I don't have any knowledge to share, but wanted to let you know that I'm thinking of you. Hang tough.

I'm sorry that I don't have any insightful comments for you, but that sounds so scary! I will keep a good thought that you find the answers and get back on track soon.

Hi there!

i jsut got on mtx back last week, 2nd dose..4 pills..starting on low dose

been on it for 16 yrs....it has helped me
i had the liver biopsy 10/.20 this yr..posted about it...was painless

had liver ultrasound a yr ago....and all the bloodwork u hgad, hepatis checking for

they came down hard on me, rheummy, loose weight
i went for Remicade, yesterday

and they had that big tall scale, with weights?..they weighhed each person getting remicade..
i lost 15 lbs in 6 weeks..and got to loose another 15

been inactive, knee revision in 09, and foot probs...but i still ate wrong

ur numbers are higher than mine..i had 188 on ALT.

first day, no pain, had my mtx, remicade eysterday....so i will get my lab reports out..july one was the highest, 188..they pulled me off MTX
nsaid, simvistatin, everything not necessary, even vitamins

AST came down to 33, normal is 32

liver doc did tell me to take 400 units of vit E, no higher, for fatty liver ( latest findings)

and i increased folic to 2mg, whether i am on mtx or not..seems to support liver

ur not alone, it scared the heck outta me, like i was going to get cirrosis...and i don't even drink...non alcoholic fatty liver i have
but they still are going to watch my labs every month, because of the mtx.....according to liver docs phone call this week...he said don't gain weight!

I had very high enzymes before I started mthx ( over 75 AST) and they continued to climb during the 10 years I was able to take it. Mine reached over 300, and I was finally instructed to not take it again by the liver specialist. I will admit, there were several other factors, which I found out reading the Canadian Pharmaceutical Compendium.

I had been on Reactine for years, an antihistamine, and it very clearly states it will raise the liver enzymes. Mine never went back to normal, until I stopped that drug, and went off mthx. In the last year of being on mthx, someone recommended a herbal supplement, Serrracor, and within a month I knew my liver was in trouble, and my enzymes were over 1100. That is highly dangerous. By that time I had switched to Sulfasalazine, and thought that was the cause. However, although I was allergic to Sulfasalazine, when I stopped the Serracor, the enzymes went to normal. I did have to stop the Sulfasalazine, and I am now on Rituxan.

My liver returned to normal, and a new test, which sends pulses into the liver determined I actually had no liver damage, which made me very happy. About a month ago, my Rituxan was failing and there had been a big mix up with the evaluation by my insurance company. I was in agony, so I decided to inject myself with 1/3 of a needle - 8.5 mg of mthx. I figured it would tide me through the 2 months, getting stronger as the Rituxan failed.

Well, the surprise was it started working in an hour! And really, I have not been as bad since. Obviously biologics work best in combo with a DMARD. But within 2 hours, my liver started hurting (the sac around it, the liver has no nerve endings). By the next day, my liver was a huge swollen, painful mess. I didn't bother with liver testing, I just phoned my rheumy and confessed my sins. I won't do that again.

So what I am saying is, look at natural supplements, OTC - especially Tylenol which is very damaging to the liver. Look at herbs, antihistamines and if you are overweight (as I was in the first 5 years on mthx) then bit the bullet and lose weight. The liver specialist told me 20 lbs would help, and I lost 80. The difference between my liver scans when I was overweight and the next year when I was normal, was so great the tech and radiologist thought there was a mistake in the labeling of the ultrasound from the year before.

The liver is a wonderful organ, but for some of us it can be sensitive. I don't eat meat, because I cannot digest fat well. I eat organic foods, and stay away from processed food. The liver has over 500 functions, but the good news is that it is the only organ that CAN regenerate. So don't give up hope. I have never heard of enzymes getting worse, but I would imagine the mthxt is still in your system. I would give it a month or more, to see if they go down.

And look at everything natural you ingest. And try not to get a liver biopsy if you can. They hurt like mad, despite the promises that they don't. LOL

Hope that helps and welcome to the RA forum

I am so sorry. I was dx this past summer and I really do not have much experience yet. My husband has Diabetes and I am so familiar with all of the drugs you mentioned. I am on mtx 6 pills/injection per week. So far my blood work has come back ok but I am worried that mtx is not doing much for me. This is a tough disease. Good luck and wanted to let you know that you are supported and cared for in this journey. :) Lisa

Wow! Thank you all for the fast replies. It is scary. I am super lucky, my rheum (I live near DFW area in TX) is quick on this, but that scared me more. He was so perplexed - to the point that I emailed him about taking the glimepiride 1 1/2 hrs before bloodwork during last 2 checks (when scores were in 100s and 200s on AST/ALT).

