HepB question - please help

1. I am a hepB holder for 4 years. Recently my tests showed an increase in my bilirubin readings from 2000 last spring to 19000 this month.  Anyone can tell me what this means  and how concerning is this.

2. Not sure if related but for the past 3 weeks my throat has been really red and dry, tongue burning and I have some red spots on the roof of my mouth. Does anyone see a relation to the first question?

Thank you.

[boron]

It would be really helpfull, if you can tell exactly which billirubin (direct-conjugated, indirect-unconjugated, or total) has rised. Also, can you place units?

Had you have active hepatitis before? Are you taking some medicines? Have you noticed any jaundice or skin itching?

Mouth/throat changes are very often in GI and liver disease. Rised bilirubin on the other hand is not necessary due to liver disease but with hemolysis - destruction of erythrocytes (haemolytic anemia).

[spdswm]

Thank you for the answer Boron. Let me know if below is more helpful.

Unfortunately I can't remember which one the doctor mentioned. My guess would be the total, then he told me that after 30 000 people start taking medicine. Do not know how or when I got it but was diagnosed by mistake in 2004. I will get the written results so I have them with me.

I am not taking any medicine and I have no jaundice however my skin has been acting a little strange for the past 4 months - redness on my knuckles and a burning feeling, same on my testicles, feet, red face and burning skull sometimes. The strange thing is that when or if my testicles are red - bright red that is, at touch they actually feel cold. Not sure what to make of it.

Also besides this type of redness, on my hands only, or forearms (and twice on my throat) I get these pink/red spots that appear with an itch.... itch dissapears after couple of hours but spot remains for 6-8 good hours.

I have been under a lot of stress this year with a death in family and then a stupid mistake that I made by sleeping with a prostitute. I am not a heavy drinker, far from that and don't take drugs.  However this throat thing is bothering me - the air is ideed dry here but the veiny looking throat and the red spots on the roof of my mouth look a little too strange.

Thank you for your feedback.

[boron]

You should make a testing for hepatitis B.

If 'red face' is like flushing, all your symptoms may be from allergy to something - food or whatever. Redness over testicles skin could be a part of it - eczema is red and not swollen or warm.

[spdswm]

Thank you Boron and Happy New Year !  The redness on my testicles and penis and face is red but it is NOT hot or warm. Would you say that this is an eczema?

[boron]

It could be eczema. Eczema can be allergic or non-allegic. Allergic eczema is hives or urticaria - hot, swollen red areas). Non-allergic eczema example is "contact dermatitis" - usually from some metal or cloth or chemical substance, or from the stool, or by washing detergent...Contact dermatitis - would be constant, not raised, not warm.

But regarding your mouth lesions, I can't get rid of a thought, it can still be a yest. Infants often get dermatitis caused by yeast Candida albicans from diapers (moist). If it will come out, that it is a yeast, ointment won't help, but systemic (oral) anti-yeast drug will be needed, and it may takes some time to be effective (weeks maybe).

It's not likely to be herpes.

We started with bilirubin. Liver disease can affect immunity, which often leads to yeast infection, or rash caused just by hepatitis virus. If you solve that, picture my become more clear, since it is possible that all things are connected.

[spdswm]

Thank you Boron. Another embarrassing and interesting fact is that I can't quite have an erection anymore and I am having some troubles peeing. You know when you finish peeing and then you squeeze a few more after. It looks like I lost the power to do the squeeze so it kind of just tinkles out. Also I used to have morning and night erections - I have not have that in about 3 weeks... I am not sure if it is from all the continuous burning in that area that something got damaged. Any thought's on this.

Thank you for all your time by the way.

[boron]

This 'not completed' peeing may come from prostate. It is really often after 50, because of prostate hyperplasia, which is so often that it is considered as 'normal enlargment'. But there may be chronic inflammation of prostate, which bulges toward urethra. It also bulges toward rectum, and doctor can feel it during rectal examination.

Bladder or urethra infection would cause burning sensation and more frequent peeing, well the same would be possible with prostatitis.

