You are asking questions no one can really answer, given you hadn't seen a Dr. for 5 years, and don't know how long your enzymes have been elevated, or for sure why they are up. What is known is that stopping the things toxic to your liver will give you the best chance of a full recovery and prevent further damage. You really will have to wait until you see on next check what direction they are heading, and if they are not dropping, further tests will need to be done to check it out. I hope they are back to normal by next visit and think it is realistic they will be, but you may have to deal with some anxiety until you get to the next step. I would truly not be overly worried, just take good care of yourself.
I agree with the recommendation for ultrasound and Hep C check if enzymes stay elevated or go higher. Your bilirubin is mildly elevated, which goes along with the enzyme elevation. You may be able to see a slight yellowish color of the whites of your eyes at this level. If you see that, and it goes away, you know your liver is getting better. If your eyes turn darker yellow over time, it is getting worse and you should notify your Dr. How is appetite? Any nausea or diarrhea, fever, food aversions, or risk factors for hepatitis of any type (travel, IV drug use, transfusion, high risk sexual exposure?) The bilirubin being a little elevated is not surprising. Any reason to suspect gall bladder disease, like right upper abdominal pain under ribs?
thanks everyone. this has freaked me out and nobody in my family knows - they only know of my drinking. would anybody think Cirrhosis or severe damage by reading my results? i had done nothing good all the way up to the blood test, even 1500mg of tylenol the morning of the test.
You can't diagnose cirrhosis by enzymes. You have to have an image such as ultrasound or CT scan showing a small fibrosed (scarred) liver or a biopsy showing the characteristic scarring. Cirrhosis develops over many years of heavy drinking. If you have an ultrasound, that will give you better information.
Hi KC, & Congratulations on your decision to start looking after your health.
Your enzymes ALT/AST really aren't all that bad... Doctors usually don't worry about slightly elevated enzymes until they are over double normal high end levels, or are high over a series of tests over several months time. Viral hepatitis A can spike your enzymes up 10 times over normal high values and most recover fully, even from this.
Your bilirubin is up around double normal and this is the one test that made me go hummm when I saw it. Some people have normally high bilirubin from a genetic condition and this is called Gilbert's Syndrome. People with Gilbert's usually don't suffer any ill effects from it, so no worries if your bili is always high like this.
Other reasons for high bilirubin might be gallstones, which should cause you symptoms (PAIN), or perhaps a sluggish liver that is not moving enough bile. Liver's need high choline foods to generate bile like meat, fish, or especially eggs which contain "Lecithin" (aka phosphatidylcholine) which is your liver's favorite nutrient.
If you're limiting your high choline foods for any reason (or hate/don't eat eggs), a Lecithin supplement might help you generate some more bile, which is how your liver dumps its toxins into the GI tract for disposal.
I like the looks of your supplement stack, but anytime you take fish oil/omega 3, you should also take some natural vitamin-E to make sure it doesn't oxidize in your liver. Alcohol and fish oil are a very bad mix as alcohol metabolism will oxidize fish oil badly, even if your adding vitamin-E, but as long as your not drinking small amounts of fish oil shouldn't cause a problem.
I must confess I'm not a big fan of fish oil, despite all the rage about it lately. It goes rancid very easily once you open the bottle, and will also oxidize in your body with any oxidative stress (like alcohol), or if you don't supplement vitamin-E.
I take all my supplements in small amounts and feel mega-dosing anything is unwise. Green tea, turmeric and SAM-e are my favorite liver supplements. Regarding the B-Complex... Some say you should take B vitamins with SAM-e to insure you don't get elevated homocysteine levels. The only dark side I've ever heard about B-Complex is that high levels of folic acid may be unwise. I actually had a hard time finding low folic acid B-Complex, but it is out there.
I like low dose 200mg SAM-e taken twice a day with my low dose B-Complex twice a day with it. SAM-e is an "empty stomach" supplement by the way so don't take it with food or much of it is wasted.
Your out of range values don't scare me all that much, and they shouldn't scare you either, but they should justify a re-test in 90 days to see if they are falling back into line. Your doc should not object to this at all, as it is standard of care to re-test when labs are out of range.
Please don't worry too much about these labs... Worry can make you sick too! I'll bet you get all green lights in your labs if you retest @ 90 days, with the possible exception of the bilirubin if you've got Gilbert's or a very sluggish liver.
I'm NOT a doctor by the way... Just an old drinker who got into liver health research once I finally cleaned up my act.
I'm confident you're in better shape than you may think. Best of luck to you!
thanks BillinSD. so helpful. rests my fears a bit. i'm still on the "new man plan". i'll cut out my Omega 3 to just 1 cap per day. is there any kind of "daily" plan/schedule you would recommend for improving liver function? I want to get it healthy and keep it there.
hot water with lemon first thing in the AM,
??? at lunch
one more question...what do you think of the drink mix "Emergen-C" stuff? it has 1000mg of vit C per packet, but also has b6 (as pyridoxine hydrochloride) at 10mg/500% and vit b12 (as cyanocobalamin) at 25mcg/417%. what do you think of this? one or twice per day or none?
thank you so much. so should I give it 90 days to go back? I was going to go back in 14-21 days. let me kjnwo what you think. thanks again.
I think 2-4 weeks is enough to see it drop and allay your anxiety. You probably don't want to be worrying for 3 months about this. In the event the enzymes go up for some reason, better to know sooner than later.
Hi KC, The liver actually does a remarkably good job of taking care of itself once you stop beating it up with toxins.
The liver's favorite nutrient is choline, found in meat, fish and especially eggs; it also needs B-Vitamins to carry out a lot of it's work, and vitamin-E will help prevent lipid peroxidation which is the liver's nemesis.
Vitamin-C is a good anti-oxidant that will help the liver maintain it's glutathione levels. The form of vitamin C really isn't all that important, but smaller doses taken a couple of times a day is better than taking one thumping big dose per day. One issue with vitamin C is that if you take it with food, it will greatly increase iron absorption from the meal. Young females tend to be low on iron, but males tend to accumulate excess iron as they age, and elevated iron can stress the liver over the long haul. I take my vitamin C, 500mg twice per day on an empty stomach with at least 8 ounces of fluid, one hour before meals or 3 hours after.
I also take low dose B-Complex twice a day and supplement vitamin E with my fattiest meal of the day.
You may see some improvement in your liver labs in just a couple of weeks, but your doc may resist doing followup labs every few weeks and the small changes over short periods of time may be a bit disappointing. I'd hang tough for a month or so and you'll probably be more impressed with the improvement you see if you do.
Good Luck and Stay Healthy!
Last edited by BillinSD; 04-19-2013 at 11:00 AM.