Liver Question for Scally & Roberts, and anyone else

[TrainHard]

Okay for about the last year I've been battling high liver enzymes, however, over the last year they really have not changed very much, and I was wondering what I can do to get them lower. I do not take anything that is toxic or can go through the liver.

Also is there anything that could be going on (damage wise) or an issue that I am unaware about causing them to be high??

Drawn Nov 2010
Here are my liver enzymes, the ones that are still high

GOT/AST 46 unitls/L H <38
GPT/ALT 74 units/L H <66

Also what could explain this to be high?
Biliruban Total 1.2 mg/dl H 0.2 - 1.0

This one is Normal:
ALK Phosphatase 54 unitls/L 50 to 136

If there are any other numbers needed let me know, everything else fell in the middle normal range.

These were the results from last years blood work done in Feb 2010
https://thinksteroids.com/community/threads/134286297

 

[Bill Roberts]

Unfortunately I have no expertise on this one; hopefully Dr Scally can contribute.

Your values are not markedly high -- two things apply here. First, the top of the normal range usually means only that of persons in normal health, 2.5% (approximately) have values higher than this. Being just over the top figure doesn't mean there is necessarily any problem, speaking in general for most tests.

The second thing is that in particular with liver enzyme tests this seems to be the case. It's really not that unusual to be slightly elevated.

I don't know of proof that good intake of phytonutrients and antioxidants will necessarily improve these values, but if it were me I would try.

There is also clinical evidence of this formulation working to reduce liver enzyme values in the face of alkylated steroid use (which I know you're not doing, but if it can do that, then it might work in other instances):

300 mg of natural, essential polyunsaturated phospholipids [polyene phosphatidylcholine]
(diglyceride esters of choline–phosphoric acid and unsaturated fatty acids, predominantly linoleic acid in 70% concentration), 6 mg of thiamine mononitrate (vitamin B1), 6 mg of riboflavin (vitamin B2), 6 mg of pyridoxine hydrochloride (vitamin B6), 6 ?g of cyanocobalamin (vitamin B12), 30 mg of nicotinamide, 6 mg of DL-alpha-tocopherol acetate

at 6 times the above doses.

This could be achieved with soy lecithin containing that amount of phosphatidylcholine, plus any good B vitamin or multivitamin. Maybe adding in the nicotinamide as a separate supplement though I don't know if it's relevant here.

Worth trying.

 

[Far from massive]

Hopefully you have been checked for all kinds of Hepatitis?

I had simalar values back in the 80s and found that I had HepC. It is important to know these things because by taking care of your liver ( no drinking, hepatotoxic drugs, keep away from loads of sugar and milk etc) you can keep this disease managable. Its probably been 30 years since I contracted it and I am still doing fine.

By the way Liv52 marketed in the US as LiverCare is in my humble opinion (and lots of medical studies LOL) one of the best liver protectants out there. I would reccomend this taken as directed in the meantime.

 

[dennis]

Trainhard, good advice above..I too have hep c geno type 1a (the bad stuff bro).I go in once yearly for blood work.My doc tells me the liver enzymes test can go up or down within a matter of days.In other words,if my levels show low on wednesday by the following wednesday if tested again I will get different results.

 

[TrainHard]

Unfortunately I have no expertise on this one; hopefully Dr Scally can contribute.

Your values are not markedly high -- two things apply here. First, the top of the normal range usually means only that of persons in normal health, 2.5% (approximately) have values higher than this. Being just over the top figure doesn't mean there is necessarily any problem, speaking in general for most tests.

The second thing is that in particular with liver enzyme tests this seems to be the case. It's really not that unusual to be slightly elevated.

I don't know of proof that good intake of phytonutrients and antioxidants will necessarily improve these values, but if it were me I would try.

There is also clinical evidence of this formulation working to reduce liver enzyme values in the face of alkylated steroid use (which I know you're not doing, but if it can do that, then it might work in other instances):

300 mg of natural, essential polyunsaturated phospholipids [polyene phosphatidylcholine]
(diglyceride esters of choline–phosphoric acid and unsaturated fatty acids, predominantly linoleic acid in 70% concentration), 6 mg of thiamine mononitrate (vitamin B1), 6 mg of riboflavin (vitamin B2), 6 mg of pyridoxine hydrochloride (vitamin B6), 6 ?g of cyanocobalamin (vitamin B12), 30 mg of nicotinamide, 6 mg of DL-alpha-tocopherol acetate

at 6 times the above doses.

This could be achieved with soy lecithin containing that amount of phosphatidylcholine, plus any good B vitamin or multivitamin. Maybe adding in the nicotinamide as a separate supplement though I don't know if it's relevant here.