[spdswm]

Thank you Boron. The thing is that I am 31... and doctor told me that all is good after a quick prostate check. I am seeing an urologist tomorrow. Hopefully he will have more to say. This is getting a little stressful...

Thank you.

[mabel8499]

I am the administrator of the BBS which provides discussion to patients with liver diseases, Mabel. Our BBS is newly-opened. You can get much useful information and let others share your experiences there. Welcome to visit http://liver-health.info/. Thank you.

[boron]

Even slight prostate (or other part of urinary tract) infection can cause this feeling of not complete bladder emptying. UROLOGIST should be able to examine you correctly, he will also make 'urinary culture' and specific blood tests for prostate. He might comment your skin redness, but it is DERMATOLOGIST who would do this better.

GP is good if he/she send you to the right specialist...no reason to be frustrated at this point. I would also not pay much attention on prostate, just wait for results. GI can comment your bilirubin and mouth lessions.

[spdswm]

Thank you. I am also meeting the GI doctor on Monday. Take a look at the article below. This is very familiar to what I have been feeling for the past months and it seems pretty concerning. Give me your thoughts on it if you get a chance.

http://chronicsorethroat.wordpress.com/2007/05/27/chronic-sore-throat/

Thank you

[boron]

Sticky nose discharge, fatigue, mental issues, neurologic issues...this is what you have never mentioned, so you'll need to convince me a little why that article is VERY familiar to you.

I believe you'll remind GI to make HEPATTITIS  tests, if this doesn't cost you an extra money...

Also you might want to red some resembling cases:
medhelp.org/forums/dermatology/messages/33455.html

[spdswm]

I am meeting the GI doctor on Monday and he will discuss with me the tests that I took last month and why my HepB viral load went up.

As for the article that I sent you and the reason why I think that's what I have it is a long story...

Last spring I had a death in family, my father, he did in a car accident overseas. By the time I got there he was in coma and than died 2 days after. In my insanity I slept with a prostitute right after that. I am no using this as an excuse, I have done it before and this is the reason why I am seeing a psychiatrist as I am married with one beautiful child and also beautiful wife.

So... about 2 months after the contact I started to feel a little strange - not sure quite how to explain it but something was not quite right - testicle burning, some discoloration on my penis and the strangest was just some strange beacons of pain moving around my lymph nodes - not crazy pain just enough to feel it (pain  2-3 out of 10). Went to my doctor and did the HIV test about 4-5 times, and all the rest of the tests of course - nothing was wrong but was told to calm down as I probably have feeling of guilt - the problem was that I DID NOT FEEL GUILTY - just concerned. I am seeing a psychiatrist because I did not feel guilty. Anyway, I started to get busy and I felt that I did not have any more symptoms for a few month - then around the beginning of October I started to feel exactly what that guy is saying in the article - slight tingling in my left leg as I was asleep - thought that simply my foot was asleep so did not give much attention - however within the next week the tingling and burning went up my arms, back, neck, skull, face, chest. At moments I had also some strange rashes appearing on my forearms and hands - small pink spots itchy and then itchiness will disappear and spots will stay on for a few more hours. Slowly the burning in my skull got pretty crazy and also the burning in my testicles (testicles extremely red but cold at touch). Red knuckles on my hands first on the pointer and middle and now - in the present completely pink red on all the fingers (knuckles). No doctor knew what to make out of it. Yes this did start to affect my relationship with everyone around me as I did not feel like talking to anybody as I was having my own issues. Lots of blood tests were done for any possible thing - all came negative.

7 weeks ago I went to europe again and AGAIN I had sex with not one but 2 prostitutes - oral unprotected and sex protected - within 2 hours one from the other - this is the place http://samya.de/

Why did I do it? After all this stress - I have no idea and I wan to crawl under the ground and stay there.

