ALT high again

[Kathyk]

Hi all! Just a quick question please. My alt levels have gone higher than ever before and I have been advised to come offMTX for two weeks and then have another blood test to see if my levels go down. This will mean up to a month off the mtx, though I will still be on hydroxy. Can I expect a return of my symptoms in that time do you think? Or would I be more likely to remain as I am for the meantime? Just wanting to be prepared for whatever may come! Thanks for your thoughts

[Sheila_G]

Hi Kathy. I think it differs with different people. I was told that mxt stays in the system for about 6 weeks and I was ok for 6 or 7 weeks then had a massive flare but I know someone who had a flare after 2 weeks without mxt. It is the luck of the draw I'm afraid. I hope you get back on mxt before it wears off fully. Good luck x

[oldtimer]

usually it takes several weeks for the MTX to wear off, but it does depend on how well your disease was controlled. If it was "on the edge" then you might get a flare sooner - but the hydroxychloroquine should hold most of it.

[nomoreheels]

I would hope your HCQ would take the strain for you. It's 2-3 weeks when I start having problems if I need to stop MTX but it is my only DMARD & though I do take an NSAID, steroid & a few different pain relief meds they don't work as well without MTX. Hopefully it'll be just the fortnight & you'll be able to restart it before it's missed. Has reducing your dose a tad been discussed to see if you could cope & it be less harsh on your liver? There are other DMARDs your Rheumy can try if it continues to be a problem so all's not lost if you have to stop it.