Cause of Liver Enzymes increasing

[TMcgee]

On 2/3, I received my first Docetaxel treatment. At the time, my AST was 33 and AIT 54. Yesterday, my Second scheduled treatment was delayed because my AST 361 and ALT 663.

Prior to the first treatment I was advised to use Tylenol for pain and swelling. I’ve never used Tylenol prior to 2/3; but, I estimate that I consumed between 1500mg and 3000mg over half the days between 2/3 and now. I have stopped using all medication, outside my Prescribed Abiraterone/Prednisone.

Questions:

I’m scheduled to have my 2nd Docetaxel next Friday. Is it realistic to expect my enzyme numbers to respond that fast?

How long can I wait between treatments without affecting efficacy?

If I can’t tolerate Docetaxel are there alternatives?

Is it wishful thinking to believe the Tylenol could be the cause?

Thank you! As always your help is awesome and I wish all of you well…

[Heykm01]

If you search these posts for ‘liver enzymes’ you’ll find a fair frequency of abiraterone related cases of high alt/ast. In some cases it’s been reported that a break or reduction of abi brings the numbers down and allows a restart without the increase.

I have similar issue, but am on darolutamide. Per oncologist direction, I have reduced my dose in half, waiting to see response.

[TMcgee in reply to Heykm01]

I’ve been on Lupron+ Abiraterone +XGeva for 3 months without it affecting my enzymes. I’ve narrowed the elevation to Docetaxel +/- Tylenol. Thanks

[Heykm01 in reply to TMcgee]

My bio has my enzyme numbers over time so you can compare if you like.

[leebeth in reply to TMcgee]

The elevation of liver enzymes with abiraterone usually occurs within the first four months, and you are within the timeframe. The most likely culprit is indeed your abiraterone. A break from that will confirm it as the cause. The acetaminophen may well have exacerbated it, but the root cause is still the abi.

[TMcgee in reply to leebeth]

Thanks! My MO believes the Tylenol is the problem, which I find a reach. I’ll bring up the Abi on Monday when I see him

[TMcgee in reply to leebeth]

Bases on your information, I researched the possibility of Abiraterone causing the elevated enzymes on NIH. I agree with your assessment that abi toxicity would occur right about now (2 months). But, in the two studies that I researched Tylenol was far and away the major cause for DILI (drug induced liver injury). Abi accounted for 6% of the incidence.

It seems that I was mistaken in believing the Docetaxel was the problem. I now have two suspects (Tylenol and Abi). I have stopped Tylenol and an crossing m fingers that it is the culprit.

[leebeth in reply to TMcgee]

I think the Tylenol pushed it over the edge. My guess is a brief break from abi, then restart when enzymes return to normal, and you will be in great shape. Best of luck!

[TMcgee in reply to leebeth]

I can’t disagree with your analysis. Everything I read on NIH supports your conclusion. Take care

[katartizo61]

I use a liver clenz product and have 19 months of great liver enzyme testing.