What causes high liver enzymes? What are the symptoms of elevated liver enzyme levels? Learn about the normal range, risk factors, and treatment options for dealing with dangerous liver enzyme levels.

Exploring the Power of Liver Enzymes

The liver is a remarkable organ, responsible for a vast array of critical functions within the human body. From fighting disease and infection to removing toxins and converting the food we consume into energy, the liver is truly a powerhouse. Enabling these essential tasks are a group of specialized chemicals known as enzymes. These enzymes facilitate and accelerate the chemical reactions that the liver carries out, allowing it to perform at its optimal level.

However, when these enzyme levels become elevated, it is a clear sign that damage or inflammation has occurred within the liver. Left unchecked, this can lead to serious and potentially fatal consequences. Understanding the causes, symptoms, and treatments for elevated liver enzymes is crucial for maintaining overall health and wellbeing.

Causes of High Liver Enzymes

There are several common causes that can lead to elevated liver enzyme levels. Some of the most prominent include:

• Fatty Liver Disease: This condition, often linked to obesity and diabetes, results in the buildup of excess fat in the liver, which can cause inflammation and cell damage.
• Hepatitis: Viral infections that target the liver, such as Hepatitis A, B, or C, can cause inflammation and elevated enzyme levels.
• Drug or Alcohol Abuse: Excessive consumption of alcohol or certain medications can be highly toxic to the liver, leading to enzyme elevation.
• Metabolic Syndrome: This cluster of conditions, including high blood pressure, high blood sugar, and abnormal cholesterol levels, can contribute to liver damage.
• Cirrhosis: This chronic liver condition, often caused by long-term alcohol abuse or chronic viral hepatitis, can lead to scarring and impaired liver function.

While some of these causes may indicate severe, chronic liver conditions, elevated enzyme levels are not always a sign of a serious underlying issue. Many times, these levels are only temporarily elevated and will return to healthy ranges once the underlying cause is addressed and treated.

Symptoms of Elevated Liver Enzymes

Interestingly, elevated liver enzyme levels do not immediately cause any noticeable signs or symptoms to develop. However, the underlying condition that is causing the enzyme elevation often will. Some of the most common symptoms associated with liver disease include:

• Jaundice: Yellowing of the skin and the whites of the eyes.
• Dark Urine: A telltale sign of liver dysfunction.
• Abdominal Swelling or Pain: As the liver becomes inflamed or damaged.
• Fatigue: A general feeling of tiredness and lack of energy.
• Loss of Appetite: Difficulty or disinterest in eating.
• Joint Pain: Inflammation in the joints, a common symptom of liver disease.
• Muscle Soreness: Liver damage can also lead to muscle aches and pains.
• Itchy Skin: A common complaint among those with liver issues.

It’s important to note that the presence of these symptoms does not necessarily indicate elevated liver enzymes. However, if you are experiencing any of these signs, it is crucial to consult with a healthcare provider for proper diagnosis and treatment.

Risk Factors for Elevated Liver Enzymes

The risk factors for elevated liver enzymes are closely tied to the underlying causes of liver disease. While some liver conditions may have hereditary or environmental factors, many are closely linked to lifestyle habits. The foods you consume, the chemicals you are exposed to, and your overall health and wellness all play a significant role in the health of your liver.

Some of the most common risk factors for elevated liver enzymes include:

• Excessive Alcohol Use: Consuming more than two drinks per day for men or one drink per day for women, according to CDC guidelines.
• Overweight or Obesity: Generally defined as having a BMI of over 25 for adults.
• Family History of Liver Disease: Genetic predisposition can increase the risk of certain liver conditions.
• Prediabetes or Diabetes: These metabolic disorders can contribute to liver damage.

By recognizing and addressing these risk factors, individuals can take proactive steps to protect the health of their liver and prevent the development of elevated enzyme levels.

Diagnosis and Treatment for High Liver Enzymes

Elevated liver enzymes are typically detected through routine blood tests, which check for abnormal levels of specific enzymes, including:

• Alanine Transaminase (ALT): Also known as SGPT, this enzyme is primarily found in the liver.
• Aspartate Transaminase (AST): Also known as SGOT, this enzyme is found in the liver, heart, and other tissues.
• Alkaline Phosphatase (ALP): This enzyme is present in the liver, bones, and bile ducts.
• Gamma-Glutamyl Transpeptidase (GGT): This enzyme is found in the liver and bile ducts.

