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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Treated For RA. Taking Methtrexate. Inflammatory Markers Remain Elevated. Is This Effect Of Tablet?

I have RA and have been in treatment for 3 years My RA seems refractive to most treatment but am currently on methtrexate .5 sq weekly and humira sq weekly. I also take Tarka for b/p, folic acid, vitamin D and calcium , prednisone 5 mg daily and hydro codone 5/325 q 8 hrs as needed. Over the counter meds include 2 aleve each morning. My most recent lab studies indicate elevated ALT/SGPT - 55 reference range 5-41. My inflammatory markers remain elevated. mcv is elevated- 110 reference range (80-102), elevated mch 35( 27-34) and elevated mchc 17 (10-15%) The elevated liver enzyme, mcv,mch and mchc are new and I was wondering if my current meds could be the culprit. Can methotrexate affect liver enzymes these values? I will be getting follow up lab this week and will discuss with my rheumatologist But wanted to get some idea of where our discussion may lead based on these labs.
Tue, 1 Apr 2014
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Internal Medicine Specialist 's  Response
Dear friend.

Welcome to HCM.

Rise in liver enzymes can be due to Methotrexate.

Rise in MCV is mostly due to Megaloblastic/ Pernicious anemia, but other serious issues can be there.
I advise you to get:
1. Vitamin B12 Levels
2. Folate levels
3. Complete hemogram and blood picture.

Review with reports

Stay Healthy.
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Treated For RA. Taking Methtrexate. Inflammatory Markers Remain Elevated. Is This Effect Of Tablet?

Dear friend. Welcome to HCM. Rise in liver enzymes can be due to Methotrexate. Rise in MCV is mostly due to Megaloblastic/ Pernicious anemia, but other serious issues can be there. I advise you to get: 1. Vitamin B12 Levels 2. Folate levels 3. Complete hemogram and blood picture. Review with reports Stay Healthy.