How worried should I be (elevated ALT)

[HRopiate]

I am quitting recreational use of painkillers and know about CWE. I never did the CWE because of the low number of percocet I ingest at a time (which was probably a mistake looking back).

I have on and off for about 3 years abused percocet. For the past year I have done a few months on and a few months off 5/325 percocet and only recently found I have elevated ALT (59). I take 4 5/325s and then 4 hours later take 3-4 more. So my first dose is above the 1k single dose at 1300mg. I never thought it was too much more to be that concerned about. I do this for a period of 2 weeks and then take 2-4 weeks off. Well after my last script, I went 10 days off and had my yearly physical and my ALT enzymes were above the average of 45 at 59. Could that just be me still recovering? How worried should I be?

I have decided to just stop taking the percocet and deal with the pain because frankly; even the 20mg I take doesn't solve the problem in entirety and makes me eat badly, smoke cigs like crazy and just be lazy. I've decided I am happier working out and eating healthy and just living with my pain.

I'm thinking my use, while not recommended wasn't completely reckless, but this is the first time I have had not the best blood work (also have low HDL good cholesterol) which is likely from the smoking and poor diet. I am retesting in a month but would like to get some input from members here. Thanks.

 

[Psychedelic Jay]

...and makes me eat badly, smoke cigs like crazy and just be lazy.

There is your problem...

Poor diet and cigarettes are as bad for your liver just as much if not more than that little acetaminophen...

Try to maintain a good diet and smoke less and exercise...

 

[opiodmaniac]

basically used 91% IPA and mixe the pills in with the IPA (2ml for every pill) then shake the solution and let it sit for about 20 minutes then shake again. then set up 2 coffe filter over a jar then pour the solution through the filters. (add mor IPA into the original mixer and pout that through the filter also.
after all of the solution has drained through I squeeze the filters and pour that alcohol into a plate with raised sides (glass ceramic etc) then I prefer to simply let it air dry (no fan no heat! this has yielded best results so far) once everything g is completely dried (bout 3-4 hours maybe a little more) scrape up what's there and voila!!
iv had some good experiences with it so far...
for the record don't do th excltractoon unless your gonna use at least 100+ mg of methylphenidate.
but smokin it is real interesting I enjoy It.

I'm open to any questions so feel free to ask more of you want!

right now I'm feelin goooood 70mg of diazepam, 1mg Xanax, some kush, half a bottle of wine and 6 beers.
how's erybody?

 

[HRopiate]

basically used 91% IPA and mixe the pills in with the IPA (2ml for every pill) then shake the solution and let it sit for about 20 minutes then shake again. then set up 2 coffe filter over a jar then pour the solution through the filters. (add mor IPA into the original mixer and pout that through the filter also.
after all of the solution has drained through I squeeze the filters and pour that alcohol into a plate with raised sides (glass ceramic etc) then I prefer to simply let it air dry (no fan no heat! this has yielded best results so far) once everything g is completely dried (bout 3-4 hours maybe a little more) scrape up what's there and voila!!
iv had some good experiences with it so far...
for the record don't do th excltractoon unless your gonna use at least 100+ mg of methylphenidate.
but smokin it is real interesting I enjoy It.

I'm open to any questions so feel free to ask more of you want!

right now I'm feelin goooood 70mg of diazepam, 1mg Xanax, some kush, half a bottle of wine and 6 beers.
how's erybody?

I've found the CWE would serve better if I had a higher tolerance. I will do them in the future if I have messed my liver up. I just didn't think my dosing schedule and the relative time I am "on" and "off" opiates would give any irreversible damage. Can anyone chime in with an assessment of how badly I have been treating my liver with the 1300mg single dosing 2x daily for 2 weeks at a time with 2-4 weeks (sometimes 3 months) off? 59 isn't super high no doubt. It was just 10-14 days after my last dose with better diet and exercise. Maybe it takes a month or so to return to normal?

As for the dietary changes and not smoking when doing opiates...that is definitely harm reduction and it's just an association I haven't learned yet...kinda like drinking and not smoking. I prefer smoking (chain smoking) when taking opiates.

 

[thesameoldfears]

^ I think opioidmaniac meant to post that in a different thread OP. So don't try to do a cwe with isopropyl or anything haha.

I wouldn't stress too much, just try and improve your health until you get retested. If it still looks bad at that retest then you can talk to your doctor. But for now I wouldn't stress.

 

[missmeyet?]

OP...you said that your cholesterol levels were also off..if you don't mind me asking, are you overweight?

Also, what did your doctor actually say? Were any other lab results abnormal? Do you smoke a lot of cannabis also? Drink alcohol? Have any other health issues?

All of these things can make a big difference in interpreting these lab results. If you could share a little more info I could probably help shed a little more light if you wish.

 

[HRopiate]

OP...you said that your cholesterol levels were also off..if you don't mind me asking, are you overweight?

Also, what did your doctor actually say? Were any other lab results abnormal? Do you smoke a lot of cannabis also? Drink alcohol? Have any other health issues?

All of these things can make a big difference in interpreting these lab results. If you could share a little more info I could probably help shed a little more light if you wish.

