Elevated bilirubin/cholestasis (bloods)

[therulersback]

About 3.5 weeks ago i finished a 3 month cycle of 400mg/wk test e 400mg/wk tren e, plus 4iu/d generic hgh during the last month of cycle. In the 3rd month I started having some digestive issues that I did not link with my cycle at the time. About 2 weeks ago I was just starting day 1 of my PCT of 40/30/20mg nolva 100/50/50mg clomid when the digestive issues came back followed with massive itching all over my body.

Got some bloodwork done, turns out my bilirubin was elevated and I have cholestasis. Subsequently for past 1.5 weeks I've been taking 2g/day TUDCA and 1.5g/day NAC, and cholestyramine as needed. My liver enzymes have dropped (AST 113->77 and ALT 222->140) but bilirubin continues to climb (3.6->4.6).

Got my full bloods today and as expected my test is shut down. I'm wondering if I should start my PCT, if it could have benefits to my liver to get my test levels back on line.

Or any other suggestions for getting my bilirubin down?

https://imgur.com/a/JppwRq2

edit: btw already had an ultrasound and no evidence of blockage from gallstones etc. Slight liver enlargement.

 

[swim15]

You’ve likely got some sort of genetic liver condition (I do as well) for bilirubin levels to be that high one cycle like that.

I’d double or triple the dose of TUDCA and potentially get some UDCA to throw in there as well.

 

[MyNameIsJeff]

I've been taking 2g/day TUDCA

You’ve likely got some sort of genetic liver condition (I do as well) for bilirubin levels to be that high one cycle like that.

I’d double or triple the dose of TUDCA and potentially get some UDCA to throw in there as well.

Are you retarded?

 

[Stewie]

Are you retarded?

I'm guessing he's talking about Gilbert's syndrome?

The liver supplements I'm not so sure about??

 

[MyNameIsJeff]

I'm guessing he's talking about Gilbert's syndrome?

The liver supplements I'm not so sure about??

Yeah, I'm only referring to the recommendation to take 6g TUDCA plus some more UDCA, which is excessive, likely counterproductive and, well, retarded.

I'd agree that an autosomal recessive disorder like Gilbert's syndrome seems the likely cause of the problem. It might interfere with the detoxification of some of the medications he took, thus explaining the elevated AST and ALT, which are usually normal in Gilbert's. Or he unwittingly injected some 17aa AAS.

OP should follow up with a physician in order to diagnose WHY the bilirubin is elevated. Rather than trying to just lower the number and forget about it. In the meantime, a TRT dose of test would be a good idea, assuming you can get it doctor prescribed.

 

[swim15]

Are you retarded?

So why would my recommendation be retarded?

 

[therulersback]

Yeah, I'm only referring to the recommendation to take 6g TUDCA plus some more UDCA, which is excessive, likely counterproductive and, well, retarded.

I'd agree that an autosomal recessive disorder like Gilbert's syndrome seems the likely cause of the problem. It might interfere with the detoxification of some of the medications he took, thus explaining the elevated AST and ALT, which are usually normal in Gilbert's. Or he unwittingly injected some 17aa AAS.

OP should follow up with a physician in order to diagnose WHY the bilirubin is elevated. Rather than trying to just lower the number and forget about it. In the meantime, a TRT dose of test would be a good idea, assuming you can get it doctor prescribed.

I went back and checked a bunch of blood tests throughout the years, and it seems my bilirubin normally hovers between 0.5-0.8. Would this counterindicate GS?

Def following up with a specialist either way. What's your reasoning for the TRT dose of test? Just to keep me from withering away while I'm shut down? (I'm already down 25+ lbs since this started ...) Or you think it would be beneficial to my liver?

 

[MyNameIsJeff]

I went back and checked a bunch of blood tests throughout the years, and it seems my bilirubin normally hovers between 0.5-0.8. Would this counterindicate GS?

Not really. Many people remain asymptomatic until adulthood, some never develop symptoms. It also seems that episodes of hyperbilirubinemia can be triggered by stress and physical exertion, and by some drugs. So the AAS cycle and the heavy physical exertion that goes along with it may have triggered your current episode, if it's indeed Glibert's.