If your healthcare provider determines that you have elevated liver enzymes, they will likely recommend additional tests to identify the underlying cause. Once the root issue has been determined, an appropriate treatment plan can be developed.

Treatments for high liver enzymes typically focus on addressing the underlying condition. This may include:

• Adopting a Healthy Diet and Exercise Regimen: This can help prevent or reduce conditions like obesity and metabolic syndrome, which can contribute to liver damage.
• Reducing or Avoiding Alcohol and Drug Intake: Limiting the consumption of substances that are harmful to the liver can help improve enzyme levels.
• Adjusting Medications: If certain prescription or over-the-counter drugs are causing liver inflammation, your healthcare provider may recommend alternative treatments.
• Managing Blood Sugar Levels: Keeping blood sugar within healthy ranges is especially important for individuals with diabetes or metabolic syndrome.

By working closely with a healthcare provider to address the underlying cause of elevated liver enzymes, individuals can take the necessary steps to bring their enzyme levels back within the normal range and maintain overall liver health.

Seeking Professional Support

If you are concerned about your liver enzyme levels or are experiencing any symptoms of liver disease, it is important to seek medical attention. The team of certified nurse practitioners at Nurse Practitioners of Florida are dedicated to providing personalized, compassionate care to help you manage your health and wellbeing.

Whether you need routine blood screenings, guidance on managing elevated liver enzymes, or any other acute or preventive medical services, our team is here to support you. Contact us today to schedule an appointment and take the first step towards a healthier liver and a healthier you.

What Causes Elevated Liver Enzymes?

Your liver is truly a powerhouse of an organ. It helps your body fight disease and infection, removes toxins, creates energy from the foods you eat, and so much more. Behind the scenes, helping the liver perform all of these critical functions are enzymes. These chemicals enable and accelerate the chemical reactions that your liver carries out as it works to keep your body healthy. When these enzyme levels become elevated, however, it means that damage has occurred in your liver. Left unchecked, this can lead to serious — and even fatal — consequences.

Causes of High Liver Enzymes

Elevated liver enzymes is a sign that something has caused damage or inflammation to occur within your liver. The most common causes of high liver enzyme levels are:

• Fatty liver disease
• Hepatitis
• Drug or alcohol abuse
• Certain prescription and over-the-counter medications
• Metabolic syndrome
• Cirrhosis

While some of the causes of elevated liver enzymes can be chronic, severe liver conditions, that’s not always the case. Many times levels are only temporarily elevated and will return to healthy levels once the underlying cause is treated.

Symptoms of Elevated Liver Enzymes

High liver enzyme levels don’t immediately cause any signs or symptoms to develop, but the underlying condition often will. Common symptoms of liver disease include:

• Jaundice – yellowing of the skin and whites of eyes
• Dark urine
• Abdominal swelling/pain
• Fatigue
• Low appetite
• Joint pain
• Muscle soreness
• Itchy skin

Risk Factors for Elevated Liver Enzymes

The risk factors for elevated liver enzymes are really risk factors for liver disease. While some liver conditions may be hereditary or environmental, many are brought on by lifestyle habits. The food and chemicals you put into your body all have an effect on your liver, and can lead to varying levels of liver damage and deterioration. Some of the most common risk factors include:

• Excessive alcohol use – more than two drinks a day for men, or one for women, according to CDC guidelines
• Overweight / Obesity – generally defined as having a BMI of over 25 for adults
• Family history of liver disease
• Have prediabetes or diabetes

Diagnosis & Treatment for High Liver Enzymes

Elevated liver enzymes are detected through regular blood tests. These tests usually check for elevated levels of:

• Alanine transaminase (ALT)
• Aspartate transaminase (AST)
• Alkaline phosphatase (ALP)
• Gamma-glutamyl transpeptidase (GGT)

If your healthcare provider determines that you have elevated liver enzymes, they will probably want to run other tests to get to the root of the underlying issue. Only once that is determined can an effective treatment plan be created.

