Arimidex (anastrozole) is a prescription drug used to treat breast cancer, and it can cause side effects that range from mild to serious. These side effects may include hair loss, hot flashes, and pain. In this case, a 58-year-old woman presented with significantly elevated liver enzymes four years after starting anastrozole. The majority of people who reported liver problems with Arimidex did not experience any symptoms, and the only change noted was a slight increase in liver enzymes. Liver injury attributed to anastrozole is usually mild and self-limited, typically a transient, asymptomatic elevation in serum enzymes.
Anastrozole can affect the liver and may cause increased liver enzyme levels, which may be a sign of liver damage. Only a few rare case reports of anastrozole-induced liver injury have been reported, and LFTs elevation occurred between two to six months after medication exposure. In this case, icterus developed four days after switching hormone therapy from tamoxifen to anastrozole, and a significant increase in liver enzymes was measured in the blood.
Autoimmune hepatitis (AIH) is an extremely rare complication of anastrozole therapy, which presents with elevated liver function tests. However, the majority of people who reported liver problems with Arimidex did not experience any symptoms. In some cases, more severe problems such as hepatitis can occur.
In summary, Arimidex is a prescription drug used to treat breast cancer and can cause side effects that range from mild to serious. It is important for healthcare professionals to review patients’ medicines and symptoms and sometimes prescribe medications to address these potential risks.
| Article | Description | Site |
|---|---|---|
| Anastrozole – LiverTox | Hepatotoxicity. Elevations in serum enzymes have been observed in 2% to 4% of women treated with anastrozole. However, these elevations are typically mild. | www.ncbi.nlm.nih.gov |
| Anastrozole-induced liver injury after a prolonged latency | Only a few rare case reports of anastrozole-induced liver injury have been documented, with the elevation of liver transaminases occurring between two and six months after the initiation of medication. | pmc.ncbi.nlm.nih.gov |
| Anastrozole-induced Autoimmune Hepatitis: A Rare … | By O. Klapko. 2017. Cited 17 times. Abstract. The background to this study is as follows: Autoimmune hepatitis (AIH) represents an exceedingly rare adverse event associated with anastrozole therapy. It presents with elevated liver function tests, which may be indicative of the condition. | ar.iiarjournals.org |
📹 Aromasin (Exemestane) Vs. Arimidex (Anastrozole) | Estradiol Management | Serum Lipids (HDL & LDL)
Can you recover from high liver enzymes?
About one-third of people with elevated liver enzymes will have normal liver enzyme levels after two to four weeks. If your liver enzymes stay high, your provider may order more blood tests, or imaging tests such as ultrasound, CT scan or MRI. They may also refer you to a liver specialist (hepatologist).
What does it mean to have elevated liver enzymes?. If you have high levels of liver enzymes in your blood, you have elevated liver enzymes. High liver enzyme levels may be temporary, or they may be a sign of a medical condition like hepatitis or liver disease. Certain medications can also cause elevated liver enzymes.
What are liver enzymes?. Liver enzymes are proteins that speed up chemical reactions in your body. These chemical reactions include producing bile and substances that help your blood clot, breaking down food and toxins, and fighting infection. Common liver enzymes include:
- Alkaline phosphatase (ALP).
- Alanine transaminase (ALT).
- Aspartate transaminase (AST).
- Gamma-glutamyl transferase (GGT).
Can steroids raise liver enzymes?
Corticosteroid therapy can cause hepatic steatosis and hepatic enlargement, which is often not clinically apparent in adults. This effect can occur rapidly and is quickly reversed with discontinuation. High doses and long-term use have been associated with the development or exacerbation of nonalcoholic steatohepatitis with elevations in serum aminotransferase levels and liver histology resembling alcoholic hepatitis with steatosis, chronic inflammation, centrolobular ballooning degeneration, and Mallory bodies. However, symptomatic or progressive liver injury from corticosteroid-induced steatohepatitis is uncommon.
