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Old 10-23-2012, 02:15 PM   #1
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Elevated liver enzymes, pain under right rib cage, coarse texture on ultrasound

I was first told I had elevated liver enzymes (AST/ALT) at the beginning of 2008. For the year and a half prior I had been battling an eating disorder, taking two types of diet pills, one dose of Tylenol per night (tylenol pm to get me to sleep), and had lost my period for a year. I had cut out many food groups and was exercising a good 3 hours a day total on about 800 calories/day.

My doctor told me to stop taking Tylenol to see if they enzymes would go down. They remained elevated a year later despite the fact that I hadn't a stitch of alcohol in years and refrained from Tylenol use. I also started eating very well as I got pregnant in March of 2008 and couldn't imagine harming by baby through my bad eating habits.

I started taking the birth control Yaz in January 2009 (first time ever being on birth control) and have been taking it since.

I had a liver ultrasound in 2009 which came back clear. Enzymes stayed elevated, though have never been too high. I don't entirely avoid alcohol, though I'm not a heavy drinker.

I started getting pain right under my right ribcage around March of this year. The pain is not constant but it is more frequent now than in March. It's mostly a dull ache like something is stuck under my ribcage with an occasional stabbing pain that takes my breath away.

We just moved so I started seeing a new doctor a few weeks ago to inquire again about the pain. He tested my enzymes and saw they were still elevated. My AST was in the 70's and my ALT was just over 100. This is not the highest they've been but they've really bounced all over the place since 2008, only once going just above normal (both were in the high 40's this May). He didn't have my full records yet from my previous doctor so he re-tested for all types of hepatitis and had me do a liver ultrasound.

I got my results back today. I again tested negative for all forms of hepatitis. Liver ultrasound showed a coarse texture but no masses/tumors/lesions or anything else specific to anything in particular. My doctor ordered for a CT scan of my liver which I'm getting done this coming Saturday.

No other symptoms of anything really though for the most part. My legs itch a lot (not due to dry weather, it's nice and humid here in Florida haha!) though there is no rash, and I'm really tired all the time but that's about it. Whether that is related or not, I don't know.

I just sort of don't know where to go from here. I don't know the questions to ask or what may or may not be helpful for me. My previous doctor left me in the dark about everything and anything I know is from research online. I don't know if this is or isn't a big deal. I'm kind of just asking for a little reassurance that I am going in the right direction here and any advice on how to help myself through this and be aggressive to get the answers that I need would be helpful.

Thank you to all who even read that enormous post I just wrote! -Kathryn.

 
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Old 10-23-2012, 08:18 PM   #2
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Re: Elevated liver enzymes, pain under right rib cage, coarse texture on ultrasound

How is your bilirubin? Let us know the results of the ct scan

 
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Old 10-24-2012, 06:10 AM   #3
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Re: Elevated liver enzymes, pain under right rib cage, coarse texture on ultrasound

They've never said anything about bilirubin or anything else. I don't know if that means they're all normal or that they just aren't testing those levels. I know my last doctor had checked my iron levels about two years ago and they were fine, but that's about it.

I will post when I get the results of the CT scan. I'm just kind of baffled. I can't imagine anything being wrong with me at all and I'm kind of unsure about all of this and what it could possibly mean. Hoping I get answers soon and hopefully they just say I'm fine!

 
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Old 10-24-2012, 06:30 AM   #4
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Re: Elevated liver enzymes, pain under right rib cage, coarse texture on ultrasound

I only asked about bilirubin because you said you were itchy. Im sure if it were elevated the doctor would have told you. Your CT findings may just be nothing, or possibly fat. Let us know and good luck. Ultrasound results can vary greatly by the radiologist reading them, the quality of the machine and the skill of the tech.

 
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Old 10-24-2012, 06:40 AM   #5
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Re: Elevated liver enzymes, pain under right rib cage, coarse texture on ultrasound

Ahh, I see. I used to think my itchiness was due to living in Colorado where it was super dry and very cold in the winters. Now I'm here in Florida and still itching like crazy and it's driving me nuts! But yeah, nobody has ever said anything about bilirubin so I suppose that's a good thing :]

Thanks for your replies, I'm definitely hoping it's no big deal! I'm not too worried, I just feel so dumb about everything and all that I read online is just way beyond me.

 
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Old 10-24-2012, 06:50 AM   #6
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Re: Elevated liver enzymes, pain under right rib cage, coarse texture on ultrasound

Are the whites of your eyes yellow? You would turn yellow before you would start itching. People would point it out to you. Its probably not bilirubin

 
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Old 10-24-2012, 06:58 AM   #7
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Re: Elevated liver enzymes, pain under right rib cage, coarse texture on ultrasound

Good to know! I am not turning yellow at all. I did have chronic hives every day starting when I was about 6 and going on for about 16 years that they were never able to find a reason for. They went away when I moved to Colorado (from California) in 2005. A few years later I started itching but no hives. I guess I'm just destined to be an itchy person!

