Liver help

[Synthetek]

question, ok so every time the docs have me do bloodwork my liver enzymes are always elevated, I was using Tudca , then as an experiment I stopped and added Synthergine liver protector from promuscle, I started Inj anadrol only 25mg every other day that's it, I took 1 day off gym then got liver tested again on Saturday and now enzymes are even worse, I had a liver biopsy done on Friday waiting on results, but its like tudca doesn't work maybe NAC will work? im on test 600 eq 300 tren ace only been on 3 weeks if that at 300mg and gh 5 iu, not really sure what to do here...

How long did you use Synthergine for before your blood test and what dose?

 

[MyNameIsJeff]

just a short follow up because some people said they would worry for values between 400 and 800 for AST or ALT
i have found an interesting study
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2291230/

this study included 15 persons (more at beginning, some for excluded)
and they did an hour of weightlifting daily.
check our the increases for ALT and AST
the value is in µkat/L (SI unit), what we usually have on our blood tests is U/L.
so
2 subjects had an AST value of 960 (!!), and 2 subjects had an ALT of around 300. this is 2 out of 15!! and i bet the weightlifting program is not comparable to what we do to our bodies ;-)..
also interesting: 50% of the participants had CK values over 10000!! (values shown in table is µkat/L again, do not confuse it with our U/L)

Conclusion:
don't pay for AST&ALT if you are concerned about liver health.
Pay for gamma GT (a bit more expensive where i live) and for Alkaline Phosphat maybe (as an add-on, not required imo but its 2€ for me)

if you wanne take ALT and AST (also CK, myoglobin, LDH etc) DO NOT TRAIN FOR AT LEAST 10 days (might still be not enough time, dependent on where those values are when you start the break)

Nice find, thanks! However, the study was done on essentially untrained subject. Clearly, for those people the amount of muscle damage caused by a session of resistance exercise is much larger than for someone whose body is adapted, similar to how you no longer get as intense DOMS once you trained for a while. Consequently, the elevations in ALT and ST should be lower for people like us. And indeed, I've rarely seen elevations above 200 U/l in mine and others' blood work on the forum. Kaladryn seems to have a similar assessment, and he's been around the block. Aren't you the guy who trained himself into rhabdo? Clearly, you are abnormal in terms of how you exercise and/or how much you muscle tissue breaks down in response to exercise, so your individual case is not representative.

I also disagree with your assessment that you shouldn't look at AST/ALT unless you haven't trained in 10 days. In principle, the elevations in AST/ALT from muscle damage are additive with those from liver injury. Hence, if you know that 1 day after exercise your AST/ALT typically is at levels x/y, then you can make an assessment of your liver health relative to those values. Let's say you get blood work again 1 day post exercise, and after taking Anadrol for 4 weeks, your AST/ALT is still at levels x/y. Then you can infer that there is no sign of liver damage despite the out of range values.

In addition, there are some conditions such as autoimmune hepatitis, where in the early stages only AST and ALT, but not GGT are elevated. So it's good to at least every couple of years take a week off from exercise to see where your 'real' values are at.

 

[musclemoose]

question, ok so every time the docs have me do bloodwork my liver enzymes are always elevated, I was using Tudca , then as an experiment I stopped and added Synthergine liver protector from promuscle, I started Inj anadrol only 25mg every other day that's it, I took 1 day off gym then got liver tested again on Saturday and now enzymes are even worse, I had a liver biopsy done on Friday waiting on results, but its like tudca doesn't work maybe NAC will work? im on test 600 eq 300 tren ace only been on 3 weeks if that at 300mg and gh 5 iu, not really sure what to do here...

