Elevated ALT

Carolina,

ALT and AST are of course liver enzymes. They elevate when the liver is stressed, and it is not uncommon for them to remain high throughout chemo. They also can indicate alcohol use and liver disease. When an irritant is removed, their numbers drift down only very slowly; they do not usuay react fast.  My levels for both were way up throughout treatment and the oncologist never commented on it at all, and would not even take me off Loritabs, which contained Tylenol, which is a serious liver irritant.

You do not say what 'seriously elevated' is, but my GP told me once that most internal medicine doctors do not worry about ALT/AST reading unless they are '2 or 3 times higher than high-normal values.'

Ask your oncologist, but I doubt it is cause for concern.

Hello Carolinagirl,

About halfway through chemotherapy, my AST and ALT levels had reached more than double the maximum normal values (and remained double-to-triple normal for a couple of months after chemo had ended) and, as stated by Max, no one even raised an eyebrow. Then, a few months out of chemo, they suddenly shot up to five times max normal values, and that caused some concern. My liver enzymes were closely monitored for a while after that, and quickly went back down (well within normal range) after this episode. As it turns out, it wasn't liver damage, but most likely the result of a ten-day course of a well-known anti-inflammatory prescribed by my GP for an acute case of back pain...

Since - if I read you correctly - you say you are nearing the end of your maintenance treatment and this liver enzyme elevation seems to have happened out of the blue, may I suggest you look back at any medication (even seemingly inoffensive over-the-counter stuff or herbs can be too much for an already-strained liver) you may have started using in the weeks leading to that blood test. And of course, ask your oncologist what s/he thinks.

Chances are, there is no cause for alarm at all.

PBL