BLood work evaluation/ Alcoholism

[Edward D.]

40 year old male. Cardiologist due to pressure understernum. Echocardiogram .Findings normal,UpperGI mild Gerd. 5 mg.of Norvasc to supplement my Toprol .EKG that was normal. Blood work High ALT- 224 ,AST- 128 . TP 7.6. Upon seeing my normal doctor he rescheduled  Blood work. Removed  from Norvasc and prescribed  20mg. of Solar. Removed  form Solar . Toprol to 50mg. Anxiety  prescribed 10 mg  Lexaprol.  5 days on  Lexaprol resulted in extreme anxiety/panic attack .Dec. 9 2006. Since then I have struggled withanxiety/Phobias .Lately I have been having strange feeling in my stomach/throat ,feelings as if my stomach was falling /dizziness  that makes me feel faint.  Morning shakiness, Evening Nausea and nervousness until I take a drink/Beer. Decided to request a copy of my blood work to my surprise there were many concerns of high findings.  So my question to you is in two parts. 1. Could the continued change of medications throw me into a whirlwind of anxiety.  Could the 50 mg of Toprol induce the feeling of anxiety..?2. I would like a professional opinion on my blood work findings. Could there be an underline condition causing all these symptoms. And are the high reading extreme or normal to my life style. Sodium132,Potassium 3.8,Chloride99, CO2 26,          Glucose81,BUN10,Creatine 1.0,Total protein7.7 , Albumin 4.5, Calcium10.1                  
Total Bilirubin1.9 ALK. Phosphate 61,AST123,ALT214      

[Kevin Pho, MD]

To answer your questions:
1) The medications you mentioned is not commonly associated with anxiety.

2) The liver tests are obviously elevated.  Many diseases can lead to the elevation of the enzymes.  This can include hepatitis, fatty liver, or other gallbladder or liver disease.  Further evaluation should be done with a liver ultrasound.  If negative, a liver biopsy can be considered.

Blood tests should also be done, including testing for hepatitis, ANA level, and obtaining a ferritin level (the last test looking for hemochromatosis).  

These options 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_

[cantlivenotknowing]

Your Bilirubin is high. It should be below 1.5 and normally should be below 1.0
Your liver enzymes are quite elevated and indicate liver cell death. Your gastrointestinal symptoms along with your bloodwork and alcoholism is indicative to me of Alcoholic Liver Disease. You need to stop drinking now. If you don't you will suffer problems unlike anything you can comprehend even now with the illness you are experiencing. It gets much worse. Get some help to stop drinking. Lexapro may or may not be helpful for you, but you need to appraoch this problem head on and stop the damage.

[Edward D.]

I wish that I could of posted my original writings. I had to condense it quite a bit to fit. I tried to leave as much history available.  I have quit drinking. I have also had an ultrasound but it has been 4 years now. Impression were  : Hepatomegaly with diffuse increased echogenicity most suggestive of diffuse fatty infiltration. The liver showed enlarged to 17 cm, Kidneys 11-12 cm and no stones or hydronephris .No Ascites also the liver didn’t show any dilated intra or extra hepatic biliary ducts. Pancreas showed no masses or abnormal fluid collection. My main concern is that with both Doctors I have seen in the past 6 months I have not had any direction from them except to quit drinking . They both have stated that the results of all the test suggest it is directly a result from my alcohol intake. to me that doesn’t make sense after reviewing all the possible causes. The doctors have my past test results and don’t feel that another ultrasound is necessary. ..? That concerns me.. Or is it possible to use a test that’s four years old..? I had a complete list of many other  blood test results but could not fit it into the allowed space. If the doctor reviews this I would not have a problem redonating if I could send a private e-mail with all the test results for a further second opinion.

  Thank you