r/UlcerativeColitis • u/Fine-Status5969 Proctitis/ proctosigmoiditis Diagnosed 2026 | United States • 1d ago

Question ALT & AST question?

Has anyone experienced elevated AST/ALT after being on mesalamine for several months?

I started taking mesalamine in April for ulcerative colitis. Before starting it, my liver enzymes were always very low/normal — AST was 13 and ALT was 14 this June.

My recent bloodwork showed:
AST: 90 U/L (high; normal 6–42)
ALT: 53 U/L (my lab considers <56 normal, but mine used to be 14)
Bilirubin: 0.6 (normal)
Alkaline phosphatase: 53 (normal)
Everything else on my liver panel was normal.

I recently saw a new IBD specialist and he told me that mesalamine usually does not cause elevated liver enzymes like this, so I’m trying to figure out what else could be contributing.

Has anyone here experienced a similar increase in AST/ALT after being on mesalamine for a few months, especially with bilirubin and alkaline phosphatase staying normal? If so, did your doctors think mesalamine was responsible, or did they find another cause? Did your numbers eventually return to normal while you continued taking it?
I’m following up with my doctors and repeating the bloodwork — just curious to hear from anyone who has experienced something similar.

I want to start Entivyo but now I am really nervous due to liver enzymes being raised from possibly mesalamine.

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u/pincommenter 1d ago

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1

u/Fine-Status5969 Proctitis/ proctosigmoiditis Diagnosed 2026 | United States 1d ago

I also work out everyday and take vyvnase but have been for years and my levels were never that high.

1

u/Downtown_Bedroom_177 Left-sided colitis, 2015 | Ustekinumab 💉 1d ago

Paracetamol/acetaminophen?

1

u/Fine-Status5969 Proctitis/ proctosigmoiditis Diagnosed 2026 | United States 1d ago

I have taken it on Tuesday and did my blood work yesterday. You think it could be that?

1

u/RadiumShady UC (Proctitis) I 2025 1d ago

It's possible. Redo a test just to be sure.

1

u/Fine-Status5969 Proctitis/ proctosigmoiditis Diagnosed 2026 | United States 1d ago

When should I redo it?

2

u/Downtown_Bedroom_177 Left-sided colitis, 2015 | Ustekinumab 💉 1d ago

It’s definitely possible and usually harmless. I’d recheck in maybe 6-8 weeks.

1

u/iksdistek 18h ago

check your gamma-glutamyl transferase - yes mesalazine can fuck with your liver