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    Old 10-20-2014, 03:41 AM   #31
    VeeJ
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    Re: Autoimmune Hepatitis in Males

    Excellent news about your liver values, but really sorry to read about your high blood glucose... Since your glucose levels were borderline before your liver ordeal began, I'm guessing that was an early warning that you were already on the brink of diabetes?

    I suspect that as we age, if the family tendency is already there, it's awfully easy to creep over the line for Type 2, even without Prednisone. My husband just did after giving up tennis (bad knee ligaments) and also falling into some lazy snacking habits. Weight isn't an issue for him (his is low-normal), so it's truly scary how delicate the balance can be.

    If your A1C continues high now that you're off Prednisone, in your shoes I'd want to consult an endocrinologist. Like I said earlier, I *think* Metformin (etc.) only work for Type 2 diabetes, not Type 1. (Type 1 is thought to be brought on by certain viruses, I think. It's more common in young people but can occur in older ones, too. In fact, in the last year alone I've met two people in their late 60's who were dx'ed with Type 1.) In short, the underlying cause of your diabetes may be very important, plus you have the added complication of possibly needing the Prednisone again if your liver values were to spike. So if you see crazy high values as you test, I'd ask to see an endocrinologist NOW, rather than waiting for your GP to run your next scheduled A1C.

    I'm not trying to be a worrywart, btw. I'm just hoping that you can get thru your liver issues and NOT end up with diabetes permanently on your plate. I'm glad you touched base. Let us know what happens. Sending my best!

     
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    Old 10-20-2014, 07:21 AM   #32
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    Re: Autoimmune Hepatitis in Males

    So glad to hear your liver responded to the Prednisone and enzymes are back down. That is great news. We'll keep our fingers crossed the diabetes issue settles down now that you are off the Prednisone. Many times, with autoimmune diseases, a course of good treatment will put the immune over-reaction into remission for awhile. It is also common for people with inflammatory conditions to get anemia of the "chronic disease" type, which usually stays mild to moderate and generally requires no treatment if iron and ferritin levels, B12, folate are all ok. As the inflammation subsides the anemia may improve. Glad you are doing better!

     
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    Old 10-21-2014, 06:03 AM   #33
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    Re: Autoimmune Hepatitis in Males

    Thanks much for the encouragement!

    One thing I forgot to mention, I have blood glucose meter, but I didn't get one that is really reliable. It's not the meter that is expensive it's the strips that cost on good meters. This meter from all the reviews I read tends to read high. Saying that if that is the case, my sugar level is back to normal. Average readings after more than a month are about 130. Top of the normal scale is 120, but again this meter has a history of reading on the high side.

    Actually the only way to find out what's going on is to get another A1c done.

    My liver doctor said at some point he wants to put me on Imuran since even the low dose Prednisone caused so much problems. 10mg Prednisone is about as low as you can go to do any good. He is still unsure at this point if he should do anything, but if left untreated he doesn't want me to come back in 5 years with liver failure.

    My preference is just to watch the liver enzymes levels. Like do a blood test every 3 months, 4 times a year to see where they are at, but I am not the doctor and I suppose he knows best.

    If any major changes occur I will post them. Take care and thanks again.

     
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    Old 10-21-2014, 08:06 AM   #34
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    Re: Autoimmune Hepatitis in Males

    Interesting about your meter possibly being inaccurate: this happened to my husband just last week. His GP asked that he bring his meter to his appt., then they applied the SAME blood drop to two different strips, his and his doctor's, and they tested one on hubby's meter and the other on the GP's. The difference between the 2 meters (two different mfgrs.) was 14 points.

    My hubby bought a new meter (old was 10 years) and TRIED to buy the "control solution" one uses to verify the meter when one opens new strips, or if one questions the readings. We contacted SIX pharmacies but none stock it. Our (cynical) thought was that because the solution has an expiration date, the pharmacies don't want risk discarding unpurchased product. If your meter calls for such a control solution, maybe you could get the mfgr. to send you some gratis? (My husband's meter mfgr. offered, which was nice of it.)

    Anyhow, it's great that your glucose readings are hovering around the cut-off, as opposed to being wildly high. Good luck on your next round of liver enzyme tests---I sure hope they're stable from here on out. Glad you touched base. Sending my best wishes.

