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Old 10-21-2012, 08:23 AM   #1
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Abnormal liver function tests from blood sample, clear ultrasound, no health issues

For 19 years my blood tests show abnormal liver function. I have had ultrasounds, no sign of gallstones, I have no health problems. I am taking thyroid medication, I am a non drinker. They want me to have a liver biopsy but I'm afraid of what might happen with this evasive test (if its not broken don't fix it). Any ideas?

 
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Old 10-21-2012, 03:40 PM   #2
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Re: Abnormal liver function tests from blood sample, clear ultrasound, no health issu

High liver enzymes indicates current inflamation of the liver, inflamation on the liver for such a long time could have made some liver damaged not able to be seen on ultrasound, CT, etc. So, that's why doctors recommend to you the liver biopsy because they want to see how much damaged currently your liver has since you have such a long time (almost 20 years) with your liver inflamed (because of the high enzymes).

The causes of high liver enzymes is not exclusive and only for the drinkers (I'm not a drinker, never had been, but I have fatty liver and that's a cause for high liver enzymes too) not your case if they haven't saw any fat on your liver on the ultrasound, also hepatitis increased liver enzymes, have you been tested for hepatitis? I guess yes since otherwise they would known the reason of your high liver enzymes which according to what you're saying they look like don't know why you have such high liver enzymes for such a long time. Some medications also increase liver enzymes (have you find out if your thyroid medication does this?), some herbs also increase liver enzymes, even hard exercise increase liver enzymes...

Is your decision to accept or not the liver biopsy, liver damaged don't show any symptom at all unless the damaged is very advanced and the liver start to fail on your body, and there isn't another way to find out how much damaged the liver has only the liver biopsy can show up a bit about it. Maybe your liver doesn't has any big damaged but maybe it does, you can't know it unless you go through the liver biopsy.

Last edited by shersita; 10-21-2012 at 03:45 PM. Reason: ortography

 
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Old 10-22-2012, 07:45 AM   #3
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Re: Abnormal liver function tests from blood sample, clear ultrasound, no health issu

I would ask them hypothetically, what the biopsy might reveal that would change your treatment?

If they're simply looking for possible fibrosis, a fibroscan might be a better non-invasive option. If they are looking for high iron, there is an MRI study that now reveals Iron in the liver. If they are looking for fatty liver, the ultrasound should have been able to see this.

What is it exactly they think they might find in a biopsy that they could treat?

 
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Old 10-22-2012, 09:07 PM   #4
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Re: Abnormal liver function tests from blood sample, clear ultrasound, no health issu

What are your ALT/AST levels?

 
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Old 10-26-2012, 01:07 PM   #5
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Re: Abnormal liver function tests from blood sample, clear ultrasound, no health issu

Quote:
Originally Posted by BillinSD View Post
I would ask them hypothetically, what the biopsy might reveal that would change your treatment?

If they're simply looking for possible fibrosis, a fibroscan might be a better non-invasive option. If they are looking for high iron, there is an MRI study that now reveals Iron in the liver. If they are looking for fatty liver, the ultrasound should have been able to see this.

What is it exactly they think they might find in a biopsy that they could treat?
Maybe the doctor is having a slow month

I say that both in jest and partially seriousness. I have been to doctors who love to over treat. Sadly, some medical practices are financially driven.

A very good friend of mine who happens to be a urologist told me he has had life long persistently elevated liver enzymes. His ultrasound shows patches of fat. His liver specialist suggested a biopsy and he refused. He confided in me that even if he has cirrhosis or fibrosis there is no specific treatment, so the biopsy would have no benefit and only create stress and worry should there be a positive finding. He is living a healthy lifestyle and eats properly.

His exact words " if my liver should ever really shows signs thats its begining to fail then ill have the biopsy and go on a transplant list, but having a biopsy now when I'm relatively healthy is unnecessary. I'm going to live my life and not spend it worrying"

That's good advice from an MD.

 
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Old 10-26-2012, 01:34 PM   #6
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Re: Abnormal liver function tests from blood sample, clear ultrasound, no health issu

There are a couple of blood tests that might be helpful in evaluating this. Also, the trend of the enzymes over the years is important. Have they stayed about the same level or are they getting worse? If getting worse, excess iron can be the culprit, and a serum ferritin level would be elevated as well as transferrin saturation, both simple blood tests. Also, an autoimmune hepatitis could be suggested by anti-mitochondrial antibodies, a blood test. Both of these conditions can be treated, and I would check with your Dr to see if either of these have ever been tested, or review your labs if you have the results. It would be nice if this could be figured out without a biopsy, and unless you have been seeing a liver specialist, you may have not been checked for everything. The ALT and AST enzymes are also found in muscle, and elevated in muscle inflammation and breakdown, so a CK muscle enzyme test or fractionation of the ALT and AST may be helpful to make sure it is liver and not muscle that is the problem.

 
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Old 10-28-2012, 07:59 PM   #7
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Re: Abnormal liver function tests from blood sample, clear ultrasound, no health issu

Wow! They want to do liver biopsy only because of abnormal liver test? I was in the ER because of chest pain, nothing abnormal except high AST, ALT (95, 76). No biopsy. But I went to a primary care physician. I had gallbladder ultrasound for gallstone, negative. Then I had Hepatitis panel blood test, positive for Hepatitis.
But I did not get liver biopsy until after several other blood tests.
I think liver biopsy was not bad for me but would not have it done if it was not absolutely necessary (risk for internal bleeding). I ended up having allergic reaction from the sedation drug they gave to me.
Hope you find your answer soon!
Good luck!

 
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Old 11-03-2012, 07:42 AM   #8
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Re: Abnormal liver function tests from blood sample, clear ultrasound, no health issu

Quote:
Originally Posted by binkyholder View Post
What are your ALT/AST levels?
Hi, don't know my levels.

 
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