Worth trying.

Thanks Bill, for your reply. That's what i already figured, i think that's probably the normal range for me. in any event i have another test around April.

Hopefully you have been checked for all kinds of Hepatitis?

I had simalar values back in the 80s and found that I had HepC. It is important to know these things because by taking care of your liver ( no drinking, hepatotoxic drugs, keep away from loads of sugar and milk etc) you can keep this disease managable. Its probably been 30 years since I contracted it and I am still doing fine.

By the way Liv52 marketed in the US as LiverCare is in my humble opinion (and lots of medical studies LOL) one of the best liver protectants out there. I would reccomend this taken as directed in the meantime.

No Hep, been tested, also had a liver ultrasound done, no damage.

 

[Michael Scally MD]

The transaminase elevations are very small, albeit outside the "reference range." Liver transaminases are commonly outside this range and close attention is paid if persistent, particuarly without a cause. Typically, unless the level is >/= 3X ULN, there is no need for immediate investigation (i.e., recheck at a later date). As far as common causes, there is exercise. [Note: I just realized after reading the levels in your prior post, do you inject drugs? If so, this will also cause an elevation.]


Brancaccio P, Lippi G, Maffulli N. Biochemical markers of muscular damage. Clin Chem Lab Med 2010;48(6):757-67. http://www.reference-global.com/doi/pdf/10.1515/CCLM.2010.179 (An Error Occurred Setting Your User Cookie)

Muscle tissue may be damaged following intense prolonged training as a consequence of both metabolic and mechanical factors. Serum levels of skeletal muscle enzymes or proteins are markers of the functional status of muscle tissue, and vary widely in both pathological and physiological conditions. Creatine kinase, lactate dehydrogenase, aldolase, myoglobin, troponin, aspartate aminotransferase, and carbonic anhydrase CAIII are the most useful serum markers of muscle injury, but apoptosis in muscle tissues subsequent to strenuous exercise may be also triggered by increased oxidative stress. Therefore, total antioxidant status can be used to evaluate the level of stress in muscle by other markers, such as thiobarbituric acid-reactive substances, malondialdehyde, sulfhydril groups, reduced glutathione, oxidized glutathione, superoxide dismutase, catalase and others. As the various markers provide a composite picture of muscle status, we recommend using more than one to provide a better estimation of muscle stress.


Pettersson J, Hindorf U, Persson P, et al. Muscular exercise can cause highly pathological liver function tests in healthy men. Br J Clin Pharmacol 2008;65(2):253-9. Muscular exercise can cause highly pathological liver function tests in healthy men

What is already known about this subject: The occurrence of idiosyncratic drug hepatotoxicity is a major problem in all phases of clinical drug development and the leading cause of postmarketing warnings and withdrawals. Physical exercise can result in transient elevations of liver function tests. There is no consensus in the literature on which forms of exercise may cause changes in liver function tests and to what extent. What this study adds: Weightlifting results in profound increases in liver function tests in healthy men used to moderate physical activity, not including weightlifting. Liver function tests are significantly increased for at least 7 days after weightlifting. It is important to impose relevant restrictions on heavy muscular exercise prior to and during clinical studies.

AIM: To investigate the effect of intensive muscular exercise (weightlifting) on clinical chemistry parameters reflecting liver function in healthy men.

METHODS: Fifteen healthy men, used to moderate physical activity not including weightlifting, performed an 1 h long weightlifting programme. Blood was sampled for clinical chemistry parameters [aspartate aminotransferase (AST), alanine aminotransferase (ALT), lactate dehydrogenase (LD), gamma-glutamyl transferase (gamma GT), alkaline phosphatase (ALP), bilirubin, creatine kinase (CK) and myoglobin] at repeated intervals during 7 days postexercise and at a follow-up examination 10-12 days postexercise.

RESULTS: Five out of eight studied clinical chemistry parameters (AST, ALT, LD, CK and myoglobin) increased significantly after exercise (P < 0.01) and remained increased for at least 7 days postexercise. Bilirubin, gamma GT and ALP remained within the normal range.

CONCLUSION: The liver function parameters, AST and ALT, were significantly increased for at least 7 days after the exercise. In addition, LD and, in particular, CK and myoglobin showed highly elevated levels. These findings highlight the importance of imposing restrictions on weightlifting prior to and during clinical studies. Intensive muscular exercise, e.g. weightlifting, should also be considered as a cause of asymptomatic elevations of liver function tests in daily clinical practice.

 

[TrainHard]

Thanks Dr. Scally, can't believe I missed this, yes, that would make sense, or at least why they would be higher. I'm sure if I took some time off training and working out before a blood draw then the levels would be in the normal range.

