Liver Lab Results After K2: Good News/bad News

[sweetpeat]

So last fall I discovered I had elevated liver enzymes. In January I did 2 weeks of high vitamin K2 (15mg) and started experimenting with caffeine. I tend to use the caffeine pills rather than coffee because it’s easier to track the dosage. I’m just now getting around to having labs done to check my progress (it was a rough winter/spring). Here are the results:

Alkaline phosphatase (39-117) 120, was 128
AST (0-40) 52, was 58
ALT (0-32) 72, was 93
GGT (0-60) 100, was 120
Bilirubin 0.3 (0.0-1.2)
Direct bilirubin 0.10 (0.00-0.40)
Albumin 4.6 (3.5-5.5)
Globulin 2.7 (1.5-4.5)

So, enzyme levels have come down but still elevated. Am I right in thinking that liver function looks ok though?

Should I do another 2-week stint of high K2 or just keep trying to increase the caffeine?
I’m doing 4-5mg K2 now, but probably not getting enough caffeine. I’m currently up to 300mg/day (200 in the am, 100 in the pm). I don’t get jittery or anxious with these dosages because I’m increasing pretty slowly, but I do get uncomfortably warm at times. Is the warmth considered a stress response or is it the thermogenic/uncoupling effect of caffeine? My temps are generally 98.6+ with pulse 85-90. Extremities are warm. I’m generally quite toasty these days.

Other things I’m taking that help the liver: cascara, vitamin A, E, B’s (especially thiamine), several grams of glycine throughout the day, a little taurine. Trying to get at least 80 grams protein.

Other items of note:
Glucose 101 - I was fasting, but this is the first time it’s ever been out of range
Total cholesterol 215
LDL 124 (was 131)
Triglycerides 115 (was 152)
Prolactin 7.7 (was 11.2)
TSH 5.19
Total t4 5.1
Total t3 136

My TSH crept up over the winter so I’m increasing thyroid supps. I have been feeling rather more fatigued lately, but my temps and pulse have been pretty good so I was surprised by this much of an increase. But now that I think of it, this is the first time I’ve ever gotten thyroid labs while fasting. Wouldn’t fasting cause higher cortisol, higher glucose, and higher TSH?

Anyway, I guess I’m looking for reassurance that I’m on the right track. Do I just need to be more patient or get more aggressive?

 

[haidut]

So last fall I discovered I had elevated liver enzymes. In January I did 2 weeks of high vitamin K2 (15mg) and started experimenting with caffeine. I tend to use the caffeine pills rather than coffee because it’s easier to track the dosage. I’m just now getting around to having labs done to check my progress (it was a rough winter/spring). Here are the results:

Alkaline phosphatase (39-117) 120, was 128
AST (0-40) 52, was 58
ALT (0-32) 72, was 93
GGT (0-60) 100, was 120
Bilirubin 0.3 (0.0-1.2)
Direct bilirubin 0.10 (0.00-0.40)
Albumin 4.6 (3.5-5.5)
Globulin 2.7 (1.5-4.5)

So, enzyme levels have come down but still elevated. Am I right in thinking that liver function looks ok though?

Should I do another 2-week stint of high K2 or just keep trying to increase the caffeine?
I’m doing 4-5mg K2 now, but probably not getting enough caffeine. I’m currently up to 300mg/day (200 in the am, 100 in the pm). I don’t get jittery or anxious with these dosages because I’m increasing pretty slowly, but I do get uncomfortably warm at times. Is the warmth considered a stress response or is it the thermogenic/uncoupling effect of caffeine? My temps are generally 98.6+ with pulse 85-90. Extremities are warm. I’m generally quite toasty these days.

Other things I’m taking that help the liver: cascara, vitamin A, E, B’s (especially thiamine), several grams of glycine throughout the day, a little taurine. Trying to get at least 80 grams protein.

Other items of note:
Glucose 101 - I was fasting, but this is the first time it’s ever been out of range
Total cholesterol 215
LDL 124 (was 131)
Triglycerides 115 (was 152)
Prolactin 7.7 (was 11.2)
TSH 5.19
Total t4 5.1
Total t3 136

My TSH crept up over the winter so I’m increasing thyroid supps. I have been feeling rather more fatigued lately, but my temps and pulse have been pretty good so I was surprised by this much of an increase. But now that I think of it, this is the first time I’ve ever gotten thyroid labs while fasting. Wouldn’t fasting cause higher cortisol, higher glucose, and higher TSH?