Anyway - one week after the contact I was taking a nap and I woke up with a massive headache. MASSIVE - could not open my eyes. Went straight to the ER and blood was tested and spinal fluid was taken. All came out ok - doctor told me that blood was showing T cells a little high but nothing like HIV - was probably fighting a cold?  The strange thing is that as I was in Europe, and before the contact - my throat became very dry and my nose very congested with this white clear and sticky mucus. What do I mean by sticky - it would be runny but it would not break but kind of will have to blow the whole long thing out. Throat got worse within the next 8-9 weeks which brings us in the present. 4 weeks ago also as I was looking at my red throat and my tongue (which is burning for the past 5 weeks) in the mirror I saw 6-7 small red spots on the roof of my mouth. As you probably realize I freaked - spots disappeared in about 5-6 days except one that got bigger and I still have it in the roof of my mouth for the past 4 weeks. It is slowly fading away but there is a strange crevice forming in that redness...

Also about 2 weeks from the last contact I got a canker sore on my tongue, not painful, yellowish and a little hard at touch. I usually get them when I am stressed but they are painful and somehow bloodier and bigger - this was different.

As you see I have a lot of the symptoms from that article but also have a lot of HIV symptoms.

I am looking at my hands and indeed they do look drier and thinner. I can e-mail you a picture if you want to see.

My libido has decreased significantly for the past month to the point that I can't quite get an erection and if I do is not that good. I had sex with my wife last night for the first time in 4 weeks and my penis got extremely red after I ejaculated and the penis opening was absolutely red to BLACK.

I did get tested for all about 25 days from the last contact and all came negative - still pretty early. What DID come as a bad result was my liver results which as the doctor explained it at that time - reading used to be at 2000 in the spring and now is around 18000. I asked what exactly are we talking about - he said it is the bilirubin level, level of infection.

Now all the doctors that I am seeing including the ones on this forum are telling me that you can not get HIV from oral sex unprotected. Still my theory was (until I read that article) that I got hit with that headache as a sign of the HIV attack, then that attacked my liver and readings went up... I do have a lot if HIV symptoms and nobody else is telling me WHAT else it could be - they all just say IT is not HIV but that's about it.

So that's my whole story. I have made some massive mistakes and I do need professional help to get out of this loop. As far as the physical symptoms - I still have very red hands and burning continuously and getting worse every day (visible every week), red burning testicles and darker spots on my penis foreskin, some strange mixes of diarrhea and constipation, very small sharp pains around my belly button and random (2 out of 10 level pain - NOT every day), 2 white spots on the head of my penis that tend to be more visible after I take a shower, rash on my anus region that comes and goes and stays for 2 days (first one) now bigger and I have it for the past 5 days.... Today I feel like my left eye is a little dry right in the outer left corner and I realized that it's been like this for about 2-3 days now - like it is not enough glide on my eye and it is scratching my eye ball, also I felt a strange dull pain in my leg (quadriceps femoris) - lasted for a few hours (pain 3-4 of 10).

I meet an urologist today and said he is not sure what to say about the redness but will give me some strong antibiotics to take for the next 4 weeks as he felt my prostate was a little spongy... Yes I do have some problems peeing for the past 4-5 weeks in the sense that after the first squeeze I can't quite do any more repeats... I assume it is the same muscle that works the erection...

Did I tell you that I lost about 13 pounds in the past 6 weeks? Not sure if is a lot or not but I simply don't feel the need to eat, with my tongue feeling like burning a little bit all day I am not even sure if I taste the food that well - reason for which I don't feel like eating...

OK. Enough. If you did finish reading this thank you. If you did not I apologize for daring to actually give you this insane story that I can not believe I first put myself into it and then pushed deeper...

Let me know your thought if you want.

[boron]

It is not likely that AIDS test would be negative after 6 months:
www.cdc.gov/hiv/topics/testing/resources/qa/be_tested.htm#tested

Here is quick overview of various STDs:
http://www.std-gov.org/stds/
Check symptoms and incubation periods. Only Hepatitis B, C and D, and syphilis match. Link for hepatitis:
http://www.hepfi.org/pdfs/ABCs_Grid__Jan_2006.pdf

About the sore throat virus article:
It is ONE person describing it. There are 8 comments, nobody mentions nothing, except sore throat. There are few forums, the same guy copy pasting his problem there. At this point I considered it as an UFO issue. I mean - it is not necessary so Unknown.

