Elevated Liver Enzymes and Running

I looked into this problem recently. The liver enzymes, ALT and AST, are can become elevated when there is tissue damage. ALT is released ONLY with liver cell damage, but AST is released in liver, heart, OR muscle cell damage.

My test results showed mildly elevated AST (65), and high normal ALT (47). Since bilirubin was normal and hepatitis tests were negative, my doctors were not concerned.

I know that when I did only about 12 miles/week of easy running, my liver enzyme levels were less than half what they are now.

So, I strongly suspect that serious training is elevating these levels. Hard training certainly causes tissue damage (this is how muscles get better adapted) and the lactic acid rush of interval training could conceivably be damaging to the liver (one of whose jobs is to remove excess lactic acid).

The question is: do healthy runners generally show such elevated levels, or are they a possible indicator of overtraining?

Interesting.... after my long run, i had AST 75 and ALT 67.... I took it easy for ten days, doing 18 miles in 4 runs over that period, and then read AST 46 and ALT 58... still above normal, but much lower.

I suspect you're right... hard training, either through speedwork or long runs, is breaking down the tissue somehow... I wonder also if it has anything to do with hydration... would being dehydrated likely increase strain on the liver from hard training?

My doctor's told me that serious runners, marathoners, etc. don't typically have these readings... I'd be interested inhearing any further opinion from anyone onthe board who has thought about this.

Wondering wrote:

I suspect you're right... hard training, either through speedwork or long runs, is breaking down the tissue somehow... I wonder also if it has anything to do with hydration... would being dehydrated likely increase strain on the liver from hard training?

I've had high liver readings when doing a lot of training, but haven't had them checked for a long time.

My doctors told me that serious runners, marathoners, etc. don't typically have these readings...

That is not true.

I'd be interested inhearing any further opinion from anyone on the board who has thought about this.

You can always do liver flushes to clean out the liver and gall bladder. I've done three of them over the last six or eight years and they work well.

What is a liver flush? Never heard of it... Thanks.

Regarding the "liver flush", The American Cancer Society has this to say:

This method is used by alternative medicine practitioners to detoxify or drive "harmful" chemicals out of the liver. A liver flush involves eating or drinking a combination of specially selected herbs, enzymes, juices, and oils. Liver flush formulas vary widely by practitioner and are also available commercially. Some practitioners advise combining liver flushes with fasting (see Fasting). Proponents claim that liver flushing rids the organ of unwanted food by-products, fats, and toxins, therefore inhibiting the formation of diseases, including cancer. They also claim that because the liver is an important hormone regulator, cleansing it will aid conditions caused by hormone imbalances. There is no scientific evidence to support any of the claims made for liver flushes. Individual components of the herbal mixtures used in a liver flush may present health hazards. Relying on this type of treatment alone, and avoiding conventional medical care, may have serious health consequences.

You guys talk about getting tested after your run? How much after? Are you talking about the morning after or a few hours after your run?

I couldn't find any info on the correlation between strenuous exercise and elevated liver enzymes..

.....

The possible causes for elevated liver tests in an individual without symptoms suggestive of other illness includes the following conditions:

viral hepatitis -excluded by appropriate blood tests

autoimmune liver disease- can be excluded by blood tests

metabolic liver disease- both iron and copper overload can cause prolonged elevations of liver tests often with the absence of other symptoms. Blood and urine tests will confirm the diagnosis

toxic hepatitis- e,g, due to prescription drugs, over-the-counter medications or industrial exposures. A detailed medical history should exclude these possibilities.

some decent info on this issues.

Wondering wrote:

What is a liver flush? Never heard of it... Thanks.

Wondering -

A

is an easy means of cleaning toxins and parasites from the liver and, therefore, from the rest of the body.

Thanks for all the helpful info...

I can't find where I originally read about strenuous exercise being a possible cause of elevated enzymes, although I seem to recall that it was somewhere on a CDC link. I also saw something about that on a cycling message board. The only other data I have to support it is that I'm ruled out for alcohol, hepatitis and medication causes, and the numbers were higher within 24 hours of a long 18-20 mile run than they were after a short week and a five mile run. I'll hopefully learn more in coming days, as I'm scheduled to see a liver specialist. I'll inquire about liver flushes and post feedback for informational purposes.

According to exercise physiologist Paul Cribb, elevated liver enzymes are indeed common among athletes who do resistance work. To the extent that running is very high rep resistance work, it makes sense that runners may also experience this (and certainly middle-distance runners who both run and do weights). Cribb says on his site, responding to a similar query,

Your elevated levels of the liver enzymes SGOT (aspartate aminotransferase) and SGPT (alanine aminotransferase) along with elevated creatinine and BUN .... are also by-products of skeletal muscle trauma, such as the damage of muscle fibers produced with heavy resistance exercise.

The spilt routines that most bodybuilders follow such as a body part each day, would not allow for complete clearance of these metabolites. Hence a build up and slightly higher than normal blood concentrations. Many athletes I have worked with in the past have had similar instances with physicians not familiar with the metabolic effects of hard resistance training.

This is good info. Are these enyzmes toxins that the body need to get rid of...what exactly are these enzymes? Are they like Lactic Acid?

here is an answer -

Thank you for your detailed explanation.

wondering -

A physician would not know anything about liver flushes -- as these pertain to self care.