Corticosteroids may also act to worsen an underlying nonalcoholic fatty liver disease rather than causing the condition de novo. The worsening may be due to direct effects of glucocorticoids on insulin resistance or fatty acid metabolism or may be the result of weight gain common with long-term corticosteroid therapy. Simple steatosis induced by corticosteroids is rapidly reversible, but steatohepatitis can be slow to resolve upon withdrawal of corticosteroids.
An important complication of corticosteroid therapy is the worsening of an underlying chronic viral hepatitis. In chronic hepatitis B, corticosteroids can induce increases in viral replication and serum hepatitis B virus (HBV) DNA levels while decreasing serum aminotransferase levels. Exacerbation of hepatitis becomes particularly evident when corticosteroids are withdrawn or lowered to physiological levels. As the immune system recovers, hepatitis worsens and serum aminotransferase levels can rise to greater than 10- to 20-fold elevated, usually accompanied by a prompt decrease in HBV DNA levels. This flare of disease following withdrawal can be severe and result in acute liver failure or significant worsening of chronic hepatitis and development of cirrhosis.
What is the dark side of anastrozole?
Long-term side effects. Anastrozole is generally safe to take for a long time. However, it can make your bones weaker and more likely to break ( osteoporosis ).
You may have bone density (DEXA) scans to check how strong your bones are, before you start taking anastrozole, 1 or 2 years into treatment, and again after you finish your treatment.
Your doctor may recommend a type of medicine called a bisphosphonate to help make your bones stronger. They can also give you advice on exercise and diet to help keep your bones strong.
Anastrozole can also increase your cholesterol levels. Your doctor will monitor this during your regular check-ups and recommend treatment if you need it.
What can falsely elevate liver enzymes?
Common causes of elevated liver enzymes include: Nonprescription pain medicines, particularly acetaminophen (Tylenol, others). Certain prescription medicines, including statins, which are used to control cholesterol. Drinking alcohol.
Why are my liver enzymes elevated all of a sudden?
Elevated liver enzymes often are a sign of inflamed or damaged cells in the liver. Inflamed or injured liver cells leak higher levels of certain chemicals into the bloodstream. These chemicals include liver enzymes that may appear higher than usual on blood tests.
Does estrogen cause elevated liver enzymes?
Estrogens and particularly combinations of estrogens and progestins have been linked to episodes of marked serum aminotransferase elevations without symptoms, jaundice or cholestasis. The abnormalities resolve quickly with stopping the hormonal treatment.
Abbreviations: OCC, oral contraceptives; FNH, focal nodular hyperplasia; BRIC, benign recurrent intrahepatic cholestasis.
Zimmerman HJ. Hormonal derivatives and related drugs. In, Zimmerman HJ. Hepatotoxicity: the adverse effects of drugs and other chemicals on the liver. 2nd ed. Philadelphia: Lippincott, 1999, pp. 555-88.
(Expert review of effects of estrogens and birth control pills on the liver).
Can testosterone cause elevated liver enzymes?
TM persons may experience modest increases in ALT and AST concentrations following testosterone initiation; however, clinical significance of the observed association remains unclear and requires further investigation.
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What is the most likely cause of elevated liver enzymes?
There are many causes of mildly elevated ALT and AST levels. The most common causes are nonalcoholic fatty liver disease (NAFLD) and alcoholic liver disease. In NAFLD, the liver has more fatty tissue in it than normal. Regular or heavy alcohol use can also hurt the liver and increase liver enzymes. Other medical conditions can increase liver enzymes, like hepatitis B or C and a condition that runs in families called hemochromatosis. Using certain medicines and over-the-counter supplements can also increase liver enzymes.
People with mild elevations in liver enzymes usually do not have symptoms.
Your doctor will ask you questions and examine you to try and find out why your liver enzymes are elevated. He or she may also do blood tests. A scan of your liver, called an ultrasound, might help your doctor find a cause.
Can anastrozole raise liver enzymes?
