elevated alt

I am 37 and have been taking birth control pills for about 10 years, I recently stopped them and drinking (1-2 glasses of red wine a night on average) and lost 7 pounds in just 2 weeks.(and I am already very thin) I had lab work done for hormones and the doc threw in a routine panel which showed my alt's at 54 (previously 12) and never before elevated.  

about 2 weeks after that I came down with a virus and ear infection and took ktek.  upon retest my atls were 74 (2 days after stopping the ktek.)

a week after after that they were tested again along with a hepatitis panel and all were negative except the alts were still up "around the same" the doc said, he wouldn't say if they were higher, but he wants to recheck them again.

I have a history of positive epstein barr virus tests many times in the past. ive tested when severely fatigued and it always comes back as a current infection, however after so many positives my doc check a viral load and said i probably just had anitbodies and no infection.

my questions are:
1. could detoxing from long term bcp use have caused the initial rise in elevated alts
2. then the ktek caused it to go a little higher?
3. and if so, should the follow up test a few days later have showed them lowered?
4. does the negative viral load test for epstein barr mean it is probably not related to the epstein barr?
5. if they go back down to normal is it still wise to drink no alcohol at all?  
thank you, sorry for the very long post.

[Kevin Pho, MD]

To answer your questions:
1) Discontinuing OCPs does not commonly raise the ALT.

2) Ketek has been associated with an increase in liver enzymes, so this scenario is possible.

3) Follow-up testing should be done to ensure the ALT is not continuing to rise.

4) A negative viral load for the EBV likely excludes this as a cause.

5) Abstaining from alcohol to see if the ALT decreases can be considered.  I would also obtain a liver ultrasound to image for any anatomical abnormalities.  

These questions can be discussed with your personal physician.

Followup with your personal physician is essential.

This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.

Kevin, M.D.
kevinmd_

[amh1234]

I too had an elevated ALT & AST after treatment with Ketek. It was a scary 6 weeks - but I've since learned it's a common Ketek side effect. Here's a link to my original post - http://www.medhelp.org/forums/gastro/messages/37769.html
hope it reassures you. Good luck