Def following up with a specialist either way. What's your reasoning for the TRT dose of test? Just to keep me from withering away while I'm shut down? (I'm already down 25+ lbs since this started ...) Or you think it would be beneficial to my liver?

Don't think it would benefit the liver much, just for general health reasons. PCT meds are out of the question for now, so to normalize steroid levels acutely, TRT is the only option. No UGL stuff though, since it's still an open question what's in your products and how that contributed to the episodes.

 

[blkhrt_jordan]

Especially because you are already taking NAC, I would add glycine. It can help in liver disorders and eases up the bottleneck to produce glutathione as long as you are still getting all the other aminos in protein meals. I would lay off the meds and if you take antioxidants make sure they are not hormetic compounds like polyphenols like green tea extract,etc. Do not take sucralose in whey powders etc. All that little stuff will add up to give the liver a chance to recover quickly.

You may want to look into sam-e and Phosphatidylcholine as well, but really, time to recover is the biggest thing and to get a proper diagnosis. When you get better, sulforaphane would probably be worth taking to stay healthy. But dont take it right now.

Out of curiosity, are your stools pale ?

 

[therulersback]

Out of curiosity, are your stools pale ?

They were initially for the first week or so of this (one of the symptoms that tipped me off) but that's been gone for a while now

 

[okko]

About 3.5 weeks ago i finished a 3 month cycle of 400mg/wk test e 400mg/wk tren e, plus 4iu/d generic hgh during the last month of cycle. In the 3rd month I started having some digestive issues that I did not link with my cycle at the time. About 2 weeks ago I was just starting day 1 of my PCT of 40/30/20mg nolva 100/50/50mg clomid when the digestive issues came back followed with massive itching all over my body.

Got some bloodwork done, turns out my bilirubin was elevated and I have cholestasis. Subsequently for past 1.5 weeks I've been taking 2g/day TUDCA and 1.5g/day NAC, and cholestyramine as needed. My liver enzymes have dropped (AST 113->77 and ALT 222->140) but bilirubin continues to climb (3.6->4.6).

Got my full bloods today and as expected my test is shut down. I'm wondering if I should start my PCT, if it could have benefits to my liver to get my test levels back on line.

Or any other suggestions for getting my bilirubin down?

https://imgur.com/a/JppwRq2

edit: btw already had an ultrasound and no evidence of blockage from gallstones etc. Slight liver enlargement.

Hi there

Was about to report same thing
High bilirubin and asat alat from tren test mast cycle no oral

My levels have raised to 1.1 ng/dl then to 1.5 slightly above limit when upping tren from 200 to 350 all other thing constant or lower (test was reduced)
Asat and alat are about 200 U/l

So relationship to tren looks very probable
Published case reports also link some cholestasis case to tren use

One very bad consequence is that igf1 levels have dropped low since liver doesn't convert it properly which is well described consequence of cholestasis

I am on udca now and stopped tren
Considering also glutathione tad 600 Injections for general reasons which should help too
Synthergine doesn't do any good to such a condition

Within 2 weeks I'll check the levels again and post it there

BTW absolutely no bad feelings or symptoms except some mild and rare nausea which is reported common side effect of tren
BW are definitely a good thing when trying a new compound

My bilirubin level even on adrol never went any close to 0,5 before...


Sent from my EML-L29 using Professional Muscle mobile app

 

[Pissbrainiac259]

I'm guessing he's talking about Gilbert's syndrome?

The liver supplements I'm not so sure about??

Did you really say Gilbert's Syndrome? Come on Stewie, you and I both know you are smarter than that. Would Gilbert's be on the DDx? Sure but wayyyyy at the bottom. Given the subjective and objective info, this particular DDx is actually easier than it appears.

Hint: Think through the biochemical processes of bilirubin/heme/hemoglobin synthesis/degradation.

 

[MyNameIsJeff]

Did you really say Gilbert's Syndrome? Come on Stewie, you and I both know you are smarter than that. Would Gilbert's be on the DDx? Sure but wayyyyy at the bottom. Given the subjective and objective info, this particular DDx is actually easier than it appears.

