Methotrexate Nightmare

Hi, I am looking for some info please from anyone who has had a similar experience to me. I have been off metho for a month due to elevated lfts and only take hydroxychloroquine at present.

Well my ALT is away up to 150 and was only at 83 a fortnight ago. Has this happened to anyone else after coming off methotrexate? It's a real mystery and I am concerned although the Rheumatology Team are keeping a close eye on things.

Thanks in advance.

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  • hi yes i have come off several times in the last few years, had a liver ultrasound last year and i have a fatty liver (goes with the rest of me :-) ) they said they would raise the trigger levels of stopping meds,my levels have no rhyme or reason for raising topped 332 this year woohoo then 2 weeks later normal i wish i could give an answer to why but my consultants are scratching their heads too,obvious one, no booze, as im teetotal not an issue for me,anyway fingers crossed they will come right eventually for you

  • Hi Niall thanks for the reply. It's a funny one the liver isn't it? How can it top the levels you are talking about one week and then the next be back to normal? I've got my rheumatology appt on Thursday so maybe things will become clearer then.

  • Thanks for asking about this. I'm also interested to hear the experiences of others. My ALT is not that high but each test since I started subcutaneous MTX has been double the previous month. My normal was in the teens, then above normal in Dec and 60 in Jan. I don't drink any alcohol but have been under a lot of stress which is affecting sleep and leading to sugary snacks. I suppose sugar affects the liver and the shortened / interrupted sleep may disrupt the liver's ability to properly detox... I have a cruise planned for March and it would be nice to have a glass of wine here or there (though I guess it's cheaper if I don't!). On the plus side, I haven't complained of pain or swollen joints in months! Good luck to you!

  • Thanks so much for your really Karen. Where is your cruise taking you? It's do difficult to balance things. I hardly had even a glass of wine over Christmas and it feels so unfair at times. I've got my rheumatology appt this Thursday so hopefully they will sort me out x

  • I'm in a similar situation. Biologics nurse told me not to take NSAIDs at one point on the ground that they too might contribute to raised ALT, though my rheumy hasn't mentioned this. So at the moment I'm hedging my bets by taking only the occasional Naproxen, which fortunately is all I need just now. Some joints are trying to flare since I stopped Mtx, it could go either way I think, so I'll have to find out more about this in case I do need Naproxen daily.

    Otherwise I just take Humira.

  • Hi postle2 thanks for the reply. The liver is a strange organ isn't it. Ive noticed to top it off since coming off the metho nodules on my knee and thumb have became more prominent. Rheumy on Thursday though... Watch this space

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