Anyway, I guess I’m looking for reassurance that I’m on the right track. Do I just need to be more patient or get more aggressive?

Liver numbers will get lower with vitamin K2, caffeine, magnesium, taurine, glycine, etc. Combining them all may work faster or may not. I have not seen studies on synergism, but since these substances tend to work on different mechanisms, they should help in combination. Usually, 5mg-15mg of vitamin K2 alone is enough to bring down liver numbers. Some people need 1-2 months for full effect and most doctors do not want to retest liver numbers anyways unless it has been at least 6 months form last check. So, you should be fine in a couple of more weeks as far as the liver is concerned. Given that your ALT and AST do not exceed 3 times the upper limit, most likely you just had slight fatty liver.
As far as the other numbers - yes, I do believe fasting tests will skew thyroid results and especially sugar. However, doctors (in USA) refuse to do otherwise. Since caffeine lowers TSH you can try increasing the dose slowly but make sure you don't over do it since it will trigger stress response and may set you back a bit.
Overall, it does seem like you are improving so keep up the good work.

 

[sweetpeat]

Overall, it does seem like you are improving so keep up the good work.

Ok, thanks for your insight. I'll keep plugging away. :)

 

[sweetpeat]

UPDATE

Updating this thread because I got recent lab work. It's taken about a year, but almost all my liver enzymes are now in the normal range. Here is a synopsis of the progression:

Alkaline phosphatase (39-117) 128=>120=>99
AST (0-40) 58=>52=>32
ALT (0-32) 93=>72=>46 (This one is still a bit out of range)
GGT (0-60) 120=>100=>58

It's interesting because soon after my initial post above, I dropped coffee/caffeine because it made me feel too hot in the warm weather. I've recently tried drinking a bit of coffee lately with the return of cooler weather, but find that it generally makes me sleepy. Maybe I should try it before bed as a sleep aid :)

Anyway, my point is that my liver enzymes have continued to fall since April with the use of relatively little caffeine. My K2 dosage is also pretty minimal – 1mg a few times a week (when I remember).
Would the high doses I took back in January still be having residual effects after all this time? Or are some of the other things I've been doing helped bring the enzymes down. These would include cascara, vitamins A and B's, glycine, taurine, thyroid.

I can't say as I've noticed anything different with lower enzymes. I do happen to know that I have pretty good t4 to t3 conversion. I had dropped my thyroid supps for about six weeks over the summer and when resuming them, I've found that I needed very little t3 (though that could change over the winter). I've been using mostly straight t4 at the moment, which I find a bit surprising.

I assume insulin resistance should be improved with a less fatty liver. What would be a good test for that – the A1c?

 

[Tarmander]

Nice work getting your numbers down!

I have found Taurine exceptional for liver health. I did about a month of high dose Taurine, as in 7-12g per day, and afterwards found all kinds of markers for liver health better. I could handle more caffeine, slept better, deeper voice, and felt less estrogenic/serotonin. These are all anecdotal, so take them for what they are worth, but I would not be surprised if your taurine supplementation was helping.

 

[sweetpeat]

post 113111 Nice work getting your numbers down!

I have found Taurine exceptional for liver health. I did about a month of high dose Taurine, as in 7-12g per day, and afterwards found all kinds of markers for liver health better. I could handle more caffeine, slept better, deeper voice, and felt less estrogenic/serotonin. These are all anecdotal, so take them for what they are worth, but I would not be surprised if your taurine supplementation was helping.

Thanks for the encouragement, Tarmander! I'm glad that taurine is doing good things for you. I've never taken nearly so much - maybe half a gram/day at the most. I read somewhere that it could be sedative at higher doses. Did you find that to be an issue?

 

[Tarmander]

post 113694

post 113111 Nice work getting your numbers down!

I have found Taurine exceptional for liver health. I did about a month of high dose Taurine, as in 7-12g per day, and afterwards found all kinds of markers for liver health better. I could handle more caffeine, slept better, deeper voice, and felt less estrogenic/serotonin. These are all anecdotal, so take them for what they are worth, but I would not be surprised if your taurine supplementation was helping.

Thanks for the encouragement, Tarmander! I'm glad that taurine is doing good things for you. I've never taken nearly so much - maybe half a gram/day at the most. I read somewhere that it could be sedative at higher doses. Did you find that to be an issue?

