new liver dr

[mtk0925]

I am seeing a new dr and he’s apparently one of the best in the area. I wanted to pass along some of his information.

he said liver inflammation starts when numbers hit 150 for ALT or AST he believes I have a condition that causes intermittent elevated liver enzymes but since mine are only at 35 and 44 he doesn’t think they are an issue yet. He says if they hit the 100s we will biopsy. I feel better right now with him watching out for me… he’s older I hope he’s in practice for a long time

[Richard-Allen]

I think it’s pretty safe to say that nearly all medical diagnosis is arrived at by ruling out what it’s not. I would have thought that this would be the better course of action rather than starting to take chunks out of the liver by way of a biopsy.

Have you been checked for possible gallstones? These stones for example can find their way into the bile duct and become stuck. This can then impede the flow of bile from the liver. As the bile is unable to flow, it can then become backed up, this will then cause a rise in liver enzymes. Once the blocked stone becomes dislodged, bile can flow once more and the liver enzymes return to normal.

These stones can then repeatedly become stuck. and unstuck again and again until they are removed. This will cause the liver enzymes to keep on rising and falling. If the stones don’t become dislodged, then the buildup of bile can become infected, which in turn can start to cause liver damage.

This is just one of the conditions that can arise and be ruled out before going down the biopsy route.

Hope this helps.

Good Luck

Richard

[mtk0925 in reply to Richard-Allen]

thanks in the past I’ve been checked for stones and they always include my gallbladder in liver scans as well. I ageee with not taking biopsy’s as the rest route of testing

[FlippinOut]

My AST has never been higher than 40 and ALT never higher than 50 but I’ve had inflammation from NAFLD for years. I now have cirrhosis and my AST is 24 and ALT 31.

LFT’s are not reliable markers of liver disease. Over the years my liver enzymes were either normal or slightly elevated. I was told this was from the statin medication I was on. Get a CT, MRI, US or Fibroscan if you’re concerned or if you have any other symptoms. Wish I knew then what I know now.

[mtk0925 in reply to FlippinOut]

Sorry to hear about your dx and thanks for the advice. I don’t want to ask personal questions so don’t feel pressed to answer. With your fatty liver how was it diagnosed? Are you overweight? I’m slightly over weight per my height but I’m 145 5’6 my cholesterol is a little high…. I get an ultrasound every other year…. No fat seen yet…. Just something is agitating my liver….

[FlippinOut in reply to mtk0925]

Hi, my fatty liver was seen on Ultrasound and CT scan done for kidney stones 10 years ago. No one told me it was a serious condition. Recently I had upper left side abdomen pain and thought I had another kidney stone. CT showed the cirrhosis. I think a CT, MRI or US will show fatty liver.

I’m overweight by about 40 lbs but I also have metabolic syndrome which is a big contributor to liver disease. My bp, cholesterol and glucose have been under control with meds but I guess it wasn’t enough to stop the progression.

Do you have any pain, diarrhea or other symptoms? Are you on a statin for cholesterol or any other medication? If your only problem is slightly elevated LFTs, it may be from medication or a number of other things, especially if you’ve had scans that show nothing wrong with your liver. But of course I’m not a doctor and just learning about all this stuff recently myself. I think it’s important to feel confident with your doctor and if something doesn’t seem right then let him know.

[mtk0925 in reply to FlippinOut]

hi there. No pain sometimes right sided discomfort here and there but my dr thinks it’s my ovaries and cycst…. I had a hida scan done on my gallbladder no stone, no statins my cholesterol isn’t terribly high and my Tricycerides are ok

[FlippinOut]

That all sounds like good news. Do you take any other meds like Tylenol or Ibuprofen?

I assume you’ve had all the various bloodwork for liver diseases (AIH, Wilson’s, Hepatitis A B C etc) and your levels of GGT, LDH, Iron, Vitamins and AFP? If all is normal then you are probably fine. Try to relax. I know how much worse it is when you don’t know for sure what’s wrong. I hope your new doc can help you figure it out.

[mtk0925 in reply to FlippinOut]

thank you. Yes I’ve had the panels ran a few time for those specific auto immune markers and hep. I had HEP A in 2012 it resolved then I had my first baby in 2013 and ever since then my liver enzymes have gone up and down. I’ve had many many tests to see what’s going on. The only thing that I do take is Prozac which very well could be the cause the drs say it could could cause a small rise but they still want to make sure it’s not anything else. I take aspirin a lot for my lower back problems, barely drink any alcohol unless it’s a special occasion I’ll have 1-2 glasses my dr said that was ok just not weekly or all the time… I also take Xanax for anxiety so that could be the cause too. It’s really a toss up. My cousin is a dr she said it could just be my normal range since it’s only out a few points but she cautions me to keep getting checked.