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Gastroenterology (Expert Forum)
Liver Enzymes for long time dilantin user
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.
Liver Enzymes for long time dilantin user
by Jwags, Sep 17, 2004 12:00AM
I have been on dilantin for 26 years and have recorded high but consistent GGT levels (375 range) and slightly high but consistent ALT levels (55 range) for at the least the last 14 years. I have not asked my doctor to go back further than that. My AST levles have been normal and consistent as well (25 range). I have my blood tested annually for dilantin count and liver panel. My doctor tells me that since the levels are consistent there is nothing to worry about as they are altered by the medication but that thier lack of movement indicates that the liver is not being damaged. I am interested in your opinion of that. Is there a substitute for dilantin (taken for seizures) that wil not affect my liver in this way? Since I have not had a seizure episode since 1984 (presumably because of the medication) should I consider trying to come off it under doctors care? All other blood levels are normal and relatively consistent except for cholesterol which we are now working on through a statin (for which we are watching the liver enzymes as well). I also take a low dose of Zestril for blood pressure.
Thanks
Thanks
Doctor's Answer
by Kevin Pho, MD, Sep 20, 2004 12:00AM
, Sep 20, 2004 12:00AM
If the ALT levels have not changed in 14 years on dilantin, it is less likely that the medication is affecting the liver.
With the persistently elevated GGT levels, a liver ultrasound and hepatitis panel would not be unreasonable to ensure there isn't any undiagnosed liver disease present.
There are several anti-seizure medications other than dilantin - including depakote and tegratol - but most of them may have elevated liver enzymes as a side effect, and may not be the best medications for controlling your specific type of seizure.
Continuing to serially monitor the liver enzymes as you are doing is the best way to ensure that the liver remains unaffected by the medication.
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.
Medical Weblog:
kevinmd_b
With the persistently elevated GGT levels, a liver ultrasound and hepatitis panel would not be unreasonable to ensure there isn't any undiagnosed liver disease present.
There are several anti-seizure medications other than dilantin - including depakote and tegratol - but most of them may have elevated liver enzymes as a side effect, and may not be the best medications for controlling your specific type of seizure.
Continuing to serially monitor the liver enzymes as you are doing is the best way to ensure that the liver remains unaffected by the medication.
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.
Medical Weblog:
kevinmd_b
