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I have had RA since October, have been on methotrexate 4 times now each time my Liver Enzymes are out of control, had been on naproxen for over a year now and it was the only drug that took my pain away they have taken me off that now because of the liver enzymes, which I understand. They have left me with tramadol, but my pain and flexibility is so sore, I can hardly climb the stairs at work, I don't know what to do, they won't give me anything until my liver goes back to normal. Alt and Ast are over 300.

4 Replies

Hi Niclyn, I went through the same thing last summer - my Alt and Ast were also over 300. It took 5 months for my liver enzymes to return to the normal range and all they gave me during that time was tramadol. It was very painful! But my liver did finally calm down. I've had two other occasions where my liver enzymes acted up. Whenever they are off, I take a supplement with the herb milk thistle, which is said to be a good liver support. It seems to help. I hope your liver enzymes calm down soon. Sorry your hurting so much.


Do please check with your rheumy about Milk Thistle. I have been advised to avoid any herbal products which stimulate the immune system - as that's our problem in the first place since Having RA means that our. immune system is up the creek.


You raise an important point, Helix. Herbs should always be used carefully and they can affect each person differently. It's also important to let doctors know what herbs are being taken. That said, milk thistle us not an immune stimulant. The various herbal material medica define it as a cholagogue (stimulates flow in the liver) and both my rheumy and GP are supportive of my use of it. Sorry if my comment came across as if I use herbs haphazardly. I've studied them, and various other complimentary treatments, carefully and always in concert with my doctors. Thanks for pointing it out. All the best.


It's not a nice place to be in, so I do feel sorry for you. But our livers are the most amazing bits of our bodies and can repair themselves extremely well, unlike other organs, so it will get there. Eat well, drink lots of water, and rest as much as you can to help it along as quickly as possible. But do steer of herbal products unless you've checked with your rheumy (see my answer below to person taking milk thistle) as they are not all good news.

In the meantime, do you have non chemical things for the pain, like ice packs and heat packs?

Hope you recover quickly.


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