If I somehow had a viral hep. I would think I'd be feeling bad. Fact is, off the MTX, I was feeling GREAT! The enbrel is amazing for me. Lisa, at 6mo was when I was put on Enbre. I had a choice of biologic and it had the oldest track record so I went with it. I felt improvement in 2 wks.

Angela, thank you! I do need to take weight off - could lose 50lbs, but 30 would be great for me right now. Does it make any sense that my enzymes would escalate with fatty liver tho? Like double twice as they did? I wonder if the MTX wore my liver down and then something (the 64K question) is hitting it hard.

Again, thank you all so much! This forum is in my "favorites" now. :)

my triglerides have been high the last few yrs..and am on prednisone now, high dose, started tapering down 5 mg last night, after remicade

but my HBA1c test...was 6.9 recently..pre-diabetic..well jsut about diabetic now!

so back on simvistatin, and hopefully the weight loss will help the trigs
all this is tied into fatty liver!

am really eating healthier now...gettign used to it!
me and the cales, cookies, my downfall....i limit it, just a teeny bit now

Fatty liver is certainly a big issue. For one thing, it stores drugs and toxins. You might actually get worse as you lose weight, because the toxins are being released. But long term, the best thing you could do.

My first biopsy I had "non-specific" abnormalities. The second I had "fatty liver". I joined the fatty liver site here at DS and came to the conclusion the liver would recover, but only if you stopped attacking it with whatever was causing the problem. So stop drinking, lose weight,stop taking meds that affect the liver or get on anti-virals for Hep C. I don't drink or have hep C, so the answer was the weight, and getting off mthx. It certainly bothers me that I can't take it, as it was a great drug for me.

But that is not the path I am going to be on, obviously.

Discuss with your doctor the addition of milk thistle and SAM-e. Individually, they can help support the liver, together, they work even better. SAM-e is very expensive, though.

I work in veterinary medicine, with internal medicine specialists. They frequently use it in their patients (and they test Copper, Cobalmin and another B-Vitamin; in which deficiencies can cause the liver to decrease it's ability to process medications).

I know that these supplements CAN be used safely in people because naturopaths and integrative medicine physicians use them. However, unlike veterinary medicine, no drug companies make the combination. (It is called Denosyl (just SAM-e) and Denimarin (sp?, both) made by Nutramax).

My geriatric dog developed toxic liver enzyme levels after an assault on her kidneys and liver from raisin ingestion. We had to take her off of ALL meds and used Denosyl for 6 weeks. Liver enzymes were normal, put her back on meds and changed a couple to less hepatotoxic types. He liver enzymes have remained normal.

I am very into supplementing (with doctor's permission) with neutraceuticals to support our bodies with these meds. We need these meds so we can function, but we need the organs that process them to survive.

(HUGS)
Good luck

Rosie!!..i got a 15 yr old , 42 lb female terrier mix...survived a stroke, msotly blind from cataracts, has a mouthful of rotten teeth

and then a 11 1/2 yr old overweight Lab...who needs a new knee

they can't handle meloxicam from the vet..cheap, but bothers there stomach....they have tramadol if needed, but the 15 yr , too much drug for her, even 1/2...

All3 dogs do well on Deramaxx from 1800 pet meds chewable NSAID,,expensive
yep, they would have to watch their livers too on certain NSAIDS

they have been getting some roasted veggies, divided a carrot today...but too much fiber for them, not always good

ppl that luv dogs and all pets are the best ppl

I've been back to the rheum. several times.
My ALT and AST continue to rise. Right now, ALT is is 473 and AST is 309. GGT is also elevated at 143 and LDH is at 296.
All viral hepatitis is ruled out from bloodwork.

I've now been pulled off all medicine as of today. That will include the enbrel. My last shot was Sunday.

I am scheduled to see a liver specialist Monday - soonest they could work me in. Thursday, I get Liver enzymes checked again.
I hope they have finally plateaued.

Really scared right now. Thank you for the support.