Patients receiving large amounts of hormone therapy may have elevated serum transaminases, but they are mostly within 5 times the upper limit of normal reference, and most of them do not have obvious clinical symptoms of liver damage. After ruling out organic liver disease, adding liver-protective and enzyme-lowering drugs, as well as hormone reduction, the majority of patients can have normal liver enzymes, so there is no need to worry too much. If liver enzymes continue to be significantly elevated, switching from prednisone to methylprednisolone or prednisolone may be considered to reduce the burden on the liver. We do not recommend routine addition of hepatoprotective drugs or routine use of methylprednisolone tablets. In addition to adjusting medications as required, it is important to regularly test serum transaminase levels to understand changes if outpatient appointments for follow-up are lengthy.