Elevated Liver Enzyes ALT 364, AST 121

[BR1217]

I recently ran a 20 week cycle of Test/ND(not actually Nandrolone but a nandrolone derivative called 8,9 Dehydronandrolone which is probably closer to Tren than Nandrolone, an extra double bond being the difference) at 400/600 respectively. I had bloodwork taken near the end of my cycle and my Liver Enzymes were elevated, ALT 364, AST 121. I did drink during cycle (possibly excessive at times), could this be the cause or should I be concerned about something else? I have been off for over a month, just using Test for now. Thanks

 

[BR1217]

Test Numbers and Ranges
Glucose 106 65-99 mgdL
Urea Nitrogen 22 7-25 mg/dL
Creatinine 1.33 0.6-1.35 mg/dl
eGFR 67 >60
Sodium 137 135-146
Potassium 4.0 3.5-5.3
Chloride 103 98-110
Carbon Dioxide 27 19-30
Calcium 9.4 8.6-10.3
Protein, Total 7.0 6.1-8.1
Albumin 4.6 3.6-5.1
Globulin 2.4 1.9-3.7
Albumin/Globulin ratio 1.9 1.0-2.5
Bilirubin, Total 0.6 0.2-1.2
Alkaline Phosphatase 29 40-115
AST 121 10-40
ALT 364 9-46

 

[Michael Scally MD]

Those are dangerous levels. These must be followed up closely. The good part is the bilirubin. There is a high likelihood these are due to the AAS, which in the future I would avoid like the plague. What about supplements? Stop any and all meds/supplements now. Also, I would do a Hep Screen.

Do you have baseline labs?
Another reason why I insist that all AAS users get baseline labs.

 

[BR1217]

I do have baselines but not readily available. As for supplements I consume Whey protein, EZ Gugglesterones, Multivitamin, Antioxidant containing CoQ10 50mg, Grape Seed Extract 200 mg, Green Tea Leaf Extract 200mg, Ginko Leaf 200mg, Milk Thistle 200mg, ALA 200mg, Lutein 10mg, Lycopene 10mg. I also take 50mg Zinc, 50mg DHEA.

MEDS
Arimidex .5mg M/W/F
Benicar 40mg daily
That is everything.
When you say avoid AAS are you also referring to Test? I am on TRT at 400mg/week.

 

[Michael Scally MD]

What did the physician have to say!

I would be instructing you to STOP any and all meds/supplements that are not necessary. As far as the TRT, 125-150 mg per week. These LFTs are at very dangerous levels. To put this in perspective, a clinical trial with this result would be placed on an immediate hold by the FDA.

And, TRT is NOT 400 mg per week.

 

[BR1217]

I have recently had to leave the TRT clinic as my new insurance will not cover alternative treatments. My new DR was shocked that I was getting 400mg Test and has asked me to go down to 200mg/week. She was also concerned about the above mentioned levels and asked me to stop all meds with the exception of Benicar at this time. She stated that she has never seen levels like these in a person whose liver isn't failing. I am scheduled for more bloodwork Friday. Also, was checked for HEP 1 year ago and was neg.

 

[Michael Scally MD]

I have recently had to leave the TRT clinic as my new insurance will not cover alternative treatments. My new DR was shocked that I was getting 400mg Test and has asked me to go down to 200mg/week. She was also concerned about the above mentioned levels and asked me to stop all meds with the exception of Benicar at this time. She stated that she has never seen levels like these in a person whose liver isn't failing. I am scheduled for more bloodwork Friday. Also, was checked for HEP 1 year ago and was neg.

And, STOP all supplements. An ALT ~10 X ULN is too be taken very seriously. As I said, the bilirubin being normal is a good sign. But, if this increases ...

 

[BR1217]

I will stop all supps as well. Thank you for your help. I will report back after I receive results from bloodwork this Friday! I am taking this seriously!

 

[Gunrunner]

Test Numbers and Ranges
AST 121 10-40
ALT 364 9-46

Holy sheep shit batman!!! My ALT (SGPT) went up to 56 while on cycle and I was worried and keeping my eye on it. Post cycle it went down to 26 so that was a relief. I was drinking (possibly excessive at times), on and off cycle. My next cycle will be no drinking and I will see what happens to my ALT.

The Doc has given you some good advice but you also need to stop all alcohol.

 

[BR1217]

I agree all the way! I will not be drinking or cycling any time soon! This has scared the daylights out of me! I just hope that I haven't damaged my liver to the point that It won't recover. I am cleaning up everything! I wont take vitamins or ibuprofen at this point! Very concerned!!!!

 

[BR1217]

Has anyone else had numbers like these and have them come back into normal range? Would like to know! Thanks

 

[Michael Scally MD]

Has anyone else had numbers like these and have them come back into normal range? Would like to know! Thanks

Yes. I have had patients with much worse.

 

[Michael Scally MD]

Hy's Law is a rule of thumb that a drug is at high risk of causing a fatal drug-induced liver injury (DILI) when given to a large population, if it caused cases of liver injury that satisfied certain criteria when given to a smaller population.

Hy’s Law cases have the following three components -

• The drug causes hepatocellular injury, generally shown by more frequent 3-fold or greater elevations above the upper limits of normal (ULN) of ALT or AST than the (nonhepatotoxic) control agent or placebo.

