Impact of Steroid Use on Liver Function: Your Health Report

Do steroids affect liver function?

In the past two years, I underwent extensive steroid treatment for chronic urticaria, which led to numerous side effects.
Fortunately, this year I have not experienced any urticaria flare-ups, and the moon facies and buffalo hump have finally disappeared.
I no longer experience nocturia at night, so I decided to undergo a comprehensive health check-up.
However, the ultrasound examination revealed a suspected liver tumor (the doctor mentioned it is small and advised regular monitoring).
Additionally, I have severe bone density loss, which the doctor indicated may be due to long-term steroid use.

Today, I received the report, which highlighted several abnormal values: GPT 50, APL 154, R-GT 93, and AFP 9.29, with no evidence of hepatitis B or C.
From the report, it appears that my liver is in distress, yet I do not have hepatitis.
Why is there inflammation present? Should I undergo further testing to confirm whether my liver is functioning normally? If additional tests are necessary, what specific tests should I consider?

Mr. Wu, 30~39 year old female. Ask Date: 2005/10/19

Dr. Lin Minghui reply Gastroenterology and Hepatology

Hello, your liver enzyme levels are abnormal, indicating inflammation of the liver.
The causes of liver inflammation include viral hepatitis (A, B, C, D, E), as well as alcohol, medications, chemicals, fatty liver, metabolic diseases, autoimmune diseases, liver abscesses, and liver tumors, all of which can lead to abnormal liver enzyme levels.
In some cases, the cause may remain unidentified.
Steroids can also affect liver function.
It is recommended that you seek medical attention for follow-up, including blood tests and ultrasound.
If necessary, a liver biopsy can be helpful in diagnosing unexplained hepatitis or tumors.
Sincerely, Dr.
Lin Ming-Hui, Internal Medicine.

Reply Date: 2005/10/19

More Info

The impact of steroid use on liver function is a significant concern, especially for individuals who have been on long-term steroid therapy. In your case, the use of steroids for chronic urticaria has led to various side effects, including changes in liver function, as indicated by your recent health report.
Firstly, it is essential to understand that steroids, particularly corticosteroids, can have a range of effects on the liver. While they are effective in managing inflammation and immune responses, they can also lead to liver enzyme elevations, which are often markers of liver inflammation or damage. The liver enzymes you mentioned—GPT (ALT), APL (ALP), and R-GT (GGT)—are commonly used to assess liver function. Elevated levels of these enzymes can indicate liver stress or injury, even in the absence of viral hepatitis (like Hepatitis B or C).

The specific values you provided—GPT 50, APL 154, and R-GT 93—suggest that there is indeed some level of liver inflammation or dysfunction. Normal ranges for these enzymes can vary, but generally, GPT (ALT) levels above 40 U/L, ALP levels above 120 U/L, and GGT levels above 50 U/L are considered elevated. The presence of elevated liver enzymes without viral hepatitis can be attributed to several factors, including:
1. Medication Effects: Long-term steroid use can lead to liver enzyme elevations. Corticosteroids can cause fatty liver disease, which may contribute to elevated liver enzymes.

2. Alcohol Consumption: If there is any history of alcohol use, it can exacerbate liver issues, leading to elevated enzymes.

3. Metabolic Disorders: Conditions such as non-alcoholic fatty liver disease (NAFLD) or metabolic syndrome can also lead to liver inflammation and elevated enzyme levels.

4. Autoimmune Conditions: Some autoimmune diseases can affect the liver, leading to inflammation.

5. Other Medications: If you are taking other medications alongside steroids, they could also contribute to liver enzyme elevations.

Given your situation, it is prudent to follow up with your healthcare provider for further evaluation. Additional tests that may be recommended include:
- Liver Function Tests (LFTs): To monitor the levels of liver enzymes and assess overall liver function.

- Hepatitis Panel: To rule out other viral hepatitis infections.

- Ultrasound or CT Scan: To further evaluate the liver and any suspected lesions or tumors.

- Liver Biopsy: In some cases, a biopsy may be necessary to determine the cause of liver inflammation or to assess for conditions like fatty liver disease or autoimmune hepatitis.

It is also important to consider lifestyle modifications, such as dietary changes and avoiding alcohol, to support liver health. Regular monitoring of liver function is crucial, especially after prolonged steroid use, to catch any potential issues early.

In summary, while your liver function tests indicate some level of inflammation, the absence of viral hepatitis is a positive sign. However, further investigation is warranted to determine the underlying cause of the elevated liver enzymes and to ensure appropriate management moving forward. Always consult with your healthcare provider for personalized advice and treatment options.

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