Thanks. My good cholesterol is low; has been for awhile. Likely due to the use of 17-AA oral steroids years ago. Fish oil and whatnot can raise them; as well as quitting smoking (two things I plan on doing). I'm overweight but it's a decent combination of muscle and just belly fat. Most people wouldn't say i'm very overweight. However losing weight is a priority (hard to do workouts since of my chronic back pain). I don't smoke any marijuana and I rarely drink. My labs overall are fine. Even my total cholesterol is ok as it's under 200. The main concern I had was my ALT. He wasn't worried about it but he doesn't know I abuse my meds. I am sure my enzymes would have been higher had I gone in that day after having taken 8-9 the night before. I was 10 days without using.

I'm curious if many people on here have used pain meds at some point in their lives like I did 1300ishmg per use 2x daily. I don't go over the 4k limit in 24 hours but I am more concerned with taking 1300mg twice four hours apart. However I only do this for two week bursts until the script ends. I have never actually drug saught or replaced after it was gone (and have been doing this for 4 years). I plan on not using for quite some time to really try to get my health in order and do more natural ways of handling my pain..and straight up dealing with it (nothing works). But this isn't a pain thread...just an assessment of how concerned I should be of still having raised enzymes 10 days out of stopping the pain meds. There is no doubt they are mainly elevated from pain killer abuse. I have never had elevated enzymes prior to abusing pain meds. My last physical was a year ago and my enzyme was only 1 point higher than the average (46 instead of 45). So I didn't think anything of it. Now it's on my radar. I am hoping I haven't really put irreversible damage on my liver?

 

[HRopiate]

Any insight from forums members on my very above post? Some old schoolers should be able to look at my ingestion of 2 week spurt APAP usage and know of people who did similar or worse combinations. Curious to see if I should expect my liver to bounce back. I'm going to just be using Lyrica for the time being for pain/recreation and leaving the APAP products alone for a good while.

 

[T. Calderone]

Hi HRopiate,
I don't think your numbers are extremely high, but be cautious with your acetaminophen intake. I believe it's not recommended to take more than 1000 mg at one sitting. Since your numbers are elevated, try and stay below 3000 mg a day. CWE would be most beneficial if you're dosing a lot. Even better stay with the lyrica if your doctor thinks it's best. Please do this because I've done some major damage and it can't be fixed.

I'm going over a medical report from when I had a mini stroke last November. They had all this information at their disposal but did not tell me what to do besides quit smoking. Plus on the discharge release form written - "No Alcohol" I have no medical insurance and they really don't care much it seems. Just "Hey you're doing better, guess you can go home in the morning." I only found out my enzymes were fucked up because I went to the hospital office and retrieved my records myself.

For example: Ideal ALT is 9-52 units mine was 235
AST is 14-36 units mine was 183

Sorry to hijack, I'm looking at these numbers and freaking out. I should have died long ago. The years of abuse caught up with me. Havn't had Percocet in 2 years but was still drinking quite a bit.

 

[HRopiate]

Hi HRopiate,
I don't think your numbers are extremely high, but be cautious with your acetaminophen intake. I believe it's not recommended to take more than 1000 mg at one sitting. Since your numbers are elevated, try and stay below 3000 mg a day. CWE would be most beneficial if you're dosing a lot. Even better stay with the lyrica if your doctor thinks it's best. Please do this because I've done some major damage and it can't be fixed.

I'm going over a medical report from when I had a mini stroke last November. They had all this information at their disposal but did not tell me what to do besides quit smoking. Plus on the discharge release form written - "No Alcohol" I have no medical insurance and they really don't care much it seems. Just "Hey you're doing better, guess you can go home in the morning." I only found out my enzymes were fucked up because I went to the hospital office and retrieved my records myself.

For example: Ideal ALT is 9-52 units mine was 235
AST is 14-36 units mine was 183

Sorry to hijack, I'm looking at these numbers and freaking out. I should have died long ago. The years of abuse caught up with me. Havn't had Percocet in 2 years but was still drinking quite a bit.

T. Calderone,

If you had bloodwork during heavy drinking I think those numbers could be expected. From my knowledge, only cirrhosis is only irreversible. I think even fibrosis is reversible. It would be interesting to see your bloodwork after 6 months of not drinking and taking any liver toxic drugs like APAP. As long as you don't have cirrhosis, you can make a good turnaround (I am sure the same with me). People with HCV often have ALTs in the 1000s and with proper treatment, the enzymes return to normal levels. I'm just surprised my enzymes were high given the short bursts I have done and the fact I was pretty clean when i took the bloodwork. I am hoping I just need to give more time to letting my liver heal. I wonder if anyone here has had really high enzymes from APAP abuse and then later retested with normal readings. I really am looking for people's time frames. Obviously 10 days was not enough (but maybe my enzymes were much higher the 10 days preceding the work I had done). I guess I will find out in 2 months. Tonight is my last night of using APAP. About to pop my last two percs and watch some movies. I have plenty of lyrica and some benzos to chill me out for the weekend while I go grocery shopping and slowly get back into moderate exercise...mentally just have to prepare to deal with my back pain.

The moral of this is to definitely do CWEs...even with small amounts of painkillers and APAP as it doesn't appear to take much APAP to raise enzymes. The stupidest harm reduction ever made=painkillers/APAP combos. It's better to treat a few more people with addiction due to lack of APAP than treat more cases of liver failure due to this horrible drug ruining livers.

 

[T. Calderone]

Thanks! I'm going to get this checked. Still waiting for county insurance approval.