Elevated Liver Enzymes and when to start back up antibiotics?

Hi all looking for insight, advice: I have been treated for Lyme for the past five months.I may have only had Lyme for about 8 months (but then again who knows). I have been on Cefuroxime 500 2x a day, Azithromycin 500 1 x, Tinidazole 2x a day, Acetyl Cysteine, Glutathione, Serra Peptase, healthy diet, salt baths, teas, yoga, etc. I was making great progress, thought I was about 90% done. I was feeling well.
I finally got liver enzymes checked and they were sky high, (6x normal). Four weeks off all meds and supplements, the #'s were coming down nicely and started milk thistle, and continued dandelion tea, lemon water, etc. Developed gastrointestinal distress, lost weight and had diarhea, (much like the Lyme supposedly started last year). Just went and had the #'s checked again, while having no meds in me, only milk thistle, and they tripled! Now my Lyme symptoms are creeping back with arthralgia all over and a completely swollen knee, just like I started this whole nightmare. I feel like I am quickly going backwards. LLMD will not let me start anything until #'s go down. He has sent me to the GI/Liver Dr to rule out any liver, gallbladder issues, going this week. I tested negative for Hepatitis. Will I ever be able to be treated for Lyme if the the liver #'s don't come down? What meds can I take some day? I am so scared I am going right back to where I started. Why didn't the milk thistle work?(He made me stop that). Not sure where to turn. The GI Dr never thought I had Lyme a yr ago when I saw him for the original abdominal distress....it turned out to by Lyme that travelled to arthritis pain everywhere, took the LLMD to figure it out and an Igenex test. I have to go back to him though to rule out any other stuff wrong w the liver or gallbladder. Thank you for any help at all!! I appreciate it.

Thank you! Well, havent asked him yet, but another patient I know seeing the same Dr wishes to get off all anbx and asked for an herbal protocol and he seems to push the "Cowden" approach? Never heard of it....$263 a month, ouch. I was doing sooo well w the meds. I'm skeptical of the herbs only bc the market is so un-regulated and ive read some herbs van actually raise liver enzymes too? Im so perplexed.

Hi pinkroses - I understand how you're feeling.

I was treating lyme for about 5 months with antibiotics and herbal...and my liver enzymes climbed - but were still in range.
Then I switched the Amoxicillin to Ceftin (Cefuroxime) and after a couple of months on it, my enzymes started to climb more...and after 3 months they were out of range...my LLND gave it a couple more months but they continued to climb...and we decided I would stop all antibiotics and herbals.
I felt like you...concerned that I would not be able to treat the infections. My regular GP ordered an ultrasound - just in case.. and my liver/gall bladder were fine.
Within two months, they were back in range...gave it an additional month to be safe...and then started antibiotics for bartonella. One of the meds is Rifampin..which can be hard on the liver.
But, amazingly, my liver enzymes continued to drop...to the lower end of range...they have stayed in range for 8 months now. I have also added the herbs back in.

So, was it just the Ceftin that caused them to rise? Or was it that the bartonella infection was causing the high enzymes, and the treating that infection...allowed my liver to stabilize?
I don't know...my LLND doesn't know...my regular GP doesn't know.

Oh, and one more thing to add to the puzzle. I was switched from Milk Thistle extract to the Pekana apo-Hepat for liver support.


But, don't despair...just take the time to get your liver function back to normal.
And, do some research on the herbal protocols in case you decide that's what you want to do.

Cowden is a popular one...so is Buhner's. There's also Byron White (I think you need a practitioner to supply the tinctures though)

You're welcome, pinkroses.


Good luck at the GI Dr. appt. yes, please update with your latest liver test results.

I feel like a nuisance, anyone have advice for my swollen knee while I'm waiting for liver #'s to come down, I can't take anything. It's huge and I can't walk well on it, its a classic "Lyme knee" and its killing me that I cant get the antibiotics in me soon enough!! What can I do? Im an active Mom of four! Tx so much.

How do I use the Curcumin or Tumeric in terms of amounts/ frequency, and in what, tea, water? Thank you! the knee is so huge, I can barely walk.

Hi all, and thanks to those who have tried to help me out here! Reporting back, my latest liver enzymes: ALT: 630, and AST: 464 ! Crazy. I have done nothing but drink dandelion tea, drink lemon water, and take salt baths. I was instructed not to take any milk thistle right now. What could this be, just the Lyme wrecking havoc? I see the GI Dr tomorrow, I wonder what your guess is he will do, what should I ask from him? Thank you all, so perplexed and frustrated. Take care.