I remember, those numbers you looked at that I posted a year ago, that blood draw was taken a day after I did a killer leg workout, 6 weeks later they were in the normal range.

This last round of blood work I was still training hard, and the dr had me on test cyp for 6 weeks, otherwise, to avoid the weekly roller coaster I switched back to androgel. I do cycle here and there, but they are short esters, and short cycles, and I don't use orals, Nova, or Clomid. Otherwise, I don't do any Rec drugs, any OTC Med's or any other drug, well besides caffeine hey need something.

Again, thank you very much for posting that.

TH

The transaminase elevations are very small, albeit outside the "reference range." Liver transaminases are commonly outside this range and close attention is paid if persistent, particuarly without a cause. Typically, unless the level is >/= 3X ULN, there is no need for immediate investigation (i.e., recheck at a later date). As far as common causes, there is exercise. [Note: I just realized after reading the levels in your prior post, do you inject drugs? If so, this will also cause an elevation.]


Brancaccio P, Lippi G, Maffulli N. Biochemical markers of muscular damage. Clin Chem Lab Med 2010;48(6):757-67. http://www.reference-global.com/doi/pdf/10.1515/CCLM.2010.179 (An Error Occurred Setting Your User Cookie)

Muscle tissue may be damaged following intense prolonged training as a consequence of both metabolic and mechanical factors. Serum levels of skeletal muscle enzymes or proteins are markers of the functional status of muscle tissue, and vary widely in both pathological and physiological conditions. Creatine kinase, lactate dehydrogenase, aldolase, myoglobin, troponin, aspartate aminotransferase, and carbonic anhydrase CAIII are the most useful serum markers of muscle injury, but apoptosis in muscle tissues subsequent to strenuous exercise may be also triggered by increased oxidative stress. Therefore, total antioxidant status can be used to evaluate the level of stress in muscle by other markers, such as thiobarbituric acid-reactive substances, malondialdehyde, sulfhydril groups, reduced glutathione, oxidized glutathione, superoxide dismutase, catalase and others. As the various markers provide a composite picture of muscle status, we recommend using more than one to provide a better estimation of muscle stress.


Pettersson J, Hindorf U, Persson P, et al. Muscular exercise can cause highly pathological liver function tests in healthy men. Br J Clin Pharmacol 2008;65(2):253-9. Muscular exercise can cause highly pathological liver function tests in healthy men

What is already known about this subject: The occurrence of idiosyncratic drug hepatotoxicity is a major problem in all phases of clinical drug development and the leading cause of postmarketing warnings and withdrawals. Physical exercise can result in transient elevations of liver function tests. There is no consensus in the literature on which forms of exercise may cause changes in liver function tests and to what extent. What this study adds: Weightlifting results in profound increases in liver function tests in healthy men used to moderate physical activity, not including weightlifting. Liver function tests are significantly increased for at least 7 days after weightlifting. It is important to impose relevant restrictions on heavy muscular exercise prior to and during clinical studies.

AIM: To investigate the effect of intensive muscular exercise (weightlifting) on clinical chemistry parameters reflecting liver function in healthy men.

METHODS: Fifteen healthy men, used to moderate physical activity not including weightlifting, performed an 1 h long weightlifting programme. Blood was sampled for clinical chemistry parameters [aspartate aminotransferase (AST), alanine aminotransferase (ALT), lactate dehydrogenase (LD), gamma-glutamyl transferase (gamma GT), alkaline phosphatase (ALP), bilirubin, creatine kinase (CK) and myoglobin] at repeated intervals during 7 days postexercise and at a follow-up examination 10-12 days postexercise.

RESULTS: Five out of eight studied clinical chemistry parameters (AST, ALT, LD, CK and myoglobin) increased significantly after exercise (P < 0.01) and remained increased for at least 7 days postexercise. Bilirubin, gamma GT and ALP remained within the normal range.

CONCLUSION: The liver function parameters, AST and ALT, were significantly increased for at least 7 days after the exercise. In addition, LD and, in particular, CK and myoglobin showed highly elevated levels. These findings highlight the importance of imposing restrictions on weightlifting prior to and during clinical studies. Intensive muscular exercise, e.g. weightlifting, should also be considered as a cause of asymptomatic elevations of liver function tests in daily clinical practice.

 

[Millard]

Thanks Dr. Scally, can't believe I missed this, yes, that would make sense, or at least why they would be higher. I'm sure if I took some time off training and working out before a blood draw then the levels would be in the normal range.

I remember, those numbers you looked at that I posted a year ago, that blood draw was taken a day after I did a killer leg workout, 6 weeks later they were in the normal range.

