Your doctor may get concerned and want to take you off MTX. Happened to me. I think the best thing to do if they start acting concerned is to disclose that you drank wine the night before. I would bet the wine was the culprit and not the meds. This will probably get you a reprimand from your doctor about alcohol and MTX, but it is better than losing MTX. Most likely they will do another blood test in a month or two and if it goes back to your 'normal', they will drop it. Just next time no alcohol within a week of the test. I also eat salads, grilled chicken or fish for a couple days prior. No fries or pizza because I don't want to have a cheat day and mess something up. My liver reacts to stuff, but it tells me bad choices make my liver work harder which really isn't a good thing to do on a routine basis.

This isn't the end of the world. I still have champagne on New Year's and red wine on occasion. I just don't go near bloodwork until I clean up my act. You still have to live a little.

Kim has some good advice. NEVER drink before a blood test. Or take antihistamines, or a host of other things that can raise liver enzymes. I also take milk thistle, which helps me keep the enzymes down.

I have had my liver enzymes as high as the thousands. I was on mthx at the time, but figured out it was this herbal concoction, "Serracor NK" which is supposed to reduce inflammation. It sent me to the liver specialist within days. But, once off of it, I was fine. Well, till my enzymes went so high I had to go off for 7 years.

It is ok to have the enzymes a bit raised, but not consistently. You may have to get retested very soon. That is what my doctor does.

Yep, what got me messed up is living in a small town - my doctor's office called and said hey, you made an appointment to get your bloodwork done next week, but the office (just one doctor, and one nurse) will be closed next week, so can you come in today? And if I said no, I'd have to drive quite a distance to a lab that would have done it for me in time for next week's appointment. So I went right in, not thinking about the wine I'd had the night before until the results came back!

Oh, that is too bad. I have to get my enzymes tested next week. So, no antihistamines no matter how itchy I get. I'll ;probably do a beet juice cleanse beforehand too. That seems to wipe out everything bad in my liver.

I have really learned my lesson about what I take the week before a blood test. Of course, if they tell you to come in early, not much you can do about that!

@MarleneJ~ you mentioned that you take milk thistle to help you liver enzymes. I was wondering if you have tried essential oils? I tried turmeric, but it made me throw up after a few weeks and I obviously, stopped taking it. I wasn't happy about the Methotrexate actually being a cancer drug and last time I was at the Dr's office, I was prescribed Leflunomide as the Methotrexate wasn't working very well. My dad died from liver cancer last winter and that's always in the front of my mind. I really don't want to take any of this poison, but I have no choice.

Essential oils have not done anything for me. That doesn't surprise me, since there are NO double blind studies showing it works. Milk thistle, on the other hand, has teams in pharmaceutical companies trying to reverse engineer it. However, when I get bad, no about of herbs help my liver. Just rest from the mthx and Arava.

I have been on mthx for 11 years now, mostly with a biologic. I had to go off for 7 years, but other than my liver enzymes going up once or twice a bit this time, and then my doctor pulling me of Leflunomide permanently, I am doing fine. But, I am not taking a full dose, which I obviously need. Even 17.5 mg puts my liver into stress.

My RA is so bad I cannot move or even get out of bed if it is not under control. Right now, I am not doing well. I see my rheumatologist on Tuesday. I personally don't really care at this point if the meds kill me. I want quality of life, not quantity. I hope you never get to that point, Joanne!

I had elevated liver enzymes once in my life, and that was after being off RA drugs for 3 months (well, not wine). I had been on MTX, but just crashed before that. Otherwise, I've enjoyed my wine, usually 1-2 glasses, with an occasional slip.

I say control all the outide factors, test again, and then start eliminating. I have no idea what Stelara is, but MTX never showed up. Good lucj=k, and try to keep the wine. It's not worth advancing that theory on this forum. Trust me.

Ironically, I didn't mean for this to devolve into a discussion of the wine. I was more interested in finding out if anyone had elevated liver enzymes during bloodwork, and what I might expect at my appointment going forward - if it was likely to be a complete stop of the meds, or a switch, or a possible wait-and-retest. I suppose I should have limited my initial post's question to just that. I was hoping to go into my appointment with some idea of what the range of options is when your bloodwork shows an elevation.

.....and now I have my answer. The rheumatologist wasn't concerned by a reading that was three points out of the normal range. A second high reading in three months would be a cause for re-evaluation. Not changing anything about the current protocol. The occasional glass of wine or a beer is fine, but we did agree that I would make sure not to have the next bloodwork done the day after having a drink just in case that was contributory..

Excellent! Glad it worked out. I'm sorry, I didn't mean to make the wine sound bad if that is how it came off. Just timing wise, unfortunate, but you explained that by the test being unexpected. It happens. Happy your doctor didn't freak out on you. I also didn't realize you were only 3 pts out of range. Pffftt.. no big deal unless it is the start of a trend. I had previous history with liver toxicity with another med, so my doctor is hypervigilant. Different situation altogether.

My enzymes went sky high again last week, rheumatologist pulled me off mthx for 3 weeks. It works well for me, and now, I just have Orencia, which is not enough. My body has always needed a biologic with a DMARD.

I had the unfortunate experience of flying by myself to see my orthopedic surgeon. And a connecting flight on the way home. After I lost my handicapped placard in the rental car, worrying about the keys I had left in my coat on the play ride out, because I couldn't stand to look at the overhead bin.

So, standing up and down all day. And screaming each time. I am just so upset it is ridiculous. And my liver, is always fine, each time it is tested - years ago with liver biopsies, now with fibroscans.

So, enzymes up, in extreme pain, my rheumatologist telling me it takes weeks to start getting flared after going off mthx - forgetting I have been going downhill since I went off of Arava, and yes, it always happens immediately.

So, fibroscan in 2 weeks, and I may give the liver specialist a piece of my mind. For now, back on prednisone, so I can stand up and sit down. And I lose my cheek bones and the weight I have lost since I stopped presdnisone a few weeks ago. Funny thing, they always say if I just lost weight, my liver will improve. But, I can't lose on prednisone. And when I lost 80 lbs in a year, about 13 years ago, my liver enzymes were at their all time worst.

Glad to hear, Kate, that you are ok, and this was a momentary blip!