I read here recently that this is not uncommon. How long would enzymes remain elevated, and what would affect it? How much does drinking alcohol elevate enzymes, and for how long? I have been drinking alcohol several times a week since IMLP.
I just had mine tested this week and found they were elevated, but testing last winter they were normal. Doc thinks its b/c of doing LP and said get retested in a month.
Should I check this out further or just wait a month without worrying?
Wait a month and don’t worry. Also how high (ALT, AST). Like 150 or 800?
I had an elevated AST during my company’s healthscreening. My GI doc suggested I stay away from alcohol for a month and get tested again and sure enough back to normal.
Some people have an intolerance for alcohol. Btw I am definitely not a heavy drinker – maybe 2-3 drinks a week max.
I can’t imagine how LP would effect the results.
Whether you get tested again is your option if you feel otherwise normal, but for me if I see elevated AST I just ignore it.
This year my healthscreening revealed low hematocrit, which turned out to be a slight anemia. Easy to fix and I feel the iron supplements definitely helped my training/racing.
I spent much of last year sidelined due to liver issues (ALT up to 1200 at one point, with an AST over 900). Mine turned out to be the result of a hepatotoxic reaction to something I must have ingested. My understanding (from my hepatologist at UCSF) is that they see hepatotoxic cases with fair frequency in which the culprit was either a supplement or essentially an overdose of acetaminophen (Tylenol). (EDIT: Not the case for me, since I don’t take any supplements or even acetaminophen/ibuprofen, apart from pretty regular endurance nutrition/hydration products.)
During my ordeal, I did quite a bit of research, and I did find several studies out on PubMed regarding endurance sports and their short-term effects on liver enzymes. One that I recall in particular dealt with elite marathon runners, and they tested both prior to an event, as well as immediately following, two days post-race, and nine days post-race. The typical curve was for a spike in the enzymes peaking at the two-day post-race test, but normalizing by the nine-day post-race test. I tested twice after IM Cd’A this June, once three days post-race, and then again a week later, and sure enough my enzymes (most notably my AST, which can be affected by both cardiac and skeletal muscle breakdown) had spiked in the first test, but they normalized completely within a week.
That said, I did NOT have any alcohol post race (I wasn’t a big drinker before, and now it’s safe to say that I’m, ahem, reticent to drink in any circumstance where I suspect my liver might be in stress). I would believe it if someone told me that alcohol within, say, a couple of weeks after an IM would stress the liver more than at other times. Definitely retest, but I’d second the recommendation to stay away from alcohol until the enzyme levels normalize.
Best of luck, and if you have any questions, feel free to PM me. I’m not a doctor, but, unfortunately, I’ve had WAAAY too much experience with liver issues. 
cramer
I think it is just a way for them to make money and justify you coming in to get more test and more office visits. I had elevated levels and man I was going to the doctor for about 6 straight months. But mine was from the flu. flu went away but i still had a slight cough, took blood test, had slightly elevated levels. Doc said it would be ok if I drank Alcohol but since I dodn’t he wanted to investigate. Get tested again 2 weeks later. then 1 month after original test than 3 months and 6 months. Ultrasound liver and all. they where all fine, but he said he had to keep testing to make sure it didn’t occur again. Well that has been over a year now. Talked to two other friends and they basically had the same thing happen to them at 2 different doctors, they are the ones that basically told me they think the doctors do this for money. I think that yeah, the values can get slightly elevated for sure. But they see that as an excuse to keep running lab test and run up office visits to make money and justify it to the insurance company!!
I think it is just a way for them to make money and justify you coming in to get more test and more office visits. I had elevated levels and man I was going to the doctor for about 6 straight months. But mine was from the flu. flu went away but i still had a slight cough, took blood test, had slightly elevated levels. Doc said it would be ok if I drank Alcohol but since I dodn’t he wanted to investigate. Get tested again 2 weeks later. then 1 month after original test than 3 months and 6 months. Ultrasound liver and all. they where all fine, but he said he had to keep testing to make sure it didn’t occur again. Well that has been over a year now. Talked to two other friends and they basically had the same thing happen to them at 2 different doctors, they are the ones that basically told me they think the doctors do this for money. I think that yeah, the values can get slightly elevated for sure. But they see that as an excuse to keep running lab test and run up office visits to make money and justify it to the insurance company!!
Dude, do a search for the possible ramifications of sustained injury to the liver before just dismissing this as a medical racket! The liver is the primary organ for buffering and clearing toxins from your body, and if you lose it, it’s a pretty serious situation. Honestly, between an insurance-covered visit to the lab (plus a relatively small amount of lost time and some possible anxiety) and the possible loss of your liver (or worse, your life), which would you choose?
I would definitely follow this through with additional blood tests. If it goes beyond a couple of months, or you start to see significant elevations (we’re more than 3-4 times the top of the normal range), then I’d start to educate yourself on liver issues, track your diet (most especially supplementation), and perhaps talk to your doctor about specialists (gastroenterologists or hepatologists). In all likelihood, it’s just the residual effects of the stress of IMLP, but do you really want to gamble?
Sorry if I sound alarmist, but I’ve been through a closer-to-worst-case scenario.
cramer
NO, all test where normal for an entire year after the original elevated test. and it has been a 1 1/2 years and everything is normal. And no I didn’t dismiss it, that is why they where doing test on me for an entire year. But the end result was that everything was normal. just saying that the same thing happened to two other friends. No Hep A,B,C, no Hep antibodies, Normal liver function and enzymes, just “1” elevated test and and I am sent back to the doctor week after week for 1 months and then 2 weeks apart and then 1 month apart and then 3 months apart and then 6 months apart. Now that I remember, I was goig to the doctor all the time. And everything was fine. Only the first test came back “SLIGHTLY ABOVE AVERAGE READING” the Doctor told me it was not even a concern except for the fact that I don’t drink, he clearly stated that “IF I WOULD DRINK THEY WOULD BE NORMAL LEVELS!” But he said he wanted to see if something was causing my levels to be slightly above the average reading. They where not elevated to a level of cocern according to him. he showed me the chart and they where just outside the level of healthy by like a few points. Don’t remember exactly. over 1 1/2 years ago.
In this day and age, when a doc can be sued successfully for just about anything, a lot gets done for lawsuit prevention. Some excesses are for money and MORE is for lawsuit prevention, and some is just physician worry when something just doesn’t seem right.
Okay, if they were sending you back repeatedly after everything had already normalized following a slight elevation, I can see calling that a bit egregious. I’m still on the monthly blood test plan following my severe elevations last year (it went as far as biopsy for me), and, frankly, I’m glad to do it, though that part in “It’s Not About the Bike” hits close to home (where Lance talks about his post-cancer follow-ups and expecting every time to hear that he had relapsed).
I did send a copy of my IM Cd’A finish photo this year to my hepatologist, though, with the subject, “Picture of a Healthy Liver”. That was satisfying!
cramer
Yeah, I know how important the liver is, and that is why I didn’t complain about going back test after test after test even though things where normal after the fitst test, because to be honest with you I was worried something was wrong with my liver. I mean it got to the point that the staff kept saying you are back again? But thank God it was all normal, it was probably the Flu and the Medication Ketek(which I read can elevate values) that did it.
Same deal as above…
Training for 1/2 IM, blood tested 2 weeks before the event and results showed elevated levels. Went on the 6 month re-testing plan. After all the testing, the results all came back normal, except for the initial test. The doc said it could have been anything, “most likely a lab error”. Whaaa??!!! Well, at least I wasn’t worrying about it for the past 6 months, Doc. 
To this day, all’s well in liver-city…
Brad