I actually could not tolerate it at lower doses. I tried to take small amounts for a little while and I literally felt like I was going insane, had insomnia... So I gave it another try a month later and just dived in with 5g and it did have a nice sedative effect. I could combine it pretty well with stimulants like MB and caffeine. The more I took it the less sedative it was though. I still take it whenever I take caffeine.

 

[NathanK]

This is great news! I found my liver health (though my enzymes were fine) improved even better after taking taurine and K2. I also did 2 weeks of milk thistle at 600mg/day and then 2 weeks of 5mg glycine+NAC to increase glutathione as Haidut had once posted before starting. To back up what Haidut said in an earlier post, I think I read a study where they measured the results of K2 after 3 months. So sometimes things just need time and perseverance.

Another thing of note is that my kidneys numbers surprisingly had the biggest improvement. At the time of starting all of this, I hadn't realized that those were some of the "sickest" lab numbers I had. Only after I noticed the jump did I look deeper into them and realize that my kidneys were at the bottom range of normal, which is close to fibrotic stage.

 

[tara]

post 113109 Maybe I should try it before bed as a sleep aid :)

:)

 

[honeybee]

When you take the Carlson k2 and caffeine, are you taking the 15 mg each time you take the caffeine?
For instance k2&caffeine together up to 3xs/day?
Or just once per day together? Just trying to clarify. Thx.
Also-anyone else experience k2 causing delayed sleep patterns or insomnia when taken later in day?

 

[sweetpeat]

When you take the Carlson k2 and caffeine, are you taking the 15 mg each time you take the caffeine?
For instance k2&caffeine together up to 3xs/day?
Or just once per day together? Just trying to clarify. Thx.
Also-anyone else experience k2 causing delayed sleep patterns or insomnia when taken later in day?

No, you don't have to take them at the same time. In fact, depending on your situation you could probably do one or the other instead of both. At the time, I thought my enzyme levels were rather high and so I was throwing everything at them. :) Turns out I only probably had a slightly fatty liver.
I did the high dosage of K2 for only 2 weeks and dosed it 3x/day. I did caffeine/coffee for about 5 months. If you want the references to the studies or more detailed information, you could do a search for posts by haidut on K2 and caffeine for liver health.

I don't remember if the K2 affected my sleep.

 

[sweetpeat]

This is great news! I found my liver health (though my enzymes were fine) improved even better after taking taurine and K2. I also did 2 weeks of milk thistle at 600mg/day and then 2 weeks of 5mg glycine+NAC to increase glutathione as Haidut had once posted before starting. To back up what Haidut said in an earlier post, I think I read a study where they measured the results of K2 after 3 months. So sometimes things just need time and perseverance.

Another thing of note is that my kidneys numbers surprisingly had the biggest improvement. At the time of starting all of this, I hadn't realized that those were some of the "sickest" lab numbers I had. Only after I noticed the jump did I look deeper into them and realize that my kidneys were at the bottom range of normal, which is close to fibrotic stage.

Oh, I forgot about NAC! I did take some of that for about 3months in late spring. I was getting a little wheeziness at the end of my exhalations (due to allergies, I assume) and find it helps with that. But it can be good for the liver too, I guess?

That's interesting about your kidneys. I've been so focused on my liver and thyroid that I haven't given much thought to other things like kidneys. Sometimes I notice little twinges “back there” where I imagine my kidneys to be. Nothing painful, more like a tingle every now and then. If it isn't too much trouble, what are good lab numbers for healthy kidney function?

 

[DaveFoster]

Liver numbers will get lower with vitamin K2, caffeine, magnesium, taurine, glycine, etc. Combining them all may work faster or may not. I have not seen studies on synergism, but since these substances tend to work on different mechanisms, they should help in combination. Usually, 5mg-15mg of vitamin K2 alone is enough to bring down liver numbers. Some people need 1-2 months for full effect and most doctors do not want to retest liver numbers anyways unless it has been at least 6 months form last check. So, you should be fine in a couple of more weeks as far as the liver is concerned. Given that your ALT and AST do not exceed 3 times the upper limit, most likely you just had slight fatty liver.
As far as the other numbers - yes, I do believe fasting tests will skew thyroid results and especially sugar. However, doctors (in USA) refuse to do otherwise. Since caffeine lowers TSH you can try increasing the dose slowly but make sure you don't over do it since it will trigger stress response and may set you back a bit.
Overall, it does seem like you are improving so keep up the good work.

You've also said pregnenolone lowers liver enzymes, but would the effect be linear, as in would 1 gram of pregnenolone lower AST and ALT more than 500 mg?

