My son is 11 years old and has been on remicade and oral methotrexate now for 1 year. He initially started on 6MP but changed meds due to diagnosis of JSpA. He's had fluctuations in his ALT since the start of 6MP, and continued even with the med change. Rheumatologist decreased the methotrexate dose but no change with the ALT. His range has been 40s-70s. Now GI wants to check him for NAFLD (non-alcoholic fatty liver disease). Does anyone have any experience with this?
Elevated ALT
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crohnsinct
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Yes. Not my Crohnies but my husband, mother AND father.
Hubby because of his weight and diabetes
Mother - has autoimmune hepatitis
Father - normal weight no clue how he got it
If you catch it early and can stop the spreading it is pretty harmless.
They are trying to develop drugs to treat it but for the most part right now they just try to control it with managing the offender.
In most cases (because most are diabetic or weight related) they recommend a HEALTHY diet...plant based. My dad (normal weight) did that and totally reversed the damage.
For my mom on aza for her AIH, they just watch and monitor and try to change drug levels.
Hubby - doesn't listen to a thing anyone says so.....
Don't get ahead of yourself. Wait for results. But a healthier diet now never hurt anyone
Hubby because of his weight and diabetes
Mother - has autoimmune hepatitis
Father - normal weight no clue how he got it
If you catch it early and can stop the spreading it is pretty harmless.
They are trying to develop drugs to treat it but for the most part right now they just try to control it with managing the offender.
In most cases (because most are diabetic or weight related) they recommend a HEALTHY diet...plant based. My dad (normal weight) did that and totally reversed the damage.
For my mom on aza for her AIH, they just watch and monitor and try to change drug levels.
Hubby - doesn't listen to a thing anyone says so.....
Don't get ahead of yourself. Wait for results. But a healthier diet now never hurt anyone
Thank you for your replies. My son is a little overweight although he eats very healthy and no he is not diabetic. He is 119 pounds and 5 feet tall. He was never overweight in the past but after taking prednisone a couple years ago he gained 30 pounds in 1 month (went from 70 to 100 pounds). So from 2016 til now he has gained 19 pounds. It’s hard not to worry about everything but I’ll just have to wait and see how his blood work comes out.
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I would talk to your pediatrician about his weight or you can ask your GI if you can see a dietician. Sometimes kids suddenly shoot up and their weight gain evens out. But sometimes they don't, and you don't want to see an overweight child become an overweight adult. It's easier to fix now (when you control what he eats) than to fix it later.
I say this with compassion because my own daughter gained a LOT of weight very suddenly, while on Prednisone. It was a real shock to us, especially since she had been naturally very thin her whole life (and had been underweight for the last 3-4 years, though she had gained and was at her "normal" weight when this happened).
She was not an unhealthy eater and certainly not a big eater. So it was not a calorie issue. Several endocrinologists laters, she was diagnosed with Cushing's syndrome, which can occur due to long-term steroid use. It left her with the puffy steroid face, dark purple stretch marks and an almost 30 lb weight gain.
Anyway, she has lost about half of it now. Even though she wasn't an unhealthy eater, she did have to change her diet. She did have to count calories and make a real effort to lose weight. And though the doctors said again and again that over time she would lose it all naturally (without dieting), she did not.
The puffy face took about 8 months to lose and now the stretch marks are fading. But 1.5 years later, I'm not sure she will ever get back to her old "normal" weight. However, she is a healthy weight and looks great. But it took a lot of work to get here!
All her doctors that we saw about this - multiple endocrinologists, rheumatologist and GI - encouraged exercise to lose the weight and she is trying to increase that but her AS makes that hard. But she can bike and swim, so she tries to do something every day.
I don't mean your kiddo has Cushing's Syndrome or anything like that (M was on and off steroids a LOT - about she was on them for about 6 months every year for 6 years and received many IV steroids and steroid injections in her joints because of the severe AS).
But he does have spondyloarthritis and extra weight will hurt his joints, over the long-term. There are even studies that show that anti-TNFs work less well on obese or overweight patients with spondyloarthritis or AS. And, as we learned, not every kid will automatically lose the weight that they gain with Prednisone (though many do - both my daughters always did prior to the Cushing's). Some kids have to work at it.
He may not even need a diet or anything like that - maybe just increasing his physical activity would help (and exercise is absolutely necessary with spondyloarthritis!!). And he is growing so it may naturally even out. But it's a good thing to get on top of early, so it's worth discussing with your doctors.
