Medication Causes Of High Liver Enzymes
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- Опубликовано: 16 июл 2024
- Are you seeing your liver enzymes go up, up, up? Maybe you recently started a new medication, and you're looking at medications that can cause high liver enzymes. In this video, we're going to look at that specific question.
We'll look at the most commonly used medications that cause high liver enzymes. We'll look at the ones that are most commonly associated with elevations in liver enzymes, and some other things to think about with this topic on medication-induced elevation in liver enzymes. This video will talk about medications that can cause high liver enzymes. There are many medications that come with the potential side effect or warning of elevated liver enzymes. However, in my experience, most medications do not cause elevated liver enzymes. Of course, the dose of the medication, the combination of medications, and your particular genetics do matter to a large extent. But even with that, there are specific medications that are more likely to cause elevated liver enzymes than others. So in this video, we'll look at some of those specific ones that are more likely to do this.
The first medication that's actually fairly common that's likely to cause elevated liver enzymes is statins. Statins are medications prescribed to lower cholesterol levels, and they usually are very well tolerated. In some cases, I have seen elevated liver enzymes that seem to be directly related to the statin medication. However, these were usually much higher doses of atorvastatin than what's generally used. So, up in the 40 to 80 milligram range. So, they were on pretty high doses of statin medications where this was occurring.
That being said, I also have plenty of patients that are on statin medications that never see a single change in the liver enzyme numbers when they start statin medications. So, it really does depend on the dose and the individual variation there. The next medication that can cause high liver enzymes is acetaminophen. Acetaminophen is the more chemical name or generic name for Tylenol, and is widely used for pain and temperature regulation or reduction in fevers and things like that. Now, acetaminophen in small doses is very, very safe. But as you get into the higher gram doses, like two grams, three grams, which is about the upper limit of what you should be taking, that's when you're more likely to see elevated liver enzymes. Use that in combination with alcohol and the chances go up that you're going to have elevated liver enzymes.
One of the ways that acetaminophen causes high liver enzymes when it does is it depletes your glutathione levels. Glutathione is needed as part of the detoxification system in our bodies. So if you don't have as much of that, you have less overall capacity to get that acetaminophen out of your body.
Anti-seizure medications or anti-epileptic medications are also commonly used for bipolar disorder. There's some overlap there. And for some of these, but not all of these, but the seizure medications in particular, like valproic acid, carbamazepine, and phenytoin, are all highly associated with elevated liver enzymes. So people that are taking those should have their liver enzymes monitored very closely, especially when they're starting out and when the doses are going up.
Some of the newer ones are less likely to do this, like Keppra, lamictal, lamotrigine, and Topamax, or topiramate. Those are generally well tolerated and less likely to cause elevated liver enzymes. Again, there are lots of medications out there that can do this, but these are some of the ones that are more commonly associated with it.
Methotrexate is another one. Methotrexate is commonly used for various conditions of rheumatic nature or autoimmune nature. So psoriatic arthritis, lupus, rheumatoid arthritis, those are all conditions that would typically be treated with methotrexate. Sometimes other medications are used, so it depends on the severity of the disease and what the doctor chooses to put you on, but methotrexate can occasionally cause elevations in liver enzymes as well.
And then the last category that I was going to cover is antibiotics. So certain antibiotics, such as Augmentin, which has amoxicillin plus clavulanic acid, erythromycin, and tetracycline, can cause elevations in liver enzymes in some individuals. These medications are typically used in limited time spans, so it is pretty rare that this is going to happen and even show up unless you are on it long term. Sometimes people are on these long term, but in order for this to happen, you have to be taking it for long enough and at the dosage that's used for infections. 
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I used to be 230 plus lbs and then i lost 80 lbs after changing my diet and getting treatment for PCOS/endometriosis. A year later, I had to get a hysterectomy. I also suffer from several chronic conditions where I take muscle relaxers, meloxicam (rarely), clonazepam, and an androgen suppressant. (no issues with insulin resistance)
Before my weight loss, I made the move to get sober. (I was high functioning. going on 3 years sober!)
During my uptick in health choices, and with the benefits of the surgery my blood tests came back great. I was looking better, feeling better, my blood pressure is highly improved, and my cardiovascular health improved. (also lowered cholesterol into normal levels)
Everything was doing great;
aaaand then I was prescribed duloxetine for my adhd recently.
Boom, high liver enzymes on the next blood test. (I get blood tested semi frequently)
Very informative. Thank You
Glad it was helpful!
Thank you for your information and having a generous and careing heart
No problem thank you
Thank you for this information. Very helpful and informative.
Glad it was helpful!
This helped too. Thanks Doc!
Very informative video!
Glad it was helpful!
ThankThank you! Answers some of my questions.
Glad to help!
Thank you Doctor for this information.
Welcome
Very helpful thank you
Glad it was helpful!
I have had 9 imunotherpy (cemplimab) tratments for skin cancer. Excellent improvement for the skin cancer. From my blood test showing liver enzymes out of spec. Can the drug therpy be the reason, and perhaps its time to stop the cemplimab trarment every three weeks as the outward symptoms are all gone? Thank you for your most helpful tutorials.
Last October my ALT was 37 and AST was 36. Last week I got tested again and my ALT was 76 and AST was 75. However I was taking Augmentin for four days prior to testing. I am hoping this increase was due to that. I will go for another test in a month or so and see how it goes.
good plan
Hey doc, great video! My father has AST 67.3 iu/l and ALT 43.2 iu/l. He has been taking Sintrom for a few years now. Can Sintrom be a cause of these results?