High Liver Enzymes Treatment

Lowering high liver enzyme levels will depend on the underlying cause, but in most cases these levels can be brought back within healthy limits and are not indicative of a chronic, severe liver condition. Some possible treatment options include:

• Healthy diet and exercise – this not only will help prevent or reduce overweight/obesity, it will boost your overall health, including that of your internal organs
• Reducing or avoiding drug/alcohol intake – since these substances can be especially harmful to your liver, keeping consumption levels to healthy limits (or avoiding them altogether) will certainly improve your liver health
• Adjusting medications – some prescription and over-the-counter medicines can cause inflammation of the liver. If your medication regimen is causing liver inflammation or damage, your doctor will work with you to create a safer treatment plan
• Manage blood sugar – this is especially important for diabetics and those suffering from metabolic syndrome. Keeping blood sugar within healthy levels can prevent the underlying conditions from causing additional liver damage

If You Need Blood Screenings or Help Managing Elevated Liver Enzymes, Nurse Practitioners of Florida Can Help

At Nurse Practitioners of Florida, we have a dedicated team of certified nurse practitioners who have an unwavering commitment to providing you with care and compassion. When you call any of our locations, you will be greeted by a live person who’s ready to offer acute medical care as well as preventive measures — including flu vaccines. And, above everything else, you will be treated like family.

If you need assistance, call us or fill out our online contact form.

danger level of sgpt and sgot – 9itl48ux0p

2 mins

• 1 sgpt and sgot risk level
  • 1.1 Elevated liver enzymes – Mayo Clinic
  • 1.2 AST (SGOT) Blood Test High and Low Levels and What They Do …
  • 1.3 SGPT and SGOT risk level – Different range and symptoms
  • 1. 4 SGPT and SGOT Risk Level – Symptoms & Treatment – HexaHealth
  • 1.5 Liver blood tests (normal high and low levels) Symptoms …
  • 1.6 High SGOT and SGPT levels – Symptoms prompt the diagnosis of …
  • 1.7 SGPT & SGOT Test Normal Range Levels & What They Do…
  • 1.8 What does high SGOT/SGPT mean on a liver test? Us…
  • 1.9 SGOT – SGPT – Risk Levels – Liver Disorders – MedHelp
  • 1.10 What is the dangerous level of SGPT and SGOT? – Wise-Answer
  • 1.11 How To Reduce SGPT And SGOT Fast In 1 Week – HexaHealth

Elevated liver enzymes – Mayo Clinic

Inflamed or injured liver cells leak higher than normal amounts of certain chemicals, including liver enzymes into the bloodstream, increasing liver enzymes in blood tests. The most common elevated liver enzymes are alanine transaminase (ALT) aspartate transaminase (AST) alkaline phosphatase (ALP) or gamma-glutamyl transpeptidase (GGT)

AST (SGOT) Blood Test High and Low Levels and What They Do …

Summary An AST blood test measures levels of aspartate aminotransferase (AST) and helps determine liver function. Too much of this enzyme can indicate a problem such as liver damage. The aspartic…

SGPT and SGOT risk level – Different range and symptoms

Normal SGOT levels 5 to 40 units per liter of serum. Normal SGPT levels 7 to 56 units per liter of serum. A drastic difference in blood test reports from the normal range can mean serious complications in the body, especially with liver disease or damage.

SGPT and SGOT Risk Level – Symptoms & Treatment – HexaHealth

Liver enzyme levels that are above the normal level are considered dangerous levels of SGPT and SGOT. This means that high SGOT above 33 μ/L 1 and high SGPT above 56 μ/L 2 are abnormal and need further investigation.

Liver blood tests (normal high and low levels) Symptoms …

What is usually most helpful is serial AST (SGOT) and ALT (SGPT) testing over time to determine if the levels are increasing while remaining stable or decreasing. For example, people being treated for chronic hepatitis C should be monitored with serial liver enzyme tests.

High SGOT and SGPT levels – Symptoms prompt the diagnosis of …

Moderately elevated SGOT levels may indicate damage to the liver or other tissues as in alcoholics. Very high levels of SGOT can be found in recent liver damage or infection involving the liver. SGOT levels tend to be higher than SGPT in non-hepatic conditions such as shock and congestive heart failure.

SGPT & SGOT Test Normal Range Levels & What They Do…

Normal SGOT levels – 5 to 40 units per liter of serum. Normal SGPT levels – 7 to 56 units per liter of serum. If blood test reports are drastically different from the normal range, they may indicate strong complications in the body, especially with liver diseases and disorders.

