Herx/Liver Enzymes

[louris]

Would liver enzymes spike during a die-off?  My ALT reading was slightly elevated at 45 (where the lab's upper limit is 40) last month.  This month they were 74.  I've been on fluconazole and cipro.  My doc obviously had me stop the fluconazole.  However, prior to the 45 ALT reading, I had been on the fluconazole for three months without any issue regarding enzymes.  Once the cipro was added (two weeks on @ 500mg x 2, one week off, repeat…for a total of four rounds), enzymes started to climb.  Hmmmmm… makes me wonder if this is more related to the addition of cipro and any additional organism die off than it is the toxicity of the fluconazole.

Once the ALT returned at 45, he had me start milk thistle.  I'm still on it.  I was on it when the ALT came back at 74. 

I know nothing about ALT, but wonder if this is my liver processing dead organisms or toxicity of the medication.

I plan to run this question by my doctor on Friday when he's back in the office, but I thought someone on the board might have some insight.

[lynnie_sydney]

Louris – my understanding – from a medical researcher friend of mine- is that it is the medications. However, best to discuss with your doc. Lynnie

Be well! Lynnie

Palindromic RA 30 yrs (Chronic Lyme?)
Mino 2003-2008 100mg MWF - can no longer tolerate any tetracyclines
rotating abx protocol now. From Sep 2018 MWF - a.m. Augmentin Duo 440mg + 150mg Biaxsig (roxithromycin). p.m. Cefaclor (375mg) + Klacid 125mg + LDN 3mg + Annual Clindy IV's
Diet: no gluten, dairy, sulphites, low salicylates
Supps: 600mg N-AC BID, 1000mg Vit C, P5P 40mg, zinc picolinate 60mg, Lithium orotate 20mg, Magnesium Oil, Bio-identical hormones (DHEA + Prog + Estrog)

[Maz]

[user=290]louris[/user] wrote:

I know nothing about ALT, but wonder if this is my liver processing dead organisms or toxicity of the medication.

 

Hi Louris,

So sorry you're going through this new hurdle. You will find some info on ALT here at lab tests online:

http://www.labtestsonline.org/understanding/analytes/alt/sample.html

Hard to say if it's a herx or not, but with elevated enzymes I don't think I'd personally be happy to just put it down to herx with my physician's input, as you say you're going to do. Can share that my LLMD did not want me on anything else while I was on the Shardt Protocol for Lyme, because Diflucan, for long periods, can be very hard on the liver on its own. Even then, he wanted me to have very regular bloodwork to watch those enzymes.

The liver is a pretty forgiving organ and, once therapy is stopped, can regenerate itself, unlike the kidneys. Best to err on the side of caution with this, Louris, and will  be interested to hear what your physician says when you get a chance to speak with him.

Peace, Maz

[louris]

Thanks Lynnie and Maz. 

I am erring on the side of caution per his directive.  The fluconazole has been stopped until things normalize.  I have been having monthly monitoring of liver enzymes and will continue if I'm to go back on the fluconazole.

I was just curious if there was more to it than just the fluconazole since the enzymes only became elevated once cipro was added to the mix. 😯

I'll post what he discloses to me once I've contacted him.

Thanks again.

[Author]

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