Hepatotoxicity. Serum enzymes are reported to be elevated in 2% to 4% of women treated with anastrozole, but these elevations are usually mild, asymptomatic and self-limited, rarely requiring dose modification. There have been rare instances of clinically apparent liver injury associated with anastrozole therapy, typically arising within 1 to 4 months of starting treatment and having variable presentations but generally with a hepatocellular or mixed serum enzyme pattern (Case 1). Too few instances have been described in the literature to provide specific characteristics or clinical phenotype. Immunoallergic features (fever, rash, eosinophilia) were not mentioned in published cases, but low levels of autoantibodies were sometimes found. Recovery is usually rapid once anastrozole is stopped. There have been no cases of acute liver failure, chronic hepatitis or vanishing bile duct syndrome attributed to anastrozole use. Unlike tamoxifen, anastrozole has not been associated with development of fatty liver disease, although some degree of steatosis and steatohepatitis have been mentioned in descriptions of liver biopsies from acute cases. According to the product label, anastrozole has been linked to cases of hypersensitivity reactions and Stevens-Johnson syndrome as well as cases of hepatitis with jaundice.
Likelihood score: C (probable cause of clinically apparent liver injury).
Mechanism of Injury. The liver injury attributed to anastrozole use is probably due to a toxic or immunoallergic intermediate of its metabolism. Anastrozole is metabolized in the liver by the cytochrome P450 system and is a strong inhibitor of CYP 2A6 and to a lesser extent CYP 2C19.
Do aromatase inhibitors affect the liver?
This study reveals that postmenopausal women with breast cancer treated with aromatase inhibitors have an increased risk of nonalcoholic fatty liver disease compared to healthy women after menopause, independent of obesity and diabetes mellitus. This suggests that the newly developed fatty liver may have an adverse influence on breast cancer disease-free survival and calls for further validation.
Aromatase inhibitors are known to benefit postmenopausal women diagnosed with hormone receptor-positive breast cancer, as they suppress total estrogen synthesis by more than 90%. Nonalcoholic fatty liver disease (NAFLD) is a growing cause of chronic liver disease worldwide, with a progressive form, nonalcoholic steatohepatitis, that may result in advanced liver fibrosis and cirrhosis. Although women at their reproductive age have a lower risk of NAFLD compared to men at similar ages, women after menopause have an increased prevalence of NAFLD.
Postmenopausal women undergo metabolic changes, including visceral fat accumulation, dyslipidemia, and glucose intolerance, which are associated with insulin resistance and the development of NAFLD. Hormone replacement therapy alleviates NAFLD in postmenopausal women, and they are at higher risk of liver fibrosis. However, a previous study found that premenopausal women had an increased risk of hepatic inflammation when NAFLD developed, contradicting the protective effect of estrogen against NAFLD progression.
Is Arimidex bad for your liver?
Severe liver problems. There have been a few reports of liver problems, such as hepatitis, since Arimidex was approved. If you have a liver problem, taking Arimidex may make it worse. Before you take the drug, talk with your doctor about any liver problems you may have. They may recommend a different treatment for your condition.
Allergic reaction. If you’ve had an allergic reaction to Arimidex or any of its ingredients, your doctor will likely not prescribe Arimidex. Talk with your doctor about which other treatments may be better choices for you.
Alcohol with Arimidex. There’s no known direct interaction between drinking alcohol and taking Arimidex.
📹 Low testosterone and higher estrogen in men: Why is it happening and what to do about it? (AMA #9)
This AMA Clip is a segment pulled from an “Ask Me Anything” episode of The Drive titled: #73 – AMA #9: NAD & metformin, …
Thing is that aromatization is mostly individual dependent . For instance i know most people won’t even need an AI when cruising anywhere between 150 – 250 mgs of test per week, but i need a low dosage of around 12.5 mgs of aromasin per week to keep my estrogen within normal range . Awesome article man !