What does high SGOT/SGPT mean on a liver test? Us…

3 minute reading shares SGOT and SGPT are common blood tests. KEY POINTS Basic liver blood tests determine the level of SGOT and SGPT. Normal SGOT and SGPT levels are 30 and 19 in men…

SGOT – SGPT – Risk Levels – Liver Disorders – MedHelp

SGOT – SGPT – Risk Levels Sameerthatte Dear I have done Liver function test only FACTORS OUTSIDE INFLUENCE BESIDES SGPT – 107 SGOT – 78 I am a frequent drinker. I have had a red rash on my skin for the past few weeks after drinking alcohol. We advise you about the status of the lever Critical values ​​for SGOT – SGPT.

What is the dangerous level of SGPT and SGOT? – Wise-Answer

What is the dangerous level of SGPT and SGOT? A score above 50 for men and 45 for women is high and may indicate impairment. There may be some variation in the normal ranges depending on the technique used by the laboratory. What is the reason for the increase in SGOT and SGPT? When the liver is damaged or diseased, SGOT can leak from the liver into the bloodstream.

How To Reduce SGPT And SGOT Fast In 1 Week – HexaHealth

A high SGPT level can indicate liver disease including fatty liver. But you should consult a doctor. they will examine and perform specific tests to check your SGPT and SGOT levels. Based on these tests they could confirm the presence of fatty liver disease.

Biochemical analysis of blood – article of the DNAOM laboratory

Biochemical analysis of blood – article of the laboratory of DNAOM

Content:

• general information
• Indications for research
• Study preparation
• Interpretation of results
• List of sources

views:
1441

Published:
02/15/2022

/

Updated:

05/08/2022

• Prevention

General information

A biochemical blood test reflects the main indicators of the work of various systems and organs: the gastrointestinal tract, the urinary system, the cardiovascular system.

Blood chemistry may include various parameters. All tests within the framework of biochemical screening are carried out for the purpose of primary diagnosis of metabolic disorders and various organs. The studies are highly sensitive and specific.

Depending on the recommendations of the attending physician, in the laboratory you can choose both the study of individual indicators and complex studies:
42.108 Biochemistry detailed
42.106 Biochemistry screening
In both complexes, the following parameters are common:

• Total protein: is the sum of all proteins in the blood at the time of the study. Proteins are made up of amino acids, which determine their characteristics. Albumins are the main blood proteins. They reflect the protein-synthetic function of the liver, the ratio of ana- and catabolism, the state of lipid metabolism, as they are involved in reversible changes in lipoproteins, oncotic blood pressure.
• Creatinine: refers to the products of creatinine-phosphate metabolism, which affects the condition of muscle tissue. In the blood, creatinine is contained in a minimal amount, which is extremely effective, because creatinine has a high biological activity. The level of creatinine reflects the state of controlled heat transfer.
• Urea: is a product of the final breakdown of protein. The level of urea reflects protein metabolism, and it is important to evaluate both an increase in the level of urea and a low level, which can be even more dangerous than uremia.
• Cholesterol total: a complex chemical substance from the group of fats, is a derivative of bile acids and steroids. Cholesterol is produced in the body and also comes from food. Cholesterol is necessary for normal processes of heat transfer, synthesis of glucocorticoids, mineralocorticoids, female and male hormones. Exceeding the norm of cholesterol in the blood can threaten the development of atherosclerotic changes in blood vessels, as well as fatty changes in various organs. Too low cholesterol can also be dangerous.
• Bilirubin is common: it is formed as a result of the destruction of hemoglobin in the cells of the liver and spleen, as well as during the catabolism of some heme-containing proteins. Bilirubin is a pigment that is insoluble in water. In the blood, it is bound to albumin. Once in the bloodstream, bilirubin interacts with proteins and is transferred to the liver. This is the free fraction of bilirubin. In hepatocytes, unconjugated bilirubin is converted into conjugated bilirubin under the action of glucuronic acids. Bound bilirubin is transported with bile, is able to be deposited in the gallbladder, enters the lumen of the small intestine, where it is converted into urobilinogen with the participation of the microbiome. Most of the urobilinogen is oxidized to urobilin and excreted from the body with feces and urine. Associated bilirubin, upon reaching threshold values ​​in the blood, passes through the renal corpuscles and is excreted in the urine. Unbound bilirubin is in strong contact with serum albumin and does not enter the renal tissue. The level of total bilirubin is a mandatory analysis of the biochemical complex, which is primarily used to diagnose hyperbilirubinemia.
• ALT: active aminotransferase present in the tissues of the liver, kidneys, pancreas, myocardium, muscle fibers. Used to diagnose pathological conditions of the liver.
• AST: a specific enzyme, the maximum concentration of which is observed in the liver, skeletal muscles, myocardium, nervous tissue. Together with ALT, it is used to assess the state of the liver, reflecting the presence of inflammation and necrosis processes.
• Alpha-amylase: an enzyme produced by the pancreas and salivary glands that affects the breakdown of starch, glycogen and other carbohydrates. The alpha-amylase test is used to diagnose inflammation of the pancreas – acute pancreatitis. The most sensitive analysis is in the study of blood on the first day of the disease. It should be noted that the level of amylase does not reflect the degree of damage to the pancreatic tissue.
• Serum iron: used to diagnose anemia, usually reflects the risk of developing the disease, may be a criterion for determining latent iron deficiency anemia.