• Among subjects showing such aminotransferase (AT) elevations, often with ATs much greater than 3xULN, some subjects also show elevation of serum total bilirubin (TBL) to >2xULN, without initial findings of cholestasis (serum alkaline phosphatase (ALP) activity >2xULN).

• No other reason can be found to explain the combination of increased AT and serum TBL, such as viral hepatitis A, B, or C, preexisting or acute liver disease, or another drug capable of causing the observed injury.

http://www.fda.gov/downloads/Drugs/.../Guidances/UCM174090.pdf

 

[BR1217]

Thank you so much! I really appreciate the fact that you took time to answer my questions and helped me understand the seriousness of the situation. I had assumed my new DR was overreacting due to the fact that I was in a HRT program that she doesn't approve of, I realize now she was freaking out for good reason! Thanks again!

 

[BR1217]

Is it possible these numbers are an anomaly? After our conversation last week i called my TRT DR and asked for my results from my bloodwork done 4 weeks prior to this last test and he told me my AST/ALT were elevated but only 10 points higher than upper limit of normal. I also started taking Benicar HCT four weeks prior to getting the bloodwork done that revealed the elevated levels. So, is it possible that Benicar HCT has contributed to the enzyme levels? Side note, i swithched to Benicar without the diuretic after the test results were discovered.

 

[toolman]

Is it possible these numbers are an anomaly? After our conversation last week i called my TRT DR and asked for my results from my bloodwork done 4 weeks prior to this last test and he told me my AST/ALT were elevated but only 10 points higher than upper limit of normal. I also started taking Benicar HCT four weeks prior to getting the bloodwork done that revealed the elevated levels. So, is it possible that Benicar HCT has contributed to the enzyme levels? Side note, i swithched to Benicar without the diuretic after the test results were discovered.

Was this the same quack that put you on 400mgs of test a week as TRT+ or all these other unnecessary supps? I wouldn't believe anything he has to say, he's liable for malpractice if the liver damage resulted from his protocol.

I know what it's like when you get the crap scared out of you and you want an immediate answer that you will be OK. Get a copy of your baseline labs as suggested and wait. The liver is an amazing organ that can regenerate provided it was not damaged too greatly. Take the docs advise, stay off everything including the booze and NSAIDs...gear as well. Buff bods aren't worth a liver transplant.

 

[BR1217]

Was this the same quack that put you on 400mgs of test a week as TRT+ or all these other unnecessary supps? I wouldn't believe anything he has to say, he's liable for malpractice if the liver damage resulted from his protocol.

I know what it's like when you get the crap scared out of you and you want an immediate answer that you will be OK. Get a copy of your baseline labs as suggested and wait. The liver is an amazing organ that can regenerate provided it was not damaged too greatly. Take the docs advise, stay off everything including the booze and NSAIDs...gear as well. Buff bods aren't worth a liver transplant.

Yes, its the same TRT doctor. Yes, I am wanting answers yesterday! I have ceased using all supps, nsaids, and no booze, ouch! I am getting bloods drawn again and should have results Friday, Monday at the latest. Believe it or not 400mg test/week only put my test number around 2000. I would have to stop injections two weeks prior to bloods to keep my number under 1500. So ultimately this is my fault, had I not manipulated the test numbers I would have been cut back to a dose that would have kept me under 1500. Either way I cant believe the test Is to blame, I was experimenting with an untested 19 Nor similar to Nandrolone and Tren for several months and drinking too much, completely irresponsible for a grown man with a family! Anyway, thanks for the encouraging words.

 

[toolman]

Yes, its the same TRT doctor. Yes, I am wanting answers yesterday! I have ceased using all supps, nsaids, and no booze, ouch! I am getting bloods drawn again and should have results Friday, Monday at the latest. Believe it or not 400mg test/week only put my test number around 2000. I would have to stop injections two weeks prior to bloods to keep my number under 1500. So ultimately this is my fault, had I not manipulated the test numbers I would have been cut back to a dose that would have kept me under 1500. Either way I cant believe the test Is to blame, I was experimenting with an untested 19 Nor similar to Nandrolone and Tren for several months and drinking too much, completely irresponsible for a grown man with a family! Anyway, thanks for the encouraging words.

Well if you are using yourself as a guinea pig for untested drugs then that is crazy, but it sounds like you have learned your lesson...we are all mortal. My guess is that it could have been any of the supps. I used to take all that crap back when I would cycle. Now the only thing I take is Vit D. If your diet is good, then you don't need all the other crap and since it is unregulated by the FDA, a lot of it can actually be harmful.

Best of luck and let us know when you get your next results how it is going.

 

[BR1217]

Well if you are using yourself as a guinea pig for untested drugs then that is crazy, but it sounds like you have learned your lesson...we are all mortal. My guess is that it could have been any of the supps. I used to take all that crap back when I would cycle. Now the only thing I take is Vit D. If your diet is good, then you don't need all the other crap and since it is unregulated by the FDA, a lot of it can actually be harmful.

Best of luck and let us know when you get your next results how it is going.

Thanks, I will certainly post with results.

 

[BR1217]

Most recent labs
Total Protein 6.9 6.0-8.4
Albumin 4.3 3.2-5.2
Bilirubin 0.4 0.3-1.3
Alkaline Phosphatase 34 25-117
SGOT/AST 64 0-39
SGPT/ALT 126 0-40