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Can Steroids Cause Elevated Liver Enzyme Levels?

Posted on Thu, 7 Sep 2017

Question: My husband has a severe case of alcoholic hepatitis. He was in the hospital for three weeks and one week ago he was discharged and went immediately to treatment. They are continuing to follow him in treatment as far as blood work, etc. When he left the hospital, his ggt was 188 and that roughly where it had been for 1 week. His bilirubin was 12, down from a high of 31 when he was admitted. His AST and ALT were also elevate, although I can't remember exact numbers. They had come down significantly from admission, and then gone up again and then down. The nurse at the treatment facility said that his ggt was up since the last test a week ago, around 220. His bilirubin had also slightly elevated, but they were more concerned about his ggt. He is on 40 mg of steroids for another 10 days when he will start to taper off. He also takes 300 mg of gabapentin for sleep, plus thiamine and folic acid. He will be abstinent from alcohol 30 days on the 18th. Although I have not seen him in a week, they say he looks good. He is eating well, he says he feels good, and he is much stronger from even a week ago when he went into treatment. I am wondering if there a connection between the steroids he is on and the elevation in the ggt? I am concerned because I don't understand why that would be increasing after no alcohol, a better diet, exercise, etc.

Answered by Dr. Ramesh Kumar (5 hours later)

Brief Answer:
Things will take time to settle.

Detailed Answer:
Hello,
Thank you for choosing HealthcareMagic for your query
Have gone through your details and i appreciate your concerns.
As per your query answer is-
Corticosteroids are hepatotoxic drugs and can cause elevation of liver enzymes however on the other hand they are very potent anti inflammatory drugs and will help to settle inflammation at cellular level.
GGT is an enzyme which is very often elevated in case of hepatic problems.GGT is very specific for liver damage so whenever there is a damage to your liver the levels of GGT would be elevated.GGT is found on the cell membrane of liver so in patient with hepatitis GGT would be elevated as due to severe inflammation of liver cell it would be more permeable to enzymes.
However in his case as he is having severe hepatitis we have to consider pros of steroid therapy over cons.
Steroids are very potent antiinflammatory and are very effective when inflammation is at cellular level.

So after going through the details and current situation to take steroid therapy is the best option.
Just keep a watch on the levels of Liver functions.

Hope i was helpful.
Thanks!

Above answer was peer-reviewed by : Dr. Kampana

Follow up: Dr. Ramesh Kumar (11 hours later)

So the elevation in GGT is not exactly all that concerning? He's been on that dose for about 2.5 weeks.

Answered by Dr. Ramesh Kumar (6 hours later)

Brief Answer:
follow up.

Detailed Answer:
Hello dear patient.
See when patient is having severe liver problem all tests would be deranged like all other enzymes GGT is also an enzyme so i don't feel that you need to worry to much about one particular enzyme.
As inflammation would settle down enzyme levels would return to normal gradually.
So don't panic dear and follow your Gastroenterologist suggestions.

I wish him a fast recovery.

Thanks!

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Above answer was peer-reviewed by : Dr. Nagamani Ng