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Climbing and liver tests.


Original Post
Raul P · · Unknown Hometown · Joined Feb 2013 · Points: 35

So, back in December I went for the ole annual check up at the doctors including blood work etc.

Liver test came in a little high.

Was told to comeback for a retest after a few days for a double check.

Still high. (I think it was the alt test, not associated with drinking but the one sensitive to stuff like hepatitis and such...)

So got the full panel of hepatitis and other tests including ultra sound etc. negative on all things bad.

Retest, still high.

Sent to specialist, guy is perplexed. We chat about the whole ordeal, I get another round of tests. We talk about my excercise routine, I tell him I primarily rock climb 3-5 times a week depending on the weather, and had been climbing throughout this testing period. This gave him an idea that it could be the climbing that is spiking the tests... another round of tests just came back in, negative for all the new bad stuff tested, but still high.

So- the question I have is- has anyone else had a similar experience receiving high liver tests due to strenuous excercise? Particularly rock climbing?

I go back for another round of tests in a few weeks where I was told to take 10 days off prior to the test to make sure it's the rock climbing. Bunch of rest days in my future I guess....

Dan Cooksey · · Seattle, WA · Joined Jan 2014 · Points: 365

I have high liver enzymes because of climbing and boozing.

But seriously my doc said its diet. I eat like an asshole.

I doubt exercise is contributing. In fact he said diet and excerise should lower it.
I said I excerise all the time and then he said watch what you eat.

RandyR · · Unknown Hometown · Joined Dec 2009 · Points: 40

Exercise can cause transient increases in serum transaminases. I've always thought of endurance athletes, weight lifters, and crossfitters when considering exercise induced ALT or AST increase. Are you using any supplements? ncbi.nlm.nih.gov/pmc/articl…

Raul P · · Unknown Hometown · Joined Feb 2013 · Points: 35

No supplements, thanks for that link. Diet is clean enough, because any cleaner I think it'd be absurdly clean. Perplexing nonetheless.

Buff Johnson · · Unknown Hometown · Joined Dec 2005 · Points: 1,145

how high is high?

Mildly is usually fatty liver (nonalcoholic, called NASH, underlying is genetic predisposition) or medication related.

Other causes nonalcoholic, but not common, are α1-antitrypsin deficiency, autoimmune hepatitis, and Wilson disease.

Doubtful is due to climbing.

One consideration with NASH is that you might have a higher risk for coronary artery disease on down the road.

Should get an ultrasound, which I don't understand why that's not on the list, but whatever.

Roger Linfield · · Unknown Hometown · Joined Oct 2005 · Points: 10,145

Two consecutive blood tests showed mildly elevated liver enzymes, and I don't drink alcohol. They wanted me to come back for a third test, so I did some web searching. Here's what I found:

"Muscular exercise can cause highly pathological liver function tests in healthy men"
Br J Clin Pharmacol. 2008 Feb; 65(2): 253–259.

Methods
Fifteen healthy men, used to moderate physical activity not including weightlifting, performed an 1 h long weightlifting programme. Blood was sampled for clinical chemistry parameters [aspartate aminotransferase (AST), alanine aminotransferase (ALT), lactate dehydrogenase (LD), gamma-glutamyl transferase (γGT), alkaline phosphatase (ALP), bilirubin, creatine kinase (CK) and myoglobin] at repeated intervals during 7 days postexercise and at a follow-up examination 10–12 days postexercise.

Results
Five out of eight studied clinical chemistry parameters (AST, ALT, LD, CK and myoglobin) increased significantly after exercise (P < 0.01) and remained increased for at least 7 days postexercise. Bilirubin, γGT and ALP remained within the normal range.

During my next doctor's appointment, I showed this article to my doctor. She checked the test and found that it used one of the liver markers which did get elevated from weightlifting. The elevated level they found in the test was normal for me.

highaltitudeflatulentexpulsion · · Colorado · Joined Oct 2012 · Points: 35

Have they checked your CK levels? Muscle break down elevates CK and the liver works hard to process it.

I have chronic high CK levels due to autoimmune bullshit. It keeps my AST and Alt higher than normal but only a tad. 3-5 workouts a week could cause it too I suppose.

Matt Himmelstein · · Orange, California · Joined Jun 2014 · Points: 125

Are you going to stop climbing long term?

I get why you would want to fast for a cholesterol test, what and when you eat will impact the test differently, but it seems like your tests are just based on what you body is like.

So yeah, it may be a good idea to make sure it is the workouts, but beyond that, my questions to the doctors would be how the slightly elevated numbers impact my health?

john strand · · southern colo · Joined May 2008 · Points: 1,640

Hydration ?

