As a general rule, as long as the liver enzymes levels do not exceed 2-3 times the upper limit of the normal range (which is between 11 and 45 in most labs), then the treatment can be kept the same. To achieve better outcomes, many many doctors choose to combine statins with fibrates, in order to mitigate the liver damage induced by statins.
The reason I asked about the SGOT level is for two purposes:
1- in general, we obtain a baseline of your SGOT (or AST) and SGPT (or ALT) levels prior to initiating statin therapy, to make sure you do not have any fatty liver disease (and by that I do not mean fat on the outside of the liver, but fat inside the liver cells) due to the elevated cholesterol in the blood. Fatty liver is a build-up of fat in the liver cells, usually related to medication, obesity, alcohol intake, starvation (severe weight loss), diabetes, or high blood triglycerides.
I do not know if you have had any of these issues in your medical history.
2- The alanine aminotransferase (ALT) is another liver marker. We usually begin testing within 6 weeks of the onset of therapy and continue testing routinely, based on the patient's response and other therapies employed. The AST test is the most sensitive marker of the impact of statins and other lipid-lowering medications. AST should not be elevated more than 2-3 times the upper limit of normal. ALT, though less sensitive to statin impact, it is excellent as an evaluation of fatty liver. Additionally, we look at the AST/ALT (or SGOT/SGPT) ratio: alcohol is one of the most important offending agent for liver, and typically causes a rise in SGOT which is more than SGPT (SGOT/SGPT ratio is more than 2).
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