Hi Jutka
I’m not on this same medication as you are so not much assistance to answering your query .
Diane

My ALT went as high as 157 (61 ULN), AST went to 94 (ULN 37). ALK went to 211 (ULN 117). We paid attention and monitored. We did decide to hold off on any dose increase even though HCT had crept up above 45%. Was taking 150mcg. I would have preferred to increase the dose but opted for a phlebotomy, the first in 2.5 years.

Fortunately, I consult with a MPN specialist who is more familiar with prescribing the interferons. Note that many hematologists have very little experience with MPNs and monitoring patients on the MPN treatments.

FYI - many supplements are worthless. It is important to use reliable sources. I was prescribed Silymarin 500mg 1x/day. It is made by Pure Encapsulations and is relatively easy to find. I use on on-line pharmacy. It is important to consult with a medical provider who is knowledgeable about complementary health. That is why I consult with an Integrative Medicine doc.

The Besremi label permits ALT/AST to go up to 5x/upper limit of normal before suspending Besremi, unless there is concomitant bilirubin elevation of other signs of liver dysfunction.
https://www.accessdata.fda.gov/drugsatfda_docs/...

At one point, my ALT/AST/ALK were 3X ULN. This was not regarded as a reason to eliminate or reduce the Besremi dose. I did consult with my Integrative Medicine doc. She recommended a Milk Thistle Extract that support liver function in people on chemo. My ALT/AST/ALK returned to the normal range within a few weeks.

Not sure what your LFTs actually are. Suggest reviewing the Besremi label and comparing your current status with the recommendations.

Wonderful thanks Steve I will purchase online! Sounds very promising! Hugs Jutka 💖

Oh wow thanks! Mine are 125 UI/L and hematologist said they were 20 before I started. However will definitely ask her again and thanks for the milk thistle extract.
Lots of hugs Jutka