Liver enzymes and exercise  

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gtrack
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23/10/2018 6:27 am  

I'd like to know if higher than normal AST and ALT numbers could be a result of anaerobic exercise.
All the rest of the liver tests (ALP,cGT) show up as normal (in fact in the low normal range),yet transaminase levels are about double the high normal.
I have the suspicion that intense exercise can cause this (like increased CpK levels) and that they don't in fact show liver stress or damage.
Any references/studies/opinions ?


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Trevdog
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23/10/2018 11:32 am  

I don't have any references handy, but based on what I have experienced and read, my opinion is YES.


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jboldman
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23/10/2018 12:19 pm  

ast and alt can be substantially elevated as a result of muscle trauma, injury, or injections into the muscle. GGT is not elevated in these circumstances.

jb


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guijr
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23/10/2018 1:09 pm  

JB has already posted a paper on that matter.

"The medals don't mean anything and the glory doesn't last. It's all about your happiness. The rewards are going to come, but my happiness is just loving the sport and having fun performing" ~ Jackie Joyner Kersee.


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gunz
 gunz
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23/10/2018 1:41 pm  

You may find this an interesting read:

http://www.jaoa.org/cgi/content/abstract/101/7/391


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jboldman
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23/10/2018 2:41 pm  

Thanks for psoting that gunz, i am going to post it up in full since it makes an important point. as a practical aside, if you are going to have blood drawn, it would be a good idea to lay off training for a week prior to the blood draw to avoid confounding the liver profile.

jb
==========
Evaluation of aminotransferase elevations in a bodybuilder using anabolic steroids: hepatitis or rhabdomyolysis?
R Pertusi; RD Dickerman; WJ McConathy
The use of anabolic steroids among competitive athletes, particularly bodybuilders, is widespread. Numerous reports have noted "hepatic" dysfunction secondary to anabolic steroid use based on elevated serum aminotransferase levels. The authors' objective was to assess whether primary care physicians accurately distinguish between anabolic steroid-induced hepatotoxicity and serum aminotransferase elevations that are secondary to acute rhabdomyolysis resulting from intense resistance training. Surveys were sent to physicians listed as practicing family medicine or sports medicine in the yellow pages of seven metropolitan areas. Physicians were asked to provide a differential diagnosis for a 28-year-old, anabolic steroid-using male bodybuilder with an abnormal serum chemistry profile. The blood chemistries showed elevated aspartate aminotransferase (AST), alanine aminotransferase (ALT), and creatine kinase (CK) levels, and normal gamma-glutamyltransferase (GGT) levels. In the physician survey (n = 84 responses), 56% failed to mention muscle damage or muscle disease as a potential diagnosis, despite the markedly elevated CK level of the patient. Sixty-three percent indicated liver disease as their primary diagnosis despite normal GGT levels. Prior reports of anabolic steroid-induced hepatotoxicity that were based on aminotransferase elevations may have overstated the role of anabolic steroids. Correspondingly, the medical community may have been led to emphasize anabolic steroid-induced hepatotoxicity and disregard muscle damage when interpreting elevated aminotransferase levels. Therefore, when evaluating enzyme elevations in patients who use anabolic steroids, physicians should consider the CK and GGT levels as essential elements in distinguishing muscle damage from liver damage.


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gtrack
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23/10/2018 3:39 pm  
Posted by: jboldman
Thanks for psoting that gunz, i am going to post it up in full since it makes an important point. as a practical aside, if you are going to have blood drawn, it would be a good idea to lay off training for a week prior to the blood draw to avoid confounding the liver profile.

jb

That's excactly why i'm looking for studies.I can't lay off training for a week every 2-3 months just to override my doctor's stubborness...Plus the reason for blood tests is to show how things are in your everyday life,not in predetermined and perfect instances.After an off-week many blood test values will be far from what they really are for the rest of the 358 days of the year.What i want to know is how my body is in those days.
I insist that high intensity exercise causes rabdomyolysis (it's on top of the list of the non-genetic causes)but he'll keep saying my liver's stressed and not by exercise.
Any studies done on lifters not using steroids ? Or any study database i could search myself ?


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bear
 bear
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23/10/2018 4:19 pm  

It strikes me as something easily enough "proven" to your physician that the elevated AST/ALT values are a direct result of weight training: Simply take a week or ten days off from training and then have another liver panel drawn. When those numbers come back "in range," given that the break from training was the only new variable, it should satisfy him. (If not, I'd think about looking for another doctor, as this one's IQ would then be suspect... )


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jboldman
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23/10/2018 5:00 pm  

bear is correct.

jb


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