Fenofibrate can cause the elevated SAT and LAT elevation
My ALT was 138 and my AST was 61. I lost 60 pounds in a year and I have NASH and I take plasma infusions of upwards of 5 hours once a month for 12 years. I have cut my carb intake and was taking Chlestrol medicine for 5 years called Zetia. Also I do the plasma infusions I take is for a Immune disorder called Primary Immune Defeciant Disorder (PIDD) which consists of ear infections and bronchitis and I have COPD and Asthma I was a former smoker until I quite 5 years ago. I don't drink soda just water, but I am guilty as of late from earlier this year to present of eating Freezepops which I know are probably high in fructose which I know effect the liver directly. But I didn't start doing that until I started the Mounjaro shot about 5 months ago,just found myself craving sugar, but my A1C is 4.6 which the shot has helped with me being a borderline diabetic. Also wondering if protonex or pepcid or allergy medicine if those can play a factor in liver enzymes. With all the information you have here I was wondering if you could help figure out the root of the cause and maybe go in depth and not have a AI generated answer. Thank you and have a good day.
Pepcid and allergy meds do not typically cause elevated liver enzymes. You have a complex case that would require a doctors appointment
I'm not a doctor and I can't definitively prove a correlation, but I was diagnosed with a liver lesion right after finishing a bottle of protonix, so now I won't touch the stuff.
@@swintegrative How about the plasma infusions for 12 years, wouldn't that strain the liver and being a 26 year ex smoker. And appointment with whom. I tried to mention these things to my Dr... but it falls on deaf ears. And I have know since of direction, like who to see and stuff, I just end up Google searching and watching RUclips videos on these types of things.
New sub ❤
Yay! Thank you!
I have been talking Diphenhydramine almost daily for 15 years. I just found out i have high liver enzymes. I don't drink alcohol at all; nor do i take other drugs of any kind. Can the diphenhydramine be causing it?
Hi Dr just saw your video I had a blood test recently n my ALP30-110U/L up by 146.
ALP is both a liver enzyme n bone enzyme is it too dangerous n what can i do or change my diet.
Ariprazole?
Finanstride Can cause also liver enzines
Elevated enzymes found at annual physical. Currently ALT hovering 180ish and ALT hovering 80ish. I was taking nitrofurantoin as a prophylaxis. I stopped asap in Jan and here 5 months later they haven’t dropped. Stopped all otc and supplements too. Biopsy showed most likely drug induced liver injury and nitrofurantoin is a known culprit. Does it normally take so long for enzymes to go down? My diet is very liver friendly and I have a low BMI.
It typically does not take more than a few weeks to see improvements and liver enzymes. Once you remove the offending agent like in your case if the nitrofuantoin was causing it, I would expect those liver enzymes to drop within a few weeks. sometimes it’s hard to get to the bottom of it though, good luck and thanks for sharing
Thanks for your response. Do you think having an occasional glass of wine can cause these enzymes to remain elevated?
NSAIDS also increase liver enzymes from my understanding. Do you have any information on that?
Tylenol acetaminophen yes but not so much for ibuprofen aspirin which are traditional nsaids. These tend to negatively affect kidneys and blood pressure
Could SSRis be a culprit with long time usage?
Not likely
What about GLP 1 medications? Like Tirzepatide? I started taking it in November and my labs were normal, now in January my liver enzymes are elevated. I
Im sure it is possible but I have not seen that in my practice.
Thank You for all this very important information. I really appreciate it.
Insulin resistance, Thyroid issues, and HRT , plus antidepressant duloxetine. I don’t know what to do. I eat very healthy, and take walks, but still having pain for fatty liver.
If I start taking metformin for pre diabetes would it help to fix the scenario …. ????
I don’t drink, nor smoke.
I don’t know what’s causing the fatty liver….. ????? Probably the combination of all that 😏
Thanks again for your help .
Insulin resistance is a big one. Check out my video on diet and elevated liver if you want
@@swintegrative Thanks so much, of course I will …. God Bless your life 🙏
What about Accutane?
Yea definitely accutane can raise liver enzymes
can azithromycin cause increase ast?was taking for 5 days and now my ast is 99
Not typically
How about Lamisil (250mg tablet)? Can it elevate your liver enzymes?
Many medication‘s can purchase because you’re taking a medication in the liver enzymes are high doesn’t necessarily mean that’s the cause.
Diltiazem?
What abt Baclofen?
Not a common culprit
I have been talking Ayurvedic medicines
Triphala powder
Moringa powder
Can they elevate liver enzymes
if they are contaminated with some kind of toxins they could otherwise not likley.
Can Benadryl raise liver enzymes ?
Corticosteroids also screw up the liver
Yes they can
Levothyroxine causing high liver enzymes?
Not likely
Can quetiapine cause high liver emzymes
not certain but would think so.
I have just diagnosed with fatty liver and already I have gastritis managing
What can I do with my situation
Please I need your help
See my other videos on high liver enzymes I think those will help
Intermittent fasting, low carb diet (Keto), no sugar, no processed foods, no alcohol is the fix. You can take NAC, Tudca, and milk thistle to help as well, but the diet is key.
My ALT went from 17 to 39 after five weeks on methotrexate the doctor doesn't seem concerned but I also have a headache daily my stomach burns and I'm nauseous when I eat I am at the moment on six pills every week and I think their intention is to keep increasing that-I'm concerned and wondering if I'm just over worrying about something that I shouldn't worry about
I was taking that medication and it’s the worse!