I have posted in here about this same problem in the past, but since this post is looking for answers, Ill quickly restate the situation: My nephew has been abusing painkillers (mainly Lortabs, but hes abused other pills as well I guess, altho he tells me its mainly the Lortab at about 10 per day of the 10mg types), and this past weekend he had a serious bout of sickness that was really quite scary---I get a call about 6:30am to hear this: in addition to painkillers, the past two nights he had taken several Sinu-Tab sinus tablets for sinus headaches he gets regularly, and woke up the next morning with several symptoms including fever, foot pain, bloated feeling in stomache, and a few others I dont recall. He was very scared of Acetomeniphen(sp?) poisoning and we were preparing to go to the ER, until he said it was going away, so I didnt wind up taking him. This was alot of new information for me to handle, and I really let him have it. I think that, in addition to his past abuse, is what finally convinced him to let me take him for the Liver/Kidney tests this week.
I recently posted about this, to get some info about the tests to check for damage to his Liver and/or Kidneys, and got the results today. First, thank you so much to Sadsister and Feelbad(Heather and Marcia) for the informative and helpful replies! Sorry I havent been around to reply sooner. However I was hoping if I listed the results here, we might get a better idea of exactly what the levels mean, or better yet to be able to compare them with somebody here with this kind of experience (because the doctor isnt in until tomorrow so were being made to wait--I guess that could be bad or good, I dont know). Anyways, here are the results the nurse read to us:
His ALT was a 67, and his bili ruben(sp?) was 1.5
Unfortunately it was a nurse who called b/c the office is closed, so we have to wait to see what the Doctor will say, but the nurse stated that these are Elevated Liver Enzyme levels. She said she has seen ppl with higher levels that showed no symptoms of liver problems, but they might have to send him to a specialist to further check his liver. Since she kept saying "dont stress about it" repeatedly, we both wondered if that was a bad sign---you know how that works. We were really hoping we could talk to a doctor about this today, and not have to wait. The waiting is harder than anything, and my nephew is literally sitting downstairs right now with a stone-cold look on his face.
From the reading Ive done in here, Im sure there are ppl who may remember what their levels were when experiencing Liver tests like this in the past. Would you mind sharing your experiences, and perhaps comment on what we should expect with test results like those listed above? I guess since we have to wait until the doctor calls tomorrow, were wondering just how serious those levels are; especially in comparison with those from ppl with similar experiences. These forums area blessing, not only for personal accounts but also for access to information that can seem hard to get elsewhere when somebody really needs it. Thank you for ANY replies that might help us when we talk to the doctor tomorrow, it would really be nice to be able to talk to the doctor armed with some knowledge and information, so thank you all again!
I wish I could help you but I know nothing. I do know that my mother died from acetametaphine poisening... Taking tons of Lortabs along w/Excedrin. However, sounds like he's barely over the recommended dose of tylenol so don't worry about it right now. In addition, I've heard that if liver damage occurs (which I seriously, highly doubt that it has) that over time and as long as the addict doesn't continue abusing drugs.... that the liver can actually heal itself, somewhat. I could be wrong and if so, someone please correct me but I'm sure he will be fine. He needs rehab and I'm assuming you know this. Or something to get him off of these pills. I wish you luck and I am telling you to try and not worry about this. Does he have any yellowing of the skin or any other signs of liver damage as far as symptoms? Seriously, don't worry until you talk to the doc. However, don't tell him not to worry. He NEEDS to worry and be scared. It might help him get off of these things. I'll write more later... gotta work. Take care and seriously, calm down and do not worry until you hear more from the doctor. One more thing... most of the time when addicts tell you the number of pills they are taking, you can pretty much double that amount. That's what I've heard by several docs and people on the board too. Probably not in every case but a lot of them so keep that in mind too.
Thanks for the quick reply Banker! He doesnt have any of the symptoms you mention, like the yellowing of the skin. When you mention that hes not much over the Tylenol level though, it made me wonder something---are the elevated Liver Enzymes usually caused by the Tylenol it has to process, or is it the Narcotic substance itself? In other words, if there were NO tylenol in painpills, does that affect the Liver in the same way? I guess since you mentioned the fact that he might actually be taking more than 10 pills a day (which would not surprise me, to be honest, since hes admitted to taking different kinds of pills too), Im wondering if the blood results are mainly from the Tylenol in them, or from the Narcotic in them?