I say this with compassion because my own daughter gained a LOT of weight very suddenly, while on Prednisone. It was a real shock to us, especially since she had been naturally very thin her whole life (and had been underweight for the last 3-4 years, though she had gained and was at her "normal" weight when this happened).
She was not an unhealthy eater and certainly not a big eater. So it was not a calorie issue. Several endocrinologists laters, she was diagnosed with Cushing's syndrome, which can occur due to long-term steroid use. It left her with the puffy steroid face, dark purple stretch marks and an almost 30 lb weight gain.
Anyway, she has lost about half of it now. Even though she wasn't an unhealthy eater, she did have to change her diet. She did have to count calories and make a real effort to lose weight. And though the doctors said again and again that over time she would lose it all naturally (without dieting), she did not.
The puffy face took about 8 months to lose and now the stretch marks are fading. But 1.5 years later, I'm not sure she will ever get back to her old "normal" weight. However, she is a healthy weight and looks great. But it took a lot of work to get here!
All her doctors that we saw about this - multiple endocrinologists, rheumatologist and GI - encouraged exercise to lose the weight and she is trying to increase that but her AS makes that hard. But she can bike and swim, so she tries to do something every day.
I don't mean your kiddo has Cushing's Syndrome or anything like that (M was on and off steroids a LOT - about she was on them for about 6 months every year for 6 years and received many IV steroids and steroid injections in her joints because of the severe AS).
But he does have spondyloarthritis and extra weight will hurt his joints, over the long-term. There are even studies that show that anti-TNFs work less well on obese or overweight patients with spondyloarthritis or AS. And, as we learned, not every kid will automatically lose the weight that they gain with Prednisone (though many do - both my daughters always did prior to the Cushing's). Some kids have to work at it.
He may not even need a diet or anything like that - maybe just increasing his physical activity would help (and exercise is absolutely necessary with spondyloarthritis!!). And he is growing so it may naturally even out. But it's a good thing to get on top of early, so it's worth discussing with your doctors.
Last edited:
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My two cents
Since he is 11
Most boys will pack on the weight prior to growth spurts
Especially at ages 11-15.
It very common and expected
My oldest non ibd kiddo gained 50 lbs in 6 months
Looked very over weight
Then proceeded to growth 7 inches after 4 months at the overweight mark
Boys turning to men
Do not need to diet
Their extra weight - turns to muscle quickly since they have a boost in testosterone levels
Second kiddo woth ibd
Similar 25 lbs gained - waited and waited
Off steriods
Grew 5 inches
Gained another 20 lbs recently
Per Endo they expect another 5 inches
11 is the wrong age to stress over weight in a boy
They finish up growing close to 17/18
So if yours hasn’t hit puberty by then
Then Endo is involved anyways
Also note growing kids are NEVER recommended to lose weight
Even if they are very overweight
Most are told to try to not gain anymore weight
Remember kids especially pre teens /teens are growing gaining machines in puberty
Their bodies are designed to do this
Young adults are different their bodies have stopped growing and most of the extra weight turns into fat not muscle so losing weight is much more difficult especially for girls
A female body is designed to keep weight on to protect the species so to speak
Diet in an 11 year old will only cause food issues later in life
Since he is 11
Most boys will pack on the weight prior to growth spurts
Especially at ages 11-15.
It very common and expected
My oldest non ibd kiddo gained 50 lbs in 6 months
Looked very over weight
Then proceeded to growth 7 inches after 4 months at the overweight mark
Boys turning to men
Do not need to diet
Their extra weight - turns to muscle quickly since they have a boost in testosterone levels
Second kiddo woth ibd
Similar 25 lbs gained - waited and waited
Off steriods
Grew 5 inches
Gained another 20 lbs recently
Per Endo they expect another 5 inches
11 is the wrong age to stress over weight in a boy
They finish up growing close to 17/18
So if yours hasn’t hit puberty by then
Then Endo is involved anyways
Also note growing kids are NEVER recommended to lose weight
Even if they are very overweight
Most are told to try to not gain anymore weight
Remember kids especially pre teens /teens are growing gaining machines in puberty
Their bodies are designed to do this
Young adults are different their bodies have stopped growing and most of the extra weight turns into fat not muscle so losing weight is much more difficult especially for girls
A female body is designed to keep weight on to protect the species so to speak
Diet in an 11 year old will only cause food issues later in life
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