Primary Sclerosing Cholangitis (PSC) - Online Support Group

ALT levels and weight bearing exercise

Hi, I’ve been attempting to counteract the PSC-induced osteoporosis in my spine by doing strength training every other day on a two day split routine. I have been feeling generally a lot better for it and I’m eager to see if I’ve improved my dexa scan results when the next one comes up (enough to avoid bisphosphonates). The thing is…In yesterday’s clinic the only comment they had was that my ALT had started to rise again after gradually normalising post-hospitalisation and diagnosis last year. They have tested again and say they may prescribe antibiotics if it continues to rise. Then I noticed some online information which suggests ALT can be elevated by weight bearing exercise and the muscle breakdown it involves. Wondered if anyone else had experienced similar with their LFT’s being affected by exercise? I don’t intend to stop strength training if it’s helping with the osteoporosis.

After races or when I’ve really cooked my muscles my ALT will temporarily bump up along with a smaller rise of AST. They go back to their usual amounts when I resume my normal level of activity.

Here’s a study: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2291230/. Interestingly, we probably notice ALT more than AST because it has a longer half life.

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Thanks jtb, this is interesting.

I never have been concerned about how exercise affects my blood levels. It is better to have the positive effects, I think, on the body than to worry if it is causing some blood levels to go up or down.

But then I do not exercise nearly as much as I used to.

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I’ve read in some nutritional information on fighting autoimmune disease that intense exercise might be linked to exacerbating conditions and I’ve often wondered (mainly because of a few of the ‘famous’ cases of PSC being sports people) whether there’s any link between this. I’ve also noticed on here that people that seem to be having an easier time of it seem also to be more regularly active. I certainly feel better for the exercise I’ve been doing to combat the osteoporosis.

For years I was told my high liver numbers were because I was extremely active. Then they discovered PSC…

I try to stay as active as my body will allow, liver numbers aside… I figure the benefits outweigh any concerns. I feel there are also mental benefits to staying as fit as possible.

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I love to read the post on this site. It makes me feel less alone in this disease. I just had a cholangitis attack this week and have lost 10ish pounds (130 to 118). I have osteopenia and my doctor recommended to walk 30 minutes a day with ankle weights and then to also use weightlifting machines at the gym. What kind of exercises are you doing? As soo. As I am off the Cipro and healed up I plan on hitting the gym again. But I was worried about exercising and putting weight on at the same time. I struggle to gain weight and I am also lactose intolerant. However, When I ran a half marathon or year ago I did not see any changes in my blood work.

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Hi Hikingbo, I hope you’re feeling better soon. Apparently even though PSC makes it difficult for us to fight osteo problems, the rate at which it reduces bone density is quite slow, I read something like -.1 per year. I have read on NHS sites that elderly non-psc females have been known to increase density through Calcium/Vit D supplementation and light exercise by something like 1.4 over 2 years…so it seems do-able. I don’t know what your hip/spine scores are but I have a normal hip and a -2.6 lumbar spine osteoporosis. The normal hip part apparently makes spinal damage even more likely for some reason. I have read that bi-lateral, compound standing resistance exercises with weights/resistance machines is the most effective as the skeleton reacts under the overall pressure by ‘thickening’ the points of stress where it’s needed. Standing dumbbell press, squats and deadlifts with as much weight that means you can only complete 6 repetitions for 3-6 sets is what’s recommended to stimulate the bones (too light a weight means the muscles will feel it but the bones not so much). I may work up to that sort of weight but at the moment I’m doing 6 sets of 8 repetitions with a reasonable heavy weight for each exercise. Obviously the form of each exercise has to be perfect, balanced and bi-lateral with no twisting or flexing of the spine involved. If the form isn’t able to be maintained, the weight is too heavy. I’m sure it must be helping, I wish they could test me now after 6 months, but I understand they usually test only every two years.