Like I said, the more I know about this before we talk to the doctor the better I will feel. Also, its kind of hard because were actually close in age---its not like Im dealing with someone who is alot younger than I am, its more like dealing with a peer. However I want to help him, and the best way I know to do that for now is to know as much as I can.
Here are the normal reference range numbers for the various liver tests:
Reference ranges vary from laboratory to laboratory and also depend upon the method used. However, normal values can generally be found within the following ranges, unless specified differently.
ALT: 5-35 IU/L (values for the elderly may be slightly higher, and values also may be higher in men and in African-Americans)
AST: 0-35 IU/L
ALP: 30-120 IU/L
GGT: Normal values for this test vary widely, depending on the laboratory performing the test, and the age and sex of the patient. For example, females less than 45 years old have lower values than both males and females over 45 years of age. Values in the newborn can be as much as five times higher than in adults.
Bilirubin: (Adult, elderly, and child) Total bilirubin: 0.1-1.0 mg/dL; indirect bilirubin: 0.2-0.8 mg/dL; direct bilirubin: 0.1-0.3 mg/dL. (Newborn) Total bilirubin: 1-12 mg/dL. Note: critical values for adult: greater than 1.2 mg/dL. Critical values for newborn (requiring immediate treatment): greater than 15 mg/dL.
Ammonia: Normal values for this test vary widely, depending upon the laboratory performing the test, the age of the patient, and the type of specimen. For example, values are somewhat higher in arterial than in venous blood.
PT: 9-12 seconds.
Last edited by User 205000; 05-12-2004 at 12:31 PM.
well banker is right in that the liver can heal itself. the values you gave are elevated but they would be this elevated after an all nite drinking binge also. the fact that this is an ongoing process is of some concern. the long term effects on the liver are cumulative. in other words the longer the abuse, the more likely permenant damage. usually liver toxification yields no symptoms in early stages. later stages are usually irreversabile and may exibit signs such as swelling of the extremeties, yellowing of the skin, fatigue, etc...an ultrasound of the liver would be the next step, and a liver biopsy if results warrant, however i think this is just a good scare and quitting now will return the liver to normal.
as for your question about narcotics causing liver problems..well...no, not for the most part. the tylenol is responsible for that.
Hey phlox, northern lights is right, In the early stages of liver problems, you generally wont even have symptoms until the damage reaches a certain point.when my son was first dxed with liver failure, we didn't even know that he was sick,and he had been down to only about 20% of his liver function left.its a very scarey thing, let me tell you.
I also agree that the tylenol is the culprit here not the narcotic itself.tylenol is extremely hard on the liver,even if you are staying within the normal ranges but using it daily.and if you are going above the recomended daily amount,you are just asking for trouble down the road.
I am glad that user gave the lab ranges so i don't have to.But the ranges that i am going to give you though are for a seventeen year old.The normal range for the AST:41, ALT:46,Bili:1.1,alkaline phosphatase:50-364.as for the ammonia levels, we had to have a blood draw on my son once a week to check the ammonia level.He had had a shunt placed in his liver when the portal vein became blocked by the cirrhotic tissue and after that ,his liver couldn't break down the protien in his blood anymore,so we had him on a low protien diet to keep his ammonia levels down.high ammonia in the blood goes directly to the brain and can cause brain damage if it is not lowered in time.
I am sure that his doc will want to follow up these tests with something like ultrasound or a cAT scan.then maybe a liver biopsy(usually a needle punch,very simple and quick,and he would be sedated).
i am glad he finally went in for tests as if there is something going on there, the earlier the treatment the better.The liver really is an amazing organ and if you stop the chemical that is causing the damage, the progression will stop in most cases, and the damaged portions can regenerate after a period of time.good luck phlox, and if you have any other questions, please don't hesitate to ask okay?
I just wanted to mention that the liver board has some really good info too,have you checked it out at all?just a thought. marcia