Member Comments are provided by individuals and reflect their personal opinions only. Under NO circumstances should you act on any advice or opinion posted in this forum. ALWAYS check with your personal physician before taking any action regarding your health! MedHelp International and our partners, sponsors and affiliates have no obligation to monitor any comments posted on this site, or the content and/or accuracy of such exchanges. MedHelp International does not endorse the views of any user.
Gastroenterology (Expert Forum)
Enlarged liver/Liver disease?
Answered by
Kevin Pho, MD - Internal Medicine
KevinMD.com
This forum is for questions regarding Gastroenterology issues such as Acid Reflux (GERD), Barretts Esophagus, Colitis, Colon/Bowel Disorders, Crohn's Disease, Diverticulitis/Diverticulosis, Digestive Disorders, IBS, Stomach Pain.
Enlarged liver/Liver disease?
by neovil, Dec 08, 2003 12:00AM
Dear Doctor,
I am trying to decide if I have a liver or other abdominal problem.
Quick history: used Propecia for 1.5 years and drank alcohol. Discovered one liver enzyme—AST-- mildly elevated in '99. Stopped Propecia and drinking. Began diet and exercise regimen. Experienced upper right quadrant discomfort—no gallstones or sludge. A doctor recommended vitamin B complex to bring enzymes down. A month later I noticed abdominal swelling told my GP I thought the vitamin b had enlarged my liver. . My GP told me it was unlikely. Ceased using vitamin B 100 time-release formula.Liver enzymes later came down, but I was told that it was unrelated to the vitamin b.
Current problem:
Have continued diet and exercise regimen closely for the last 3 years. 2 months ago blood work-up for treatment of mildly high blood pressure—140/90—for a 28 yr old man showed:
GOT:44(0-40)GPT: 22(0-40)ALP:263(103-335)r-GTP:19(11-50)
Only GOT slightly elevated.Other liver enzymes in normal range.
Also of note-HDL:31(42-74) glucose(fasting):56(70-110)
I told my GP I had been hungry and eating in middle of night. He suggested vitamin b 50 complex to help with carbohydrate metabolism. He said it would not affect my liver because I would excrete the excess during urination. 26 pills later I noticed that my abdomen had enlarged again. Now, I am sure that it was from the vitamin b complex. I thought I had been gaining weight because I had stopped eating in the middle of the night, but closer inspection made me think abdomen had enlarged again. I have since learned from the Internet that niacin–-50 mg in my tablet--can enlarge the liver. I have been off vitamin b for more than a month.
I expressed my concerns of liver enlargement to another doctor in Seoul. According to the radiologist, an ultrasound says liver size is normal. Aren’t all liver sizes different? I admit that my liver enzymes are normal. Wouldn’t any toxicity effects from the niacin be lost during that month between stopping and before the blood test? This week’s blood test using a different hospital scale:
T.Bilirubin:0.7(0.2-1.5) AST:19(0-40) ALT:14(0-40) ALP:91(53-128) CRP:0.03(0-0.3) PT(sec):14.3(11.8-14.3) PT%: 86 (84-113)APTT(sec):39.5(32-41.2) Total Protein: 8.1 (6-8.2) Albumin: 4.9(3.5-5.2) Globulin:3.2(2-3.5) A/Gratio:1.5(1.3-2.2)T.Cholesterol:156 HDL:35(35-50)
--I’ve had loss of appetite and fullness feeling, but I’m not experiencing any abdominal pain or pain to touch. Despite this, I definitely have an enlarged abdomen. Korean GP told me that I should work my abdominal muscles. I don't believe it's fat.
Do I drop the situation and live with an enlarged abdomen or do I pursue some other test? Can I rule out the liver? I have had the enlargement for almost 2 months. I am concerned about drug-induced liver disease but don’t want to over react. Is a biopsy warranted? What should I do? Liver disease/enlargement with normal liver function?? Thank you.
I am trying to decide if I have a liver or other abdominal problem.
