AST 107/ALT 203- talk me down please

I’m currently dealing with a similar situation. My high liver enzymes showed up incidentally on a CMP that my endocrinologist had ordered a year prior. They ran a whole battery of liver blood tests and did an ultrasound. The doctor also stopped my lovastatin which I have been taking for over two years since it can rarely cause drug induced liver injury. It’s been five months now and the AST/ALT are slowly coming down. I have an appointment with a hepatologist in a couple of weeks.

How much I drank was the first question I was asked. I stopped drinking after my first child was born since it caused migraines. The doctor said quitting cold turkey would have been his advice otherwise. Crestor can cause DILI as can chemo, immunotherapy and Femara. OTC drugs like acetaminophen are also DILI culprits.

The liver is pretty good at healing itself but anything which happens to be toxic to your liver needs to be stopped to allow repair. You should make an appointment with a liver specialist gastroenterologist to go through the process and evaluate whether there is any permanent damage (scarring.) If the ultrasound shows fatty liver you will probably be given dietary advice to follow. Sometimes you are able to restart meds in an organized challenge process to avoid the culprit(s.) Otherwise alternate drugs for your medical problems can be found.

Mets are a less likely possibility. I’ll be having a fibroscan and possibly a biopsy to check for permanent damage since the ultrasound showed some irregularities. DILI due to the statin seems to be the cause in my case but my slow rate of improvement means it will be up to the hepatologist to figure out if I need to treat my high cholesterol another way. My MO will order a liver MRI if the hepatologist thinks it is warranted.

Finding the cause of high liver enzymes is a process but most likely it will not be cancer. I hope things work out well for you.

They decided my high liver enzymes were due to drug induced liver injury from lovastatin. I had taken it for two years so it took a long time for them to move down. I’m not quite at normal yet but am getting there. I’m now using Repatha which is not a statin (a PSCK9 inhibitor.) They checked that my liver was healing itself by doing a fibroscan and biopsy.

Crestor is a statin but if the US looked good there is probably no need to worry. They don’t seem to do anything if the numbers are within 3 times the normal value which is where yours are now. Both lupron and femara have been known to cause slightly elevated liver enzymes so you should make sure your doctor monitors things.

I developed hand/arm numbness and weakness which was originally attributed to the elevated liver enzymes but it has gotten worse instead of better. That is my next medical mystery which needs to be solved. So far I have been given two different diagnoses which have not held up. A lumbar puncture is next on the agenda. It took eight months to get an appointment but I’m finally seeing a neurologist.

I hope your enzymes stay in the acceptable range.