FML: Heavy lifting made me look like I was in liver failure

@halifax24 So you haven't gotten an official diagnosis from your doctor and haven't had any further testing done yet and this is all speculation by you and the research team, right?

Please say you've gone to your doctor by now. I had a patient just the other day who has liver granulomas and absurdly erratic LFTs, symptoms lasting for years - even did a liver biopsy - and the doctors came away with no real diagnosis. She continues to have liver "flare-ups" from time to time, still for no discernible reason.
 
@drycleaner hey! do you have any news regarding your patient? i know it’s been 7 years haha but im struggling with the same thing and im only 20 years old ! did a liver biopsy five days ago …
 
@halifax24 I first heard about this with cory (of mean kitty fame)having some checks to make sure he was okay to go on naked and afraid. He had the same thing happen, luckily his levels went down/didn't work out as strenuously in time so he could go on the show.
 
@halifax24 What if this heavy work was a regular part of your life? I can't imagine my liver exists in cirrhosis levels of AST/ALT/LFT/CK 24/7 just because I lift?
 
@mippop AST and ALT are primarily considered liver enzymes, that alert you do damage because they leak when the cells are damaged. However, they're actually present in other cells including muscle. The OP basically did the physical equivalent of beating her muscles with a big stick, and the damaged muscle cells leaked out enzymes like they do. If you're adapted and conditioned such that you aren't damaging your muscles when you lift heavy (as in, having signs of severe or debilitating soreness), then your levels are probably fine.

You can actually see small increases in ALT and AST with less strenuous activity, but the OP's levels are similar to what I see in patients (dogs mostly) who have been smacked by a car.
 
@mippop OP exercised so much she literally couldn't walk. Lab tests weren't necessary to realize that was pretty unwise... So there's no reason to expect the same results when training at normal levels of intensity.
 
@aamyggirl Good, I'm getting older and probably have to have shit like this done at some point in my life and I already have to remember to tell them I'm on creatine XD
 
@halifax24 This happened to me, although I also had swollen muscles as well (arms, from pull-ups) -- but no other classic rhabdo symptoms. My doctors called it rhabdo, treated it like rhabdo, and because of the muscle swelling, it seemed fair to call it rhabdo. CK levels were around 68,000, and even after they started to come down, my liver enzymes were quite high (AST 524, ALT 171), kidney function normal. I spent 2 nights in the hospital being pumped full of saline, and felt completely fine throughout.

Reading through other people's experiences, it became clear that they were treating me for the "rhabdo" that happens when, say, you are found in a collapsed building, or have a stroke, or experience a drug overdose. And again, because of my muscle swelling, maybe I did have rhabdo. But as I started reading about it, it became very clear that there are a lot of instances of highly elevated CK levels from exercise, and that lots of people seem to experience the type of symptoms I had just from exercise and recover just fine without medical attention.

Anyhow, IANAD (or a nurse), but it's really interesting to hear that you say this is a totally different issue than rhabdo. I wish my doctor had known there were other possibilities, especially if there's any chance that I could have avoided an expensive and stressful hospital stay.
 
@halifax24 Are you for real? About 3 months ago I also got a call saying that my AST/ALT were abnormaly high (150 IU/L for AST)! My doctor was very concerned about my liver and had me do a bunch of testing and several ultrasounds. I'd never guess it would be because of lifting, which I do on a daily basis. I was suffering from terrible DOMS the day I had that bloodwork done.
Two weeks after, my AST/ALT levels were back to normal and I do realise it was because I did the tests on a monday after not working out from friday to sunday.

Should I be concerned about this???

EDIT: Oh yeah, about the further testing... Everything was k, very k. No issues. lol
 
@dawn16 I read an interesting piece by a hepatologist (liver doctor) that it's pretty common for primary care practitioners to refer patients out for this issue. Good to know everything else was okay, that more than likely was the culprit of your elevated levels like mine!
 
@halifax24 Seems like a form of rhabdomyolysis. That's when your muscles break down and your kidneys can go into failure as they're trying to clear the contents of your muscle cells out of you blood. Dark brown urine is a common symptom of due to that.

A month or two ago, I got to the part of strongcurves with the negative chin ups. I did 3 sets of 5 maybe. So barely any at all. A couple days later (I did lift after that), I noticed that my arms were swollen like quite big. (At first I thought I was just getting super swole). Researched it and it sounded like rhabdo although I didn't have darkened urine, which is a major symptom. Couldn't straighten my arms for the first few days. As the soreness improved, the swelling got worse and moved from my upper arms to my forearms/lats.

Did some research. Turns out it's relatively common when you are going from doing no strength training to an overload of strength training (lol 15 negatives). It's also much more likely when you're doing eccentric movements (negatives). I was just so surprised because I had done so little and I'd already been lifting for 2-3 months. I guess it was just the eccentric movement.

CK can be super elevated after working out (especially eccentric movements). Most marathon runners also have mild rhabdo at the end of a marathon due to the impact on leg muscles. I took a week off the gym and decided not to go get blood work because my urine was fine. I just hydrated. Apparently, according to stories I've read, exercise induced rhabdo isn't well known in the medical community. So most people who went in and got their blood tested got hospitalized and put in IV fluids and monitored for a week.

I think it's always best to be on the cautious side but I'm in the medical field and didn't want to spend a week in the hospital. It did totally freak me out because everything we learned about rhabdo was hospitalization and serious chance of death. One of the case studies I read mentioned that the elevated CK didn't seem to have the same complications in a younger, exercising population as it does in other populations.

Edit: it is scary though; I haven't attempted a negative since and have subbed out all chin ups in the program. I'm terrified of doing it again. Which suck because I'd love to be able to work towards doing a chin up :(
 
@ladysparkle Doesn't the discrepancy in reported survival rates for rhabdo have to do with the fact that many (or maybe most?) people who are hospitalized for rhabdo developed it due to a severe crushing injury?
 
@dawn16 I know right? Eccentric movements cause more muscle damage than concentric. If you google elevated ck and eccentric exercise there's a bunch of literature.
 
@rubernli Haha. What are the chances! Glad you are still working towards a chin up. Maybe I'll muster up the courage to try on my next program. But yeah definitely no negatives for me.
 
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