May I chime in here? Is it the ALT & AST youre referring to here?

Last month my ALT was 38(HIGH) range 6-29, but my AST Is in range
My ND asked if I drank alcohol and I said ONLY special occasions 1-2 glasses of bubbly wine. She didnt say anything else about the liver enzymes but requested I do the KPU urine test because im holding on to heavy metals but excreting zinc(below range zinc)...

Not sure if these efect liver enzymes:
Im on Valacyclovir for the HIGH viral load,
I also had my gall bladder removed...
OH and I ALSO had a severe salmonella 'poona' strain infection last Sept....

Okay, so the top of the range is most likely 100.

Is it suspected you have bartonella co-infection?

For me, the raised liver enzymes I'm suspecting is from bartonella.

But, these infections in general can be hard on the liver...the liver is a big part of the detoxification process...and is constantly being flood with toxins...and working hard to get rid of them.

Hello there, not sure anyone wants to chime back in, it's been a little while, and I am still trying to work with the GI Dr to figure out the source of my elevating enzymes, and how to be cleared to return to the LLMD to resume treatment for my ever-returning Lyme, and/or try an herbal regimen such as Cowden's approach. I have had many tests done, a negative ultrasound of the liver, gallbladder, etc., many blood draws for GGT and CK to tell where the ensymes were coming from, only the GGT was elevated (indicating inflammation, no kidding), but the liver looks fine and I feel fine that way, no pain, no jaundice. The enzymes got to 902/635 (ALT & AST), crazy. My GI Dr consulted with a specialist and he has ordered a Biopsy of my liver next week! Both suspect "An Auntoimmune response to either one of the antibiotics, maybe Tinidazole".....my GI doesn't really want to explore the idea of it being Lyme itself causing trouble. I will go for the biopsy because we have to make sure it's ok, but I don't know what to do otherwise. I am getting worse by the week, and feel like I'm being bounced around. Noone wants me back on antibiotics, and I don't want to ruin my liver either but I fear the Lyme is going to wreck havoc in me as the days go by. It's been 2 months since I've been on antibiotics. Thank you so much, any help at all greatly appreciated!

Acetyl Cysteine - I bought some but it says "do not take while on antibiotics" - can someone please explain?

Hello all, wanted to report back as I said I would on my liver enzyme saga, I'll try to be concise: had a liver biopsy 5/26, results showed "mild-moderate inflammation of unknown cause", did not suspect it's from antibiotics necessarily, maybe Autoimmune, or the Lyme????...., so the GI Dr referring me to a liver specialist, appt in 3 days.....meanwhile, the latest test results of ALT/AST was 34/36!!! They came down without taking anything, not milk thistle, besides water w lemon and lots of herbal teas, nothing else, they came down! I was so happy! I have been feeling very well too, not 100% Lyme free but better, still stiff knee, but less tired and more energetic....why....go figure? LLMD wonders if my immune system didnt just "repair" somewhat on it's own.? Meanwhile, the Lyme still evident in my body needs to be dealt with. He has prescribed Mepron (alone for now as we go slowly and test liver enzymes), later add Azith for Babeesia. I am taking milk thistle, being careful to drink lots of water. What does anyone think? I'm a little scared of Mepron. I am also covered on insurance for the drug as opposed to doing an all herbal route. This all has been so costly to begin with and I'm willing to try the antibiotics again, since no Dr blames my elevated liver enzymes on any one antibiotic, they figure either "Autoimmune" or the Lyme itself, a virus, or who knows caused the elevation. Thoughts, suggestions or related experiences welcomed and appreciated. I have hope and am determined to kick this out of me one way or another! Thank you so much for all of your support!😃

Hi pinkroses
I am thrilled your enzymes went down. Your body likely just had enough time to help your liver fully detox. Also - it's pretty common for enzymes to creep up during tx so don't get too worried.

I have no idea why your LLMD told you to stop taking the milk thistle seed - makes no sense. I would press him for a reason for that. Everyone else I know was advised to continue taking MTS while their body continued to help the liver detox. Anyway, continue doing what you're doing and I would also incorporate burdock root. MTS wasn't enough for me when my enzymes got really high (6x) - had to add the burdock root.

I would be sure to take the maximum doses of both twice/day.

I would also incorporate dry brushing.

And a good GI binder will be very important given your GI history.

Also, Japanese knotweed is very effective for inflammation.

Hope this is helpful!

-p