Hint: Think through the biochemical processes of bilirubin/heme/hemoglobin synthesis/degradation.

First of all, stewie never suggested that it's Gilbert's, he merely speculated that the poster above him was referring to that condition when talking about a 'genetic liver condition'.

Besides that, Gilbert's should be on top of the list. It affects 5% of the population and fits the symptoms well if you know about the impaired drug detoxofication that comes with it.

Hemolytic jaundice/hemolytic anemia, which I guess you are referring to, is extremely unlikely. First of all, this would show in the blood work w.r.t. iron and hemoglobin status. The OP did not mention any of those values being out of range. Also no leukopenia or mention of infection or blunt trauma. OP is not a runner. Also none of the drugs OP took are known to cause hemolytic anemia. So I don't know where you get that idea from.

 

[Swifto]

The testosterone level shown on your BW is not endogenous Test, its still exogenous Test lingering around from your cycle.

2 weeks is not sufficient for PCT to begin.

You're also wasting your time using SERMs during this time IMO. You need to wait until androgenic and estrogenic negative feedback has decreased enough to simulate endogenous Test. Thats likely 25-30 days.

 

[Stewie]

You’ve likely got some sort of genetic liver condition (I do as well) for bilirubin levels to be that high one cycle like that.

I’d double or triple the dose of TUDCA and potentially get some UDCA to throw in there as well.

Did you really say Gilbert's Syndrome? Come on Stewie, you and I both know you are smarter than that. Would Gilbert's be on the DDx? Sure but wayyyyy at the bottom. Given the subjective and objective info, this particular DDx is actually easier than it appears.

Hint: Think through the biochemical processes of bilirubin/heme/hemoglobin synthesis/degradation.

As Jeff pointed out, I was referring to swim15 of possibly having Gilbert's, not the original poster.

I'll take 'what's cholestasis' for $500 and the win tho

 

[Pissbrainiac259]

First of all, stewie never suggested that it's Gilbert's, he merely speculated that the poster above him was referring to that condition when talking about a 'genetic liver condition'.

Besides that, Gilbert's should be on top of the list. It affects 5% of the population and fits the symptoms well if you know about the impaired drug detoxofication that comes with it.

Hemolytic jaundice/hemolytic anemia, which I guess you are referring to, is extremely unlikely. First of all, this would show in the blood work w.r.t. iron and hemoglobin status. The OP did not mention any of those values being out of range. Also no leukopenia or mention of infection or blunt trauma. OP is not a runner. Also none of the drugs OP took are known to cause hemolytic anemia. So I don't know where you get that idea from.

Dude, relax. Stewie and I have an ongoing and friendly repartee with this sort of thing. And no, I am not referring to hemolytic anemia b/c you'd see schistocytes on the peripheral blood smear and elevated haptoglobin. Q.E.D.

 

[Pissbrainiac259]

As Jeff pointed out, I was referring to swim15 of possibly having Gilbert's, not the original poster.

I'll take 'what's cholestasis' for $500 and the win tho

Gilbert's disease is a benign diagnosis which usually manifests in adults after 24-36 hours of fasting as jaundice and mild-to-moderate unconjugated hyperbilirubinemia and all other lab values being unremarkable.

 

[Pissbrainiac259]

As Jeff pointed out, I was referring to swim15 of possibly having Gilbert's, not the original poster.

I'll take 'what's cholestasis' for $500 and the win tho

And that's our first Daily Double today, Stewie. Now for $500 worth of Bitcoin, pay careful attention to the following clue:


These two hepatic enzyme substrate systems are responsible for most of the biochemical detoxification of both endogenous and exogenous compounds in the average adult human body.

 

[MyNameIsJeff]

If it's plain simple cholestasis, then what's causing it?

 

[swim15]

As Jeff pointed out, I was referring to swim15 of possibly having Gilbert's, not the original poster.

I'll take 'what's cholestasis' for $500 and the win tho

You would be correct, sir