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Thread: Elevated Liver Enzymes?

  1. #1
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    Question Elevated Liver Enzymes?

    DH went to the doctor a couple of weeks ago regarding an irregular heartbeat that had been going on for a couple of months. For starters, the doctor ordered a complete blood analysis. Interestingly, between the time of the blood draw and receiving the results, the irregular heartbeat seemed to clear up spontaneously.

    However, the bloodwork shows elevated AST and ALT enzymes, as well as an elevated bilirubin count. The AST was minimally elevated, but the ALT was double the maximum acceptable. (I think I've got those right--I don't have test results in front of me. The one that's double is the one that's supposed to be most indicative of actual liver damage.) His bilirubin count was also about 50% higher than the maximum. Hepatitis B and C have been ruled out, test isn't back yet for Hepatitis A, but no reason to think he might have it, other than this test.

    He doesn't drink--never has. His triglycerides are 75, cholesterol ratio 3.5:1, within normal weight, no indications of diabetes, etc. His blood work was all done after a 10-hour fast, although he did apparently take his handful of supplements about 8 hours before going in. (He didn't check with me first! )

    I know there are doctors and nutritionists out there. Anyone have any ideas? He has a follow-up appointment on Feb. 12, but may drive me crazy before then!

  2. #2
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    Bumping this up for you.

    I'm not in the medical profession, but I'd think if it were serious, the Dr. would have him in the office sooner. Hope it's nothing.

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    I have to have blood tests once a month to check for elevated liver enzymes because of a drug that I take for rheumatoid arthritis. They do go up sometimes, and then they watch it for a couple of months to see if it will go back down again, which it always has. So I think your husband will be fine waiting until the middle of February to see the doctor. I've gone three months in a row with elevated levels without my doctor getting too concerned about it.
    <)>>< Candace ><<)>

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    I know bilirubin can be elevated for several reasons (heavy exercise, dehydration, vegetarian diet combo)...
    If this is the first time it is elevated, I'd urge him to have a retest done before you worry.

    Sometimes the lab results are just wrong.

    Does he take aspirin daily? or Ibuprofen or acetomenophen??

    How old is he and does he have a weight issue??

    Good luck.
    Thoreau said, 'A man is rich in proportion to the things he can leave alone.'

  5. #5
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    Thanks, everyone, for the responses.

    Originally posted by wallycat
    I know bilirubin can be elevated for several reasons (heavy exercise, dehydration, vegetarian diet combo)...
    If this is the first time it is elevated, I'd urge him to have a retest done before you worry.

    Sometimes the lab results are just wrong.

    Does he take aspirin daily? or Ibuprofen or acetomenophen??

    How old is he and does he have a weight issue??

    Good luck.
    He is taking 81 mg. of aspirin daily for heart health, as well as garlic supplements and fish oil, but don't know if that would have any impact. He doesn't take any pain relievers. He's disgustingly pain-free, even when he's hurt.

    He's 43, 175 pounds at 5'9" after a recent weight loss of about 17 pound on SBD. We do workout about 3 times a week with weights, and he climbs a mountain once a week. His workouts are strenuous. He did have a staph infection about 10 years ago, and we were warned that it could show up at any time. I don't know if there's anything there that would be significant.

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    did he tell his doc he took the supplements 8 hours prior to a blood work-up?
    I still say have it redone..
    I'm not a doctor so don't go by me, but I AM A HUGE worrier
    Thoreau said, 'A man is rich in proportion to the things he can leave alone.'

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    Who KNOWS what he told the doc? He doesn't think anything's important. I'll definitely go with him on the follow-up. I tend to be a worrier, too, especially since we know the staph infection could be lurking. However, CBC was normal, and I'd think he'd have an elevated white count or sed rate if the staph infection was present. Hopefully, we'll hear something soon.

  8. #8
    Garlic and fatty acids don't raise liver enzyme levels, but drugs do. These tests can be so wrong so frequently I would have them redone at a different lab. The biggest mistake people make is to get the test redone at the same office that uses the same lab, which increases the possibility of false results again. Remeber the Seinfeld episode where they're all eating "non-fat yogurt" but they all start gaining weight, and a lab result shows it is super high in fat, then Kramer and the lab tech are having sex in the lab and the yogurt sample dumps into Mayor Giuliani's blood sample and his cholesterol is "through the roof"? So, if your doctor sends stuff to the same lab all the time have them send the tests somewhere else.