Indications for research

• Comprehensive diagnosis of diseases of the liver and biliary tract: in order to clarify the genesis of cholestasis, diagnosis of inflammation, cirrhosis, pathology of the gallbladder and ducts;
• Laboratory diagnosis of acute conditions of the pancreas, including acute pancreatitis;
• Primary diagnosis of disorders of fat metabolism, in order to identify hypercholesterolemia as a risk factor for the development of atherosclerotic changes;
• Assessment of protein metabolism and kidney function – screening of filtration capacity, reabsorption of protein breakdown products;
• Scheduled examination and medical examination of various groups of the population;
• Examination at the stage of pregnancy planning, during gestation.

Study preparation

It is recommended to donate blood in the morning, between 8 a.m. and 12 p.m. Blood is taken on an empty stomach or after 8-12 hours of fasting. Drinking water without gas and sugar is allowed. On the eve of the examination, food overload should be avoided.

It should be noted that the extended biochemical complex includes additional indicators:

• Uric acid.
• LDL.
• HDL.
• Triglycerides.
• Glucose.
• Bilirubin direct.
• Phosphatase is alkaline.
• Gamma GT.
• Calcium total.
• Magnesium.
• Phosphorus.
• LDH.

The study of glucose levels deserves special attention. The concentration of glucose varies depending on gender, age, and its reference also changes with pregnancy. The primary diagnosis of gestational diabetes necessarily includes a study of glucose. With its slight increase, the doctor can change the planned examination of the pregnant woman, excluding the glucose tolerance test from it.

Also in advanced biochemistry, low and high density lipid fractions are assessed, which may be a marker of atherosclerosis as a result of alimentary obesity or genetic predisposition.

Reference values ​​of each indicator depend on gender, age, other characteristics (gestation period, treatment, etc.)

