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Momjenny 01-15-2012 12:57 PM

Palmar erythema and normal blood work
 
Let me start off....I am a 39 year old female (married mother of two amazing boys!). I unfortunately have a past history of drinking....i would drink every night...never to the point of enebriation but every night nonetheless for the past nine years. Fairly heavy social drinker on weekend before that. I started to feel strange sensations in the area of my liver off and on for a few years. I stupidly ignored it until recently. I made the decision to give up drinking....it has been seven days since my last beer. It has not been easy. I saw my GP lady week and told him about the pain/sensation I was experiencing in the liver area. Also, most alarming to me, I now realize I have palmar erythema. He basically dismissed me and said I was fine since myiver function tests from 8 months ago were normal. Two days later I was having what I assume to be was a panic attack and ended up in the ER. They took blood and ran liver function tests. All were normal. I am still terrified because of the red palms though....they seem to have heat coming from them too! Hard to get my head off of this when I can constantly feel the palms of my hands! I have no idea how long they have been like this...never thought to check my palms before I stopped drinking. Well, now I am in a panic and I have convinced myself I have cirrhosis. Has anyone else ever had this experience? Any help would be so greatly appreciated!

cheffyd82 01-15-2012 01:22 PM

Re: Palmar erythema and normal blood work
 
Hey There

soo sorry to hear what you are dealing with,

Palmer erythema with liver dieses usually will present itself with portal hypertension, portal hypertension will present itself in mid to late stages of liver dysfunction. if you had mid to late stage liver dysfunction, they would show in your blood work ie: bilirubin, ggt, alk phosphate, ast, alt etc.

its possible that this could be associated with your thyroid (hyperthyroidism) your doctor would need to measure your TSH, free t3 and t4, anti-thyroid antibodies, anti-microsomal-antibodies.

you need to be calm and try and look on the positive your liver enzymes are fine which most likely means this could be realted to a completely benign issue, but you should have your thyroid checked to rule out any thyroid problems.

**Please note this is meant as advice coming from experience i have had... and in no way should be taken as sound medical advice...only a certified MD can diagnose any problems after thorough examinations***

Momjenny 01-15-2012 03:02 PM

Re: Palmar erythema and normal blood work
 
Thank you so much for responding! I will definitely ask my doctor about hypothyroid issues. So scary to have a doctor confirm palmar erythema and not be able to give any other information. Everything I keep reading states that it only shows up in cirrhosis...and I have also read that blood tests will be normal if the liver has already progressed to the cirrhosis stage. So frustrating...especially with the guilt that I have brought this on myself. Never thought that this horrible disease could start this young...I was definitely uninformed and I am sure in denial!

Again, thank you so much for responding!

BillinSD 01-15-2012 04:33 PM

Re: Palmar erythema and normal blood work
 
Hi Momjenny, I developed palmar erythema AFTER I quit drinking myself, and also have normal liver enzymes and other blood work results.

My blood pressure spiked up quite high the month after I quit alcohol and this is when the PE appeared. I too have looked high and low for an explanation, and no one seems to know exactly where it comes from.

I have read about it being possibly related to estrogen, and that it can occur in normal pregnancies, as well as a possible link with high blood pressure.

Best not to stress out over what we can't change now, and hope for the best. Even if we have some liver issues going on, avoiding alcohol seems to give a good prognosis for those who catch it at an early stage.

My concerns about liver disease have lead me into a lot of research on this matter, and there are some remarkable studies regarding the effects of diet on the development and progression of liver disease.

A few things you might want to look into...

Coffee drinkers seem to have far fewer problems with fibrosis and cirrhosis than folks who don't drink coffee. Google around on: coffee and cirrhosis, and read all about it. Coffee won't dissolve fibrosis you already have, but it may slow progression of fibrosis yet to come.

Lecithin (aka phosphatidylcholine), and choline, both found in large amounts in EGGS, seem to be a liver's favorite food/nutrients and are often mentioned regarding liver health. Search: Lecithin and Liver for more info on this. Breakfast really is the most important meal of the day if you've got liver issues, and coffee and eggs should be frequent fliers on your menu.