And read about citomegalovirus (CMV). It matches somewhat with your symptoms:
http://www.cdc.gov/cmv/facts.htm

So:
- It is possible, it is sexually transmited (not necessary, but if it is, it means it is CONTAGIOUS (!!)). AIDS test, now after 6 months, would be quite reliable. Hepatitis B,C,D - you'll probably ask GI for tests. I suggest you write a list of your symptoms and their time course. Mention swollen gland and all other. Btw, at my place INFECTOLOGIST is the separate specialization in medicine.

[spdswm]

Regarding the first article - I took the RNA test after 25 days and came neg. It says in the article

"Another type of test is an RNA test, which detects the HIV virus directly. The time between HIV infection and RNA detection is 9–11 days. These tests, which are more costly and used less often than antibody tests, are used in some parts of the United States."

- u said " It is not likely that AIDS test would be negative after 6 months" - so you mean that I might actually have it even if I took the test after the 9-11 day window as it is mentioned. What makes you think that? Just consulting with you.

Regarding the HEP article - I already have B so I assume that worse case scenario I probably got D now IF this is a liver issue.

Regarding the UFO article - I agree with you that it is a little weird how nobody else is comenting about this BUT - the tingling in limbs - starting with the feet, the dryness of the skin on hands - that is very symilar to what I have.... so not sure what to make of it. Ofcorse - most of these can be caused by stress...

On the CMV - they don't quite say anything about men - and was hoping that they will giv some more details - I will do some more research on it tonight.

I did see a specialist in infectious disease - he told me that if the tests came back negative after 25 days - especially with the RNA test done also - that I probably just have something else - OR just under large amounts of stress - now - I KNOW that there is something else besides stress... So still trying to work out WHAT.

Will write a list for the GI doctor - good ideea as I tend to forget some of the things when I go in and then get frustrated that I did not mention all of them.

Let me know you coments on the above if any. My GI appt. is on Monday so I'll give you an update then and all the liver readings...

By the way - which one do you have?

[boron]

AIDS test: RNA test at 25th day would be reliable. I was thinking you've done a more usual antibody test, which is reliable only after 6th month.

Tingling may be something real, also dry hands. There are some microorganisms which may cause weird symptoms, one of them is Borrelia (probably not in your case), Herpes virus may invade nerves and brain,

I have no specialization, if this is what you ment.

It is possible that symptoms are caused by various organisms, it happens in lowered immunity. Your immune status will be seen from the blood work.

[spdswm]

Thank you Boron. I was asking which one you have on hepatitis not on specialization. I have been told that I have herpes virus in me however I have never had an outbreak - I would think that I would have an outbreak first and then other developments.  Also when the did the spinal fluid test they said hat there was nothing there of any concern - herpes would have shown in the spinal cord as it sems to be the most reliable test for that....

I think I need to suck it up for a few more weeks until I do the test again - Monday will also clarify some things when I meet with the GI.

[alone and scared]

(Feb 13-15) I took a vacation to Santo Domingo.  I think I had unprotected oral sex. Everthing is a blurry. I had been drinking heavy.  However, about 9 days later, I begin to experience similar symptom as spdswm.    Some of the following symptoms: my mouth had this weird coating taste. It tasted like I had something metallic inside mouth, the next day I was having anxiety attacks, at the same time, something felt like is was traveling through my blood system all over my body, then I begin to experience pressure around my face and head.  I could not eat for about a four days.  I lost about 7 to 10 lbs in two weeks. I immediately had a HIV blood test done two weeks after, as well as two oral HIV swab test. They all have come back negative.  The next week I had a lower back ache which moved down into the upper part of thighs.  I have had tingling sensations in both my hands and feet.  I developed callous between my two baby toes and the second toes.  By the third week, I begin to have strong under arm perspiration and order.  I could not sleep. So my doctor perscribed me some sleeping pills.  In the fourth/fifth week. I am beginning to experience headaches during the day and abruptly, I just get fatigue and tired.  After resting for a while, I get this burst of energy.   I have a light shiny bump on both of my arms and in the middle of lower chest.    I feel pressure building around head and ears.  I go on vacation and get plaster for the first time in months and this happens.  I have not even had sex in nearly two years before this happened. Idepending what I eat, I may experience an irritable bowel syndrome and diarrhea.  From time to time, I experience a weird feeling sensation across my forehead, but mainly around the left side of my ear. I also get feeling mini shocks all over my body.  My pinky ringers get numbness from time to time. I beginning to develop an ear ache.  I tested positive for Hep B antibodies at five months.  However, I tested negative for HIV at 5 months. I know my body.  Something is going on.  It is going on 11months from this horrible nightmare.   Thank Heavens I tested negative for HIV at 10 months post experience.  So I know exactly what you are going through.  I made plans to go back to Santo Domingo and concur my fears about what happened.  Unfortunately, my ex-bodies who I let entice me into this situation will be there at the same time.  However, I plan to be with me, myself and I only this time.  Life is a challenge.  Bad things happen to good people!!!!!