Raul P · · Unknown Hometown · Joined Feb 2013 · Points: 35

Thanks for all the replys. Had the ultrasound. Not a fatty liver, I go back for another round of tests ina few weeks. I'm 10% high, so not overly high. I forget the numbers.

Doc says to take some time off climbing before the next test to confirm.
Strange indeed.

ViperScale · · Unknown Hometown · Joined Dec 2013 · Points: 235

Try drinking before the next test and see if that fixes it.

Probably nothing you are doing your just dying like everyone else, no big deal.

Buff Johnson · · Unknown Hometown · Joined Dec 2005 · Points: 1,145

Raul good luck!
Hopefully it turns out not a big deal.

caesar.salad · · earth · Joined Dec 2012 · Points: 85

I'm a doctor and I prescribe more climbing.

Why are they checking a liver panel in an otherwise healthy person in the first place?

Buff Johnson · · Unknown Hometown · Joined Dec 2005 · Points: 1,145

Sounds like just part of an annual and they pulled a CMP

T Roper · · DC,VA,NM,UT,CT,MA · Joined Mar 2006 · Points: 860

I'm no doctor but when I'm really pushing it I notice changes in my body, specifically dehydration even though I've been drinking plenty of water. Apparently adrenaline changes the liver a bit - news-medical.net/health/Wha…-(Adrenaline).aspx

Ask the Dr if they actually have time to talk with you, I have not yet.

Russ Keane · · Unknown Hometown · Joined Feb 2013 · Points: 140

Strange idea. This could be a case of medicine getting overly involved. Fresh air and exercise is bad? Uh, what?

FourT6and2 · · San Francisco, CA · Joined Mar 2015 · Points: 45

I climb as much, if not more, than you each week. I don't drink. The only liquid I put in my body is water and sometimes orange juice or milk (if I'm pounding cookies). My liver enzyme test at my last physical was normal and on the low end of the appropriate range. So I don't know what to tell you. If anything, I doubt exercise is bad for you unless you have some other type of medical issue going on.

So... maybe you drink too much booze or you don't drink enough water?

Raul P · · Unknown Hometown · Joined Feb 2013 · Points: 35

I drink water and coffee through out the day, 3+liters total. And don't drink a lot of booze anymore.

It's not so much that it's unhealthy from what I'm currently understanding, but more of an anomaly caused by excercise. Just annoying, but I guess worth it to rule out all the other crap I've been tested for.

I have a follow up test next week that I'll try and be well rested for. I'll post the results when I know more.

Thanks for all the replies.

Mike Brady · · Van Diesel, OR · Joined Jul 2014 · Points: 681
FourT6and2 wrote:I climb as much, if not more, than you each week.
I don't know why but I am really curious how you know this?
Guy Keesee · · Moorpark, CA · Joined Mar 2008 · Points: 310

I drink a six-pack or more a day... Sierra Nevada, or what ever hoppy drinks are going around at the time.. climb 2x week and I love BBQ food and sushi... and In-in-Out.

My doc tells me I am JUST FINE... except for slightly hi-BP....

Sounds like your Doctors are perplexed... and they wish for you to get more tests and more tests and probably more tests...

And the question was posted up thread.... So are you going to QUIT climbing, if the Docs say so???

maybe try another set of doctors

good luck to you.

Boissal · · Small Lake, UT · Joined Aug 2006 · Points: 1,315
Drew Sylvester wrote: So, barely high? You've not said *which* enzymes are elevated, but classically measured are AST, ALT, GGT. Since you said "it's not the one that's high with alcohol" I'll drop GGT, so either AST or ALT. At the lab my clinic utilizes, the reference ranges are: AST 0-40 IU/L, ALT 0-38 IU/L. So at most, you're under 44 for an AST, 42 for an ALT. Further, it would help to know if one or both are elevated--if just one, is it the ALT? ALT elevations are common in children and teens who are still growing, as bone is also a source of ALT. If both, I still wouldn't consider these elevated without any other signs or symptoms of illness. Infection, inflammation, recent use of antibiotics can all increase these. I don't generally worry about either unless they come back 100+. Finally, remember that you might be a slight outlier. Reference ranges for labs were developed off of large populations to determine 'normal', but you might run slightly over/under at baseline. Without any other physical signs or symptoms of an actual illness, this sounds like a potential case of "chasing the labs." The first rule of assessing a lab value: does the patient look ill? Does this lab make sense with the clinical presentation?
He said it's ALT. 10% high puts you at 44ish which, as you mentioned, isn't exactly concerning in the absence of symptoms or other abnormalities.
Guideline #1: Don't be a jerk.

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