elevated liver enzymes

[bBarnabus]

Does anyone else have experience of raised liver enzymes whilst takin steroids? My recent blood test showed a GGT ( gamma gluts ultrasound transferease) reading of 340. A normal reading should be under 30. It has not been elevated in former blood tests. I am taking 12 mgs defazacort per day. Equivalent to 9 mgs pred. At the time of the test I had been on 18 mgs for one week to cover a flare. I also take 20 mgs citalopram. Any Ideas? Can it be connected to medicines? I drink very little alcohol

[PMRpro Ambassador]

It can be raised due to PMR itself but that is a lot more than I'd expect for that if you were flaring.

However, GGT can be raised in fatty liver - or be raised predicting it developing - and steroids can increase the risk. What does the doctor have to say?

[bBarnabus in reply to PMRpro]

thanks for your prompt reply. I have to wait until Friday to see her again she said she would look into it. But Obviously neeed more blood test.

[MrsNails]

Hi - l’ve always had raised GammaGT Levels - firstly it needs to be repeated in case it’s a glitch but they should check all your Liver Levels - did they do your ALT Levels - mine always go up correspondingly.

I’ve had/maybe still have a Fatty Liver & my levels have shot up this month alongside my ALTs however, l’ve been on more Pain Meds than usual so l attribute it to that.

One raised level in isolation is not usually enough to concern them unless there are other matching raised results. My Drs decided a long time ago my high GGT was ‘just me’

I’d ask for a repeat blood test if the Drs don’t suggest it themselves.

A lot of Meds are processed in the Liver so it can get a bit overwhelmed at times, that’s why they need repeating. Mine have been high this month but l have a ‘MrsNails’ Level that my Consultant will accept but we keep a close eye on it.

Let us know how you get on.

MrsN

[Nightingales in reply to MrsNails]

Hi Mrs Nails, I hope you don’t mind another question. Have you been offered or taken any DMARDS or othe meds to help reduce pred., even with your increased LFTs. I have raised AFT and ALT about 50 over recommended limits. They have been that way for more than ten years with very little change. The GP decided it was fatty liver, which does show on us. Now I am struggling with being advised to add something as I am back at 20 mg or pred again after seven years. My blood tests preclude Azathioprine so the next advised by my rheumatologist is Leflunomide, famous for being hard on the liver. Any suggestions gratefully received.

[bBarnabus]

is ‘Mrs Nails levels’ as high as 340? they don’t appear to have done alt tests but I will raise that with my GP and ask for another blood test. Thanks for your prompt reply. It’s rather perplexing because I don’t seem to have any syptoms

[MrsNails in reply to bBarnabus]

My ‘MrsNails’ Levels are for my ALT Levels - Top of Normal being 35 but at 50 Methotrexate is generally stopped but for me they’ll allow it go to 100 - however the highest it’s ever been is 87 but l pulled it back to within normal parameters by reducing my Carb & Sugar intake thus lessening the stress on my liver.

My GGT Levels have always been way above 150+++ even when all my other levels were all in Normal Range, so it’s probably ‘My Normal’…….

Let us know how you get on.

Good Luck 🍀

MrsN

[bBarnabus in reply to MrsNails]

thanks

[Skysey in reply to bBarnabus]

I would say that they need to repeat the blood tests to include ALT. I do not have fatty liver as I have had a liver biopsy in the past and recent fibroscan which were all fine. My ALT levels were high from 2016 onwards until moving within normal range once I was prescribed Ursodeoxylic acid. I have PBC but have had no real symptoms apart from raised ALT. My ALT levels were all fine whilst on steroids for GCA and I am taking Leflumonide as a steroid sparing drug. I have been off steroids for many months now. My ALT levels have increased to around 80 recently and the hospital consultant did a fibroscan to check the condition of my liver. It was all fine. Sometimes your ALT levels can increase due to being unwell with viruses or change in diet.It is important to keep a check on your levels. Don’t dismiss leflumonide as you have monthly blood tests to check your liver etc and it has helped me to come off steroids which I had been taking for 2/3 years. Keep us updated on your progress.

[piglette]

That is quite a high reading. GGT can get raised for several reasons including drugs, but should be checked with other things as well. Just one reading of GGT is not the be all and end all. I am sure your doctor will check on it at that level. .

[bBarnabus]

thanks

[Skysey in reply to bBarnabus]

Apologies, my comment about leflumonide was meant for Nightingales not you! I’m texting late at night. Must be tired!😂

[powerwalk]

My GGT has been raised a lot since i went on pred. I rarely drink alcohol so its probably the pred and whatever over the counter painkillers i take. I did get liver tests and it was ok. My gp wasnt the slightest bit interested/concerned, it was a hospital doc that sent me for liver investigations. And yes it was around the same as your level.

[dolphin39]

I had the same experience, turned out to be due to gall bladder problem

[Bachfugue]

My liver function tests appear to be within the normal range BUT since starting Prednisone for PMR (20mg at the start in 2019 to now,7mg 2022) I cannot tolerate alcohol in any form. My rheumy can’t explain it.

[bBarnabus]

poor you!!