Quick history: used Propecia for 1.5 years and drank alcohol. Discovered one liver enzyme—AST-- mildly elevated in '99. Stopped Propecia and drinking. Began diet and exercise regimen. Experienced upper right quadrant discomfort—no gallstones or sludge. A doctor recommended vitamin B complex to bring enzymes down. A month later I noticed abdominal swelling told my GP I thought the vitamin b had enlarged my liver. . My GP told me it was unlikely. Ceased using vitamin B 100 time-release formula.Liver enzymes later came down, but I was told that it was unrelated to the vitamin b.
Current problem:
Have continued diet and exercise regimen closely for the last 3 years. 2 months ago blood work-up for treatment of mildly high blood pressure—140/90—for a 28 yr old man showed:
GOT:44(0-40)GPT: 22(0-40)ALP:263(103-335)r-GTP:19(11-50)
Only GOT slightly elevated.Other liver enzymes in normal range.
Also of note-HDL:31(42-74) glucose(fasting):56(70-110)
I told my GP I had been hungry and eating in middle of night. He suggested vitamin b 50 complex to help with carbohydrate metabolism. He said it would not affect my liver because I would excrete the excess during urination. 26 pills later I noticed that my abdomen had enlarged again. Now, I am sure that it was from the vitamin b complex. I thought I had been gaining weight because I had stopped eating in the middle of the night, but closer inspection made me think abdomen had enlarged again. I have since learned from the Internet that niacin–-50 mg in my tablet--can enlarge the liver. I have been off vitamin b for more than a month.
I expressed my concerns of liver enlargement to another doctor in Seoul. According to the radiologist, an ultrasound says liver size is normal. Aren’t all liver sizes different? I admit that my liver enzymes are normal. Wouldn’t any toxicity effects from the niacin be lost during that month between stopping and before the blood test? This week’s blood test using a different hospital scale:
T.Bilirubin:0.7(0.2-1.5) AST:19(0-40) ALT:14(0-40) ALP:91(53-128) CRP:0.03(0-0.3) PT(sec):14.3(11.8-14.3) PT%: 86 (84-113)APTT(sec):39.5(32-41.2) Total Protein: 8.1 (6-8.2) Albumin: 4.9(3.5-5.2) Globulin:3.2(2-3.5) A/Gratio:1.5(1.3-2.2)T.Cholesterol:156 HDL:35(35-50)
--I’ve had loss of appetite and fullness feeling, but I’m not experiencing any abdominal pain or pain to touch. Despite this, I definitely have an enlarged abdomen. Korean GP told me that I should work my abdominal muscles. I don't believe it's fat.
Do I drop the situation and live with an enlarged abdomen or do I pursue some other test? Can I rule out the liver? I have had the enlargement for almost 2 months. I am concerned about drug-induced liver disease but don’t want to over react. Is a biopsy warranted? What should I do? Liver disease/enlargement with normal liver function?? Thank you.
Doctor's Answer
by Kevin Pho, MD, Dec 11, 2003 12:00AM
, Dec 11, 2003 12:00AM
With the normal liver tests it is unlikely that there is an obvious liver or gall bladder disorder going on. If you feel that there is an enlargement of the abdomen, the most reasonable test would be an abdominal CT scan. This can determine whether there is fluid or a mass that could be contributing to your symptoms.
If the liver tests are normal (as in your case), you may want to consider tests for hepatitis first. It is unlikely that a biopsy is warranted if the liver enzymes remain normal.
As for the next step, I would suggest discussing an abdominal CT scan.
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.
Thanks,
Kevin, M.D.
If the liver tests are normal (as in your case), you may want to consider tests for hepatitis first. It is unlikely that a biopsy is warranted if the liver enzymes remain normal.
As for the next step, I would suggest discussing an abdominal CT scan.
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.
Thanks,
Kevin, M.D.
Member Comments (1)
by neovil, Dec 09, 2003 12:00AM
The enlargement that I've described appears significant. I have a tightness in my chest and upper back. I have not been eating very much lately. My pants are loose around the waist but my shirts are much tighter. I have not been bulking up from lifting weights. Thank you in advance.
