liver problems?

[NuttyR]

My consultant hasn’t commented on my blood tests from end of March, only does so if I need to increase pred and I don’t see her until July.

I’m down to 4mg and doing ok with it. Good energy levels.

Inflammatory markers all within limits apart from WBC at 17.1 My platelets are always high and that has previously been investigated

More worryingly Alanine Transaminase is 38

Calcium 2.62

Neutrophils 14.6 ( but down from 17.3)

Prothrombin Time 12.1 so bit slow.

I read about liver rebound as we decrease the pred the liver tries to repair itself and causes increase in AL? I’m on atorvastin too and I believe this can cause liver issues. I’m also hypothyroid. Pre diabetic.

Basically should I be pressing my consultant about the possible liver issues? Is this common? I definitely do need to lose weight and finding it bit easier on 4mg pred than before. My GP surgery are checking calcium levels and bone profile in couple of weeks.

Thanks for any advice, appreciate you may not be able to comment on test results etc.

BTW I don’t drink alcohol, lots of water but occasional bit of lemonade to flavour the water!

[PMRpro Ambassador]

What is the quoted normal range for ALA? Or the units. It is always helpful if you quote those as ranges do vary a bit from lab to lab and units are always confusing ...

[NuttyR in reply to PMRpro]

Oh apologies. Range: 0 - 34 U/L So not hugely high thankfully. Looking back it’s been high once before in January 2023 so couple of months after I started 60mg pred. Maybe I’m worrying about nothing. Wait for the next test in July. Thanks PMRpro 🤗

[PMRpro Ambassador in reply to NuttyR]

It is often raised in PMR/GCA and at that level I really don't think I'd be too concerned.

[NuttyR in reply to PMRpro]

I will sleep better tonight thank you for that. I hadn’t realised it was often raised with GCA/PMR. Thanks to you and Piglette for your help.

[piglette]

Are you able to contact your consultant and tell them about your worries?

[NuttyR]

Yes I could email her team I guess. Thanks Piglette. 🤗

[Sunburst001]

Hi. I had my ALT monitored fortnightly once I started on MTX. ALT showed a steady rise from the first test. I was only on MTX for 6 weeks - 2 @ 10mg, 4 @ 20 mg. In NZ our reference range for ALT is 5-30 U/L - so a bit lower than yours. During the six weeks my reading went from 22 up to 38. At that point my rheumatologist told me to pause MTX until my liver recovered. She would then restart MTX at a lower dose. My relationship with MTX was short lived - we just didn’t get along and I couldn’t see any prospect for a brighter future. I decided to end our connection and be faithful to Prednisone. Very pleased to see my liver has recovered - in only 10 days my ALT was back to 26.

A thought - sometimes it’s not so much the actual number value of a test result that’s important - the trend or change from a previous history often indicates that’s there’s something to be looked at. Do you know what your earlier ALT readings have been?

🌻

[NuttyR in reply to Sunburst001]

Hi thanks for this reply. Good to hear your liver repaired that quickly. I was thinking maybe it was the pred but sounds like your liver repaired while you just took pred. Looks like it might be something else.

I only had one test prior to GCA and I then had PMR but was being mistakenly treated for long covid by local nurse practitioner and the reading was 13. As soon as GCA turned up it started to rise to 21 then 30’s but within range and now twice above the range but below range between. So bubbling away at the top of the range since onset of GCA. I think I will ask the consultant through her team and if she is ok with that maybe she can write to our local nurse practitioners to monitor it more. Interesting thank you so much. 🤗