Increased aspirate aminotransferase (AST)?

I’m about 6 weeks in on rapamycin, first 4 at 5mg/week, now doing 6mg/week with grapefruit juice. Did some labs today and saw a big spike in one of my liver enzymes, AST, from 39 in January to 73 today. ALT is down from 35 to 29.

Has anyone else seen this?

I haven’t seen it before, but thats a pretty big jump… from 5mg/wk to 6mg W/GFJ - which is equivalent to 18 to 20+mg…

I would suggest you may want to slow down on the rapid increases. I’ve found slow increases have yielded the best results for me, at least.

Did you have a recent heavy workout, take a dose of acetaminophen or have alcohol the night before the blood test? If so, I’d point to that before suspecting the rapamycin.

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Hmm. I’ve been on a 2 week break from working out, never take acetaminophen, and while I don’t often drink, I did have several cocktails - maybe 7 over the course of a long party - 5 days prior. No alcohol since. Possible my liver enzymes were still affected by that?

Maybe? I’d ask your doc to let you recheck them in a couple of weeks to see.

Normally, I’ve seen liver enzymes go down with the introduction of Rapamycin. My own markers and postings from others on several forums.

Liver enzymes can go wonky with dietary interventions, especially alcohol. I don’t normally measure AST in my panels, but my GGT rockets if I have some sustained alcohol, takes a while to come down. Even after quitting most all alcohol consumption, my GGT sort of flatlined for a while. Only after starting Rapamycin did it drop significantly, including ALT/ALP/URIC acid, and my eGFR increased.

Separately, I’ve found many references of AST going up with high doses of Rapamycin. I am referring to transplant/cancer scenario, daily dosing, high therapeutic doses. Dosen’t sound like you’re anywhere near this type of chronic dosing.

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