How is the liver toxicity? Is it as bad as it’s reputation?
Doing 20mg E3D. Can’t get smaller gelcaps.
No, risk is FAR lower than it was initially feared 40 years ago, and unless you start with preexisting liver problems the chance of liver injury is near nil.
Liver enzymes will rise slightly, and I personally think it’s a good idea to avoid additional liver stress from heavy drinking or high dose oral anabolic steroid use, but many derms stopped routine liver tests, just checking once prior to initiation to make sure there isn’t undiagnosed liver disease.
The increase in liver enzymes is typically 10-15%, much lower than many over the counter supplements.
The number of people who see enzymes rise to 3x the upper limit of normal, which is the threshold it’s recommended usage stop, is 0.2%.
Actual reported cases of hepatitis or other serious liver problems can be counted on your fingers. That’s out of tens of millions of patients over nearly 50 years.
So if you want to be as safe as possible , take a baseline blood test to make sure you’re starting with normal liver function (AST/ALT/GGT), then check again 4-8 weeks after starting. If it’s 15% or less higher than baseline, you’re fine. You can reassure yourself by checking again 8 weeks after stopping.
The only serious risk is to pregnant (or who might become) pregnant women. Isotretinoin will cause severe birth defects. (This is only during development, not some genetic change that continues after you stop taking it and it’s completely cleared from your system within a couple of months).
If you aren’t aware, Isotretinoin is essentially a super-potent form of vitamin A. (And you should stop supplementing Vitamin A while on it btw).