This last round of blood work I was still training hard, and the dr had me on test cyp for 6 weeks, otherwise, to avoid the weekly roller coaster I switched back to androgel. I do cycle here and there, but they are short esters, and short cycles, and I don't use orals, Nova, or Clomid. Otherwise, I don't do any Rec drugs, any OTC Med's or any other drug, well besides caffeine hey need something.

Again, thank you very much for posting that.

TH

These abstracts would be useful to print and take to your doctor. You could also discuss with doctor and schedule blood tests after a short break from training to confirm it is exercise-induced.

 

[someanddone]

Not
Posted from my iPhone

 

[someanddone]

Sorry about the above post. iPhone glitched and now won't let me edit. Moving on though.

Today I was admitted to the hospital with a viral infection esophageal ulcer that spans half the length of my esophagus. Bottom line, I haven't eaten anything in 3 days and I've lost 18 pounds in that time. 231-213.
They have run all sorts of blood tests including liver related tests, and my liver results were high as well (don't have the numbers).

I was reading the post about 15 minutes before the dr walked in to talk about my elevated liver values. I explained to him my laymen's terms what dr. Scally posted and he was very impressed that I had researched it and come up with a plausible cause.
Point is, thank you Dr. Scally and to the meso board in general, y'all have educated me in so many facets of health and self-improvement.
If any of this post seems sappy, go fuck yourself. Lol. They have me on delotid which is 8 times as powerful as morphine mg for mg.
Posted from my iPhone

 

[Bill Roberts]

Best wishes on a fast recovery! I really sympathize with what's happened for you -- that's indeed rough.

 

[Michael Scally MD]

Sorry about the above post. iPhone glitched and now won't let me edit. Moving on though.

Today I was admitted to the hospital with a viral infection esophageal ulcer that spans half the length of my esophagus. Bottom line, I haven't eaten anything in 3 days and I've lost 18 pounds in that time. 231-213.
They have run all sorts of blood tests including liver related tests, and my liver results were high as well (don't have the numbers).

I was reading the post about 15 minutes before the dr walked in to talk about my elevated liver values. I explained to him my laymen's terms what dr. Scally posted and he was very impressed that I had researched it and come up with a plausible cause.
Point is, thank you Dr. Scally and to the meso board in general, y'all have educated me in so many facets of health and self-improvement.
If any of this post seems sappy, go fuck yourself. Lol. They have me on delotid which is 8 times as powerful as morphine mg for mg.
Posted from my iPhone

I wish you well. If you can, what is the diagnosis? Also, what symptoms, if any, have you been experiencing and for how long? This sounds like a real ordeal.

 

[someanddone]

Best wishes on a fast recovery! I really sympathize with what's happened for you -- that's indeed rough.

I wish you well. If you can, what is the diagnosis? Also, what symptoms, if any, have you been experiencing and for how long? This sounds like a real ordeal.

Thanks Bill. It is truly devastating to go balls out for 7+ years to hit 215lbs naturally, then do one cycle with complete and utter determination and discipline, hit 255 at the peak and 232 after pct and three months off, at a lower bf% than my natural 215, and then be under the 215 mark in a matter of days due to illness.

Dr. Scally, the diagnosis is that I have a severe case of esophageal ulcers, up to 9 and probably more that the scope didn't get pictures of, spanning the length of my esophagus. Symptoms were very mild for about a week, just acid reflux issues a couple times per day, and then, like a blow-torch lit up my esophagus one night, I woke up in extreme pain and haven't eaten solid food since then. It's going on a week now without solid food and barely, excruciatingly, downing 2-3 ensures per day. The delaudid (8 times more powerful than morphine mg for mg) takes the edge off and allows me to drink water and painfully sip ensure, but almost all of my sustenance has come from PPN bags and saline. I think the PPN stands for Parenteral Peripheral Nutrition and has a bare minimum of nutrients dripped slowly throughout the day.

The GIs are in the process of trying to figure out what has caused all of this by examining biopsies and cultures of the ulcers. Prognosis is, as soon as they figure out why these ulcers presented, 7-10 days before solid food can be re-introduced and 4-6 weeks for complete recovery.

The reason why the doctors are so stumped is because I don't drink, smoke, dip, eat spicy foods, or work in a stressful environment. My wife and dog and I have a great home life, and nothing has changed in my peripheral life at all. I am truly an anomaly at this point.

Needless to say Bill, this has completely changed my timeline on when my next cycle will start, because not only do I need to wait until the ulcers are completely healed, but I would also like to wait until I have regained the strength and muscle lost during this ordeal.

Thanks for the concern guys. And sorry for hijacking your thread TrainHard.