On 200mg TRT my estradiol is around 70. With 0.15mg arimidex per day my E2 was around 20-25. Very strong stuff. With DIM and Cal-D-G I find I need 400-600mg DIM and 100-300mg Cal-D-G to get symptom relief. ( I get estrogenic sides once I go above 50, also since I use dutasteride theres is just alot more aromatisation even though my BF levels are quite low ) It works though.
Every one says don’t use AI, but what if you have Oestradiol 239 pmol/L and the symptoms I have erectile dysfunction, can’t loos weight, enlargement of the breast tissue, depression, loss of energy or feeling tired and decrease in muscle mass and acne, sweats at night. water retention, brain fog. I have to do something. I take only T enanthate. 50 x 2 =100mg a week.
Sad fact is i taking 250 test and 600 masteron and 4 iu hgh with 25 aromsin every day My free test 1700 My estrogen in the middle exactly I guess im so sensitive to estrogen like crazy I don’t know what to do to make my AI less use Drop the test lower like 150 or take ai 4 times a week and then see what happens I was really surprised with this results What you think about it?
I was just looking into DIM and saw this in an article “DIM blocks the effects of testosterone. Higher doses (greater than 100mg) of isolated pure DIM can saturate tissues and block androgen (e.g. testosterone and dihydrotestosterone) receptors and inhibit the protein synthesis induced by the anabolic effects of androgens.” — I’m wondering if you’re aware of this claim and if so does it still help?
I know this an old article but I hope u can help me out. 4 years ago I started off on 150mgs a week with 37.5 mgs of aromasin a week. My e2 would be around 20. Now I’m doing the same thing and my e2 stays around 80! Can it be that my body is compensating by making more aromatase enzymes for the 1s the aromasin is destroying?
Hello Steve, im french so my english is not perfect, Can you write the exact name of what you taking at 250 mg of test in cruising for me ? i have somes issues of gyno/bloated face cuz of oestrogène at my 150 Mg/ crusing dose and i want tto try to fix it witthout Arimidex or Aromasin. Thanks a lot for you’re precious informations. reguards from france
Im on 140 mg test E once a week. Im seriously considering underground labs so I can pin twice a week (20 mg a day). I think im getting sides (pimples, bloated feeling, intermittent BP spikes) from that little test because im fat (21% bf). Im trying to get lower BF to mitigate sides. For now, im on a quarter mg of Arimidex a week. What throws me off is my 25mg 3× week enclomiphene. It does mitigate the bloated feeling somewhat. Do you think enclomiphene would help?
Another question Steve, absorption; does testosterone enanthate get absorbed equally as well whether injected in the butt or in the quad? (not really flexible enough to safely/confidently self administrator an injection in the butt so was thinking it being intramuscular I should be able to inject in my quad as well? (rephrase, are there any downsides to injection in the quad instead of the butt.)
So I’m on legit TRT (no cycle, no trend) and I’m taking 200mg of Test C, 50 units of HCG x2 week, and 1mg of Armidex 2x a week. I feel like that armidex is a bit excessive.. i feel fantastic really, but I did have problems before adding the extra dose of armidex with my estrogen going a little above 50. I felt good around 30-35 and just had blood work done which I’m waiting on the results to come back still. Should I space out that second dose of armidex? Or try to swap to armosin instead? I’ve read that armosin also further ups testosterone levels as well.
Guys ..i know steve is not recommending to mix deca and tst but im exactly on this setup ..im on 600 tst mix /300 deca 40 mg of mestrolone as dht ..was also taking 75 mg of oxymetholone for 6 weeks but cutting it this friday ..i dont want to use exemestan i have better feel with arimidex personally but im unsure About dosage and here atm cant to my bloodwork ..should i take ed or eod ? And what dosage would u reccomend me ..0.25 mg eod would do the job ?
I just started hcg and clomid as HRT instead of test and my estrogen was pretty high about 60 when I had bloods done. I asked my doctor for aromasin because I saw it was better overall but he didn’t know anything about it as far as dosage wise. I started taking 12.5mg EOD, would you do the dosage differently?
