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Liver impaired on leflunomide

Not a happy bunny here. Went to pain clinic last week and she said she could not start me on Gabapentin as my liver enzymes were raised. I have psoriatic arthritis and been on leflunomide for 7 months and had 2 weekly blood tests. Angry that nobody picked this up. Saw rheumatologist 2 days later and he fudged a bit but has now taken me off it. Got a Isotope bone scan next week to check for inflammation and help plan next treatment. He is speaking to a liver specialist. Having a liver scan and had lots extra blood tests. I've been complaini g of abdo pain for 10 months and got the specialist nurse to check my blood 3 weeks ago as feeling even more fatigued than ever. Anyone else had liver problems? How did you feel?

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Hi there.

I have PsA too and had raised ALT for getting on for a year whilst on Mtx and Humira. I'd been on Leflunomide a few months before it started and suspect it may have contributed to the ALT levels. I stopped Mtx but as the ALT remained high I had a liver scan which was normal. Subsequently re-started Mtx as stopping it had triggered a severe psoriasis flare. I then started taking Folic Acid 6 days a week instead of once a week and my ALT returned to normal levels double quick.

There's a few things I'm wondering after reading your post. It sounds as if your doctors are somewhat concerned, so is your ALT extremely high / are there other reasons for thinking that you may have some liver damage? Raised enzymes don't automatically mean liver damage. Have you been having regular blood tests? If so it's odd if the raised levels didn't show up, poor practice if they did but nobody flagged it up & acted accordingly.

Or is it that you have to have a super tip-top liver to start Gabapentin? It's not a drug I know anything about. But it just seems strange that suddenly it's action stations.

To answer your actual question, yes I had raised ALT but it turned out not to be a problem. And I didn't have any symptoms, certainly no abdominal pain.

Hope things turn out okay for you. Might biologics be an option?

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I'd been having 2 weekly blood tests for months. I even phone the nurse few weeks back as my hip is playing up and wanted to know if I could take ibuprofen. She said all my blood tests were fine. I have IgAdeficiency so have to carefully monitored with anything that might lower immune system. Im on antibiocs all the time. That a pickle I am

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I had to stop Methoxtrate because it gave me the liver of an Alcoholic. I stopped taking leflunomide after coming down with C diff, have tried it again but the fatigue was just too much. Have been on biologics for several years now, and had severe liver pain every month for a couple of days (couldn't do anything except take pain killers and go back to bed). I'm now on Rituximab (infusion every 6 months) and decided to try a liver detox with natural remedy and gave up coffee. Touch wood this works and I now do the detox after each cycle of treatment, but have started to drink coffee again. It seems as though we receive a treatment for one problem and because our immune systems are so weak we end up suffering with another problem. I am nearly always severely fatigued, but make myself get on with as much as I can, with lots of mini breaks. Hope they are able to sort out your problem soon. xo


Sounds like what I went through. My AST started to elevate so I stopped taking Arava. Then my ALT to elevated. I was having right quadrant pain and was awful fatigued. Tested positive for AMA. I ended up having autoimmune PBC and also found out I had fatty liver disease caused by high fructose corn syrup. It's in everything. I was itchy for a couple of years. Thought maybe from high sugar. Didn't know liver disease made one itch. Since I changed my diet and avoid all high fructose corn syrup, preservatives and other chemicals that you find in processed foods, I don't itch now. One is better off preparing fresh homemade foods than taxing the liver in getting rid of all the toxins found in processed foods like hot dogs and boxed foods. Let us know how you make out with all of your testing.

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