Tamoxifen and fatty liver disease
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One thing I learned is to be my own advocate. Amazingly docs don't always know everything. Sad that an mo wouldn't think to do labs.
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When I took a break from tamoxifen it didn't reverse the FL. It is a nasty drug no doubt about it.
They always check. My liver enzymes at my MO that is how I got referred to a gasteoentologist for fatty liver. I was able to reverse it by eating a lot of greens and seriously cutting my animal products. The goal was for me to lose 10 percent of my body weight bit good luck doing that on tamoxifen.
That did not become the end of. My problems. Tamoxifen, hysterectomy, chemo and cancer teatment have permanently raised my fasting blood sugars. They decided to diagnose me with insulin resistance and metabolic syndrome. They have no experience with dealing with women who have had cancer.
The insulin resistance is far more danger us than the fatty liver. So you ladies may want to go to an endocrinologist whose specializes in cholesterol, pre-diabetes and fatty liver because the problem is a lot bigger than my MO cared about.
Maybe I would have developed some. Of this 15 to 20 years from now but thanks to the beating my body took in treatment I am facing these problems in my early 40s.
Just thought it was worth sharing in case it helps someone else.
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Hi, back on this site after a long hiatus...overall doing well but a few things have come up. During an MRI for another issue, one finding (one of several) that came back was mild steatosis (had to google that to find out it is fatty liver). Wth! I am fairly youngish (mid 40s) and normal bmi. I was on tamoxifen for 4 years...switched to anastrazole last Spring. I know nothing about fatty liver so will be reading this thread with interest and plan to follow up with my MO and PCP. Honestly between this and the osteopenia and the anastrazole joint pain I feel like a million years old!0 -
Hi All
Thought I’d check back in with an update. In July 2019 I was diagnosed with NASH and increased A1C levels stemming from years of Tamoxifen use. Much research and conversations with Dr have confirmed this, as ALL my levels were normal prior to chemo/and tamoxifen use. My ALT liver count was off the charts at 137 and my A1C was high as well in the 6+ range not to mention my platelets were very low as well. All of this was confirmed through research findings. It’s all there. Do your research. Oncologists often don’t like to admit it though. Here’s what I did once I wrapped my brain around the seriousness of the situation. Immediately my oncologist took me off Tamoxifen. I had been on the extended use for additional five years and that was nearly up. I was put on Metformin to stabilize my glucose levels. I went on a super restrictive diet - low carb, no sugar, very little dairy, heavy veggie, lean protein diet. All organic and of course no alcohol ever again. It was a lifestyle change to say the least. I have an excellent GI specialist and he said to also stop any use of Advil or Tylenol and no supplements herbal or otherwise and to refer to him before taking any medications for anything. My liver was to be under as little strain as possible. I’m now down 30 pounds and my A1C is back in the normal range. My liver counts have improved and my ALT is now down to 60. I still have to get to ALT to 40 to be in normal range so there’s more work to be done My dr is very pleased and said while the scarring can’t be reversed it can become stabilized. My liver is functioning but wasn’t filtering which caused the enlarged spleen and low red cell counts. My most recent MRI showed that I’m at stage 2 cirrhosis. All this to say diet DOES help to improve liver function though it can’t be reversed and absolutely INSIST that your Dr do ultrasounds of your liver frequently while on Tamixifen because it can cause damage. Wish I knew to ask about all this before I got to such a bad place. I’m hoping this helps someone out there
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aszhbaro - thanks for the update & information.
I started tamoxifen on Aug 1. I started at 10 mg, then took 12.5 mg for 50 days from last Aug thru early Oct. Then I went back down to 10 mg.
I had my first liver blood test a couple of weeks ago and all results were in the normal range and in line with where they were a few years ago.
My Kelsey Med Onc who I won't be seeing any more does blood tests for liver function every 3 months, but no ultrasound.
My MD Anderson Onc who I will be continuing to see does not do anything at all to check liver function. My plan is to ask my PCP to run bloodwork to check my liver function again in March and then every 6 months or every year after that.
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I had a CT scan in October, and surprise, surprise, there's a fatty liver! My new PCP says it's because of my weight gain since my surgeries last year, but she's not familiar with the fact that this is not the heaviest I've been, and my liver was just fine then. I stopped the Tamoxifen, at least until I can get my weight down and have a good talk with all my doctors. To be continued, I guess...
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...just bumping this for new members....
Ask your teams to monitor liver levels before and during Tamoxifen.
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I just had a chest CT and got a copy of the report. It states “visualized portions of the superior abdomen demonstrate hepatic steatosis.” I am wondering what I should do with this information, besides it causing my anxiety to spiral🙄. Do I call my MO? I have been on tamoxifen since February 2019. It sounds like some people continue the tamoxifen despite the fatty liver, correct?
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Hi Dani444, I was diagnosed with a fatty liver just before my BC. My triglycerides were elevated on my yearly labs and the doctor was confused by that. I started to have some upper right sided discomfort and the ultrasound showed a fatty liver. When I started Tamoxifen this was a major concern. I have a liver function lab test every 6 months and my levels have been within normal limits. If they were abnormal then I would have to go every 3 months. My Triglycerides have come down. The Tamoxifen did decrease my cholesterol level. The only advice I got was to decrease carbs and loose 20 pounds. With covid I have regained the 10 pounds I had lost! I also take fish oil/krill combo to help with the triglycerides/dry eyes and that seems to be working. It is in the back of my mind, but my MO seemed to be more concerned with blood clots which doesn't worry me! My primary takes care of my Labs.
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Hi Dani444 I also have hepatic steatosis which was confirmed on an MRI. I'm not sure what my triglyceride levels are like, I haven't had that tested for a few years (I know I should). I do know my ALT levels are above normal (ranging from 55 to 84 at various times) and they were normal before I started taking Tamoxifen in March 2019. My MO didn't seem to be that bothered and said the levels seem to be stable. With a bit of searching I found that AST and ALT levels can go into the thousands when the liver is having real problems, so that explains why no one is worried. It seems I'm just going to keep having the blood tests by my MO every 6 months. She definitely wants me to stay on the Tamoxifen.
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