Interpretation of results

Total protein
An increase in the level of total protein can be caused by dehydration, as well as the deposition of immunoglobulins as a result of monoclonal gammopathy. Also, the concentration of protein in the blood is influenced by eating habits, the use of high-protein foods, sports nutrition.
A decrease in total protein levels can be observed with age, but is usually physiological in nature. The lack of protein is observed with insufficient nutrition, the consumption of nutrients, protein foods. Chronic liver diseases reduce the level of protein in the blood, kidney pathology can cause increased excretion of protein in the urine. With a pronounced lack of protein in the blood, edema develops.
Total bilirubin:
An increase in total bilirubin can indicate both hepatic pathologies and be a manifestation of hemolytic disorders. Therefore, it is important to conduct an additional study of direct or indirect bilirubin on the recommendation of a doctor.
Creatinine
An increase in creatinine indicates severe impairment of kidney function, and may be a sign of renal failure.
Decrease in the level of creatinine: can be observed during starvation, dehydration, destruction of muscle tissue with the development of its atrophy.
Urea
An increase in blood urea usually, like creatinine, indicates kidney disease, but is not as sensitive an analysis. Usually, the excess of the norm in the blood occurs somewhat later than hypercreatininemia is observed.
A decrease in urea occurs in violation of protein metabolism, in particular in diseases of the liver, kidneys, starvation and dehydration, acromegaly.
Total cholesterol
An increase in cholesterol levels indicates the need to evaluate a complete lipid profile, since it is extremely important to assess the risks of developing atherosclerosis, which can only be done with a comprehensive examination. Hypercholesterolemia can occur in malnutrition with the consumption of large amounts of fat-rich foods.
Reducing cholesterol levels should also alert, since its lack leads to insufficient synthesis of hormones. Usually, a decrease in cholesterol levels indicates starvation, liver diseases, and can occur with hyperthyroidism, oncological diseases.
ALT, AST
An increase in liver enzymes, first of all, indicates certain damage to the liver tissue. An increase in ALT is more characteristic of changes in inflammatory origin, while an increase in AST may indicate non-necrotic or more pronounced disorders.
Alpha-amylase
An increase in the enzyme level is the main symptom of acute pancreatitis, but can also be observed in kidney disease, intestinal obstruction, appendicitis, and biliary tract diseases.
A decrease in alpha-amylase can also be a dangerous sign of the presence of severe hepatitis, cystic fibrosis.
Serum iron
A decrease in the level most often indicates the presence of iron deficiency anemia, as well as anemia as a result of blood loss. It can also be observed during pregnancy and when limiting the consumption of animal products. Chronic liver diseases, tumor diseases, collagenosis and hypothyroidism are also accompanied by a decrease in the level of serum iron in the blood.
An increase in serum iron is observed with improper dosing of iron preparations, their excessive subsidies. Some types of anemia may be accompanied by an increase in the concentration of iron. Prolonged intoxication, liver disease, and neoplasia also occur with a change in serum iron.

Author:

Latynina Yulia Sergeevna

Specialization:

clinical laboratory diagnostics biologist

• Prevention

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List of sources

1)
“Medical laboratory diagnostics”, Karpishchenko A.I.

2)
“Clinical laboratory diagnostics”, Kishkun A.A.

3)
Clinical laboratory diagnostics. National leadership.

4)
“Rules for reading biochemical analysis” I.M. Tall

5)
“Encyclopedia of clinical laboratory tests” V. V. Menshikov

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instructions for use, price, analogues, composition, indications

Black/orange gelatin capsules.

• Active ingredients in one capsule:

• Excipients
Potato starch, Aerosil, Talc, Magnesium stearate, Calcium hydrogen phosphate anhydrous and Gelatin capsule (gelatin, ponzo 4P (E124), quinoline yellow (E104), sunset yellow (E110), titanium dioxide (E171), brilliant black (E151)).

ATC code: Al 1EB. A complex of B vitamins with vitamin C.

The combination of B and C vitamins in Neurobex Neo is used to influence a number of important processes and functions of the body. Vitamins of this group are part of enzymes that catalyze the metabolism of carbohydrates, lipids and proteins.
All active components of the drug are rapidly absorbed in the small intestine and distributed in the body. They are excreted mainly in the urine. Since all the vitamins of Neurobex Neo are water-soluble, their accumulation in the body does not occur.

Neurobex Neo is used in the treatment of neurological disorders caused by a proven deficiency of B vitamins, which cannot be corrected by dietary modification.

The drug is taken 1 capsule 1 time per day during or after a meal, without chewing, with a sufficient amount of liquid (water at room temperature). The duration of admission is determined by the doctor. If symptoms persist for two weeks during treatment or if the condition worsens, you should consult a doctor.
If you forget to take Neurobex Neo, take the capsule as soon as possible before your next dose is due. If it is time for your next dose of medication, do not take the missed dose. You can not double the dosage of the drug to compensate for the missed! Further, the drug is used according to the recommended dosing regimen.