     
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    Old 10-21-2014, 05:58 PM   #35
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    Re: Autoimmune Hepatitis in Males

    Ok I have the ReliOn Prime meter sold at Walmart. 50 strips only $9. Should of known better when something looks too good to be true it usually is.

    I had to go to the ReliOn website to get the free Control Solution. I got it in the mail in about a week.

    I tested the meter with the solution and it was in range. These meters by FDA regulations could be as much as 20% off and still be sold. From what I read on reviews of all meters, you will never get two meters to read exactly the same even from the same blood sample. Some will be close, but many are way off from each other.

    I didn't want to spend a lot on a meter not knowing if I really have diabetes. This all could caused by the prednisone I was taking and my adrenal glands are taking there time getting back to normal. Hopefully that is the case. I will know when I get another A1c test done.

    Thanks again for the info. Will update.

     
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    Old 10-22-2014, 12:42 AM   #36
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    Re: Autoimmune Hepatitis in Males

    Most insurances cover meters, strips, lancets, etc. You could ask your pharmacy for quotes. On the model my husband just bought, he can see averages for pre- versus post-prandial, over various numbers of days (90, 60, 30). In effect, he can see a running A1C. Good luck.

    Last edited by VeeJ; 10-22-2014 at 12:49 AM. Reason: Hit send too soon

     
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    Old 10-22-2014, 03:54 AM   #37
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    Re: Autoimmune Hepatitis in Males

    Thanks for posting, I've been following the post as its up in the air if I have AIH or Lupus with liver involvement. I just started my journey recently, but my dsdna was positive and I only caught a glimpse of my liver function panels... Bilirubin was elevated, and either ALT or AST was over 120 - maybe more things were elevated... He only let me look at the paper for a split second. I need to obtain my own copy next time I see him.
    I havent had the smooth muscle antibodies checked yet.

    At my age (30) with no history of heavy drinking, and the current meds Im taking rheum doesnt think either of those are the offenders. Your posts have given me a lot of insight and strength

     
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    Old 10-22-2014, 06:19 AM   #38
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    Re: Autoimmune Hepatitis in Males

    Quote:
    Originally Posted by VeeJ View Post
    Most insurances cover meters, strips, lancets, etc. You could ask your pharmacy for quotes. On the model my husband just bought, he can see averages for pre- versus post-prandial, over various numbers of days (90, 60, 30). In effect, he can see a running A1C. Good luck.
    Exactly about the running A1c. That is what I was referring to by being able to see your average over a period of time. I will look at being covered by Medicare also. Many people get a meter called Freestyle which they say is pretty accurate. I have to wait though for a few more A1c tests to find out for sure if I am diabetic. Thanks again for the info.

     
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    Old 10-22-2014, 06:36 AM   #39
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    Re: Autoimmune Hepatitis in Males

    Quote:
    Originally Posted by alicake View Post
    Thanks for posting, I've been following the post as its up in the air if I have AIH or Lupus with liver involvement. I just started my journey recently, but my dsdna was positive and I only caught a glimpse of my liver function panels... Bilirubin was elevated, and either ALT or AST was over 120 - maybe more things were elevated... He only let me look at the paper for a split second. I need to obtain my own copy next time I see him.
    I havent had the smooth muscle antibodies checked yet.

    At my age (30) with no history of heavy drinking, and the current meds Im taking rheum doesnt think either of those are the offenders. Your posts have given me a lot of insight and strength

    Hi and thanks for posting on this thread. Hopefully you can get a positive answer to your questions from your doctor. I am diagnosised with AIH with Cirrhosis, hopefully if you do have AIH it has not advance to the cirrhosis stage, which I don't think it has considering your age, but make sure you keep on top of it so it doesn't. Do not know too much about Lupus, but maybe some others can chime in and give you some insight. If you only looked at your blood work for a second you may have read your ALT and/or AST wrong, so don't jump to conclusions until you actually have the paper in your hand. At the lab my doc uses, normal ALT and AST has a range of 0-41 and 0-40 respectively. Saying that, if you think you seen a number of 120 make sure you follow up on this because that is way high and you might have some inflammation going on with your liver. I say might because I am not a doctor and it could be caused by something else. First thing though get a copy of your blood work to make sure you are reading the numbers right. As you probably know, Lupus is predominately found in females although my brother had Lupus in his elderly years. My doc says my AIH is not Lupus, but since it's the autoimmune family, both my brother and I have the gene responsible for contracting what I have and what he had. My other brothers and my sister did not have any autoimmune diseases so go figure. Since you are relatively young I am sure with proper medical treatment you will be fine after you get your numbers under control. Good luck and keep us advised.

