I had my routine yearly blood work scheduled a day after Eagleman. Results indicated some elevated Liver Enzymes. Nothing out of control, but enough to couse me to be concerned.
Can copeting in a long course tri cause elevated liver enzymes? ANyone know?
I’m not a doctor, but I played one in preschool.
Did you consume alcoholic beverages after the race?
Did you take Tylenol before, during, or after the race?
Are you taking cholestrol meds (statins)?
I had two beers after the race…
No tylenol during before or after…but I did take several e-caps…
No cholesterol meds…
I am wondering if the changes in the enzymes were a result of my liver/glycogen depletion.??..
If you are talking about something like ALT (amino liver transferase) then the answer is absolutely yes.
Basically this enzyme is more abundant in liver tissue than most other cells, any damaged liver cells add ALT to the blood stream. Elevated ALT levels are simply a marker of liver trauma, and as such is used to look for Hepatitis. Exercise can cause mechanical trauma to the liver and elevate ALT levels. A follow up test within a few days should return to normal, assuming no underlying liver problems.
Pain-killers alcohol and other things can cause chemical trauma and trigger high ALT readings as well.
Can copeting in a long course tri cause elevated liver enzymes? ANyone know?
Yes it can. It doesn’t necessarily mean there is liver damage.
Follow on question. Can years of competiting/training for competitive endurance sports results in frequent micro liver trauma that effects the liver function and result in the liver producing higher LDL cholesterol than normal ?
I have many friends as well as myself who competed for 10-20 years in this boat at a pretty intense level and many of us have elevated LDL cholesterol. Anyone done any studies in this area to determine if there is in correlation ?
As a bit of background, my dad too has high LDL but that did not kick in till his late 40’s, not at the age of 38 like myself (ie 10 years earlier than my dad), so I have wondered if all this endurance stuff has any impact.
Dev
I read a study, and they did find that after a two week layoff from endurance training, that the cholesterol shot through the roof for most folks. Now which one I don’t know, and I thought it lowered after time. I also don’t know if at that time it had been a long term study.
Graz,
I had the worst muscle cramps in my legs that lasted for a week, after a 5-week build to peak for a 40K time trial – which I was not able to race. The pain was unbearable even at slow speeds. Very unusual. So I had bloodwork done that revealed elevated liver ezymes. Specifically, AST: 286, ALT: 215. Billirubin was normal. I did some research in some medical journals that said that muscle damage can elevate liver enzymes. My doctor, however, dismisses this as a possibility completely. He says there’s something definitely going on with my liver with those high numbers. I take another blood test next week, so we’ll see if the levels have dropped. Incidentally, he checked for Hepatitis as well – which were all negative. Electrolytes too were all in check. The only thing out of the norm were the liver enzymes. He’s thinking gallstones maybe.
Never heard ALT (alanine aminotransferase) called amino liver transferase, but I guess that’s “close enough for triathlon”. 
It really doesn’t even have to be liver trauma either since just an increase in hepatocellular permeability can allow intracellular concentrations of ALT to leak into the general circulation. This can occur from anything that causes liver trauma. Also cellular leakage from increased membrane permeability has been attributed to hypoxia (low oxygen concentrations) as can occur following anaerobic efforts.
AST (aspartate aminotransferase) is another enzyme that is often in routine blood chemistry panels and can be elevated with hepatocellular leakage or damage. However, this one is also found commonly in striated muscle cells, so microtrauma to skeletal muscles will cause this one to be elevated following exercise too.
There is yet a third “liver enzyme” that is often elevated following periods of stress and endogenous corticosteroid release. This one is called alkaline phosphatase and has nothing to do with the former Hall of Fame right fielder for the Detroit Tigers. However, this one usually takes more than a day to be elevated following the event if memory serves me.
Bottom line: Assuming everything else is normal, a half-IM is more than sufficient to cause increases in these enzymes. Any clinician worthy of his/her degree should be able to distinguish elevations due to exercise from those due to some pathologic process. I used to volunteer for Phase I studies of potential new drugs at the pharmaceutical company for which I work. If I went for a routine 1 hour training run within 24 hours of having my blood drawn, it was very common for me to have high levels of these enzymes.
Not sure - I’ve never heard of training causing liver damage, and it seems like if your liver cells were damaged enough that they could no longer absorb LDL they might not be able to synthesize new cholesterol (which is secreted as VLDL - very low density lipoprotein) either.
(from Cotran: Robbins Pathologic Basis of Disease, 6th ed)
My layman’s understanding of what I have read is that your body starts to use the fat stored in your liver as fuel after you have been training or racing for more than three hours or so. As a result, you can get elevated liver function readings in blood tests if you have such a test done within a day or two of such exercise. So, having elevated levels of liver function can be the result of your half IM. I have no idea what else having such test results could mean. So, I would explain to your doctor what you did immediately before having the test done and let him or her figure out what to do next.
I really don’t mean this sarcastically, but I know lots of sedentary people who sit on their asses all the time who have elevated LDL. In my case, since I started doing tri’s, my overall cholesterol is only down a little, but my HDL is up alot, which is good. With my family history of heart disease and high cholesterol, I don’t expect my LDL to get too low, even with my moderately strict dieting.
As far as the cholesterol going up thing, one of my brothers is 43, and just had a heart attack, last week as a matter of fact. He has hypertension and does not exercise(I don’t know what his cholesterol is like.) My other brother, 42, has been active and fit his whole life, and went on Lipitor last year because his cholesterol was high. It started getting higher around the time he turned forty.
My opinion(that’s all it is, and I’m not a doctor) is that your genetics may cause you to have higher cholesterol regardless of your exercise regimen, and that your cholesterol may go up as you age, but that frequent exercise will moderate your cholesterol, lower your risk of heart attack, and lessen the amount of calcification in your arteries.
When I was out of shape at 32, my cholesterol was 275. I changed my diet and got it down to around 240. With diet and exercise, it’s down to around 200, and my CRP risk is “very low”. I doubt I’ll ever get it much below 190(the lowest it has ever been measured), but my doctor agrees that exercise and diet are the best way to manage it(as opposed to just taking Lipitor, which does have effects on liver function, and no one knows the long term effects of taking it for 30, 40, or 50 years. We only know that using Lipitor and drinking or taking tylenol can be dangerous.)
So I would guess that if your cholesterol is somewhat elevated due to racing, it is still lower than it would be if you were sedentary. Further, any study similar to the one you suggest would have to factor out the fact(?) that your cholesterol goes up as you approach your forties(which coincides with your “competing for 10-20 years” clause.)
Anyway, that’s my entirely amateur opinion.