From the gastrointestinal tract: rarely – anorexia, nausea, bloating, flatulence; the frequency is unknown – vomiting, colicky pain in the stomach, diarrhea.
From the immune system: rarely – allergic reactions, including erythema, rash, itching, urticaria, shortness of breath and anaphylactic reactions (including shock), anaphylaxis, fever.
Vessel side:
frequency unknown – hot flashes.
From the side of the skin and subcutaneous tissue: rarely – urticaria, rash, eczematous rash. Allergic reactions include skin manifestations and angioedema; frequency unknown – redness of the skin.
From the side of the nervous system: dizziness, sleep disturbance, irritability, fatigue, frequency unknown – headache.
From the side of the kidneys and urinary system: the frequency is unknown – an increase in the frequency of urination.
Due to the content of individual components, the following adverse reactions are possible: From the respiratory system:
bronchospasm.
From the side of the cardiovascular system: arterial hypertension, myocardial dystrophy.
Blood:
hemolysis of erythrocytes in patients with glucose-6-phosphate dehydrogenase deficiency, impaired blood clotting.
From the gastrointestinal tract: dyspepsia, heartburn, belching, pain in the stomach, increased secretion of gastric juice, damage to the insular apparatus of the pancreas (including the development of diabetes mellitus), damage to the glomerular apparatus of the kidneys, the formation of stones in the kidneys and urinary tract, kidney failure, discoloration of urine.
Other adverse reactions: hypercalciuria, crystalluria, glucosuria, sensation of heat, impaired zinc, copper metabolism, irritability, hyperhidrosis.
With prolonged use of high doses of individual components of the drug, the following adverse reactions may occur: hyperuricemia, impaired glucose tolerance, hyperglycemia, paresthesia, convulsions, arrhythmias, arterial hypotension, erythrocytopenia, neutrophilic leukocytosis, gastrointestinal disorders, hair loss, seborrhea, hyperpigmentation, renal failure, jaundice, fatty liver, myalgia, myopathy, transient increase in the activity of aspartate aminotransferase, alkaline phosphatase, lactate dehydrogenase, electrolyte imbalance.
Reporting adverse reactions
If you experience any adverse reactions, please consult your physician. This recommendation applies to any possible adverse reactions, including those not listed in the instructions for use. By reporting adverse reactions, you help to get more information about the safety of the drug.

• Hypersensitivity to the active substances or to any of the excipients in the formulation.
• Acute thromboembolism.
• Erythrosis and erythremia.
• Hyperoxaluria.
• Deficiency of glucose-6-phosphate dehydrogenase.
• Malignant tumors.
• Tendency to thrombosis, thrombophlebitis, severe kidney disease, peptic ulcer of the stomach and duodenum, severe liver dysfunction, active hepatitis, arterial hypertension (severe forms), gout, hyperuricemia, nephrolithiasis, iron and copper metabolism disorders, hypercalcemia.
• Children’s age up to 18 years.

In some individuals with glucose-6-phosphate dehydrogenase deficiency, ascorbic acid may cause acidosis or hemolytic anemia. With a significant overdose of ascorbic acid, renal failure may develop.
Ascorbic acid is a water-soluble vitamin and excess amounts are excreted in the urine. However, long-term use of vitamin C in large doses may inhibit the function of the insular apparatus of the pancreas, which requires monitoring of its condition. Overdose can lead to changes in the renal excretion of ascorbic and uric acids with the risk of precipitation of oxalate stones. In case of an overdose of the drug, dyspeptic symptoms, changes in the skin and hair, liver dysfunction, headache, drowsiness, lethargy, flushing of the face, irritability can be observed.
In such cases, the drug should be stopped and consult a doctor. In case of acute overdose, gastric lavage is recommended. Treatment is symptomatic.

