Hi, @A myRAteam Member. I have struggled with elevated liver enzymes many times in the past as well. It's the main reason I've had to discontinue all the oral RA meds and IV infusions I've been on. When a major flair hit in 2009, I was on Orencia infusions once a month which was working great for me until that point. I flaired up and got very sick with uncontrollable vomiting and diarrhea, requiring many ER trips for fluid replacement and finally a full work-up at Mayo. After drawing my blood, my liver enzymes were found to be: AST of 450 U/L (normal is 10-40 U/L) and an ALT of 289 U/L (normal is 7-56 U/L). I was taken off all my meds except pain meds and they very slowly decreased on their own.

This happens to a certain extent every time I initiate a new RA med, unfortunately. It will work for awhile, then my liver enzymes slowly creep up until I have to discontinue it. After stopping it, they slowly decrease on their own without any other intervention. Thankfully, I've been on Actemra for a couple years now and although I've had some enzyme increases, it always comes down on its own.

I hope this helps and I wish you the best of luck with your health.

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A myRAtea...

Hi, I'm on actemra infusions and they automatically draw lipids, cholesterol, etc every three months because it's known to increase these levels. Lots of medications are metabolized in the liver so the possibility is always there to have these unwanted side effects. My rheumatologist keeps my primary informed of my lab results so everyone is on the same page. I was told that because these levels would come right back down if the medication was discontinued, it's not anything to worry about unless they get really high!! I wish you all the best!!

I am on Actemra also. It seems to work for me also. I still have pain but not as bad when they found my RA. The pain then was do bad I was ready to give up on life. Now it is a little more bearable.

Mine were recently done & about twice normal and never heard a word from my rheumatologist! I found out because I checked my own results!

From past experience, I stop the MTX for 2-3 weeks, then resume - usually fine.

This time I stopped on own past two wks but had an ESI in my neck today, so will hold one more week.

Thanks Cindy. I'll keep y'all posted after doc appointment.