Im confused cause you said "you was using tudca, then as an experiment you stopped" and then "started injecting anadrol". Seems to me first of all if you start injecting anadrol then its common sense your enzymes would get worse and than since you decided to experiment by stopping Tudca that added to the reason your enzymes are raised. plus your on tren ace which raises enzymes

 

[musclemoose]

just a short follow up because some people said they would worry for values between 400 and 800 for AST or ALT
i have found an interesting study
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2291230/

this study included 15 persons (more at beginning, some for excluded)
and they did an hour of weightlifting daily.
check our the increases for ALT and AST
the value is in µkat/L (SI unit), what we usually have on our blood tests is U/L.
so
2 subjects had an AST value of 960 (!!), and 2 subjects had an ALT of around 300. this is 2 out of 15!! and i bet the weightlifting program is not comparable to what we do to our bodies ;-)..
also interesting: 50% of the participants had CK values over 10000!! (values shown in table is µkat/L again, do not confuse it with our U/L)

Conclusion:
don't pay for AST&ALT if you are concerned about liver health.
Pay for gamma GT (a bit more expensive where i live) and for Alkaline Phosphat maybe (as an add-on, not required imo but its 2€ for me)

if you wanne take ALT and AST (also CK, myoglobin, LDH etc) DO NOT TRAIN FOR AT LEAST 10 days (might still be not enough time, dependent on where those values are when you start the break)

yes you are 100% correct. You really need to Pay for gamma GT test if you want full results on liver. AST/ALT doesnt show complete picture.

 

[M@NU]

Nice find, thanks! However, the study was done on essentially untrained subject. Clearly, for those people the amount of muscle damage caused by a session of resistance exercise is much larger than for someone whose body is adapted, similar to how you no longer get as intense DOMS once you trained for a while. Consequently, the elevations in ALT and ST should be lower for people like us. And indeed, I've rarely seen elevations above 200 U/l in mine and others' blood work on the forum. Kaladryn seems to have a similar assessment, and he's been around the block. Aren't you the guy who trained himself into rhabdo? Clearly, you are abnormal in terms of how you exercise and/or how much you muscle tissue breaks down in response to exercise, so your individual case is not representative.

I also disagree with your assessment that you shouldn't look at AST/ALT unless you haven't trained in 10 days. In principle, the elevations in AST/ALT from muscle damage are additive with those from liver injury. Hence, if you know that 1 day after exercise your AST/ALT typically is at levels x/y, then you can make an assessment of your liver health relative to those values. Let's say you get blood work again 1 day post exercise, and after taking Anadrol for 4 weeks, your AST/ALT is still at levels x/y. Then you can infer that there is no sign of liver damage despite the out of range values.

In addition, there are some conditions such as autoimmune hepatitis, where in the early stages only AST and ALT, but not GGT are elevated. So it's good to at least every couple of years take a week off from exercise to see where your 'real' values are at.

well, true that you should do that "once in a while". But i mean for the typical "supp" user who wants to assess damage to liver during a 12 weeks cycle. I would prefer Gamma GT in this case.

About me being the guy with rhabdo. Yes, this is correct. Was it from training ALONE? I dont think so.
the emotional stress caused by the breakup with the love of my life, the dehydration caused by fluid loss, sweating like a mofo because my heart beat like hell, the "no sleep for 3 days", crying etc PLUS the training was too much for my body to handle.
Ive trained much harder in the past and do now then when this happened. you cant train hard with a broken heart.
yeah, i know, betamale etc..

about your opinion taking ALT/AST during training because its "additive"
Well, that would be the case if your session is the exact same every time and does the exact amount of muscle damage. I would say this is not the case. So on day1 after legs you could have AST of 200, on day 29 after legs and 4 weeks anadrol you could have AST of 400. Does this automatically mean that the 4 weeks anadrol increased your AST 200 points? I would not say so. It could be the case, it could also be that the sessions leading to the D29 Bloodwork where harder, you were slightly more dehydrated... and so it caused more muscle damage

and the guys in the study where moderatly physical active but not weightlifting. Maybe they did boxing or any other sport that also requires some muscular work?

who knows, i just wanted to share the study

 

[Kaladryn]

GGT is a good marker of bile duct damage but it isn't going to show lots of stuff and there is not a marker that will "asses liver damage over a 12week cycle." At best you can find out if you are fucked or not, AST/ALT are nice to show how much stress the liver is actually under and are a decent marker if used properly.

