I posted this in Pbc UK. I though I'd do the same here.
Well just a few months ago my Alp was up. I had broke my finger and we thought that caused it. That was the beginning of June. Now it's Oct. and my finger is healed and my last two blood tests all of it's high. My Alp is high and so is my Ast and Alt. My ALT used to be around 52, a lil high and the other two were more normal. Now Alp is 163 normal range is 44-121. Alt is 153 range 0-32 and Ast is 77 range is 0-40. My Ama M2 is still positive but not as high as it was 7-8 years ago at 68. It's 29.1 about 5 point over equivocal. I'm also taking new meds metformin and doxycycline and linzess every few days. I wonder if they in some way had anything to do with it. My Alp went down in Sep. to 130 and then back up again on the next test. The Dr said he was going to start me on Urso if still positive after hepatic panel that he wanted me to do in the first week of Nov. Does pbc present this way with the other lft's increasing dramatically too?
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Zelda5
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Hi Jean! When I was diagnosed already at stage 3/4 my Lft’s were all up. ….and sometimes down. AST,ALP, bilirubin ALP and also GGT. Sometimes they were super high and other days not so much.
Just curious if you have fatty liver too. I was diagnosed years ago with mild fatty liver from biopsy. I lost weight then gained it back. I guess that's probably why my Alt was a lil elevated. lm starting to feel like I should've been on urso all along. And, that biopsy didn't show the whole picture.
I think my LFTs fluctuated too so it was hard to pinpoint and my primary care doctor suggested a biopsy and referred me to the hepatologist who did all the in depth tests, scheduled the biopsy. Even then the biopsy came back in conclusive. The hepatologist then sent the biopsy slides to a world renown liver disease pathologist for a 2nd opinion and he diagnosed the pbc. The hepatologist put me on urso right away.
Now I see him once a quarter for labs and to chat. He mainly focus on the alk phos as that is what they track for pbc. He wants it to be under 150. My LFTs went back to normal after taking the urso for several years. In recent years though my alk phos is abnormal which he said is expected because of pbc.
Hope this helps. A fatty liver will also cause LFTs to be raised, so watching your diet helps as well if you have that.
If your Alk Phos is so high and you have a positive AMA that makes the diagnosis of PBC. Urso is a pretty benign drug and could help you keep your liver functioning well. Why risk progression? The earlier you treat it the better your chances
And by the way, if you think a broken bone bone is causing the AlP to be elevated, it can be be fractionated so it's clear how much from bone how much from liver.
I hope you're seeing a good hepatologist. Do you have other autoimmune diseases? My Alk Phos had come down and now went back up. Probably from a short course of steroids I needed to take. We are increasing my Urso dose before adding anything else. AST and alt have fallen into normal range. My liver looks perfect on recent mri.
Interesting, it was because of me taking steroids he decided to wait and see if it wasnt, because of that. I only took it 2 weeks at most a pill a day. So he wanted to wait a month and retest.
Yeah I paid for that test isoenzyme . That was the test that it went back down to 130, only slightly elevated then. It didn't show individually neither bone or liver to be elevated.
I had a biopsy back in 2014. It showed a mild fatty liver and my Alp wasn't elevated . The hepatologist I see again in Dec. He may go ahead and decide to prescribe urso before then. Im to get another hepatic panel again first week in Nov. I'm not sure it's even necessary at this point.
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