 
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Old 10-24-2012, 06:59 AM   #8
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Re: Elevated liver enzymes, pain under right rib cage, coarse texture on ultrasound

Quote:
Originally Posted by abouttwodays View Post
Good to know! I am not turning yellow at all. I did have chronic hives every day starting when I was about 6 and going on for about 16 years that they were never able to find a reason for. They went away when I moved to Colorado (from California) in 2005. A few years later I started itching but no hives. I guess I'm just destined to be an itchy person!
What is your current height and weight and what did you weigh before your diet?

 
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Old 10-24-2012, 07:06 AM   #9
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Re: Elevated liver enzymes, pain under right rib cage, coarse texture on ultrasound

Current height and weight is 5'5" and 150. I weighed 135 before I started restricting. I currently cannot lose weight to save my life unless I drop my caloric intake to around 900/day, but I'm guessing I messed up my metabolism.

 
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Old 10-24-2012, 07:09 AM   #10
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Re: Elevated liver enzymes, pain under right rib cage, coarse texture on ultrasound

Your not really overweight much. But the fact that its so hard to loose weight could point to fatty liver and metabolic syndrome.

 
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Old 10-24-2012, 07:26 AM   #11
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Re: Elevated liver enzymes, pain under right rib cage, coarse texture on ultrasound

Well that's definitely good to know. I mean, I eat better than anybody I know and I'm a fairly active person. I rarely eat at restaurants (I've eaten at a restaurant maybe 6 times in the past 5 years) and never eat fast food. I've tried everything just short of restriction again and nothing I do helps. I was eating around 900 cals/day upon moving to Florida because I was super stressed and I lost a few pounds but gained them right back. I can gain muscle pretty easily but can't lose fat no matter how hard I try. Finally decided to ditch the scales and full length mirrors otherwise it messes with my mind. I only know how much I currently weigh because of recently going to the doctor. I had told my previous doctor about this but she had no advice.

 
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Old 10-24-2012, 07:38 AM   #12
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Re: Elevated liver enzymes, pain under right rib cage, coarse texture on ultrasound

When you put the liver problem together with a history of chronic hives and fatigue, it points to an autoimmune disorder. Autoimmune disorders can cause thyroiditis (Hashimoto's), hepatitis (all viral hep. tests will be negative), chronic hives and itching. I would ask Dr. to check antithyroid antibodies, TSH, free T4, T3 (all thyroid tests), an ANA for lupus, sed rate, CRP, urinalysis, and anti-mitochondrial antibodies, often present in autoimmune hepatitis. If your Dr is nice and doesn't have a huge ego, he/she will do these. If anything shows up, a referral to a specialist should be done. A gastroenterologist deals with hepatitis, including autoimmune, and other liver disorders.

Last edited by ladybud; 10-24-2012 at 07:39 AM. Reason: typo

 
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Old 10-24-2012, 08:00 AM   #13
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Re: Elevated liver enzymes, pain under right rib cage, coarse texture on ultrasound

This is exactly why I came on here. I have no idea what to tell my doctor, what could or could not be relevant, so mostly I keep to myself. I did briefly mention to him yesterday that I grew up with chronic hives and that I am currently itching the skin straight off my legs. My legs are all bruised up from the itching! In one night I accumulated 8 bruises on my calf just from itching. More than anything that alone is driving me nuts...I thought all the itching was over some 6 years ago! About my hives, I was always told, "your body just naturally releases too many histamines." I would swell up as well. At one point I was denied my medication from my doctor and wound up in the ER because my entire body, including my throat, was swelling fast.

I am pretty sure my last doctor said she tested my thyroid when I told her about not being able to lose weight. However, she never told me what it was exactly that she tested. My aunt has a thyroid problem and her son suffers from the autoimmune disorder "alopecia areata" and so does my sister. I think someone else in my family has a thyroid issue as well. Oh and my mom itches a lot too. Her legs and back will itch and itch and she will keep itching and itching until she bleeds.

 
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Old 10-24-2012, 10:26 AM   #14
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Re: Elevated liver enzymes, pain under right rib cage, coarse texture on ultrasound

The itching may be related to allergies, but autoimmune disorders and thyroid problems run in families and they can cause excess histamine release too. I would definitely take antihistamines for it, but I would ask for a copy of all your recent labs. You can post them for comment if you'd like.

 
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Old 10-24-2012, 10:46 AM   #15
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Re: Elevated liver enzymes, pain under right rib cage, coarse texture on ultrasound

Thanks! My doctor's office from Colorado is being a real pain in getting my records out here. So far my doctor only has my last year of records. My husband and I both sent a detailed request to send our full records over (I was very specific in making sure any lab results be sent) and to have them faxed immediately. I just went to the doctor yesterday and it had been almost a week since we made that request and neither of our records had arrived yet. I will probably be going to the doctor next week as my CT scan is on Saturday and I need to go back to my doctor to get the results, so I will see if he has the records and ask about what has been tested for. I'll make sure I post when I find out :]

 
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