From the Guidelines
Adderall can potentially affect AST (aspartate aminotransferase) levels in some individuals, and regular monitoring of liver function is recommended for patients on Adderall therapy, especially those with pre-existing liver conditions or who take other medications that affect the liver. While not common, Adderall may cause elevations in liver enzymes including AST, particularly with long-term use or higher doses. This effect is generally mild and transient in most cases. The mechanism behind this effect involves the stimulant properties of amphetamines in Adderall, which can alter liver metabolism and potentially cause stress on liver cells, leading to the release of enzymes like AST into the bloodstream. Patients taking Adderall should be aware of symptoms that might indicate liver issues, such as yellowing of the skin or eyes, dark urine, upper right abdominal pain, or unusual fatigue. If you're taking Adderall and concerned about liver function, it's essential to follow your healthcare provider's recommendations for periodic blood tests to monitor liver enzymes, including AST, as suggested by recent guidelines 1.
Key Considerations
- Regular monitoring of liver function is crucial for patients on Adderall therapy, especially those with pre-existing liver conditions or who take other medications that affect the liver.
- Adderall may cause elevations in liver enzymes, including AST, particularly with long-term use or higher doses.
- Patients should be aware of symptoms that might indicate liver issues and follow their healthcare provider's recommendations for periodic blood tests to monitor liver enzymes.
Monitoring and Management
According to recent guidelines 1, monitoring of liver tests and detection of drug-induced liver injury (DILI) is essential in patients with nonalcoholic steatohepatitis (NASH). The guidelines suggest that treatment-emergent ALT values exceeding 3× ULN should trigger close observation and workup for likely causes of hepatic injury other than the study drug. In patients with elevated baseline ALT levels, a cut-off value of >2× baseline may be more appropriate for suspecting DILI.
Recommendations
Regular monitoring of liver function and prompt reporting of any symptoms that might indicate liver issues are crucial for patients taking Adderall. Healthcare providers should follow the guidelines for monitoring and managing potential liver injury in patients on Adderall therapy, as outlined in recent studies 1.
From the Research
Aspartate Aminotransferase (AST) Levels and Adderall
There is no direct evidence in the provided studies to suggest that Adderall (amphetamine and dextroamphetamine) affects Aspartate Aminotransferase (AST) levels.
AST Levels in Various Conditions
- AST is a biomarker for liver damage, but it is also present in cardiac and skeletal muscle and in erythrocytes, making it less specific for liver damage than Alanine Aminotransferase (ALT) 2.
- Elevated AST levels have been reported in patients with anorexia nervosa, binge eating disorder, and bulimia nervosa, and may be associated with body mass index and psychopathological features 3.
- AST levels can also be elevated in cases of acetaminophen overdose, and the kinetics of AST and ALT release into and disappearance from the circulation have been studied in this context 4.
- AST is useful in the differential diagnosis of various liver diseases, and the ratio of AST to ALT provides additional clinical insight 5.
- AST is also useful in the diagnosis or estimation of severity of myocardial infarction, and the mitochondrial isoenzyme of AST has a growing significance in the diagnosis of alcoholism and other conditions 5.
Monitoring and Interpretation of AST Levels
- The normal ALT level ranges from 29 to 33 IU/L in males and 19 to 25 IU/L in females, but the normal range for AST is not specified in the provided studies 6.
- Elevated AST levels require further investigations, including testing for viral hepatitis, assessment for nonalcoholic fatty liver disease and alcoholic liver disease, screening for autoimmune hepatitis, and exclusion of hepatotoxic drug consumption 6.