Liver Enzymes and Bilirubin Values?

[sds81]

Hi! I'm in the States, but all the best sites with the most accurate info seem to be in the UK! So I'm hoping it's okay to post here.

I'm not sure if this is the best forum to post, so please let me know. About six months I started noticing symptoms such as tingling, numbness, twitching/jolts and followed up with a neurologist recently (major health anxiety and doctors make me so nervous). I finally had bloodwork done, which came in online over the weekend, and I am super concerned by the liver numbers (not sure if they have anything to do with the symptoms for which the bloodwork was ordered). I have severe health anxiety, and I have been Googling for the past day.

My AST is 209, ALT 216, and bilirubin is 2.9 - I hope it is okay to share these. I'm not sure if these numbers are the same in the US. A few others were a bit off, but those were the main ones. I am nearly 43 and have been a drinker on and off for nearly 20 years (1 bottle of wine a night on and off for years and more recently 2 bottles a night and weekends maybe even more). I will stop drinking for a while, but then when I try to be social with friends, I always slip. I drank rather heavily for about 10 days prior but abstained for a few nights before the bloodwork. I have also put on approximately 60 pounds in the last 7 years and do not have the best diet.

I don't have any noticeable symptoms that I have read about on Google (nausea, weight loss, swelling, etc). I keep reading that a bilirubin of 2.5 and above will cause jaundice. But, I have also read you can have liver disease and/or Cirrhosis without symptoms at the beginning.

I am obviously very upset with myself because I put myself in this position and worried about these extremely high numbers. I haven't had any alcohol in a week, and I have realized that for me, it cannot be a casual thing, so I will need to abstain and change my exercise and diet habits.

The results came just in time b/c I actually have an initial appointment with a new Primary Care Physician tomorrow morning (it takes months in the US to schedule a new primary). I'm bringing the bloodwork with me, but I guess my question is how alarming are these numbers? Everything I'm reading on the internet indicates that these three high levels (AST, ALT, Bilirubin) point to liver cancer or Cirrhosis. I know the doctor will discuss this with me, and I'm a bit embarrassed to admit my drinking habits to him, but I still have 18 hours to go, and I was hoping to get some thoughts on my situation and/or what the doctor will recommend so that I will be prepared tomorrow.

Thanks so much for any thoughts, ideas, or suggestions!

[darshaks]

dont worry these rise in enzyms seems related to your drinking habbit please stop drinking which is most culprit for liver surely your blood work will return to normal .. its alarm for you and ofcourse share your each habbit with doctor and if you are scarred you may have liver fibrosis or chirrosis then talk to your doctor for fibroscan for your satisfaction ... dont worry all the best

[sds81 in reply to darshaks]

thank you! i'm hoping that the blood work will return to normal (fingers crossed) and will discuss options with the dr. when i meet with him this morning.

[MisterX]

Hi,

It’s perfectly fine for you to reach out here. Nobody will mind - as it happens I was in the US when I was diagnosed.

I’ll keep it simple.

Firstly - STOP drinking. Now. No exceptions.

Secondly - The AST and ALT numbers look high to me but that depends on the normal range for the test you took. You need to run them past your doctor and probably get a referral to a gastroenterologist or hepatologist. This definitely needs investigation.

Thirdly - STOP Googling - esp if you have anxiety. Rely on your doctors who are trained and talk to people here who can provide extra context. Googling will not help you as you don’t have the experience to contextualise what you read.

Fourthly - The docs need to determine what is happening - firstly how much inflammation (hepatitis) of the liver is happening and for what reason secondly how much scarring (fibrosis) has resulted.

Fifthly - REALLY important - Inflammation is called hepatitis regardless of cause. Fibrosis is when prolonged inflammation causes scarring of the liver. Fibrosis is measured according to a number of stages. The FINAL stage of fibrosis - when the ENTIRE liver is scarred is called Cirrhosis.

Sixthly - THE MOST IMPORTANT BIT - If you and your doctors can STOP what is causing your liver inflammation (if you have it) whether it’s drinking, fat or some other cause then your liver can start to REVERSE the fibrosis - even the early stages of cirrhosis if caught early enough in the process. DO NOT ASSUME it’s too late. Many people do this because their brain is wired to find excuses for drinking. STOP DRINKING. STOP NOW.

Hopefully the results are a warning sign to you but you must take it seriously and act sensibly.

Very best wishes to you and do let us know how things develop.

Best wishes

PS - Be HONEST with your docs. There’s nothing you can say to them that will be more embarrassing than not being honest about serious health issues for fear of embarrassment.

[sds81 in reply to MisterX]

thank you so much! i stopped drinking last week, but it took several days before i was feeling better - i didn't realize how much i was drinking until i wasn't. i have finally realized i am not one of those people that can have "just one", so i just will not have any. i am also working on a diet plan - eating healthy is pretty easy for me once i start. and, i will just have to make more of an effort to find the time to work out.

also, thank you for the clarification on hepatitis vs. fibrosis. when i hear hepatitis, it often confuses me bc my brain thinks of viral hepatitis. i didn't realize that it was the first step (inflammation) but rather thought it was a different type of liver disease.

than you again. i have a dr. appointment later this morning, and i will most likely be posting with more questions/clarifications.

[MisterX in reply to sds81]

Hi,

Happy to help. Well done on stopping drinking and starting to change eating habits. It’s a good positive start and it’s important to try to stay positive and take control of how you deal with things.

Yes the hepatitis confusion is common. Bit silly of the medical profession to call those viruses “hepatitis” as shorthand but what can you do? It’s not unreasonable as they do cause hepatitis but it can be unhelpful. By the same token people - including doctors - will often confuse fibrosis and cirrhosis and talk about “a bit of cirrhosis” when they mean “a bit of fibrosis” - cirrhosis is a measure of fibrosis and means the entire liver is scarred.

Anyway important not to get too far ahead of the facts. Keep your chin up and do all the right things and hopefully this is just a warning.

Good luck.