Elevated liver enzymes on Methatrexate?

[amberd521]

Hi! I’m very new to all of this and very excited to have found this site. My name is Amber and I’m 32. My symptoms first started with numbness and tingling in my hands and arms. Then came a spot on my leg that wouldn’t go away. First thought it was a bruise but was sent to a dermatologist to find it was morphia which is a form of localized scleroderma. I was then sent to a rheumatologist who says I “don’t fit in a box”. He doesn’t think I have systemic scleroderma at all but that I lean more towards lupus or ra. My mother passed in September with leukemia and from what I’ve heard, stress can really accelerate these things. Suddenly my neck was very stiff, my shoulders would ache when raised above my head at night, one of my hips constantly ached, my feet began to hurt and I was never comfortable. Seems it was something new every couple of days. I was so tired all of the time. The worse was my hands. They were very swollen and painful. I couldn’t even open a water bottle. The rheumatologist had given me plaquenil but it wasn’t helping at all. He then gave me the Methatrexate and put me on 6 weeks of Prednisone. What a magic drug that is! I had taken it once for an upper respiratory infection and knew it helped. This time every ache and pain went away. My fingers were still slightly swollen but I had all the strength in my hands back. It was great! His hope was that the Methatrexate would be built up in my system by the end of the 6 weeks. A few days after stopping them, my hands began to swell again. Since then, my hip has began to hurt and now my shoulders and neck are beginning to ache again. It’s been about a month since I quite taking the steroids so I’m not sure if the Methatrexate is keeping it from being as bad as it was or if it just hasn’t progressed back to that point yet, if that makes sense? The rheumatologist seemed to think it was helping some when I seen him last week but wanted me to up my Methatrexate from 6 per week to 8. Then I got a call from the nurse yesterday saying he wanted me to stay at 6 because my liver enzymes came back elevated and that he would recheck me in three months. Is it normal for Methatrexate to raise your liver enzymes? Will I have to discontinue taking it and if so, are there other drugs I can take? Why can’t I take low dose steroids if they help so well? I’m so sorry for all of the questions. Just worried about this all.

[Hidden]

Hello Amber, yes I'm afraid it happens only too often. Hence the need for regular blood tests. The first time it happened to me, I was taken off MTX. But I was also taking Leflunomide, so things weren't too bad I'm now back on MTX but at a lower dose. There are lots of other drugs your consultant could try you on. I personally wouldn't advocate too many steroids. They are OK for a short time, but they can cause Osteoporosis - which you don't want, Voice of experience here! If you visit NRAS website (nras.org.uk) there is a booklet you can either send away for free, or download. nras.org.uk/publications/me... You will find an enormous amount of advice on this website, which also has a free helpline. Freephone Helpline: 0800 298 7650

[e-mail]

I advise you to take a look at it. XX

[summer32 in reply to Hidden]

Yes prednisolone aka oral steroids is a magic drug, they can relieve so much of the pain but I have been diagnosed with osteopenia the stage before osteoporosis, due to several lots of oral steroids due to my first rheumatologist being non proactive that the polite word!!,

[karenpenn]

Hi Amber yes this is normal of this DMard as it raised mine so high that I had to come off them and will start biologic injections soon.

[fluffness]

Everyone is different. I'm 31 and my weight is 120 pounds. I took 20ml methotraxate injection every week which is quite high. My liver was fine for the 1 year I took it. Just try to stay away from alcohol.

[Neverending63]

I had to come off the methotrexate because it raised my liver enzymes. I’m now on Benepali injections instead.

[Hidden]

I have had raised liver enzymes twice, both times after Xmas when I had fractionally more alcohol than my usual half a glass of wine on a Sunday. The lesson I learnt is I can’t take alcohol. Otherwise my has been a magic drug. I hope it works well for you but you have to be patient. Unfortunately getting the right drug balance takes time. Sue

[amberd521]

Thank you all! I really appreciate all of the input. I’ve always been in great health until the arthritis so the idea that something is elevated worries me. The fact that this is normal puts my mind a bit more at ease. Thank you again.