Question about test results

[jr978]

Were do I start??  I had a very stressfull situation a year (sept 05)ago and started to have severe anxiety symtoms that included buzzing feeling all over my body, muscle aches and pain.  The reason for this stress is I had an extramarital affair and was so worried that I contracted some disease.  Most comments I have gotten have been the symptoms are anxiety related.  These symptoms have not gone away since then.  I have been on antidepressants and antianxiety meds for sometime with about 60% good effect.  I went about 6 months ago to my MD and he took some basic labs (cbc,chemistry's,thyroid,cpk,liver etc.)and it came back with an elevated ALT's of about 50 (H) and the alk phos was about 89 (still in normal range).  I had the test repeated 6 weeks later with same numbers (roughly).  The MD ordered an liver ultrasound and a hepatitis panel.  All came back negative including hep c (so this was 6 months after potential exposure).  No fatty liver and they also tested something to do with iron levels.  All normal.  I just this past week went to my MD again ( tired of muscle tightness soreness and thinking that I have some dreadful disease) to get evaluated again.  The MD ordered a lymes test, ANA, and thyroid and a liver panel again.  STill waiting for results but if they are the same (elevated ALT's), what do you suggest I do?  Would a Hep C test 6 months after the start of muscle aches be considered accurate?  I have a BMI of 29.8 so I am borderline obese and live a sedentary lifestyle.  I forgot, I also had a hepatitis C test (i believe it was a HCV-PCR test about 2 weeks after the "exposure" and was negative (it may have been just an anti-body test I can't remember and I know if it was an anti-hcv at 2 weeks it isnt accurate).  I also had a hepatitis B and A vaccination years ago.  If the test comes back the same results (alt) and my md say don't worry, should I pursue further testing?  Thanks in advance

[Kevin Pho, MD]

You have had a pretty reasonable initial evaluation of the elevated ALTs with the ultrasound and hepatitis tests.  

If the ALT continues to be mildly elevated, they can be observed with serial ALT testing (i.e. every 3 months), to ensure they are not rising.  

A liver biopsy would be the most definitive test, but this is not normally suggested until the enzymes approach 3 times the upper limit of normal.

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_

[mommyb]

For the last 2 months, my alkaline phosphate blood level have been 185, and this Thursday 9-28-06, will be having some additional blood test done to see what's causing this.  I had gastric-bypass surgery done in 1986 at Hershey Medical Center, and I know they moved some stuff around, so the food took longer to do its thing.  Six days after going home I had a pulmonary embolism go into the left lung and collapsed it.  Survived that and in 2003 went into congestive heart failure and had two arteries blocked one 95% amd the other 75%; received a stint in one and balooned out the other; had a mild heart attack 6-1-06 with minimal damage; my ejection fraction is 74%, which I'm told is really good.  But I have had 2 heart attacks since 2003.  Is my elevated alkaline phosphate level of 185 have anything to do with the heart, I also have lo-thyroid, or is it coming from the by-pass surgery in 1986.  Also have the irritable bowel syndrome.  Lost my mom to colon cancer in 2001, and will be having a colonoscopy(the one they do in the hospital), cause the one my former Dr. did he could only reach a certain point and couldn't go anyfurther due to the gastric bypass surgery.