Has methotrexate caused liver damage

[Beanyynwa]

I had a blood test which showed raised levels of ALP 136, Aspartate Transaminase 68. My GP said that my RA meds have caused damage to my liver!!! I am having a liver fibroscan tommorrow to check for fatty liver. Very anxious but will need to take it one step at a time. Any guidance and advice welcome. 🙂

[AgedCrone]

Presumably you have been having regular blood tests….I’d check with your rheumy team..on the nhs site they say only 1 patient in 1000 has liver problems with Methotrexate……let’s hope you aren’t that one!

[Beanyynwa in reply to AgedCrone]

Thanks AgedCrone. I just hoping that if there damage that it's something that can be fixed. Been researching and there are so many other things that can cause liver problems - over the counter painkillers, Vit D deficiency and celiac disease. I have just ordered a liver support supplement with Choline and milk thistle in it. fingers crossed 🤞

[AgedCrone in reply to Beanyynwa]

Not a good idea to self prescribe Beany….speak to your rheumatology team.

I have only been on this site for maybe six years and I don’t remember anyone coming on saying they’ve had serious liver problems with methotrexate, the odd niggle maybe but nothing serious…..get on to rheumy…GPs often don’t know much about Mtx.

[cathie]

it did to me. Taken off it. Regular scans for past 10+ years.

[Marionfromhappydays]

It is a possibility that methotrexate can cause liver damage along with other things (diet etc) but this is why we have regular blood tests and it's picked up quickly.

The liver Is so regenerative if you remove the cause it can rebuild itself !

Hope the scan goes well x

[Runrig01]

A normal ALP is 30-130, so you are only just outside the normal range. AST is usually less than 50, again only a little raised. It most likely indicates a little inflammation in the liver. For liver damage your AST would be very high, like 1000. In my Trust they don’t even stop meds till the enzymes are 3 x higher than the upper value. So I really wouldn’t worry, I used to take Azathioprine, after they increased it to max dose, my AST was 140. The medication was stopped. I had an ultrasound a few weeks later, and it was normal, inflammation had subsided. I was then switched to MTX, this was 8yrs ago and I’m still on it.

I assume you’ve been getting regular blood tests, so the team will have picked up damage occurring. GPs can often panic with results. Have you phoned your rheumatologist to get their take on it, if not I’d do that. I have a gp who is good at dropping bomb shells over the phone, when I’m home alone, like, your heart is enlarged and you’ve pulmonary fibrosis. You go into panic mode, then the experts put it in perspective. I think your gps choice of words is poor, with the results you’ve quoted, this is likely inflammation, but phone your rheumatologist. Have they said what the plan is, hold off MTX, repeat bloods or doing an ultrasound? Liver damage would be picked up early, if your having your regular blood tests 🤗

[Fra22-57]

Methotrexate started to damage my liver so I was given alternative meds.Hope your doctor reassures you

[J1707-]

I had a rituximab infusion my liver ALP levels were 277 six months after now waiting to see a liver specialist to confirm it is drug related May mean I can’t not start any new drug until I get the say so from specialist. I have been on MTX for nearly 8 years

[Bethany02]

Liver issues with methotrexate they tried a restart and they went off twice as much so it's a definite I can't have it again the rheumatologist said