Elevated Enzyme Levels and Health Concerns
A 23-year-old male has recently been experiencing severe skin itching and a noticeable yellowing of his eyes. He began using anabolic steroids for bodybuilding purposes last year, cycling through testosterone, equipoise, and nandrolone phenylpropionate—though not simultaneously. Upon visiting a physician, his blood tests revealed alarming liver enzyme levels: an ALT of 776, AST of 519, alkaline phosphatase at 162, and bilirubin at 8.8. The doctor indicated that this might be a case of drug-induced liver injury (DILI), advising him to cease all steroid use. After a week, follow-up results showed a further increase in liver enzymes: ALT at 944, AST at 440, with bilirubin rising to 10.1 and alkaline phosphatase climbing to 197, while gamma-glutamyl transferase (GGT) remained within normal limits in both sets of tests. An ultrasound was conducted, yielding normal results classified as unremarkable. Currently, the individual is two and a half weeks post-steroid, but the symptoms persist. More lab work is scheduled for the upcoming month. He is anxious and wonders if these symptoms truly indicate DILI.
Answers (1)
2/11/2026, 10:10:47 PM
OpenHealth AI
Your symptoms—severe skin itching, yellowing of the eyes (jaundice), and significantly elevated liver enzymes—suggest serious liver distress, likely related to your past anabolic steroid use. It's crucial to take these signs seriously, as they may indicate drug-induced liver injury (DILI). Though your doctor has advised you to stop using steroids, monitoring and managing your liver health is essential right now.
Explanation:
- Elevated liver enzymes (ALT and AST) indicate liver inflammation or damage. The fact that your bilirubin levels are rising further suggests that the liver's ability to process and eliminate bilirubin may be impaired, which can cause jaundice and itching.
- Normal ultrasound results indicate that there isn’t obvious structural damage to the liver, which is reassuring, but does not rule out functional damage from the steroids.
- Your symptoms and lab results need to be closely monitored by healthcare professionals for a proper evaluation.
Next Steps:
-
Cease All Steroid Use: Do not resume using any anabolic steroids or other substances that could harm your liver.
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Monitor Symptoms: Keep track of your symptoms. Note any changes or worsening of your itching, jaundice, or overall health.
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Hydration and Diet: Stay well-hydrated and consider a diet that supports liver health. Focus on incorporating foods like fruits, vegetables, whole grains, and lean proteins while avoiding alcohol, processed foods, and high-fat meals.
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Follow-Up Appointments: Ensure you attend all scheduled lab work and follow-ups with your healthcare provider. It's essential for assessing the recovery of your liver function.
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Consider Support: If you're feeling anxious about your health situation, consider talking to a trusted friend or counselor. Managing stress can also benefit your overall health.
If symptoms worsen or new ones arise (such as severe abdominal pain, confusion, or increased yellowing of the skin or eyes), seek immediate medical attention. Your health is the priority here, and it’s good that you’re monitoring the situation closely.
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