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)
Years of “elevated liver function”
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.
Years of “elevated liver function”
by drblkjk, Aug 24, 2004 12:00AM
I am a 39 yr white male. On my 30th birthday I had a physical exam from my family physician. Everything checked out “very good”, however, after reviewing the blood work, my physician explained that I had elevated liver function (ELF) and that I should be further tested for hepatitis and I should stop drinking alcohol for a while. The hepatitis results were negative and I have been alcohol free for nearly 10 years now. However, I have been to several family physicians and recently to a gastroenterology specialist and I still am diagnosed with ELF. During the last nine years and regular blood work, I have had two ultrasounds on the liver. Both times the results gave no indication of a problem. We continued to monitor the ELF approximately once a year. I have never “felt” any symptoms that there is something wrong. October 2003, my family physician recommended that I see a specialist. “Extensive” blood work was done and I reviewed the results with the gastroenterologist physician in 11/03 and in 5/04. I have not seen my physician since the last results (which are concerning!).
Results over the last 10 months have been:
Protein-Total - 7.4 g/dL(11/03),7.4 g/dL(2/04),7.2 g/dL(5/04),7.4 g/dL(8/04)
Albumin - 4.0 g/dL(11/03),4.3 g/dL(2/04),4.2 g/dL(5/04),4.1 g/dL(8/04)
Globulin - 3.4 g/dL(11/03),3.1 g/dL(2/04), 3.0 g/dL(5/04),3.3 g/dL(8/04)
A/G Ratio - 1.2 LOW(11/03),1.4 (2/04),1.4(5/04),1.02 LOW(8/04)
Alkaline Phosphatase - 122U/L(11/03),96U/L(2/04),78U/L(5/04),183U/L HIGH(8/04)
ALT (all HIGH) - 129U/L(11/03),81U/L(2/04),102U/L(5/04),412U/L 8/04)
AST - 61U/L HIGH(11/03),37U/L(2/04),35U/L(5/04),171U/L HIGH(8/04)
GGTP – 183U/L HIGH(8/04)
Billrubin-Total - 0.41 mg/dL(11/03), 0.76 mg/dL(2/04), 0.631 mg/dL(5/04), 0.61 mg/dL(8/04)
Billrubin-Direct - 0.10 mg/dL(11/03), 0.14 mg/dL(2/04), 0.121 mg/dL(5/04), 0.20 mg/dL(8/04)
Hep. Bc Antibody, IgM - Negative (2/04)
Hep. Bc Antibody, IgG & IgM - Negative (2/04)
In November 2003, we decided to treat with diet and monitor blood work every 3 months. No medication at this time. I was to loose 10% of my body weight. I went from 145 pounds (height 5’-8”) to 130 pounds in 3 months by dieting alone.
In 5/04, my physician still expressed concern. He recommended medication (Actigall) to see if that would help. I elected to not take the medication at this time and continue with watching my weight, since it appeared that what I was doing was “working”.
Can the results vary monthly, daily or hourly depending on intake, exercise, weight?
I had a sinus cold the few days prior to the August 2004 blood work and I was taking an OTC decongestant (Comtrex). Could that have skewed the results?
Should I be alarmed and get into see my physician immediately?
Now I am considering taking the Actigall. How can I find out more about the associated long-term risks of this medication?
