Liver Enzymes - Stage 1 Gets the Blues

MJo · 01-22-2009, 09:38 AM

My liver enzymes climbed. I didn' t get specifics from the doctors, but one enzyme which should have been around 50 was 200. That can be sign of many things, including lesion or tumor. Possibly I am one of the women whose liver enzymes rise with Femara. I am off Femara and have been off for two weeks, along with all my other medications and my beloved Yogi teas. The oncologist suggested eliminating anything that could irritate my liver. That includes the occasional glass of beer or wine. Blood test this week showed my enzymes "moving in the right direction" -- down, but they aren't back to normal. I am happy that I don't need a liver scan. I will stay off Femara and everything else, and get another blood test in two weeks. I was petrified that I might have a liver met. I argued with myself that research data for Stage I is on my side, but emotionally I was a wreck on and off for two weeks before my repeat blood test. Fear is the new normal. I am also worried that I might not be able to go back on Femara or another AI. I could lose the peace of mind that protection brings. Yup, Cancer is the gift that keeps on giving!

Jean · 01-22-2009, 10:17 AM

MJo,
I am really sorry that you have to deal with this stress.
First of all, as you already know the rise could be from many other issues, weight, diabetes, a host of medications can cause the levels to raise, (as you already know) simple use of Tylenol can raise levels.
Antibiotics - have you been fighting a cold? Have you introduced anything new? Are you taking an Anti-depressant? How is your cholesterol?

In regards to the Femara, I think (not sure about this) but often times the AI will have a side effect that requires to switch over to another. No one knows why,
but sometimes when switching you avoid that side effect and your body works better with the new AI. Femara could be causing an imbalance by depleating you're estrogen. So hopefully if it turns out to be Femara causing the liver levels to raise you could switch over and try another AI.

How are you feeling otherwise...no other symptoms?
How is your digestive system?

-
Please keep us updated on your next blood tests.
I understand how difficult the next 2 weeks will be
try to stay positive.

Thinking of you.
Hugs,
Jean

sarah · 01-22-2009, 10:39 AM

Sorry to hear about this. How long have you been on Femara? Do you drink lots of water. I wish I could offer a helpful answer but push your doctors and nurses for answers. I wouldn't think you'd want to be off an AI for too long but I really am not that knowledgeable.
hugs and love
sarah

Rich66 · 01-22-2009, 12:15 PM

Maybe the serum her2 test would be helpful. Maybe getting a scan would resolve the question sooner.

Believe51 · 01-22-2009, 12:49 PM

MJo, sending you a hug and a smile as you work this thing through. Let us know what the test results show, until then I am saying extra prayers that this is nothing of worry.>>Believe51

PS: Had a chuckle at the 'cancer is the gift that keeps giving!', how true!!

MJo · 01-22-2009, 01:45 PM

My health is pretty good except for the blood test results. No other symptoms of liver disease. I was taking a very mild dose of a drug "Abilify" that could lead to elevated enzymes. Possibly the combination of femara and abilify was toxic to my liver. Can't remember if I tok tylenol, but maybe. My cholesterol also went up, so perhaps there is a connection. It wasn't weight related, since I have maintained my weight loss for six months and I stick to low fat diet. I had a blood test in August and all was normal, so the change happened between then and January, when I started Femara and later abilify. Perhaps I can go back on Arimidex if I don't continue with Femara. I switched from Arimidex to Femara in in September 2008 as part of a clinical trial. I think there are a few other women on this board coping with similar situation. We can add this to the list of possible side effects -- even though I'm three years out.

schoolteacher · 01-22-2009, 02:16 PM

MJo,

I hope you are feeling better.

Amelia

ElaineM · 01-22-2009, 03:20 PM

I am sorry this has caused you so much concern. I wonder if an ultra sound of your liver would help?

chrisy · 01-22-2009, 06:06 PM

MJo
Lots of things can cause liver enzymes to fluctuate. You have a lot going on with the various things you are taking, one or more, or a combination may be making your liver work overtime.

I'll say this in the spirit of hopefully reducing your worry about liver mets: I always had normal liver enzymes even when diagnosed with extensive liver mets in 2004 and recurrence in 2007 and 2008. The only time this ever changed was when I went on DM1 - so in my case it was definitely treatment related, not a sign of anything going on with cancer.

Bill · 01-22-2009, 06:58 PM

Hi Mjo! I'm sorry to hear about your enzyme elevation. It seems like you know to to watch your intake of anything that can affect these levels, acetaminophen, alcohol, etc. I'm no authority or expert on anything, but for what it's worth, Nikki had extensive liver mets and her liver enzymes were always within the normal range. Even when her bilirubin counts were extremely high. My thoughts and prayers are with you.

Cannon · 01-22-2009, 08:12 PM

My liver enzymes have also been running high (like yours, multiples of normal range) for nearly a year. My onc is not concerned, and I had a clear PET in August, just did another one this week, no results yet. Mine probably is at least partially weight-related, I put on weight rapidly after I finished chemo and herceptin. I take a variety of medications for a variety of things, so perhaps they are doing something, but so far so good.

karenann · 01-22-2009, 10:13 PM

My ast liver enzyme has been high for years, pre bc and the docs can't figure it out. Like everyone has said in their posts, lots of things can cause your enzymes to rise. Try not to worry, too much.

Karen

Joan M · 01-23-2009, 12:45 PM

Mary Jo,

Sometimes our liver enzymes can rise and we don't even know it unless we happen to have a test at that time.

I'm praying that all will be okay with your next test.

Joan

Becky · 01-24-2009, 03:16 PM

Many medications can raise the liver enzymes especially cholesterol lowering drugs. This is why many doctors do bloodwork about a month after going on some meds. Sometimes they forget to test. You are going in the right direction with the enzymes so it was probably something you were taking or a combo - where one thing by itself wouldn't do it but has a synergy with something else.

swimangel72 · 01-24-2009, 10:45 PM

MJO I too worried about my liver enzymes - mine were elevated after my mx and bc recon due to all the antibiotics, and also because of a gall stone. I've since stopped worrying about the liver even though they are still a bit elevated, the numbers dropped. They probably won't become totally normal until I get my gall bladder removed. So hang in there - the good news is that your numbers are dropping!