Includes Expert Content
Help, need infoabout Methotrexate and Low Albumin, high liver enzymes
amb1954 posted:
Hi, Just need to get some opinions because my last liver function test showed a low albumin level of 3.1. My liver enzymes were also slightly elevated. I have been on Methotrexate for many years. I have had elevated liver enzymes off and on during that time period, but this is the first time for a low albumin. My RA doctor has now sent me to a Liver Specialists. I just had a lot of blood drawn for a better liver panel, but won't know anything until next week. I am now off of methotrexate and folic acid, but still am on plaquenil and prednisone. Can anyone tell me if they have any experience with this. Thanks

Scott Zashin, MD responded:
Elevated liver tests are not uncommon with MTX. If the tests remain elevated, are frequently increased or the albumin remains low, I will refer my patients for a liver consult if they wish to remain on MTX.If they decide not to stay on the med, then I typically stop the drug and monitor the testing. If it does not normalize, then I will refer those patients too.
amb1954 replied to Scott Zashin, MD's response:
Thank you for your reply. Had all my test come back and my albumin was now at 4.1. One liver test (ALK PHOS 164) was still a little high. others were in the normal range. This is after abourt 1 week of being off Methotrexate. Other tests done were my iron levels.

Ferritin 47.5
Iron total 15 (low)
Iron binding capacity 304
% TRF saturation 5 (low)

I am going in for a colonoscopy today

Thank you for your reply
EvilScarrlett replied to Scott Zashin, MD's response:
I saw your discussion of elevated liver tests. I was recently taken off mtx and tylenol, asprin and alcohol (not that I could drink being on biologics), they said my ALT is 99 & AST is 54; nobody has really given me any answers when I ask why I'm so tired, etc. I know besides RA I have Fibromyalgia so I thought maybe the symptoms were blurring and tried not to worry, Instead of answers they have scheduled ma for an ultrasound in about 2 weeks, with my condition I want to understand more about what these tests and numbers mean- can you advise?