    Last edited by retired521; 10-22-2014 at 06:37 AM.

     
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    Old 10-22-2014, 07:28 AM   #40
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    Re: Autoimmune Hepatitis in Males

    Im not sure which one it was, I just know it was flagged high and normal range was lower than 40. I know the bilirubin was flagged too, but didnt see the level. The bilirubin wasnt a surprise as my home urine test had shown bilirubin a week before our follow up.
    Like I said, it was a fast glance and rheum seemed really concerned. I tried cracking some jokes and he wasnt having it.

    Right now we're re re-running the functions, and then also a hepatitis panel, although I highly doubt that would be positive(hubby had negative panels 4 months ago as his new PCP insisted on all those tests, we've both -as far as I know- have been monogamous for the 10 years we've been together) except maybe hep A which is food borne?? We dont eat out a lot, but that can take only one time. We're also a no tylenol household, so it wouldnt be from that, but I do take NSAIDs & low dose of cymbalta.

    Theres some overlap symptoms with me, so could be anything at this point. Interestingly, my SED rates and CRP have been normal - even when my joints swell.

    I dread the possible liver biopsy. Was it bad?

    Last edited by alicake; 10-22-2014 at 07:29 AM.

     
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    Old 10-22-2014, 07:14 PM   #41
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    Re: Autoimmune Hepatitis in Males

    Well the liver biopsy is really not that bad, but don't want to mislead you either. Actually it over pretty quickly and you feel the needle a bit which is normal since you are not under any anesthesia. After the biopsy you may feel some pain in your right shoulder, this also is normal in some people. They will keep you in the hospital for at least a half hour after the biopsy and you can request more time if you need it until you are feeling okay to get up.

    After a few hours you will be back to normal. This is how think the liver biopsy went for me.

    Not sure why you need a liver biopsy. I think you need more testing done on liver function before they need to do a biopsy.

    Like I said earlier, stay on top of this, especially if you have liver involvement because if your liver is inflamed over a long period of time it could lead to cirrhosis and that is not good. Good luck.

     
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    Old 10-23-2014, 04:32 AM   #42
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    Re: Autoimmune Hepatitis in Males

    I hope I dont need one, I guess I probably wont, or at least im really hoping I dont. lol

    I went to ER last night for stomach pains, gallbladder was brought up but totally clean looking. They ran LFT tests, bilirubin was back in normal range (yay) but AST was 176. So that means its risen 50 pts in like 4 weeks even though I've abstained from everything since hearing the first results two weeks ago( except cymbalta) and my eye drops. Obviously, nothing ER could do about that. Potassium was ultra low, so they gave me potassium pills.

     
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    Old 10-23-2014, 05:07 AM   #43
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    Re: Autoimmune Hepatitis in Males

    alicake, so sorry you landed in the ER. I think Cymbalta does carry liver warnings; and although the known incidence isn't very high, who's to say that you aren't one affected? (Of course, whatever is going on with your liver could be due to something other than your meds.)

    Are you calling all your doctors today---incl. the doctor who prescribed Cymbalta---to discuss the ER findings? I would. Although the hospital may fax paperwork to any doctor you named, doctors don't necessarily read all they receive in timely fashion---so I'd just take the bull by the horns, if I were you. Please let us know how you're doing. Sending extra hugs!

     
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    Old 10-23-2014, 09:59 AM   #44
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    Re: Autoimmune Hepatitis in Males

    I agree with VeeJ and not to be a cynic, almost all drugs for any condition have some side effects that are not good.

    I would surely take Predisone off the market, but maybe some people do tolerate it with no side effects.

    Yes, your AST level should be checked ASAP, in my opinion that is too high to be normal.

     
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    Old 10-24-2014, 04:09 AM   #45
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    Re: Autoimmune Hepatitis in Males

    Ive been weaning the cymbalta from 60mg to 30mg anyways, as there was no difference in doses and rheum had talked about taking me off last appointment. We were going to revist after my next LFT.

    My Rheum is on vacation currently, I went to drop off ER findings to his staff so they could have copies and the office was closed. Totally forgot he was going away. I see him in a week and a couple days anyways. I'll drop a line to my PCP via email in the meantime.

     
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