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LFT basics
How familiar are you guys with your liver…or livers in general? Everyone thinks of their liver as a blood “filter”. While this is true in some ways, it does waaaay more than most people give it credit for. The liver manufactures bile to facilitate fat absorption, converts proteins, carbs and fat into other essential elements. It also caches fat-soluble vitamins, B12 and carbs as glycogen. It processes drugs, creates blood-clotting factors, maintains BGL by means of glycogen breakdown and discharges it into blood as glucose. There’s probably about 300 more things it does, but who’s counting.
I’ve been a BSN-RNFA, CNOR for about 11 years and have spent most of that time in solid organ transplant…..and weight lifting. I know that doesn't make me an expert, but during this time, I’ve seen a lot of jacked up livers. While I do use AAS recreationally, I certainly try to use them responsibly. Hopefully, all of you do too. If you use steroids, you likely know that oral steroids can mess up your liver, right? In turn, anyone who knows anything about steroids has heard of “c-17-alpha alkylated”. The description “c-17-alpha alkylated” refers to a change made on position 17 of the basic steroid structure. This concept isn’t too daunting. Anyone who has taken a chemistry course will likely understand. In very oversimplified terms; the c-17aa modification aids the drug to endure first pass metabolism. First pass metabolism occurs when a drug is absorbed from the GI tract and passes via the portal vein into the liver where the drug is metabolized. Sometimes, the result of first pass metabolism means that only a proportion of the drug reaches systemic circulation. Moreover, this c-17aa modification allows a very large portion of the drug to enter the blood stream and not be simply deactivated during portal circulation. This whole process sounds great, but… C-17 alkylated androgenic steroids have all been implicated in cases of liver injury, including prolonged cholestasis, peliosis hepatis, nodular regeneration, hepatic adenomas and hepatocellular carcinoma. In addition, they can also hammer your HDL level which is a beneficial cholesterol carrier in the blood. A lowered HDL level is considered a risk factor for cardiovascular disease. This is why ALL oral cycles should be limited in length and LTFs should be acquired to ensure enzyme levels are not greatly elevated.
LFT (liver function test)
Certain labs may include different panels in their own specific LFT. Sometimes, their values may vary. However, this should give you a roundabout idea of what to look for. I feel that whenever you’re going to run a cycle of any type, it’s a great idea to obtain blood work BEFORE you begin. This will give you some baseline data to compare any aberrant findings. A typical LFT will consist of AST, ALT, ALP, GGT and a total or conjugated bili. I’ll briefly try to explain each component of the LFT:
ALT (alanine aminotransferase) aka “Serum glutamic pyruvic transaminase”, and AST (aspartate aminotransferese) aka SGOT “Serum glutamic oxaloacetic transaminase” are two enzymes that are necessary for the metabolism of amino acids and protein within the liver. In the event that the liver receives any potential insults, these amino acids matriculate into the blood stream thus elevating their lab values. Now remember… these elevated liver enzyme levels can be due to oral anabolic steroid use, excessive ETOH or other drugs. In contrast, ALT and AST enzymes aren’t entirely specific to the liver. They are also present in other tissues such as cardiac and skeletal muscle. That being said, any type of mass injury to muscle including intense weight training can cause an elevation of those enzymes. This little caveat can easily trigger a false positive leading one to think that their liver is indeed being compromised. If you plan on having a LFT done, it’s best to take a day or two off of the gym prior to blood draw. The same could be said for any blood work. If ALT and/or AST are markedly elevated, measuring enzymes such as creatine kinase and GGT would provide a more definitive picture of existing liver function, as would liver imaging tests.
Elevations in ALP ( alkaline phosphatase) and GGT (gamma-glutamyl-transpeptidase) can be indicative of bile duct obstruction. In case you didn’t know, bile is a green liquid created and released by the liver. It contains cholesterol, bile salts, and waste products such as bilirubin. Bile salts help your body break down (digest) fats. Bile passes out of the liver through the bile ducts and is stored in the gallbladder. After a meal, it is released into the small intestine. When the bile ducts become blocked, bile builds up in the liver, and jaundice (yellow color of the skin) develops due to the increasing levels of bilirubin in the blood. If you start to turn yellow…STOP the cycle!! I hope I didn’t really have to say that! lol
Values found to be WNL:
ALP: 25-150 iu/l
GGT: <50 mol/l
Bilirubin: 0.08-1.3 mg/dl
ALT aka “SGPT”: 0-55 iu/l
AST aka “SGOT”: 0-40 iu/l
OTC liver supps
Liv-52 (available in double strength)
NAC (N-acetylcysteine) and gluthionine
Essentiale Forte N (enteral/parenterl): I believe this is proprietary blend of vitamins, Linoleic, Linolenic and Oleic Acids.
Silymarin (milk thistle)
If anybody has something to add, or finds something incorrect, please contribute. I'm always open to learn!
