I was injured during a routine surgery and lost 20 lbs in 10 days. Was transferred to a great hospital, got tpn, and my body returned to normal after 5 surgeries (gallbladder & ileostomy reversal). Last Jan. my liver enzymes were normal but they started going up in Feb (still in the normal range) as I gained weight. I gained an extra 20 lbs by June and my enzymes went up. Ast was normal, Alt was 119 (normal max is 63). In August they went up to 55 and 152. I had a few drinks the two days before. I saw a heptologist at a major teaching hospital (same as I went to get better). My enzymes went down to 57, 112. Lost 8 lbs (155 lbs) and the ast went up to 58, but alt went to 107. I lost 3 more lbs but they shot up to 75 and 140. Dr thought I had fatty liver b/c of the high fat diet that I was on to gain my weight back. I had 2 ultrasounds done in Oct & Jan and they were great. I am negative for Hep. A,B,C,D, no autoimmune hep., no hereditary diseases. Dr is not sure what's causing the levels to go up. She said we can do a biopsy in 6 months if I want for my own mental health as I need to get life insurance and I can have a glass of wine now and again. I ran a half-marathon last month so I am in good shape. I started taking milk thistle and livercare last week. I started taking vitamin c & e in October, too.
Any ideas? This is frustrating plus I am worried that I will have cirrhosis in time. My lifer function is great, as there has been no change in albumin, alk. phos. I have gilbert's syndrome, too. Thanks.
My first thought would be to ask if you are on any meds, as many can cause liver enzyme elevation as side effects. So can some supplements. The other question would be related to alcohol intake. A GGT enzyme, not always routinely done, is a very sensitive test to sort out liver injury caused by alcohol. The third is related to the internal injuries from your surgery. Was any damage done to your pancreas? Have your pancreatic enzymes been checked (amylase and lipase)? Any inflammation or problem in the pancreatic duct or pancreas can raise liver enzymes. I would be sure to get those checked (blood test). The Gilbert's disease is probably unrelated, but you obviously run an elevated bilirubin at times which makes the picture even more confusing. Please let us know what turns up as to the cause when it gets figured out.
I don't think my pancreatic enzymes were checked. After two bouts with sepsis, my dr is thrilled that my liver function did not waiver, so that is some good news. Also, after my hernia surgery next week, she said I can take Tylenol, so perhaps things are not too bad. As for alcohol, I don't drink at all, but my hept. said I can on occasion. I goto a top 10 hospital, so I have faith that they know what they are doing, but it still is frustrating. She also thinks b/c I went through so much trauma, these high enzymes might be my new normal. I will continue to take milk thistle and livercare and see what happens.
I am sorry you have been through so much, but it is amazing how you've recovered and feel well enough to run marathons. That brings up one other possibility- ALT and AST elevations can be caused by skeletal muscle injury as well. So maybe these enzymes are elevated because of running, not your liver. They can be fractionated at the lab to determine if they are coming from liver or muscle. Another muscle enzyme, CPK or CK, can be checked too which would provide a clue. I would hate for you to go through liver biopsy if it was from your muscles all along. Can't hurt to have that done next time it is checked! Anyway, glad you are doing so much better!