Where do I find out about the facts (health risks/deaths) associated with people that haveELF
Results over the last 10 months have been:
Protein-Total - 7.4 g/dL(11/03),7.4 g/dL(2/04),7.2 g/dL(5/04),7.4 g/dL(8/04)
Albumin - 4.0 g/dL(11/03),4.3 g/dL(2/04),4.2 g/dL(5/04),4.1 g/dL(8/04)
Globulin - 3.4 g/dL(11/03),3.1 g/dL(2/04), 3.0 g/dL(5/04),3.3 g/dL(8/04)
A/G Ratio - 1.2 LOW(11/03),1.4 (2/04),1.4(5/04),1.02 LOW(8/04)
Alkaline Phosphatase - 122U/L(11/03),96U/L(2/04),78U/L(5/04),183U/L HIGH(8/04)
ALT (all HIGH) - 129U/L(11/03),81U/L(2/04),102U/L(5/04),412U/L 8/04)
AST - 61U/L HIGH(11/03),37U/L(2/04),35U/L(5/04),171U/L HIGH(8/04)
GGTP – 183U/L HIGH(8/04)
Billrubin-Total - 0.41 mg/dL(11/03), 0.76 mg/dL(2/04), 0.631 mg/dL(5/04), 0.61 mg/dL(8/04)
Billrubin-Direct - 0.10 mg/dL(11/03), 0.14 mg/dL(2/04), 0.121 mg/dL(5/04), 0.20 mg/dL(8/04)
Hep. Bc Antibody, IgM - Negative (2/04)
Hep. Bc Antibody, IgG & IgM - Negative (2/04)
In November 2003, we decided to treat with diet and monitor blood work every 3 months. No medication at this time. I was to loose 10% of my body weight. I went from 145 pounds (height 5’-8”) to 130 pounds in 3 months by dieting alone.
In 5/04, my physician still expressed concern. He recommended medication (Actigall) to see if that would help. I elected to not take the medication at this time and continue with watching my weight, since it appeared that what I was doing was “working”.
Can the results vary monthly, daily or hourly depending on intake, exercise, weight?
I had a sinus cold the few days prior to the August 2004 blood work and I was taking an OTC decongestant (Comtrex). Could that have skewed the results?
Should I be alarmed and get into see my physician immediately?
Now I am considering taking the Actigall. How can I find out more about the associated long-term risks of this medication?
Where do I find out about the facts (health risks/deaths) associated with people that haveELF
Doctor's Answer
by Kevin Pho, MD, Aug 25, 2004 12:00AM
, Aug 25, 2004 12:00AM
The liver enzymes are certainly concerning - especially since they are still increasing. An ALT of over 400 certainly warrants further investigation. Ultrasounds and hepatitis screens are not-revealing. There are plenty of other liver conditions, including autoimmune disease and hemochromatosis amongst others. With persistantly elevated enzymes, and an ALT more than 3 times the normal limit, it may be worth considering a liver biopsy for further evaluation.
To answer your questions:
1) Yes, th results can vary from month to month - but enzymes above 400 requires further evaluation.
2) It is possible that Comtrex may have affected the results (as it has acetaminophen in it). However, I would ensure that nothing more serious is going on.
3) I certainly would discuss the option of a biopsy with your physician.
4) More information on Actigall can be found here:
http://www.gettingwell.com/drug_info/rxdrugprofiles/drugs/act1006.shtml
More information on elevated liver enzymes can be found here:
http://www.healthscout.com/ency/68/83/main.html
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
To answer your questions:
1) Yes, th results can vary from month to month - but enzymes above 400 requires further evaluation.
2) It is possible that Comtrex may have affected the results (as it has acetaminophen in it). However, I would ensure that nothing more serious is going on.
3) I certainly would discuss the option of a biopsy with your physician.
4) More information on Actigall can be found here:
http://www.gettingwell.com/drug_info/rxdrugprofiles/drugs/act1006.shtml
More information on elevated liver enzymes can be found here:
http://www.healthscout.com/ency/68/83/main.html
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
Member Comments (1)
by drblkjk, Aug 26, 2004 12:00AM
Thank you for your comments and information. I have scheduled an appointment with my physician, and as I dscussed with him on the phone, we will be considering a biopsy. Will the biopsy discover autoimmune disease and/or hemochromatosis?
by SylviaS4, Aug 26, 2004 12:00AM
To: drblkjk
I am a 33 year old black female with the exact same problem. I have had this problem for about a year. I had been going back an forth to the Mayo Clinic for months, when finally last month they decided to do a biopsy. The results came back showing I had a perfectly healthy liver. They are still trying to figure out what is going on. One of my co-workers (not a doctor) insist it is my gallbladder. My doctor thinks that is out of the question. Please let me know what you find out. I discovered this problem while trying to increase my health insurance. Now I can't get insurance through anyone because of this blood work.