Howdy everyone. New to this realm . If possible anyone can assist. I want to obvious get a bit bigger (I’m 1.7m tall and 71kgs) a friend of mine has instructed me to get sustonan 325PL using 2ml per week, 50g anavar per day and 4ml Decca per week over 10 weeks. Does this seem okay and I was thinking of using this arimadex as well to counter the estrogen. Any help I’ll greatly appreciated. Thank you
My question to you is: How much letrazol roughly = 1mg of Adex? The reason I ask is because im getting a flare up on one nipple every couple months. I know this is due to GH that I take in the AM (3i.u) correct me if I am wrong. I have been taking 150mg of test per week and 3 Nolva per week that I thought would keep my nipples in check as an ongoing HRT protocol. I also started taking 400mg of DIM and 1-2 shots of HCG @ 300i.u per week. I need to bring the flare up down, and I’m thinking of taking 1/4 letro every 3 days for 2 weeks since it’s worked in the past, and then what would you recommend to keep it down? Thank you 🙏🏻
From the engineering side of the equation. Material science has taught us that polymers can diffuse and creep at very fast rates relatively. Due to the amorphous molecular structure. Those rates are exponentially dependent on temperature, pressure and time. Some polymers are very “active” at atmospheric pressure and room temperature. Plus polymers are new so humans are not well adapted yet.
What I do understand is that there are multiple possible reasons for this issue, in addition to what Peter said, I’m sure lifestyle plays a role, too. How good is your sleep, your diet, are you stressed at work, do you get enough natural light and especially sunlight, these factors are all important.
This is the type of question I like asking people to know if they are intellectually honest and rigorous enough. Peter answered this well. If you say you know the exact reasons why testosterone is down, you are lying or too overconfident to be trusted. Especially something as heated as testosterone where men will feel insecure about it, the men who claim they know the exact reasons are motivated by ideology and that’s it. No rational thought. Stop saying it’s “the chemicals” and then potentially point to a random study. You have no idea what you are talking about.
I’m 50, 6’6 195lbs. Tall, lean, pretty decent shape. I just got tested and my estrogen (estradiol) is high. The reason I got tested is because I’m having issues with my thyroid. Hashimoto’s Hypothyroidism (self diagnosed, my mom has it) and I thought there was a chance it was estrogen related. Looks like I’m at least partially right, if not 100%. I was going to do TRT on my own a while back and never started it, but I’m very knowledgeable about TRT, AI, Serms, PCT, etc….and I have a stack of testosterone, proviron, clomid, nolvadex and arimidex. In your opinion and not as medical advice, in order to decrease my estrogen, which would be the best choice: 1. Supplement 10 weeks with low dose testosterone to increase the test/estrogen ratio & use Nolvadex or an AI to keep estrogen down 2. Take low dose Arimidex by itself to drop estrogen 3. Neither. Here’s my suggestion. Thank you very much if you end up replying to me.
My testosterone was 5% of the other young men in my class growing up and through puberty, and while there’s many other chemical issues there, you could tell and technology wasn’t there, but look at a class, mine for example I was born in 1984, in gradeschool (I am 6″3 and skinny now at 38 due to health issues, but was overweight in gradeschool and while I grew in height it was and is clear hgh was the only hormone that may have been there in some capacity, let me explain and forgive me as I’ve been through hell in life) I have never had muscle, I was last picked on sports teams, made fun of, always cried as a child and adolescent, was afraid of catching a football or basketball, dad had a full beard and was agressive, I didn’t even have a facial hair until 30, and pubic hairs until 17. My energy was 0 ZERO and my childhood and forward was HELL and health issues abound. My sex drive was never good but by 27 it was 0, I had my testosterone tested by a quack finally near 30, and it was that of an 85 year old man, something like 50-80ng/dl total or free I have to find the papers but it was bad, my estrogen was very bad also albiet this some 9 years ago and I’ve been through hell and never had proper medical care or family, friends, help, income. And all while trying to raise a newborn alone which is a whole story that broke me and is one of the worst injustices I’ve seen as a human. Anways.. There’s something to chemicals, I knew I was “sick” by 12/13, I wasn’t like the other boys, I am not or never have been gay or wanted to be a girl but I feel like issues like mine but in different ways play into much of that and the confusion, (another topic and I don’t judge anyone and anyone who would know me even as I have noone would know that).