[spdswm]

Story is pretty similar. You are right. Just stay strong and relax. I am trying to do the same.

I am waiting now to get the second test. As for the second trip - sincerely - I would not go if I were you. I said the same thing when I went the second time and did it again. Forget about conquering your fears, just stay away from the temptations. There are so many other things that you can challenge yourself with and actually that make you a better person. Just my opinion. Personally I learned a lot from this experience - I just hope I did not kill myself. We'll see.

[spdswm]

Hi Boron,

hope you had a good weekend. Got my GI meeting today.  Here are the readings as far as I was told was the most concerning -  Quantitatio@ 19300 - last spring was at 2000. Also this was higher than normal - TBILX - 2 where the reading should be between 0.2 and 1.0.

They told me that we should do the tests again in 2 months and see how it goes.

[boron]

TBILX  (total bilirubin) is raised. Probably not enough to cause jaundice, but you might noticed darker urine. I guess that there was no anemia found, so this test means liver disease. Tests for hepatitis were not done?

Quantitatio@ - I'm not sure what's this.

[spdswm]

I do have Bep B. The quantitatio it is I guess the total rate at which the disease multiply. I was at 2000 last spring and now I am at 19k. This is most concernin. GI said that I will retest in 2 months to see if any changes in better (or worse).

Today I also did the other test - THE BIG ONE - will find out in 1.5 weeks. My conspiracy theory tells me that I have it - not sure if you got the chance to read the whole story - but that really bad migrane (migraine) that took me to the ER tells me that I got hit bad by something 1 weeks after impact. Also the increase in the HepB virus from 2k to 19k kind of confirms that. So - what can I say - freaking out pretty much for the next week.

Saw the ENT doctor today and he said that redness in the throat and spots on the oof of my mouth is stress related - i think it is just another symptom to prove that I got tht F...ing thing...

Not to much to say at this point...

[boron]

Yes, I've read about the headache, and I kind a forgot...Keep te big secret tightly, in meantime you can scroll up and down this "causes of headache" (it's awfully long, be selective as possible):
http://www.wrongdiagnosis.com/h/headache/causes.htm

[boron]

Yes, I've read about the headache, and I kind a forgot...Keep te big secret tightly, in meantime you can scroll up and down this "causes of headache" (it's awfully long, be selective as possible):
http://www.wrongdiagnosis.com/h/headache/causes.htm

[boron]

Yes, I've read about the headache, and I kind a forgot...Keep te big secret tightly, in meantime you can scroll up and down this "causes of headache" (it's awfully long, be selective as possible):
http://www.wrongdiagnosis.com/h/headache/causes.htm

[boron]

Yes, I've read about the headache, and I kind a forgot...Keep te big secret tightly, in meantime you can scroll up and down this "causes of headache" (it's awfully long, be selective as possible):
http://www.wrongdiagnosis.com/h/headache/causes.htm

[boron]

Yes, I've read about the headache, and I kind a forgot...Keep te big secret tightly, in meantime you can scroll up and down this "causes of headache" (it's awfully long, be selective as possible):
http://www.wrongdiagnosis.com/h/headache/causes.htm