 

[M@NU]

GGT is a good marker of bile duct damage but it isn't going to show lots of stuff and there is not a marker that will "asses liver damage over a 12week cycle." At best you can find out if you are fucked or not, AST/ALT are nice to show how much stress the liver is actually under and are a decent marker if used properly.

it does not only show bile duct damage.
GGT is definitely a much better mrker for liver health than ast and alt.
ALT and AST are enzymes that are also found in other organs and even muscles. Elevated alt/ast does not explicitly show liver health..
GGT is almost exclusivly found in liver cells...

 

[MyNameIsJeff]

it does not only show bile duct damage.
GGT is definitely a much better mrker for liver health than ast and alt.
ALT and AST are enzymes that are also found in other organs and even muscles. Elevated alt/ast does not explicitly show liver health..
GGT is almost exclusivly found in liver cells...

You are full of shit, don't talk about things you know nothing about. And then be cocksure about it :banghead:

As kaladryn correctly pointed out to you, and which you didn't even bother checking, GGT is only elevated in case of bile duct injury. It's elevated from a small number of (non-bodybuilding related) drugs, after alcohol ingestion, and in some chronic liver diseases like viral hepatitis.

It is generally not elevated in acute drug-induced canalicular cholestasis, which is the type of liver disease caused by the use of 17aa AAS. So if people were to follow your advice and not check their AST/ALT, then they could well destroy their liver with orals since GGT won't be elevated in their blood work until they are in liver failure. Your retard-level medical advice can get people killed, you know.

A much more reliable indicator for liver damage is alkaline phosphatase (AP/ALP). It is elevated in almost all types of liver disease, though it generally lags elevations in AST/ALT. Indeed, the diagnostic criteria for 17aa AAS induced liver damage are a combination of elevated AST, ALT and AP (and bilirubinemia at later stages). So for a bodybuilder who wants to check how his steroid use is affecting his liver, these are the primary markers to look at.

All those markers plus GGT will be part of a standard panel, so there is no reason to pick one or the other. All markers confer some information about the presence and type of liver injury. To focus on one of them is idiotic.

 

[M@NU]

You are full of shit, don't talk about things you know nothing about. And then be cocksure about it :banghead:

As kaladryn correctly pointed out to you, and which you didn't even bother checking, GGT is only elevated in case of bile duct injury. It's elevated from a small number of (non-bodybuilding related) drugs, after alcohol ingestion, and in some chronic liver diseases like viral hepatitis.

It is generally not elevated in acute drug-induced canalicular cholestasis, which is the type of liver disease caused by the use of 17aa AAS. So if people were to follow your advice and not check their AST/ALT, then they could well destroy their liver with orals since GGT won't be elevated in their blood work until they are in liver failure. Your retard-level medical advice can get people killed, you know.

A much more reliable indicator for liver damage is alkaline phosphatase (AP/ALP). It is elevated in almost all types of liver disease, though it generally lags elevations in AST/ALT. Indeed, the diagnostic criteria for 17aa AAS induced liver damage are a combination of elevated AST, ALT and AP (and bilirubinemia at later stages). So for a bodybuilder who wants to check how his steroid use is affecting his liver, these are the primary markers to look at.

All those markers plus GGT will be part of a standard panel, so there is no reason to pick one or the other. All markers confer some information about the presence and type of liver injury. To focus on one of them is idiotic.

how old are you that you instantly go toxic if you are another opinion? 13?
i didnt check it out because i know its not correct
check this and read it completely
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4620378/
+ https://en.wikipedia.org/wiki/Gamma-glutamyltransferase
alcohol and some medications elevate gamma gt.. due to bile duct injury? guess not

and i said i would take gamma gt and alkaline phosphat to assert liver health in my first post.
in this post, i just said gamma gt is better for liver health than alt/ast and this is correct since its way more specific.
i am out since i have no clue.

 

[MyNameIsJeff]

how old are you that you instantly go toxic if you are another opinion? 13?
i didnt check it out because i know its not correct
check this and read it completely
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4620378/

and i said i would take gamma gt and alkaline phosphat to assert liver health in my first post.
in this post, i just said gamma gt is better for liver health than alt/ast and this is correct since its way more specific.
i am out since i have no clue.

Was the "your retard-level medical advice can get people killed, you know" part not clear enough as to why I get pissed?