Polyunsaturated fats and oils are supposed to be good for your heart, but they oxidize very easily in the liver, and livers actually prefer saturated fats (real butter, not margarine; avoid deep fried foods). Learn more about "lipid peroxidation" and the dangers of polyunsaturated fats.

IRON can be a very powerful pro-oxidant in the liver (where iron is stored) if iron storage levels get too high, and excess iron should be avoided if you are not anemic or pregnant. Avoid supplements containing iron unless your doctor says you absolutely need to keep on taking them.

Time is now on your side... If you're worried about your liver, learn more about it, and this knowledge will give you peace of mind.

Good Luck and GodSpeed to you!

Momjenny 01-15-2012 05:16 PM

Re: Palmar erythema and normal blood work
 
Thank you so much for the info! I had read about coffee and am now drinking at least three cups a day! I have replaced my nightly beer habit with it....pretty sure that's one of the reasons I can't sleep! I also have high blood pressure, and have definitely had a spike this last week after I quit drinking. I am truly hopeful that is the reason for the suddenly burning palms. As I said earlier, I have no idea how long they have been red but I think I would remember if they were burning before. I only noticed the burning aspect of the palms on day four after my last drink.

Good to hear about the eggs and the butter...I love real butter! I will definitely stop frying so much as well. Raised in the south and that's always been a way of life in my household! I am willing to do whatever I can to try to save my liver.

Weird that I started noticing some of my symptoms only after I stopped drinking. I would never drink until nighttime so I would think I would have noticed some of these things during the day before. Truly has me scared out if my wits! I'm driving my husband crazy....I have been relentlessly reading about palmar erythema for days....usually the same websites over and over. Definitely not helping with my stress level!

I appreciate your advice so much! Hope you are also doing well! Hate that you have gone through this too, but I am glad to hear that someone else has had this and they didn't have cirrhosis. I have read others stories regarding living with cirrhosis and it is truly heartbreaking.

BillinSD 01-15-2012 09:40 PM

Re: Palmar erythema and normal blood work
 
Glad you find my post interesting... 'Tis a fine line between fibrosis and cirrhosis, and I do not know exactly where I stand myself. A liver biopsy is the only way to tell accurately what is going on, and as the prescription is the same regardless of what a biopsy shows (no alcohol, eat well, watch for new symptoms), I will simply follow the prescription as though my life depended on it.

From what I gather, cirrhosis is the point where disease progresses regardless of whether the initiating cause is stopped or not. I know a lot of folks lead long and normal lives with significant fibrosis that does not progress, and this is what we must hope for.

Regarding the fried foods... Frying in saturated fat (lard, palm, or coconut oils) should be fine. Its the polyunsaturated vegetable oils that oxidize in your liver and can stress it out. I've read vitamin-E can help control this oxidation, so if you eat a lot of salad dosed with vegetable oil, or can't resist a fried meal once in a while, some vitamin-E might help.

All the fast food places used to fry in saturated beef tallow, but this was changed to polyunsaturated vegetable oils around 20 years ago as these are considered less likely to promote heart disease. Good news for those with a family history of heart disease, but bad news for young people who live on fast food, and may be drinking more than is good for them.

I was thinking, if you are on estrogen birth control, or may have changed pills,
this might have something to do with your PE. You might google around on palmar erythema and hormonal birth control and see if this is a known side effect. Perhaps your doctor could shed some light on this.

Best of Luck to you!

Hypochondriacyy 02-08-2012 09:53 PM

Re: Palmar erythema and normal blood work
 
Yea I am similar to you, and I am a SEVER hypochondriac. I also have a history of red palms and feet. And for the last 2 weeks my hands have been in fire like burning. My blood work is also normal. If I look really hard I can find a few spider veins ere and there.
I had an ultrasound last year and it showed mild fatty liver. A couple years ago an ultrasound showed severe fatty liver with mild enlargement. Thats what scared me to stop drinking. I asked my doctor about the fact that I read that people with cirrhosis can have normal liver enzymes, he said yes they can, but most don't. Something would show in the bloods, platelets, CBC, etc something would be very off. AST would rise 3 times the level of ALT usually. Lots of other things can cause red palms. Hormones, lupus, Raynauds etc