[boron]

Yes, I've read about the headache, and I kind a forgot...Keep te big secret tightly, in meantime you can scroll up and down this "causes of headache" (it's awfully long, be selective as possible):
http://www.wrongdiagnosis.com/h/headache/causes.htm

[boron]

Yes, I've read about the headache, and I kind a forgot...Keep te big secret tightly, in meantime you can scroll up and down this "causes of headache" (it's awfully long, be selective as possible):
http://www.wrongdiagnosis.com/h/headache/causes.htm

[boron]

Yes, I've read about the headache, and I kind a forgot...Keep te big secret tightly, in meantime you can scroll up and down this "causes of headache" (it's awfully long, be selective as possible):
http://www.wrongdiagnosis.com/h/headache/causes.htm

[spdswm]

Meningitis
–May present with fever, photophobia, neck stiffness, nausea/vomiting, papilledema
–Brudzinski's sign: Neck pain upon passive flexion of neck
–Kernig's sign: Neck pain and involuntary flexion upon passive extension of knee with hips flexed

above is very similar to what I had -  threw up 2 timed during those 2 hours, came and went away, had a hard time keeping my eyes open because of the light - never had this before... What can I say. I am really scared.

[boron]

Spinal fluid test - you mentioned it a while ago...nothing was found there? A short interpretation of spinal fluid test in meningitis:
http://www.mayoclinic.com/health/meningitis/DS00118/DSECTION=6

Negative result excludes viral meningitis, but not bacterial meningitis. Meningitis goes with high fever, neck stiffness, it puts you into the bed for several days. OK, just writing down my thoughts.

[spdswm]

This as just a few hours thing - woke up after a nap with a strange dizziness and headache - not sure if the headache woke me up. Watched TV for an hour as I was hoping it will go away. It got worse and got sensitive to light. I had some somon and some bread with olive oil before the nap - threw that up as the headache got worse. In another 30 min I was in the ER as headache got really bad and could not open my eyes - or better said it was more confortable keeping them closed. Was there for about 2 hours - spinal fluid was taken came out clear and nothing in it. Blood tests showed that I was fighting a cold as blood cells were a little raised (per doctor).

As you said negative results exclude viral meningitis - I think that's the one I should be afraid of. Corect?  Bacterial would mean a cold or food intoxication... Right?

After fluid was taken out they gave me some medicine to calm down and symptoms left. I was still pretty duzzy that evening and felt dizzy also the next day - but no more pain. I never had this thing before or ever had bad headaches.  Just too many symptoms in the same time for the past weeks make me stop believing in coincidences.

What do you think?  Thank you for all your time by he way. I have no words to tell you how much it means to me. It helps a lot.

[boron]

In almost every post you make, you mention some additional symptom. It will maybe help, if you manage to write down a complete history of what happened in all this time: symptoms, their TIME COURSE,  investigations with results.

You've mentioned skin changes on scrotum, knuckles, legs, tingling (over all body?), changes in mouth mucosa, problems with peeing, swollen nodes, headache + temperature + vomiting + photofobia.

Negative AIDS, positive hepatitis B (?), almost negative spinal fluid, blood: elevated bilirubin and...(?)

It may be one or more causes, one or more causing agents, which may occur from one common disorder. One of them is deranged immunity from ...(?)...(this would be seen from detailed check of immune cells limphocytes, leukocytes.. and immunoglobulins in blood).

I know for that crazy headache, my uncle had it once, and all weird symptoms just migrating through his body over 2 months, before they made a diagnosis: Lyme disease. Herpes simplex virus (HSV) is known to stuck in your nerves and being reactivated...

[boron]

If a doctor who investigated was searching for meningitis, and has found nothing, it means:
- there was not viral meningitis, since this cause obvious changes in spinal fluid
- it could be bacterial meningitis, which may be more insidious...but...
meningitisin general don't just go away so quickly.

A migraine may cause almost identical symptoms: headache, typically over one half (left or right) of the head, vomiting, photofobia, you just have to lay down - I've seen that.