Liver function and drugs

[jan-ran]

Hi everybody, I now have a new scary thing going on. A recent blood test showed raised level of some enzymes. (ALT for info). I was told that I may have fatty liver disease. I was questioned quite closely on how much I drink. (Not that much in the broad scheme of things) I had to have a second blood test, which showed the original raised level had returned to normal, but another one, gamma gt, has shot up alarmingly. More questions about my drinking habits. I began to feel like a secret alcoholic. I will now have to go for a third blood test, and who knows what else after. The one thing I'm hanging on to is the fact that I started rivaroxaban several months ago, also my gp changed my simvastatin to atorvastatin recently, so I'm thinking maybe the problem is drug related. Has anyone else had this experience? I ve gone into worry mode, just when I thought I d got all my health issues under control! JanR

[BobD Volunteer]

Sorry Jan I can't help but do feel for you. Keep us informed please.

[Hidden]

Hi Jan,

These things aren't always drink related - my mother in law was practically teetotal all her life and she had cirrhosis of the liver. Having said that, she lived to a ripe old age and passed on from something completely different so take heart! If I were you I'd ask the experts a lot of questions about what you should be doing, in terms of diet and lifestyle, to try to get your liver back on an even keel. I'm guessing they told you to steer clear of alcohol?

Lis

[feejbee]

Hi Jan

Snap.I discovered via a blood test and later ultrasound that I have fatty liver disease.I am not teetotal but almost ( a glass of wine if we have dinner with friends to be sociable but prefer a coke really)

It was then found I have multiple gallstones with sludge-a medical term but sounds disgusting. I am overweight but not hugely and I never had any problems before all this medication I now take.I had an ablation 18 months ago and have been reasonably ok since.Meds -Bisoprolol /Simvastatin /Prednisolone /Alendronic Acid/Omeprazole

You can have fatty liver disease without being an alcoholic.

Fi

[meadfoot]

Hi Jan

I take Rivaoxaban which was reduced from 20mg per day to 15 mg after poor liver function tests. My GP has kept an eye on it and my recent blood test just before Christmas was fine again as was the previous one. When I saw her again last week as my heart consultant had asked me why I was on 15mg she said it was to protect my liver and they are being extra careful to protect me. Hope this helps.

By the way I have never ever drunk any alcohol and only ever drink water. I am convinced the issue was prescription drug related. As with any drug these are the risks v benefits we take.

Dee.

[jan-ran]

Thany you for those replies. Meadfoot, I take 20mg rivaroxaban, so if it turns out to be that, there is a solution. Feejbee, I had my gall bladder removed years ago, but I think blocked bile ducts can be a problem.....I was only questioned about my drinking, but have made the decision to lay off completely until I know more, eatsalottie. Thanks for your support, bob. Janr

[Marion62]

May I ask if you get routine liver function and cholesterol blood tests?

Even though I had to change statins 20 months ago and rate control drugs the following month, I have not had my cholesterol tested for nearly two years. ( and not my liver function either as these two were always done at the same time).

My GP refuses to test my cholesterol level saying it is not in the new guidelines.

Thanks

[jan-ran in reply to Marion62]

Hi Marion, I do get routine blood tests (6 monthly) because I have type 2 diabetes. Those look at LDL cholesterol, HDL cholesterol and total cholesterol, triglycerides, and blood sugar (HbA1c), there are other tests besides the bloods. (Retinopathy screening, weight, BMI, blood pressure, foot checks). I feel so privileged and lucky that this care is provided, free and with such dedication. Long live the wonderful NHS.

I believe the liver function tests, which I have not had before, were generated specifically because I started taking rivaroxaban in Sept. My gp did say something about it at the time. I guess from now on I will be in the liver function testing loop, and again I am heartily grateful. It seems sort of likely that my raised ggt level could be caused by the meds.

I don't know why your gp should ban the cholesterol test, if only to put your mind at rest. Good luck with that.

Jan

[Marion62 in reply to jan-ran]

Thanks Jan,

My husband also has type 2 diabetes and gets regular check ups and blood tests etc. and access to the nurse at the surgery - as you say an excellent service.

I do wish there was such a set up in place for AF monitoring and advice for those of us who are only under GP care.

Take care

Marion

[jan-ran]

Thank you bigleg, that is very helpful. I now have a mantra I can hang on to - less sugar, less carbohydrate. I'm trying to lose weight anyway, and I feel that after this scare, I am really motivated. Also I can hold my head up because I KNOW my problem is not alcohol related, and I just need to understand that the professionals do see so much alcoholic liver disease, and they know how most of the population will be in denial about it, so why should I expect special treatment?

[shirlygirly]

Hi It does make you think, my husband has been on Rivaroxaban for about

six years, plus Bisoprolol and Ive been taking it about 2 half years. We have

never had a check up and its never been suggested and I saw my GP last

week about an unrelated matter. It does make you think but there are so

many contra indications to every medication we take, you just take it and

hope for the best.Shirley.

[fallingtopieces]

Jan, My liver is fine but 12 years ago, just before I had my gall bladder out, I unknowingly had a gall stone stuck in my bile duct and this made my ALTs very high.

I can't forget the result which was '421' when normal levels should be 7-56!

No one(GPs and A+E Drs) knew what was wrong with me at the time(even though I discovered I had classic gall stone symptoms.) Eventually it was discovered to be my gall bladder which I had whipped out but not until 6 weeks later. Once the stone had passed through my bile duct my results went back to normal so I could wait the 6 weeks.

Are you on statins Jan? I believe they can raise the ALTs.

Pat.

[jan-ran]

Thanks for replying. Yes I am on statins. When I had my gall bladder out, I don't think anyone bothered to mention my liver test results. and I wasn't even concerned, being more worried about the op. I can only surmise that a stuck gall stone must have been excruciatingly painful, Pat

Shirley, I fail to understand how there can be so much discrepancy (between practices) with what should be a routine liver check after starting a NOAC. It makes me think maybe I'm making too much fuss about this. Anyway, when I get the final results, I will let you know.

Jan

[carriewoods]

Hi Jan, that happened to me just over a year ago. I'd had a PAF episode and ended up in A&E. They ran tests on me and I had the same as you, they told me I had to stop drinking immediately. I told them I only had a couple of glasses of wine when visiting my son which was probably one every one/two months. They didn't believe me and, like you, they thought I was an alcoholic. As soon as I was home, I visited my doctor and he ran tests again and my tests were normal. As a result I very rarely have an occasional glass of white wine. I must admit I have got used to being tee total and am always the nominated driver. I haven't had any tests since then. I hope all is OK with you and your liver tests are back to normal.

[CreateHealth]

Statins can hurt your liver too. They are processed by your liver.

And 20% of people in the US have fatty livers. I am sure the UK is similar.

[jan-ran]

Thanks folks, all very helpful comments. I saw my gp this morning, and to my chagrin she told me I had been having regular liver function tests since 2009, when I started with diabetes! I was astonished. I can only suppose, as all tests have been 'normal', I wasn't told, or I never asked, or I filtered the knowledge out, knowing all was well. Anyway, my gp says it's all probably a blip, and I am to carry on as before. Now I have to get my arthritic hip sorted out.....but that's another story. lol

Jan

[Miriam123]

I had exactly the same experience a few weeks back. It seems the most prevalent reason for high gamma alt is alcohol related or taking paracetamol. I don't drink so I knew immediately that it was paracetamol. I had been visiting family in Canada and had been taking Tylenol Arthritis tablets for a sore hip. I stopped immediately and my next blood test number had halved. So I think you are right. Can be drug related, even seemingly innocuous drugs like paracetamol.