Hi Susie
How upsetting!
Positive effects of MTX are going to last a different amount of time in each person so it is really hard to predict. And how it makes our joints feel is different from how long the drug is actually acting in our body. We take it weekly, since the drug peaks about the second day or so and is nearly gone by 7 days. (Some people know it by day 6-7 when they are due for the next dose.) But the overall effects in your body may linger for months (you should not get pregnant within 3 months of stopping it for example).

I would ask what the levels were and keep in mind other factors may be contributing to the problem. A simple viral illness can bump up your enzymes, and of course we all know alcohol can too. Other medications can affect the liver, and it may be worse when paired with MTX. They may also check you for other liver problems.

I hope they are able to get you some answers and that your levels come down quickly.

I have no experience with Xeljanz, sorry.

Were you by any chance taking a lot of aspirin or cold meds like Nyquil before the blood draw?

That could boost liver enzymes.

Another thing that can boost liver enzymes is alcohol. I know several people who took one drink, and weeks later their liver enzymes were elevated. For me, I had extremely high enzymes (from 300 to 1000) 7 years ago. I was on a diet, and I believe that it was a lack of fat that was causing the problem. I read that somewhere, and I have been very careful to get enough fat in my diet.

What were your numbers for ALT, AST, GGT etc? GGT is always high for me. It is supposed to be the one that measures the alcohol you drink. Except I haven't had a drink in 37 years! But it also seems like the doctors don't care much about it, either.

I was on Xeljanz last year for 5 months and it did absolutely nothing for me. But of course, you could be quite different.

what was your liver number before starting mtx? i've heard this on here before. some rheum's stop, lower, re-start

what is the number now? i usually print those labs from the patient portal sign in because I forget a year later.

are you taking any dietary supplements? have any pre-existing co-stuff? some folks drink alcohol, have a fatty liver, are obese, or otherwise have borderline liver numbers before taking mtx which their rheums have to follow pretty closely. not diagnosing just talking out loud.

sorry about the interruption. this is a bummer for you. i get a crapload of lung infections annually so I am always stoppin and startin. i feel your pains

your insurance will cover a first go to xeljanz without going through one of the first standard bearers of humira or enbrel first? that's great. is xeljanz an anti tumor necrosing factor? I forget.

depot

The portal is not showing my results yet, so I don't have the actual numbers, I just know that my original blood work (late Aug) and then after one month on MTX, everything was normal. I am coming down with bronchitis (thanks hubby!), but when I had the blood draw I hadn't started taking anything. And on a regular basis, all I take (took) is MTX and the folic. No aspirin, NSAIDS, nothing.

I don't know anything about Xeljanz except that it is a pill.

Wow! That sucks to hear. I went through that a few times but each time it was definitely my doing. I still had my Friday night happy hour drinks, typically 2-3 beers but what was weird is my liver enzymes were never elevated from just the drinking, but boy when I would get a cold & take the OTC medications then it would skyrocket!

Is it taking you off for like a week or 2 & then re-testing? That was MO each & every time. Stop, "flush out" & then re-test.

A MONTH!

Would be interested in before and after numbers.

Me, too! Interested in the numbers, that is!

Xeljanz is the first pill biologic. It attack the jaknase cells or something. You might want to look it up. I think it can also affect the liver, but it did not personally affect my liver, like antihistamines and mthx the first round did.

I actually started with my ALT at 75, before mthx, where it stayed for many years. When it started to gradually slide up, I discovered that it was Reactine, an antihistamine I was supposed to be permanently on for allergies that was the culprit. When I went off, my enzymes went back down to normal for another 4 or 5 years. Till they weren't.

Initial ALT 16, also after 1 mnth on MTX. Don't have Monday's #S yet. Thus my surprise.

So my #s: ALT went from 16 to 163 and AST from 16 to 100. Sounds like many of yours were much higher than that so WTH?

Susie,

Are you drinking alcohol?

No more then pre diagnosis and I did tell doc that.

The issue is probably more due to the degree of change from your baseline levels, which were nice and low. But they increased quite a bit in 2 months (10X with your ALT). Some liver diseases cause levels much higher than that, but mildly elevated numbers show some change and your rheum probably wants to stop before they get higher and indicate real damage. Best to stop check to be sure the number recovers, double-check other problems that may be contributing, and then decide what to do. Most people on MTX have levels every 3 months -- if you waited until your next labs or follow-up, maybe in 2 more months, you'd go up another 10X?

Yes, well, it was three months. I just hope one month before my retest is enough to flush it from my system.