    Bilirubin
    Bilirubin is the end product of hemoglobin breakdown in your body (hemoglobin is the molecule in blood that carries oxygen to where you need it to go). Some bilirubin is water soluble and will spill over into the urine, so doing tests for bilirubin spillover in the urine may show a biliary obstruction, as will (possibly) light colored and "fatty" stool. Bilirubin can be elevated in excessive red blood cell turnover rates, too. CBC with differential and reticulocyte counts can be helpful, as well as alkaline phosphatase test, to gain further clues.

    In general, bilirubin can be elevated in genetic hereditary enzyme dysfunctions, cholestasis (obstructive cholecystitis or pancreatitis, estrogen use, oral contraceptives), hemolytic anemia, liver dysfunction, resoprtion of a large hematoma (bruise, etc), viral hepatitis, infections or exercise and fasting. Pretty generic test in and of itself, but gives the doctor clues to look at other things and figure out what's up. Sometimes switching to a diet high in beets, beet greens and green leafy veggies will clear this number up.

    ALT
    This enzyme is associated with liver function and glucose conversion. It focuses not on long standing liver disease, but rather on cellular damage to the liver (i.e. acute damage from hepatitis or acute gall bladder inflammation). It can be increased in hepatic inflammation (hepatitis, pancreatitis, mono), injuries to skeletal muscle, heart attack, renal infarction and heparin therapy, to name a few (or as a result of drugs that are damaging liver cells).

    AST
    Focuses on cellular damage, in particular heart, liver, muscle and other highly metabolic cells. This enzyme is released into circulation following the injury or death of cells. May be increased in liver inflammation (hepatitis, mono, cholestasis, alcoholism, drug toxicity), damage to other tissues (skeletal muscle injury, lung infarct, burns, seizures, eclampsia), heart muscle damage (heart attack, myocarditis, trauma), red blood cell pathology (severe hemolytic anemia, megaloblastic anemia) and malignancy. Drugs will raise AST, too, in particular oral contraceptives, acetaminophen, aspirin, isoniazid, codeine, cortisone, heparin.

    I don't mean to try to scare you with all this. The most logical explanation is a poorly done test, but think about other stuff, too, like prescription and OTC drug use in particular, or injuries, healing bruises, etc. These are all fairly nonspecific tests, so in and of themselves they don't mean much, but with a good case history and the rest of the bloodwork, assuming it's accurate, your doctor should be able to piece the puzzle together. Let us know how it all turns out!
    Chiropractic care is health care for the 21st century.

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    Doc Agocs, thanks for the info. That seems consistent with what I've heard. We're hoping for an inaccurate test, or something transitory that will be gone when another test is done, which we assume it will be. Since DH takes nothing except supplements and hasn't suffered any injuries, it is a bit worrisome, but we'll just pursue until it's been thoroughly checked out. Thanks again.

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    Do any of the supplements he takes contain a high dosage of Niacin??
    It is part of the B-vitamins; it has been used therapeutically to lower cholesterol but it does affect the liver in high doses.
    Thoreau said, 'A man is rich in proportion to the things he can leave alone.'

  11. #11
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    Did he work out strenuously the morning of his blood draw?? I know from personal experience that this can raise liver enzymes. If a blood redraw is done make sure he does not exercise that morning.
    does he have his gall bladder and/or any history of gallstones?

  12. #12
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    Liver enzymes

    Have your husband tested for hemochromatosis. This is sometimes known as iron overload. Tests should be run for ferritin. What you are saying in your post sounds like classic symptoms. I am NOT a doctor, but I do have this genetic disease.

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    He didn't work out that morning, but did the night before. He did have his gallbladder removed about 9 years ago. Again, who knows if he's told the doctor or not? He doesn't consider any medical history significant as long as all visible limbs are still attached. Will definitely talk to the doctor about hemochromatosis as well, if he doesn't bring it up first! Thanks again!

