I'm a mystery - help! Elevated enzymes, but nothing fits

04-05-2006, 02:10 PM

I'm hoping someone here will have some good possibilities for me - right now from everything I see, I've got readings consistient with alcoholism - and I've never had a drink in my life (OK, a sip or two, which always verified that I just can't stand the taste of alcohol, no matter how well hidden)! So, something weird is up. Here's the details

I'm pregnant. However, I'm in my 2nd trimester (start of 5th month is when the tests were done) (most pregnancy specific liver diseases show at 1st or 3rd trimester). I've got gestational, or maybe plain old type 2 diabetes (found in first trimester, so they think I may have always had it. I'm also having a lot of trouble gaining weight during the whole pregnancy (pre-pregnancy, unfortunately, I had no trouble at all, gained a bunch of weight right before) - I am down 3 pounds for the entire pregnancy - and I'm now just 6 months in - I should be up at least a couple pounds - I'm eating as much as I can manage (some nausea).

Doing blood work to see how well I was dealing with this, they found some elevated numbers - same results 2 different tests

AST 250-300
ALT 90

No symptoms that I can think of - some heartburn issues, diabetes is well under control, allergies, but nothing really bad. Looking online, whenever AST is over ALT significantly, they first look to damage from alcoholism - which isn't a possibility in my case. I've got the tests running, more bloodwork, ultrasound, but I won't get results for more than 2 weeks, and the possibilities I'm finding online are way too scary.

I was hoping someone here might possibly be able to help me out with what the possibilities are - especially any benign ones. I don't seem to find anything that matches at all, other than things with symptoms I don't have, or alcoholism. It's a mystery - and a very disturbing one.

04-06-2006, 07:52 AM

Ok, I'm not a doctor here but there are many factors that may be contributing to the high AST levels (besides alcohol).

First off, I notice that your ALT levels are also high. It's hard to diagnose something when you haven't gotten the results of the tests/ultra sound back yet. But aside from the bad possibilities such as liver cancer, breast cancer, and heart disease, small non-deadly things can be causing it as well. Herbs and natural minerals, strenuous exercise and medications can also be factors. Have you checked into the possibility that whatever you take for the diabetis could be raising your levels?

I wish you the best of luck on finding out the reason. Take care!

04-07-2006, 10:55 AM

Thanks. Yeah, it's the ratio that seems to be the odd bit.

No strenuous exercise, meds are allegra, prozac, prenatal vitamin, and a very small dose of glyburide at night that I wasn't taking when I got the readings. No herbs or other vitamins or whatever.

We got the bloodwork back - the doctor just said that nothing in that explains the readings. Which leaves the uncertainty, but at the least it doesn't confirm any of the bad ones. Should have an ultrasound result soon.

04-07-2006, 12:32 PM

Got data - blood tests don't indicate anything new, but ultrasound finds liver has fat in it - what the heck does that mean?

04-10-2006, 08:39 AM

I have a fatty liver also, but mine is from alochol abuse. My brother also has a fatty liver and its from years of taking zoloft so I think some meds can cause this. Ask your dr.

Fatty Liver
The Liver
The liver is the largest organ in the body. It is found high in the right upper abdomen, behind the ribs. It is a very complex organ and has many functions. They include:

Storing energy in the form of sugar (glucose)
Storing vitamins, iron, and other minerals
Making proteins, including blood clotting factors, to keep the body healthy and help it grow
Processing worn out red blood cells
Making bile which is needed for food digestion
Metabolizing or breaking down many medications and alcohol
Killing germs that enter the body through the intestine

What is Fatty Liver?
Fatty liver is just what its name suggests: the build-up of fat in the liver cells. Although this is not a normal condition, fat in the liver usually causes no damage by itself. However, on some occasions it can be a sign that other more harmful conditions are at work. Fatty liver may be associated with or may lead to inflammation of the liver. This can cause scarring and hardening of the liver. When scarring becomes extensive, it is called cirrhosis, and this is a very serious condition. Therefore, it is important that a physician thoroughly examine a patient with fat in the liver.

04-12-2006, 04:58 PM

Hi,
I am certainly not an expert, but I have been learning quite a bit lately regarding these tests and the liver because my husband has just been diagnosed with liver disease.
He do not drink, and he has a fatty liver. His ALT and AST were elevated as well. They also did a blood test called Ferritin. Ferritin identifies iron stored in the liver. My husbands was quite high. I have learned that one can get a fatty liver from different reasons, and after reading your messages I think it is most likely your diabetes. Diabetes, high triglycerides, high cholesterol and excessive alcohol consumption are possible reasons for those elevated labs. My husband has none of the causes, but does have a poor diet. I wonder if the pregnancy is elevating these numbers.
If I were you, I would request a Ferritin test, and then enjoy the rest of your pregnancy. As long as things are a problem for the baby, I would put in on hold until after you give birth. I know, easier said then done. But I would urge you to pursue this after you deliver. As it turns out, my husband has cirrhosis, and we had absolutely no clue.
I wish you the very best, take care

04-18-2006, 07:32 PM

Finally had my appointment (how they expect you not to go absolutely nuts waiting is beyond me!) - all my numbers, including Iron and ferritin were completely normal, except where they were abnormal in the way expected for pregnancy.

We're looking at two possible causes here - most likely NASH. But...... some chance of AFLP

that just can't be ruled out. Some things are trying to rule it in a little - so far as I know (and since I donate at the blood bank, they'd probably have told me) - my AST/ALT levels were normal before. And, I'm pregnant. It started way too early to be standard, but not quite impossible either, if we caught the very start of it. And my latest tests show a higher level on the enzymes - AFLP gets worse fast, all the way up to liver failure if you don't catch it. The only cure is to deliver the baby early. It's sure earlier than I'd want to do it, so hopefully it either isn't AFLP, or it's a mild case that can wait for another month or so.

04-28-2006, 03:11 PM

Oh, thank goodness - they are now saying they're pretty sure that it's not AFLP - and they finally gave me some numbers - they don't like me sitting in the 450's, but AFLP tends to show numbers in the thousands - so I'm off by a factor of 10. We're now thinking the glyburide they had me on might be the issue, so I've been switched to insulin, and they're monitoring me more frequently (weekly blood draw and NST on the baby), so I'm feeling a ton more comfortable!

I'm a mystery - help! Elevated enzymes, but nothing fits

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