Liver enzymes are high and I’m terrified.

[bran_sun]

I had routine blood work done with my doctor, I wasn’t feeling sick nor did I have any symptoms. Well, the same say I did my blood tests, my doctor called and told me to go to the ER since my liver enzymes levels were extremely high. ALT 589 and AST 132. No jaundice, no pain, nothing. The ER did more tests on me, all blood results came back fine, thyroid, hepatitis, etc... but still my liver enzymes were still high. Albumin, Billirubin, all in normal range. I was taking a prohormone supplement, essentially an anabolic steroid. I have since stopped the pills and stopped drinking, which I normally don’t do much of. I have never had liver issues when I have had my bloods tested, this is the first time and my docs think it’s from those pills. I am a 25 year old male and I am concerned this might be cancer or an autoimmune disorder. I would like insight please.

[CarpeDiem11]

I have autoimmune hepatitis and apart from sleeping more, I did not have any symptoms prior to diagnosis. I was fit and active. My liver enzymes were around 1000 and I was jaundiced at these levels.

Autoimmune hep cannot be diagnosed through blood tests alone, it is a process if eliminating all the other things it might be- viral, alcoholic etc. Once they have done that, and there is other evidence such as autoantibodies, then they will confirm with a biopsy. It is possible to get this through prescribed drugs, but I haven't heard of it through steroids.

There are 3 autoimmune liver diseases, PBC & PSC are the other two, of which I know nothing, so cannot offer advice here.

If you did have what I have, and it is classed as rare, then it can be managed with meds. I have had it for over 10 years. Many people with it carry on much as before, although it can affect energy levels. They should be doing an ultrasound to give them some further clues as to the state of your liver, but this won't always tell them much.

Ask them specifically if they suspect any of these conditions and if not why they have ruled them out.

I wish you all the very best and hope they get to the root cause soon. Good luck.

[bran_sun in reply to CarpeDiem11]

Just curious how old were you when you got diagnosed? I know that my doctor had tested for hepatitis but not specifically antibodies

[CarpeDiem11 in reply to bran_sun]

When they tested for hepatitis, it is likely to be viral ones, most commonly Hep C, but there are others( usually A-E). They can't test for autoimmune with bloods. High enzyme levels can be caused by a number of things. The British Liver Trust page will give some information as to these conditions. As I say, this will be a process of elimination. For me they ruled out viral, drug use, alcohol, before doing a biopsy to confirm AIH.

In answer to your question, I'm not sure it's relevant, but people can be and are diagnosed much younger and older than you, although it is more commonly seen in women. Hope that helps.

[gwillistexas in reply to CarpeDiem11]

Hello. One thing you said I would like to ask about. You say autoimmune cannot be tested through bloods??? Mine were all tested through blood at a pathology lab.

[CarpeDiem11 in reply to gwillistexas]

The liver enzymes alone ( tested from bloods)can only indicate a number of conditions. If the autoantibodies are present through blood results, again it adds to the picture, but these results cannot confirm AIH, they are just indicators.

AIH is diagnosed by eliminating other possibilities firstly. Then liver enzymes and presence of certain autoantibodies may indicate it. Then ultrasound will look at the state of the liver, before a biopsy is used to confirm.

I know someone who had raised enzymes, but was diagnosed with heart issues because heart issues were in the family. They were looked after in ICU whilst diagnosis was done, before finally getting AIH diagnosed. AIH diagnosis is complicated and bloods alone are not enough! Hope that explains things.

[gwillistexas in reply to CarpeDiem11]

I didn’t realize you were referring to AIH.

[CarpeDiem11 in reply to gwillistexas]

Yep! Just because the original poster said they'd been tested for hepatitis!

[CarpeDiem11 in reply to gwillistexas]

Bloods are usually tested in haematology, whereas tissue samples are usually done in pathology. Maybe you had tissue from biopsy examined at pathology?

[gwillistexas in reply to CarpeDiem11]

No, I didn’t have a tissue biopsy. My internist sent labs to Clinical Pathology Associates in Austin, TX. They do the “in depth” lab tests.

[CarpeDiem11 in reply to gwillistexas]

Ah! Clearly the UK has a different protocol to Texas. I think this is what causes confusion for a lot of people, as even in the UK people seem to get told different things. I am fortunate to be able to attend talks given by the leading clinicians in AIH, so get the definitive answer from them.

[gwillistexas in reply to CarpeDiem11]

Clinical Pathology Lab Associates

[bran_sun in reply to CarpeDiem11]

Thanks!

[AyrshireK]

This is highly likely to be the effect of taking the anabolic steroids as doctors have said. Your liver is inflamed as indicated by the rises in your AST and ALT. I found this medical journal piece about anabolic steroids and their effects on the liver - they are extremely hepato toxic.

journals.lww.com/acsm-csmr/...