GIST Support Wiki

 
Elevated Liver Enzymes

Prescription Drug Treatments

Prednisone

I guess the cause of high liver enzymes may be different. In my case it believed to be Autoimmune Hepatitis caused by Gleevec. Pomegranate juice or lower Gleevec dose DID NOT help me. Short course of Prednisone helped to remove the problem permanently. Several GIST doctors acknowledged that this is the standard practice today to treat these cases.

My liver enzymes went sky high last year. My Dr. put me on 20 mg of prednisone and 50 mg of Immuran. Within 10 days, the counts were back down near normal. I continued the treatment and weaned off after 3 weeks.


I also had elevated liver enzymes (within 6 weeks of being on 600 mg of Gleevic). I was taken off Gleevic and once my enzymes came down to near normal I was put on 100 mg. After having the efficacy tested (how much my body was actually receiving from the dosage) it was determined that I was at full efficacy at 100 mg and have been on it now for about 6 months with no problem.

My doctor at MSK indicated it is best to remain on a low dosage (100 mg) than none at all once the liver enzyme levels near normal.


When I found out about elevated liver enzymes I stopped Gleevec completely. That helped ALT/AST to go lower. As soon I restarted Gleevec at ANY dose - 400 or 100 or 50 mg enzymes were going up again. I did stop/start cycles for about 9 months.

When I finally took Prednisone and it quickly dropped my ALT/AST I also started Gleevec at 100 and slowly increased it to 400 mg. A year later I switched to 800 mg for different reasons and without any problems.

Dr. Blanke at OHSU told me several times that after my "miracle" recovery Prednisone become a standard practice for such cases. He also gave a presentation on the subject about a year ago. Dr. Druker (CML Dr.at OHSU) also told me he uses Prednisone.

Dr. Blanke discusses use of prednisone in a webcast at this link: http://www.gistgolscme.com/Presentations2.aspx Go to that page and then click the second presentation listed: "Liver Toxicity" by Charles Blanke.

I remember that number of patient with elevated liver enzymes was estimated a while ago as "a few percent" of people taking Gleevec.

Non-prescription Approaches

Omega-3 Fatty Acids: Change your diet to drastically reduce omega-6 fats (corn oil) AND INCREASE omega-3 fats (flax oil, fish oil). This really does work, as there are papers tracking pre- and post-operative patients with versus without "immunonutrition" that has omega-3 fatty acids plus arginine and some other stuff. Those taking the omega-3 had less elevation of liver enzymes post-surgery and the values returned to normal faster. Click the following link to view abstracts about this in PubMed immunonutrition in PubMed.

Pomegranate Juice: Several people have had good results from drinking pomegranate juice to lower their liver enzymes. However, there is some evidence that pomegranate juice could interfere with absortption of Gleevec.