People back in the 1950’s were eating food that was pure. Vegetables tasted better, meat was cleaner, and Glyphosate wasn’t used. Now days everything is rushed along in order to profit or meet demands. The quality of what we eat has deteriorated immensely and many people eat processed food. I have never seen so many fat kids in my life as today. When I was a kid an overweight child was not nearly as common as today.
Hello. I have been on TRT therapy for approximately 3mths. I started off at the low dose of 60mg a week. I felt amazing for about 6 weeks. Then I felt like my old self was creeping back in. I was advised by my doctor to up the dose to 90mg twice a week for a total of 180mg. This helped a bit but suddenly I started to retain lots of water and fell the soreness of post workout sessions and started to feel a little depressed. I did some more blood work and it showed that my test has went a bit higher but my estrogen doubled from my previous test (first test was 6 weeks after starting TRT). I was hoping to get more answers from this article but it didn’t give me that much. I forget to mention I did have a couple days of heavy drinking. I am not a big drinking I just had two days of partying to take care of for a weeding ha. But yes my body held water weight and I went form 200lbs to 215lbs. I had a few days of bad eating in between. If anyone can offer advice it be great. I am awaiting another apt with the doctor was just hoping for another opinion. Thanks
I don’t think people realize or appreciate how often food or drink that you buy at the grocery store is deliberately adulterated with hormones or hormone like chemicals as a means of controlling elements of the population. This is illegal, but requires a vast amount of scientific understanding and equipment as well as a legal team to actually combat – which are things the people doing this know very few of their targets actually possess.
In similar cohorts, is testosterone production a consistent percentage less between now and the 50s? Or is it like some people have 1% less, some have 25% less, some have 70% less, etc.? Wouldn’t the clustering or granularity of that data point to the number of contributing factors right off the bat?
Can you explore the effects of HRT on performance in women i.e maintaining and /or increasing muscle, improving bone density, keeping tendons and ligaments maybe less ‘brittle’ etc Been taking HRT for 17 years (now 68) and main reason I started (shhhhh.. not what I told my doctor then) was for hanging onto hard wongains from runnning and weight training etc and hopefully less injuries. Back when I started HRT i read just a couple of studies on Russian female athletes which gave me the idea! Never seen any mentions of women asking for HRT because not wanting to lose athletic performance as a main reason. I reckoned that as oestrogen (and progesterone?) was linked to cell growth (hence slight increased cancer risk) it made sense that it might help maintain muscle and bone density growth in my training. I find this fascinating but only guessing as can’t find any studies on older female ‘athletes’….or at least active women like me (who are going for your centenary decathlon and would like all the help they can get!). Please Peter could you look into the latest research. Seems as I started HRT at 51 I am in a very very low breast cancer risk demographic…so I was told by a GP who had really looked into this. Worth the teeny teeny risk to be able to carry on quality training.
Women in the workforce. When men work with men and women are not included, their testosterone levels increase another factor to look into is the increase in testosterone in women since the 50s, nobody wants to hear this unfortunate truth, but men biologically are wired with their testosterone highest in the morning because they’re supposed to go out and gather resources and bring them back to the family. Nobody will study this because it sounds sexist, but biologically it makes sense. After childbirth men’s testosterone levels, drop temporary if they continue to stay home with the child there testosterone levels will drop. Even more, this is fact look it up.
I’m going with the main driver being too many carbohydrates in the diet (insulin, an anabolic, suppresses T both acutely and chronically) and being overfat (too much adipose tissue means excess production of aromatase and subsequent conversion to estrogen). Add to that environmental toxins/estrogenic substances and yeah, sure, you have a bunch of men, even young men, walking around with T in the basement.