  14. #14
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    Liver Enzymes

    No! Do not wait for a doctor to bring it up. Chances are he/she will not. Many doctors are unaware of this disease because it mimics other things they are familiar with. It is important that YOU bring it up. It was thought rare until a few years ago, but now it is thought to affect 1 in 400 primarily males.

  15. #15
    He is taking 81 mg. of aspirin daily for heart health


    This could do it, depending on how his body metabolizes the drug.
    Chiropractic care is health care for the 21st century.

  16. #16
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    Two cents worth

    I'll throw in my two cents worth having been a pin cushion within the past year. I had and still have liver enzymes that are high/above the normal range. They have been for about 5 years and they've varied from just a little high to very high (double in a couple cases). The first doctor I saw was very concerned about my liver (because I was having other conditions - edema in my lower extremities) and did the full work-up at least twice. I had blood tests galore without any specific indication of liver disease or malfunction.

    Personal history: I'm a marathoner who is fairly light weight. I don't normally eat beef (about 2 or 3 times a year if that) but do eat chicken, fish, pork, beans, etc. I tend to consume a low-fat diet and tend to have a significant amount of calories from carbohydrates (to support marathon training). I used to drink but not "heavily" by medical standards. I've never had hepititus and I've been vaccinated for Hepititus A and B. With all that said the doctors were very perplexed.

    Suffice to say the testing and diagnosis went from merely blood tests all the way through a CT Scan, Ultra Sound, and ultimately to a liver biopsy. What was the finding? (1) I have an absolutely healthy liver - no indication of scarring (and I used to drink a little) or other disease. (2) My liver enzymes are just naturally high. Remembering that the "normal limits" should encompass about 98% of all people (statistically speaking to 3 standard deviations). (3) I should keep an eye on the liver enzymes by periodic blood tests (about every 6-12 months).

    My recommendations - not being a doctor but someone who has been scared out of my wits by medical people and blood testing: (1) Take the blood test as scheduled on the 12th. The liver enzymes will vary throughout the month (personal experience) and as I'm told there may be no specific reason for the variation - just does vary. (2) Although it will be difficult try not to think your DH condition is more than it is. It appears that most of the "big nasties" have been ruled out already and the doctor - even though you'd like answers now - is taking a reasoned approach trying not to over-react.

    I'd be willing to converse with you (or anyone else for that matter) via pm or off-line. Feel free to drop me a note.

    Les
    Be strong and courageous. Do not be afraid or terrified because of them, for the LORD your God goes with you; he will never leave you nor forsake you." Deut. 31:6 (NIV)

    Reflections on life and spirituality can be found at https://revles.wordpress.com

    Visit my new ministry site: St. John's Episcopal church, Suffolk VA.

  17. #17
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    Another thing to consider is whether this is something new. were these values checked in the past & were they normal then? or is this something that has been present a long time.
    family history is another issue. my husband's family has a history of somewhat elevated liver tests. several have had gall bladders removed & it made no difference. No one is "sick" despite the long history of slightly abnormal values. Exposure to any toxics at work? chemicals, fumes of any kind?

    Good luck with this. they are just trying to be sure they don't miss something.

  18. #18
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    Thanks again, everyone. I printed off all your responses for DH, and I think we're both feeling at least a bit better. When we hear anything else, I'll update. Still, though, feel free to post or PM if you think of something else. I feel that the more information we have when we visit the doctor, the more effective the visit is likely to be.

  19. #19
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    Just an update. We went back to the doctor on 2/12, and he drew more blood to see if the enzymes were still elevated. We just got the call today that one of the enzymes is back within normal range, and the other is nearly back to normal. So...the doc wants to look at the blood again in a month, and providing it is normal at that time, will just monitor periodically. We are optimistic that it was a temporary situation and will need no further treatment. Thanks for all the good thoughts and prayers.

  20. #20
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    You both must be relieved. Thanks for the update.

  21. #21
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    Exclamation Great news!

    I'm glad that you received such great news. May things continue to be as good as they are right now and that the condition is finally resolved.

    Peace,
    Les
    Be strong and courageous. Do not be afraid or terrified because of them, for the LORD your God goes with you; he will never leave you nor forsake you." Deut. 31:6 (NIV)

    Reflections on life and spirituality can be found at https://revles.wordpress.com

    Visit my new ministry site: St. John's Episcopal church, Suffolk VA.

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