Hypochondriacyy 02-09-2012 06:36 AM

Re: Palmar erythema and normal blood work
 
And just to add, red palms seems to be VERY common in the general population. Jus do a search on here and see how many people ask about it. :)

Donbo 08-11-2012 01:33 PM

Re: Palmar erythema and normal blood work
 
I became aware of my red palms about 3 years ago when someone asked me if I had burned my hand. I recently saw an old photo of myself from 10 years ago and sure enough, the deep red classic PE was clearly visible. My blood work cosistententy shows elevated ALT but only by one point so I think this is simply normal for me. I do have a history of fairly heavy drinking and I've developed a beer belly but I have no signs of liver disease other than the PE.

I cut way back on alcohol consumption but the PE was unchanged. I then cut all alcohol consumption for 3 months and still no change. I always wondered if my nicotine consumption might be a factor but I never saw anyone discuss nicotine as a possible cause of PE. I recently spoke to my sister who is a nurse and she said the doctors at her hospital say PE is caused by drinking and smoking.

I'm a former smoker who transitioned to chewing tobacco and then to nicotine gum. I've never completely ended the nicotine habit during the last 10 years. I decided to quit nicotine completely for at least 7 days to see if it had any impact on my PE. Sure enough, after 4 days the PE began getting slightly lighter, after 7 days I was able to confirm a change and it was definately in remission. It has now been 11 days and the white areas of my palms are continuing to spread as the red areas recede. I have never seen my PE recede before. Clearly, nicotine was the culprit.

ladybud 08-11-2012 03:43 PM

Re: Palmar erythema and normal blood work
 
I would ask your Dr to order an ultrasound of your abd with special attention to liver. You will get some additional info that way that may help you feel better. Fatty liver is common and some of that may recede as you abstain from alcohol. A cirrhotic liver will look small and dense. You could also ask for a ferritin blood test, to make sure there is not excess iron stored in the liver causing the PE. Rheumatoid arthritis, lupus and other connective tissue diseases can cause PE, as well as estrogen excess. If you have fatty liver and are overweight, weight loss will help the fat decrease also. Please consider getting involved with a support group for maintaining alcohol abstinence. After 9 years of drinking daily and heavily at times, stopping and staying abstinent is going to be very difficult without a good support system to help you stay away from it.

BillinSD 08-11-2012 09:37 PM

Re: Palmar erythema and normal blood work
 
Hi Donbo and thanks so much for sharing your PE discovery. My PE has persisted after I quit drinking too. I was on IP6 to reduce iron for a while and that would help, but if I go off the IP6, back comes the PE.

I'm still smoking my pipe tho, so perhaps this is contributing. I shall try to cut back and see if this helps. Pleas let us know if it's gone for good. There is remarkably little information available on PE other than it being associated with liver issues and a couple other things. The nicotine is a new one to me and if it's truly gone for good, this would be an impressive discovery.

Thanks for your input!

Donbo 03-11-2013 05:11 PM

Re: Palmar erythema and normal blood work
 
[QUOTE=BillinSD;5038090]Hi Donbo and thanks so much for sharing your PE discovery. My PE has persisted after I quit drinking too. I was on IP6 to reduce iron for a while and that would help, but if I go off the IP6, back comes the PE.

I'm still smoking my pipe tho, so perhaps this is contributing. I shall try to cut back and see if this helps. Pleas let us know if it's gone for good. There is remarkably little information available on PE other than it being associated with liver issues and a couple other things. The nicotine is a new one to me and if it's truly gone for good, this would be an impressive discovery.

Thanks for your input![/QUOTE]

Donbo 03-11-2013 05:13 PM

Re: Palmar erythema and normal blood work
 
[QUOTE=Donbo;5145362][/QUOTE]
Hi BillnSD, It looks like I must have been wrong about the connection with nicotine. It did appear to recede somewhat after stopping the nicotine but It did not actually go away.


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