<s>[INST] Hi, my 22 year old daughter recently was diagnosed with mono.  She had a blood test and her spleen was normal but the office said that one panel indicated slightly elevated liver enzymes.  She was on mega doses of tylenol and motrin.  Could that have affected her numbers? [/INST] Hi there,High doses of tylenol can absolutely cause liver damage. I personally recommend my healthy patients never to exceed 4g (4,000mg) of tylenol per day and not to exceed 800mg of ibuprofen every 8 hours.  Anything more can make her liver enzymes increased. I wouldn't worry too much about a slight increase of liver enzymes. If they are continuing to rise, then that could be more worrisome, but a slight elevation shouldn't cause any reason to panic. I usually start to get more worried when AST/ALT are over 200 and continuing to go up.  I'd have her cut back or take a break from the tylenol for a bit, and see if that helps.I hope this answers your question. Please feel free to contact me if you have any further questions. </s>