or slow growing PC.

[Kentucky1]

My liver enzymes went up during the initial few months that I started abiraterone. By month 4 they had returned back to normal range. A dose reduction may be necessary if they are greatly elevated. Your doctor can assess this need based upon guidleines from the manufacturer.

[Vangogh1961 in reply to Kentucky1]

Same for me, month 3 spike but not in the "stop" range and dropped the next month.

[Mackeyandme in reply to Kentucky1]

Thanks for your response, gives me some comfort.

[Ptripp2]

I don’t know the answer to this, but I’m wondering if you could tell me what to look for on my fathers labs to see if this is happening. He is on the same exact regimen as you since March. What is the name of liver enzymes on the labs? I can’t tell what is what.

[Mackeyandme in reply to Ptripp2]

I believe it is ALT, AST and BUN levels. On my lab report it indicates an "H" or "L" by those items that are out of line.

[Grandpa4 in reply to Mackeyandme]

Alt and AST not BUN. BUN measures kidney function and hydration status.

[dhccpa in reply to Grandpa4]

Maybe Albumin?

[treedown]

I dropped Zytiga for a month for another issue and resumed at 750mg daily with decent results.

[Tall_Allen]

Sometimes the liver just has to accommodate. Talk to your oncologist about easing off the dose for a while, and then slowly ramping back up. Maintain 5 mg prednisone.

[GoBucks]

Your numbers can go up to 5 times normal. When mine reached that point I stopped Zytiga until numbers went back to normal. (off about 7 weeks) Then restarted at 1/2 dose. Numbers ok so went to 3/4 dose in about August 2018. Been there since and at <0.01 the whole time.

[G-Man-00]

I started Zytiga/Prednisone in Nov and had a 1 month spike, but the numbers have been normal since. There has been some research on the effects of coffee and liver enzyme levels you might wish to explore.

[Chrisbaird]

Same happened to me was in 1000gm zytiga for 3 months liver toxicity so came off zytiga for 2 weeks then reduced to 500gm PSA remained 0.01 and below 9 months. But have noticed slight discomfort past month within stomach when take zytiga 7am got a 3x monthly call with MO next week

[leebeth]

Do you drink any alcohol? It might be too much, while your liver is accommodating.

[ukulele_grandpa]

I appreciate your input. Matches my treatment and timing, so I want to follow your experience. 👍

[Carlosbach]

Over the first 6 months my ALT bounced around between a low of 17 and a high of 87

My AST ranged anywhere from 15 to 47.

My MO said that we shouldn't worry unless the highs were several times greater, and that the results stayed high for successive tests. After a while the numbers started dropping and they have been in "normal" ranges for the last year.

[Si52]

It happened to me when I was first prescribed Zytiga. I was prescribed Heptral. It brought the liver numbers back to normal after 3 months and I then stopped taking the Heptral.

[Dlanghorne]

I started 1000 mg Zytiga plus 5 mg Prednisone in August 2019. Then in November 2019 my AST and ALT rose out of range. MO reduced to 500 mg which I still take today. PSA has been undectable since then. FYI did have Prostatectomy plus 19 Lymph nodes in Jan 2019.I test blood every month to catch ANY rise.