How familiar are you guys with your liver…or livers in general? Everyone thinks of their liver as a blood “filter”. While this is true in some ways, it does waaaay more than most people give it credit for. The liver manufactures bile to facilitate fat absorption, converts proteins, carbs and fat into other essential elements. It also caches fat-soluble vitamins, B12 and carbs as glycogen. It processes drugs, creates blood-clotting factors, maintains BGL by means of glycogen breakdown and discharges it into blood as glucose. There’s probably about 300 more things it does, but who’s counting.
I’ve been a BSN-RNFA, CNOR for about 11 years and have spent most of that time in solid organ transplant…..and weight lifting. I know that doesn't make me an expert, but during this time, I’ve seen a lot of jacked up livers. While I do use AAS recreationally, I certainly try to use them responsibly. Hopefully, all of you do too. If you use steroids, you likely know that oral steroids can mess up your liver, right? In turn, anyone who knows anything about steroids has heard of “c-17-alpha alkylated”. The description “c-17-alpha alkylated” refers to a change made on position 17 of the basic steroid structure. This concept isn’t too daunting. Anyone who has taken a chemistry course will likely understand. In very oversimplified terms; the c-17aa modification aids the drug to endure first pass metabolism. First pass metabolism occurs when a drug is absorbed from the GI tract and passes via the portal vein into the liver where the drug is metabolized. Sometimes, the result of first pass metabolism means that only a proportion of the drug reaches systemic circulation. Moreover, this c-17aa modification allows a very large portion of the drug to enter the blood stream and not be simply deactivated during portal circulation. This whole process sounds great, but… C-17 alkylated androgenic steroids have all been implicated in cases of liver injury, including prolonged cholestasis, peliosis hepatis, nodular regeneration, hepatic adenomas and hepatocellular carcinoma. In addition, they can also hammer your HDL level which is a beneficial cholesterol carrier in the blood. A lowered HDL level is considered a risk factor for cardiovascular disease. This is why ALL oral cycles should be limited in length and LTFs should be acquired to ensure enzyme levels are not greatly elevated.
LFT (liver function test)
Certain labs may include different panels in their own specific LFT. Sometimes, their values may vary. However, this should give you a roundabout idea of what to look for. I feel that whenever you’re going to run a cycle of any type, it’s a great idea to obtain blood work BEFORE you begin. This will give you some baseline data to compare any aberrant findings. A typical LFT will consist of AST, ALT, ALP, GGT and a total or conjugated bili. I’ll briefly try to explain each component of the LFT:
ALT (alanine aminotransferase) aka “Serum glutamic pyruvic transaminase”, and AST (aspartate aminotransferese) aka SGOT “Serum glutamic oxaloacetic transaminase” are two enzymes that are necessary for the metabolism of amino acids and protein within the liver. In the event that the liver receives any potential insults, these amino acids matriculate into the blood stream thus elevating their lab values. Now remember… these elevated liver enzyme levels can be due to oral anabolic steroid use, excessive ETOH or other drugs. In contrast, ALT and AST enzymes aren’t entirely specific to the liver. They are also present in other tissues such as cardiac and skeletal muscle. That being said, any type of mass injury to muscle including intense weight training can cause an elevation of those enzymes. This little caveat can easily trigger a false positive leading one to think that their liver is indeed being compromised. If you plan on having a LFT done, it’s best to take a day or two off of the gym prior to blood draw. The same could be said for any blood work. If ALT and/or AST are markedly elevated, measuring enzymes such as creatine kinase and GGT would provide a more definitive picture of existing liver function, as would liver imaging tests.
Elevations in ALP ( alkaline phosphatase) and GGT (gamma-glutamyl-transpeptidase) can be indicative of bile duct obstruction. In case you didn’t know, bile is a green liquid created and released by the liver. It contains cholesterol, bile salts, and waste products such as bilirubin. Bile salts help your body break down (digest) fats. Bile passes out of the liver through the bile ducts and is stored in the gallbladder. After a meal, it is released into the small intestine. When the bile ducts become blocked, bile builds up in the liver, and jaundice (yellow color of the skin) develops due to the increasing levels of bilirubin in the blood. If you start to turn yellow…STOP the cycle!! I hope I didn’t really have to say that! lol
Values found to be WNL:
ALP: 25-150 iu/l
GGT: <50 mol/l
Bilirubin: 0.08-1.3 mg/dl
ALT aka “SGPT”: 0-55 iu/l
AST aka “SGOT”: 0-40 iu/l
OTC liver supps
Liv-52 (available in double strength)
NAC (N-acetylcysteine) and gluthionine
Essentiale Forte N (enteral/parenterl): I believe this is proprietary blend of vitamins, Linoleic, Linolenic and Oleic Acids.
Silymarin (milk thistle)
If anybody has something to add, or finds something incorrect, please contribute. I'm always open to learn!
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