hi
I was just wondering if anyone has had elevated liver enzymes while on this drug. (mine are fine touch wood). What does one do if they are elevated?
Go off the drug or decrease it???
Is in right only to test the ALT and AST?
Thanks for all your help
Cathy/
I've been on MTX for over ten years and have my blood checked every 6-8 weeks. I've tracked the liver function tests which include Total Bilirubin, Alkaline Phosphatase, AST and ALT results and mine are still well within the normal range. I found that MTX, depending on the dose, doesn't drive the test values up quickly - it takes time. With bi-monthly bloodtests you've got PLENTY of notice if you're headed for trouble. [They'll take you off the MTX until you're in the normal range again.]
Perhaps this is a good time to point out that few family physicians will prescribe MTX. To my way of thinking, they should leave that to the Rheumatologist. You wouldn't go to a tax accountant to get your appendix out, would you? Too, it seems many people are NOT aware that liver biopsies for people that have been on MTX for a while and whose blood tests do not support having a biopsy is very, very outdated medicine. Used to be that every two years you'd have a biopsy. No longer true. And no, I've never in ten years of MTX had a liver biopsy.
My liver enzymes were high and I was taken off MTX, now I'm just on Humira until they are back to normal.
Hi,
I wanted to reach you for two reasons:
Most of us have moved to www.rafriends.com It's a friendlier site with lots more people and lots more feedback. So why not register there.
I want to talk about MTX liver biopsies. Vast majority of RD's will tell you that biopsies are "old school" thinking. There is absolutely no need for it because they monitor your blood. Any abnormal rise in the liver function tests tells them to take you off MTX until these test results are normalized. Therefore there is no need to do a biopsy UNLESS after being off MTX for a short while your liver function tests don't come down. Once they are down in the normal range you can resume MTX.
Do testing for AST, ALT, Total Bilirubin, and Alkaline Phosphatase. Do testing every month for a while when starting MTX. Once you're "established" with the drug and your test results have stabilized, testing is usually done every other month.
Anyone who tells you you need a liver biopsy while you are actually taking MTX, regardless of how long you've been on it, needs to go back to med school, in my opinion. Used to be that if on MTX you'd have a biopsy every two years or so, regardless of your blood test results. They found it was absolutely unnecessary. I've been on MTX for almost 12 years - I've never had a liver biopsy.
Lovie,
There is only a little bit of difference. Without MTX I have a little more aches and pains, but not terrible. I take ibuprofen more often though.
My liver levels are up so my doctor has told me to stop the MTX and do weekly blood tests until the levels are normal, then start it again. Will see how it goes.
MTX shot my liver enzymes up quickly. I was taken off of it and am now going to try either Enbrel or Humira. I was told that with some people, MTX can do significant damage to your liver. That's why its critical to have your blood work done periodically.