Longterm effects of Bactrim, now 19 months after..

I was precribed bactrim on July 3rd, 2008, and took it 3x per day for 8 days.  I consumed hardly any water during that time, and ate 1-2 times per day.  On the 8th day, I got extremely sick.  Major headache, vomiting, naseau, jaundice, urinating blood, almost passing out, along with chills.  I never expereinced such head pain, I went to my doctor and had lab tests performed, came back acute heapatitis on 07/17/2008 AST 425, ALT--687 billirubin 6.0(results were taken next day after reaction), next blood test 07/31/2008 AST 211, ALT 474, Alkaline Phosp. 424, bilirubin 2.2.
I had a ultrasound and everything was clear, except some crystalized stones in my gallbladder.  I have been under a Gastro doctor the last 1.5 years.  I had a Cat-Scan with contrast 02/2009, which showed nothing, it was clean.  I have been over the past year and half taken alot of supplements, herbs, vitamin A,D,E in large quantites for 6 weeks at a time and stopped. I took 10,000 IU of D3 when my ALT was 90 in sept. 2009, for 6 weeks and it went to 107.  Presently, since 01/19/2010 AST 51, ALT 87, Billirubin .5, Alkaline Phosphatase 107, but a test which was just performed was GGT- 173.  I did take as of 12/20/2009 milk thistle 575mg per day, presently i am off of everything, and will continue that way.  In addition, when I first had the reaction to the drug, I dropped from 175 pounds (height 5'10") to
147 pounds.  Presently, I am at 158 pounds.  I do not drink at all, I consume plenty of water daily, diet, alot of salads, fruits, veggies, gave up on any carbonated drinks.  I could put weight back on, but I choose a lean diet.  My weight has been stable.  My question to you is?  Can this still be the effects of Bactrim?  My GI wants me to get a biopsy, but it may show fibrosis, but it won't tell them where it's coming from? so why?  Is there any other non-evasive tests that can be performed? GGT, what is the probability it is coming from my heart with other elevated liver enzymes?  Thank you.

[Enoch Choi, MD]

Elevated liver enzymes after taking any medication worries one about the possible hepatotoxic effects of that medicine, and when liver enzyme levels decrease afterwards, it's reassuring.  If they do not return to normal, a gastroenterologist may reccomend a liver biopsy since it's uncommon for medication associated hepatitis to last for a year and a half.  The biopsy can look for other causes and determine the current state of your liver.  Ask your gastroenterologist as to the risks and benefits, to see if it's definitely useful.

Enoch Choi, MD