 

[haidut]

You've also said pregnenolone lowers liver enzymes, but would the effect be linear, as in would 1 gram of pregnenolone lower AST and ALT more than 500 mg?

In higher doses, pregnenolone's effects tend to be mostly anti-inflammatory.
Pregnenolone (and DHEA) May Protect From Heart Disease
If the liver issue is caused by inflammation then higher doses may be more beneficial but many of pregnenolone's other beneficial effects come from conversion into progesterone, allopregnanolone and DHEA. And for optimal steroidogenesis it seems lower doses pregnenolone may be better. Anyways, this has not really been tested yet so I don't know. Maybe somebody with elevated liver enzymes can try higher doses and report. Pregnenolone is after all a mostly saturated lipid so may have direct benefits for liver similar to other SFA Peat has mentioned in regards to liver disease.

 

[DaveFoster]

In higher doses, pregnenolone's effects tend to be mostly anti-inflammatory.
Pregnenolone (and DHEA) May Protect From Heart Disease
If the liver issue is caused by inflammation then higher doses may be more beneficial but many of pregnenolone's other beneficial effects come from conversion into progesterone, allopregnanolone and DHEA. And for optimal steroidogenesis it seems lower doses pregnenolone may be better. Anyways, this has not really been tested yet so I don't know. Maybe somebody with elevated liver enzymes can try higher doses and report. Pregnenolone is after all a mostly saturated lipid so may have direct benefits for liver similar to other SFA Peat has mentioned in regards to liver disease.

That's interesting. While taking large amounts of pregnenolone (probably averaging around a couple grams daily), some K2 and coffee with some vitamin E and Energin (B-vitamins), I increased my cyproheptadine dosage (to very high amounts) and added in the maximum dosage of mirtazapine (45 mg, also known to elevate AST and ALT) without any changes in AST and ALT at all, where they remained around a lab value of 60 for each.

 

[FitnessMike]

I actually could not tolerate it at lower doses. I tried to take small amounts for a little while and I literally felt like I was going insane, had insomnia... So I gave it another try a month later and just dived in with 5g and it did have a nice sedative effect. I could combine it pretty well with stimulants like MB and caffeine. The more I took it the less sedative it was though. I still take it whenever I take caffeine.

whats MB?

 

[milkboi]

whats MB?

methylene blue

 

[FitnessMike]

No, you don't have to take them at the same time. In fact, depending on your situation you could probably do one or the other instead of both. At the time, I thought my enzyme levels were rather high and so I was throwing everything at them. :) Turns out I only probably had a slightly fatty liver.
I did the high dosage of K2 for only 2 weeks and dosed it 3x/day. I did caffeine/coffee for about 5 months. If you want the references to the studies or more detailed information, you could do a search for posts by haidut on K2 and caffeine for liver health.

I don't remember if the K2 affected my sleep.

how can you possibly take 15mg of k2mk4 if they sell it in 100mcg capsules

Liver numbers will get lower with vitamin K2, caffeine, magnesium, taurine, glycine, etc. Combining them all may work faster or may not. I have not seen studies on synergism, but since these substances tend to work on different mechanisms, they should help in combination. Usually, 5mg-15mg of vitamin K2 alone is enough to bring down liver numbers. Some people need 1-2 months for full effect and most doctors do not want to retest liver numbers anyways unless it has been at least 6 months form last check. So, you should be fine in a couple of more weeks as far as the liver is concerned. Given that your ALT and AST do not exceed 3 times the upper limit, most likely you just had slight fatty liver.
As far as the other numbers - yes, I do believe fasting tests will skew thyroid results and especially sugar. However, doctors (in USA) refuse to do otherwise. Since caffeine lowers TSH you can try increasing the dose slowly but make sure you don't over do it since it will trigger stress response and may set you back a bit.
Overall, it does seem like you are improving so keep up the good work.

Can you overdose vit k2mk4 eventually?

 

[sweetpeat]

how can you possibly take 15mg of k2mk4 if they sell it in 100mcg capsules?

I never said I was taking 100mcg capsules. At the time of my original post I was using Thorne vit K drops. Each drop=1mg. This was the product: https://www.amazon.com/gp/product/B000FGWDTK/ref=ppx_yo_dt_b_search_asin_title?ie=UTF8&psc=1

I now use vitamin K from Health Natura: healthnatura.com/true-k2-mk4-1-mg-per-drop-1-ounce/
It also delivers 1mg per drop and is cheaper than the Thorne brand.