Use with extreme caution in patients with severe and acute forms of decompensated heart failure and angina pectoris.
The drug is not recommended to be prescribed together with other drugs that contain vitamins, since an overdose of the latter in the body is possible.
In patients with a tendency to hyperoxaluria, due to a possible increase in oxalate excretion, it is not recommended to take ascorbic acid in a dose of more than 1 g.
Increased intake of ascorbic acid over a long period can lead to an increase in renal clearance of ascorbic acid, followed by the development of a deficiency with reduced intake or rapid withdrawal.
When conducting analyzes (determination of the content of schdukose, creatinine, uric acid in urine), it is necessary to take into account the possibility of the influence of ascorbic acid on obtaining distorted test results. The use of high doses of ascorbic acid can lead to false negative results in the determination of occult blood in the feces. With prolonged use of the drug, it is necessary to monitor kidney function and blood pressure, as well as pancreatic function.
The drug should be used with caution in patients with a history of kidney disease.
Do not prescribe large doses of the drug to patients with increased blood clotting.
Since ascorbic acid increases iron absorption, its use in high doses can be dangerous for patients with hemochromatosis, thalassemia, polycythemia, leukemia, and sideroblastic anemia. Patients with a high iron content in the body should use ascorbic acid preparations in minimal doses.
The simultaneous use of the drug with alkaline drink reduces the absorption of ascorbic acid, so you should not drink it with alkaline mineral water. Do not take the medicine with hot drinks (especially coffee), alcohol. Also, the absorption of ascorbic acid can be impaired in intestinal dyskinesias, enteritis and achilia.
The drug should be taken with caution in patients with diabetes mellitus, degenerative heart disease, cardiac decompensation, coronary heart disease, diseases of the hematopoietic organs, gastrointestinal diseases, cholelithiasis, chronic pancreatitis, liver diseases, patients with acute nephritis, with glaucoma, hemorrhages, moderate arterial hypotension.
Ascorbic acid can affect the results of laboratory tests, for example, when determining blood levels of glucose, bilirubin, transaminase activity, lactate dehydrogenase.
It is possible to stain urine yellow, which is safe and is due to the presence of riboflavin in the drug.

Clinical studies on the use of Neurobex Neo in women during pregnancy have not been conducted, so the drug should be used with caution, especially in the first trimester of pregnancy, and only as directed by a doctor if the expected benefit from the drug outweighs the potential risk to the fetus / child .
Vitamin B6 passes into breast milk and passes through the placental barrier. High doses of vitamin B6 may also suppress milk production.
Studies evaluating the penetration of vitamins into breast milk have not been conducted. The decision to stop breastfeeding or to use the drug should be made taking into account the importance of taking the drug for the mother. If you need to take the drug, you should stop breastfeeding for the period of treatment.

The drug is contraindicated for use in children under 18 years of age.

The drug does not affect the ability to drive a car and use machinery.

Due to the presence of Ponceau 4P (E 124), Sunset Yellow E110), Brilliant Black (E151) dyes, the medicinal product may cause allergic reactions.

If you are taking other medicines at the same time, consult your doctor.
Ethyl alcohol dramatically reduces the absorption of thiamine. Thiamine is inactivated by 5-fluorouracil as a result of competitive inhibition of thiamine phosphorylation by the latter. With long-term treatment with furosemide, an increase in renal excretion of thiamine is possible.
Vitamin B6 affects the metabolism of certain drugs. High doses of vitamin B6 reduce the antiparkinsonian effect of levodopa. This vitamin enhances the peripheral decarboxylation of levodopa and thus reduces its effectiveness in the treatment of Parkinson’s disease. It is an antagonist of isoniazid and thiosemicarbazones, correcting sideroblastic anemia caused by these anti-tuberculosis drugs. Prolonged use of penicillamine can lead to the development of vitamin B6 deficiency. Hydralazine and cycloserine are also its antagonists, and the simultaneous use of vitamin B6 with them reduces the adverse neurological reactions caused by these drugs. The amount of vitamin B6 decreases when taken simultaneously with oral contraceptives.
Colchicine, ethyl alcohol and neomycin inhibit the absorption of vitamin B12. Oral antidiabetic agents of the biguanidine type, p-aminosalicylic acid, as well as chloramphenicol and vitamin C interfere with the absorption of the vitamin.
Vitamin C increases the half-life of paracetamol, increases iron absorption, and increases renal excretion of amphetamine. The concentration of ascorbate in plasma decreases with smoking and taking oral contraceptives.
In renal failure, oral vitamin C increases the absorption of aluminum, which can reach toxic levels. The simultaneous use of aluminum hydroxide and ascorbic acid may cause an increase in the absorption of aluminum in patients with normal renal function.
Co-administration of ascorbic acid with amygdalin (alternative medicine) may lead to cyanide toxicity.
Ascorbic acid can be used in conjunction with deferoxamine to increase iron excretion. However, in the early stages of treatment, when there is excess iron in the tissues, there is some evidence that ascorbic acid may increase iron toxicity, especially in the heart. Thus, ascorbic acid should not be administered within the first month after starting treatment with deferoxamine.

Hard gelatine capsules.