Liver Effects

[Maddie Secutura]

I had a checkup with my doctor and he said my ALT and ALS levels had risen.  Apparently sublingual pills are not for me because they do weird stuff to my liver (unless I happened to catch hepatitis  which is highly unlikely nevertheless I have to get a blood test for it).  My doctor said to stop taking the hormones until my next appointment and we may have to go a different route with administering the hormones. (beginning of June)

My point is this: do injections/cream/patch bypass the liver? 

Also I tried something which might be dangerous just to see if it would work: crushed up a tablet and dissolved it in lotion, then applied the lotion.  Has anyone ever heard of doing that?  I only did it once to see if there were any effects from it which there were, however an oral dose is probably higher than a patch or injection so I'm not continuing with it since I have no idea how much is too much.

[Hannah]

I've always found it odd how freely they toss around the "stop taking them" instructions. I wonder if he stopped for a minute and thought about what your'e going to go through if you do. June is not that far away and bouncing on and off of them is just as hazardous, you can break your liver, give yourself an autoimmune condition, and so on. My labs show my liver results coming back a bit high too, but considering what it's doing, my doctor isnt alarmed. I suppose you should do as he says, but maybe bounce these points off him first before you put yourself through menopause.

As far as the other methods you mentioned, they should all have similar results to sublingual pills. The argument of pills vs. injections is as old as time, and have fun wearing  many patches to get the right levels.

[Alyssa M.]

I wouldn't mess around with using medication intended for one form of administration differently from how it was intended, for the reasons you mentioned.

Nothing bypasses the liver, but oral administration means it goes around an extra time before it can have an effect (because everything absorbed in the digestive system gets processed through the liver). Injection and gels ought to be easier on the liver, but sublingual ought to be as well (since you are absorbing it directly into the bloodstream).

Maybe you can only handle a lower dose than you are getting right now, and you'll just have to use a bit less for now. I hope it works out for you.

edit -- Yes, I suppose Hannah's right. Just stopping "cold turkey" does seem extreme, when it's only for two weeks.

[Ms.Behavin]

As Alyssa said everything you eat gets absorbed by the intestines and passed to the liver via the hepatic artery where it is converted to things the body needs.  For estrogen about 97% of the estrogen taken in pill form is converted to something else and also results in stress tot the liver.  In GG's Estrogen never enters the liver via the hepatic artery.  So about 3% OR LESS is passed into the body as estrogen.  Now Sublingual, quite a bit is absorbed by the mucosa membranes, But about 1/2 or more ends up being swallowed too with slivia, etc.

Injections, patches and gells bypass the hepatic artery and go direct to the blood.  The liver will still process some of this via normal arterial flow, but not as much.  As such the doasages are much smaller

The problem with patches is it will take more then one  patch while "Pre-Op" for you to get results.  Injections work well, but they have their own issues, Risk of infections, risk of cutting a nerve or artery, etc.  Plus injections cause a bit of an emotional spike in some people (me for example)  Gells well you never know if you have too much or too little. 

Also drinking stresses the liver also.  So while on estrogen, it's best to be kind to the liver as much as possible.

Being an older lady, after a few months I went to patches and injections. I used a single patch to keep a minimum e level and then injected once a week or so. 

Check with your doctor or Endo for sure.  You REALLY don't want to mess the liver up.  Like the heart, you only have one it you must have a working one to live. 

Beni

[Renate]

Remember, concerning the two big anti-androgens:

Cyproterone acetate (Androcur) is a risk to your liver.
Spironolactone is a risk to your kidneys.

Take your pick.

[NicholeW.]

Remember, concerning the two big anti-androgens:

Cyproterone acetate (Androcur) is a risk to your liver.
Spironolactone is a risk to your kidneys.

Take your pick.

Pick actually following instructions for use and making sure you're well-hydrated and are leaving out foods that are contra-indicated while you're on the meds.

Nichole

[Hannah]

This has been bugging me, so I went in and talked to my Physiology professor who kind of clued me in a little bit on the lingo, and vouched for the wiki on this topic. My doctor isn't alarmed by these raised levels, but I'm not entirely sure about her sometimes so when your doc took it so seriously I got a bit worried. Anyway, here's some stuff to ask your doc about.

From the wiki:
Significantly elevated levels of ALT often suggest the existence of other medical problems such as viral hepatitis, congestive heart failure, liver damage, biliary duct problems, infectious mononucleosis, or myopathy. For this reason, ALT is commonly used as a way of screening for liver problems. However, elevated levels of ALT do not automatically mean that medical problems exist. Fluctuation of ALT levels is normal over the course of the day, and ALT levels can also increase in response to strenuous physical exercise.

When elevated ALT levels are found in the blood, the possible underlying causes can be further narrowed down by measuring other enzymes. For example, elevated ALT levels due to liver-cell damage can be distinguished from biliary duct problems by measuring alkaline phosphatase. Also, myopathy-related ALT levels can be ruled out by measuring creatine kinase enzymes.

~hugs~

[gothique11]

A lot of other things can affect the liver. Estrace shouldn't be affecting the liver that much; it's not as harsh as other medications (ie, tylenol). I've had my liver to the brink of failure before, and it took years to recover and constantly having my blood tested weekly. I'm on estrace and it hasn't affected my liver at all. That's just me, but talk to your doctor about any other medications and possible reasons why your levels are higher. Higher levels can mean a whole lot of things; it can be as simple as fatty liver (in that case, diet), or damage from something, or something health wise going on. You'd have to be taking a lot of meds to start frying it, and your liver can heal if you don't completely fry it. It sounds weird that a doctor would suggest you to go off HRT just because of the levels being elevated a bit. Estardol isn't as bad on your liver as some doctors claim it to be.