The reference you posted is completely irrelevant since it barely even discusses liver disease. Not to mention it does not differentiate between pathologies and doesn't even contain the word cholestasis. By no means does the article support your claims

Your statement that "i didnt check it out because i know its not correct" may be one of the dumbest things I have ever read. Maybe be more concerned with your IQ than your GGT. You should take a test and see if you qualify for some disability benefits.

EDIT: The wiki page you just added doesn't support your case either, but nice try. This will be completely over your small head, but take a look at this and try to understand it: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3089004/

 

[M@NU]

Was the "your retard-level medical advice can get people killed, you know" part not clear enough as to why I get pissed?

The reference you posted is completely irrelevant since it barely even discusses liver disease. Not to mention it does not differentiate between pathologies and doesn't even contain the word cholestasis. By no means does the article support your claims

Your statement that "i didnt check it out because i know its not correct" may be one of the dumbest things I have ever read. Maybe be more concerned with your IQ than your GGT. You should take a test and see if you qualify for some disability benefits.

you make absolutely no sense but ok
"ggt is only elevated in bile duck injuries" were your words.
now i post a study that shows its also elevated in other injuries/diseases and suddenly it is irrelevant!?
i make no posts that get others killed. I post my suggestion.
Everyone can take the values they think are good after reading about them.
And dont worry about my IQ, it is high enough

 

[MyNameIsJeff]

you make absolutely no sense but ok
"ggt is only elevated in bile duck injuries" were your words.
now i post a study that shows its also elevated in other injuries/diseases and suddenly it is irrelevant!?
i make no posts that get others killed. I post my suggestion.
Everyone can take the values they think are good after reading about them.
And dont worry about my IQ, it is high enough

My god :banghead: The context of the discussion is obviously liver disease. So yes, the fact that GGT plays a role in non-liver related disease is irrelevant here.

 

[M@NU]

My god :banghead: The context of the discussion is obviously liver disease. So yes, the fact that GGT plays a role in non-liver related disease is irrelevant here.

i am still not sure why you are pissed, sorry..?
page 1 i said for liver health, take GGT and Alkaline phopshate because
ALT and AST are not specific enough to check liver health.
then i repeated that GGT is better for liver health than ast and alt.
suddenly you are pissed?

the study you posted says you are right, yes. But i could also
find cases that say otherwise (ggt also elevated due to medications/alcohol)

i am stating what i do when i take bloods.
If someone prefers alt and ast, good, they pay for it so they get what they want.

You should think about your behavior dude, will not get you far in life (or do you only act like that on the forum?)

 

[MyNameIsJeff]

Take this example of someone who took low to moderate dose Accutane for 5 months. As you can see, only ALT and AST are elevated.
Note that the ratio of AST/ALT<1. This rules out exercise as a cause since in exercise-induced elevated transaminase levels, AST/ALT>1:

The AST/ALT ratio was >1.0 in all subjects from 6 h to 7 days post exercise. At the follow-up visit, the mean value curve for ALT showed higher values than for AST and 12 of the subjects had a ratio < 1.0. The highest AST/ALT ratio was 6.2, observed in subject 1 on day 2 post exercise. The lowest ratio was 0.36 in subject 2 at follow-up (Figure 3).

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2291230/

So if that person had ignored those values or never measured them, he would have concluded that his liver is in great condition and that e.g. he could start an 8 week cycle of orals. Clearly not a good idea.

 

[MyNameIsJeff]

i am still not sure why you are pissed, sorry..?
page 1 i said for liver health, take GGT and Alkaline phopshate because
ALT and AST are not specific enough to check liver health.
then i repeated that GGT is better for liver health than ast and alt.
suddenly you are pissed?

the study you posted says you are right, yes. But i could also
find cases that say otherwise (ggt also elevated due to medications/alcohol)

i am stating what i do when i take bloods.
If someone prefers alt and ast, good, they pay for it so they get what they want.

You should think about your behavior dude, will not get you far in life (or do you only act like that on the forum?)

I would react just the same way in real life if someone made these kind of ignorant and irresponsible statements. in fact, I would use a lot more swear words.

