3J
Musclechemistry Member
A good article on how to accurately identify liver damage via rippedzilla
How to accurately identify liver damage from oral steroids
I'm making this topic after doing a little bit of reading that explained why the usual liver function test that most guys take is NOT effective at spotting liver damage from oral steroids.
Lets start with the data...
Muscular exercise can cause highly pathological liver function tests in healthy men
AIM:
To investigate the effect of intensive muscular exercise (weightlifting) on clinical chemistry parameters reflecting liver function in healthy men.
RESULTS:
Five out of eight studied clinical chemistry parameters (AST, ALT, LD, CK and myoglobin) increased significantly after exercise (P < 0.01) and remained increased for at least 7 days postexercise. Bilirubin, gamma GT and ALP remained within the normal range.
CONCLUSION:
The liver function parameters, AST and ALT, were significantly increased for at least 7 days after the exercise.
In addition, LD and, in particular, CK and myoglobin showed highly elevated levels. These findings highlight the importance of imposing restrictions on weightlifting prior to and during clinical studies. Intensive muscular exercise, e.g. weightlifting, should also be considered as a cause of asymptomatic elevations of liver function tests in daily clinical practice.
There was also a very enlightening commentary on this study that shows us EXACTLY how to determine liver damage from oral steroids:
Enzyme elevations with muscle injury: know what to look for!
"We reported almost 10 years ago on the severe elevations that may be seen in competitive bodybuilders both on and off anabolic steroids [2]...
Most significantly we found the most simplistic laboratory value that should be included when examining resistance-exercise athletes is to include gamma glutamyl transpeptidase (GGT). We found none of our exercise subjects had elevations of GGT while patients with any form of hepatitis, who were analyzed retrospectively, all had GGT elevations [2]."
My interpretation
The first study shows that resistance training alone will cause an asymptomatic increase in ALT & AST values, which is what most people look at to determine whether or not orals are causing any harm to their liver.
The second commentary illustrates that GGT would only increase if their was actually any damage, not simply as a response to resistance training.
The main levels people see when taking a basic liver function profile are ALT, AST & Bilirubin.
ALT & AST levels can be elevated simply as a result of training induced muscle damage and therefore is not an accurate method of determining what's really going on.
Serum Bilirubin is accurate in showing potential liver damage but not as a measurement on its own (unless your levels are really high, twice the reference limit for example).
The solution is to measure GGT levels.
GGT levels will only be elevated to show direct liver damage from the orals and any high value should be taken very seriously. Of course the damage can be caused by other factors such as excess alcohol intake, diabetes, etc so its a good idea to get a pre-cycle test to eliminate other potential factors outside of the oral steroids.
At the same time, normal GGT levels will indicate that there is nothing to worry about - so it ticks all the boxes as a method to be used to determine liver health.
Summary
Considering both the liver function profile and the GGT bloodwork cost around the same amount, I strongly recommend going for the GGT if you cannot afford both.
It will give you a much more reliable measure of monitoring your liver and taking action to protect it from future harm
How to accurately identify liver damage from oral steroids
I'm making this topic after doing a little bit of reading that explained why the usual liver function test that most guys take is NOT effective at spotting liver damage from oral steroids.
Lets start with the data...
Muscular exercise can cause highly pathological liver function tests in healthy men
AIM:
To investigate the effect of intensive muscular exercise (weightlifting) on clinical chemistry parameters reflecting liver function in healthy men.
RESULTS:
Five out of eight studied clinical chemistry parameters (AST, ALT, LD, CK and myoglobin) increased significantly after exercise (P < 0.01) and remained increased for at least 7 days postexercise. Bilirubin, gamma GT and ALP remained within the normal range.
CONCLUSION:
The liver function parameters, AST and ALT, were significantly increased for at least 7 days after the exercise.
In addition, LD and, in particular, CK and myoglobin showed highly elevated levels. These findings highlight the importance of imposing restrictions on weightlifting prior to and during clinical studies. Intensive muscular exercise, e.g. weightlifting, should also be considered as a cause of asymptomatic elevations of liver function tests in daily clinical practice.
There was also a very enlightening commentary on this study that shows us EXACTLY how to determine liver damage from oral steroids:
Enzyme elevations with muscle injury: know what to look for!
"We reported almost 10 years ago on the severe elevations that may be seen in competitive bodybuilders both on and off anabolic steroids [2]...
Most significantly we found the most simplistic laboratory value that should be included when examining resistance-exercise athletes is to include gamma glutamyl transpeptidase (GGT). We found none of our exercise subjects had elevations of GGT while patients with any form of hepatitis, who were analyzed retrospectively, all had GGT elevations [2]."
My interpretation
The first study shows that resistance training alone will cause an asymptomatic increase in ALT & AST values, which is what most people look at to determine whether or not orals are causing any harm to their liver.
The second commentary illustrates that GGT would only increase if their was actually any damage, not simply as a response to resistance training.
The main levels people see when taking a basic liver function profile are ALT, AST & Bilirubin.
ALT & AST levels can be elevated simply as a result of training induced muscle damage and therefore is not an accurate method of determining what's really going on.
Serum Bilirubin is accurate in showing potential liver damage but not as a measurement on its own (unless your levels are really high, twice the reference limit for example).
The solution is to measure GGT levels.
GGT levels will only be elevated to show direct liver damage from the orals and any high value should be taken very seriously. Of course the damage can be caused by other factors such as excess alcohol intake, diabetes, etc so its a good idea to get a pre-cycle test to eliminate other potential factors outside of the oral steroids.
At the same time, normal GGT levels will indicate that there is nothing to worry about - so it ticks all the boxes as a method to be used to determine liver health.
Summary
Considering both the liver function profile and the GGT bloodwork cost around the same amount, I strongly recommend going for the GGT if you cannot afford both.
It will give you a much more reliable measure of monitoring your liver and taking action to protect it from future harm
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