The fact that GGT can be elevated due to some causes of liver injury but not others is something I already mentioned. The point is that elevations in GGT are a sufficient but not a necessary condition for liver disease.

 

[M@NU]

Take this example of someone who took low to moderate dose Accutane for 5 months. As you can see, only ALT and AST are elevated.
Note that the ratio of AST/ALT<1. This rules out exercise as a cause since in exercise-induced elevated transaminase levels, AST/ALT>1:


https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2291230/

So if that person had ignored those values or never measured them, he would have concluded that his liver is in great condition and that e.g. he could start an 8 week cycle of orals. Clearly not a good idea.

i would say it now depends when those blood values were taken
the complete abstract:
The AST/ALT ratio was >1 in almost all subjects during 7 days post exercise. However, at the follow-up (10–12 days post exercise) the majority of subjects had an AST/ALT ratio < 1 and ALT concentrations above the upper reference range. This could be explained by the longer half-life of ALT (47 h) compared with AST (17 h) [20, 21]. If liver fuction tests are performed at that time point, a misleading picture may result, suggesting mild liver disease.

but you might be correct and i might be wrong. If this is the case, i am sorry. i also would suggest to stop with the toxic behavior and be friendly again please

@your second post:
irresponsible statement? i am still the opinion alt and ast are almost useless and other markers are better but ok
maybe the biopsy was no bad idea after all

 

[MyNameIsJeff]

i would say it now depends when those blood values were taken
the complete abstract:
The AST/ALT ratio was >1 in almost all subjects during 7 days post exercise. However, at the follow-up (10–12 days post exercise) the majority of subjects had an AST/ALT ratio < 1 and ALT concentrations above the upper reference range. This could be explained by the longer half-life of ALT (47 h) compared with AST (17 h) [20, 21]. If liver fuction tests are performed at that time point, a misleading picture may result, suggesting mild liver disease.

but you might be correct and i might be wrong. If this is the case, i am sorry. i also would suggest to stop with the toxic behavior and be friendly again please

@your second post:
irresponsible statement? i am still the opinion alt and ast are almost useless and other markers are better but ok
maybe the biopsy was no bad idea after all

That's a fair point, actually. If one trains 7 days in a row and then on day 8 gets blood work, the ratio of AST/ALT may actually be reversed due to the differences in half lifes. Regardless, the overall levels posted above were still highly elevated compared to the value without Accutane, with the same training schedule. So the difference in AST/ALT is indeed due the drug-induced liver injury. Yet, AP and GGT were low-normal. There's no way around transaminase levels, despite the difficulties in interpreting it in athletes.

 

[M@NU]

That's a fair point, actually. If one trains 7 days in a row and then on day 8 gets blood work, the ratio of AST/ALT may actually be reversed due to the differences in half lifes. Regardless, the overall levels posted above were still highly elevated compared to the value without Accutane, with the same training schedule. So the difference in AST/ALT is indeed due the drug-induced liver injury. Yet, AP and GGT were low-normal. There's no way around transaminase levels, despite the difficulties in interpreting it in athletes.

can you link me to the study where you found those values and comparision between drug and non drug user?
not that i do not believe you but because i am still willing to learn and
i love to read such studies.

so in your opinion, to be "safe":
-take a break 7+ days from training (better 10?)
and take ast+alt+ggt+alp

 

[MyNameIsJeff]

can you link me to the study where you found those values and comparision between drug and non drug user?
not that i do not believe you but because i am still willing to learn and
i love to read such studies.

so in your opinion, to be "safe":
-take a break 7+ days from training (better 10?)
and take ast+alt+ggt+alp

The observation is based on my own and mates' blood work, have not seen any study that would look at the interplay of resistance exercise and drug toxicity, especially not in people whose musculature has adapted to resistance exercise.

Yes, either don't train for 5-10 days (where at 5 slight elevations could be taken as normal, whereas at day 10 you'd want to be completely in range), or consistently take blood work x days after training cycle: Let's say you train push/rest/pull/rest/legs/repeat. Then you would e.g. always take bloods on the rest day after the push session, and take some care to keep the intensity moderate and consistent with previous times you went for blood work. This way you can reliably determine the additive impact of the drug toxicity on ALT/AST.