Elevated Liver Function - Life Insurance ... Am I infected w/ something?

[LiveOutLoud]

Hello forum,

I took a life insurance examine in December '06 and found out yesterday that I got a poor/low rating (Table-F) because of an "elevated liver function".  I've never heard of that before and didn't know what it meant ... I've been checkin' it out online and found many different possibilities, causes, etc.

I guess my question is, does "elevated liver function" automatically mean that I have hepatitis?

As for my current health ... I don't seem to have ANY of the symptoms I've seen on various sites ... I feel the same as I've ever had felt.

Any advice would be much appreciated ... would like to ease my mind if that is possible.

I'm going to get a physical soon - would you advise getting something more that just a physical?  If so, what do you suggest?

Thanks in advance.

[mremeet]

Do you know how high your enzymes were? Elevated liver enzymes can be caused by all sorts of things, and sometimes are just temporary and do not indicate any meaningful or permanent liver damage. They also do not necessarily mean you have any form of viral hepatitis, although it can be a sign of this. So if you do have elevated liver enzymes (ALT and AST), they should be looked into by a good GI. A complete hepatitis screening should be performed, including hep A, B and C. Hep A is caused by contaminated food, hep B is primarily blood borne and sexually transmitted, hep C is blood borne and is usually transmitted via IV drug needle sharing and blood transfusions prior to 1992 or thereabouts. There can be other causes for high ALT/AST including everything from tylenol to alcohol to autoimmune issues, to gallstones/cholestasis, to a myriad of other possible causes.

Bottomline is don't freak out, just get yourself checked out as soon as possible. With any luck it'll turn out to be some relatively benign factor temporarily irritating your liver that will pass soon. But if it does turn out to be something more serious like viral hepatitis, don't freak. Most forms can be managed with due care and patient education (I've had Hep C for 24 years and am in pretty good health, for instance). So just take it one step at a time and get to the bottom of it as soon as you can.

Good luck to you, take care.

[LiveOutLoud]

Thanks for the re: ... thanks for easing my mind.  I truly appreciate you taking the time to post your thoughts, experience, etc. concerning my situation.

[LiveOutLoud]

And no ... I do not know how high my enzyme levels are/were from the test.  I had to send a form in yesterday via snail mail to request my results paperwork.

BTW - I'm a 28 y/o male ... when physicals are taken, and if enzyme levels are found to be 'elevated' or 'high', does that require additional tests or can they find out what is wrong by all of the tests that are done during a comprehensive physical?

Thanks.

[LiveOutLoud]

Thanks, copyman.  That's reassuring ... didn't know if they test for it specifically ... it's probably the reason why they have those big buildings, huh ;-)?!  They want to know everything and if you are insurable.

[mremeet]

You're certainly welcome, we're all glad to help new people here in any way we can, that's what this place is about. Just keep in mind that we're not doctors here, this is only a patient to patient forum (although there is a real doctor that casually posts here on occasion).

As far as your question: "when physicals are taken, and if enzyme levels are found to be 'elevated' or 'high', does that require additional tests or can they find out what is wrong by all of the tests that are done during a comprehensive physical?"  Yes, it should warrant additional testing depending on what your doctor suspects might be going on. Typically if you have elevated enzymes a complete viral hepatitis panel is run for hep A, B and C. There may be other tests ordered as well, depending on what your doctor reads into the tea leaves of your remaining workup and physical examination. The first hepatitis tests will check for the presence of antibodies for each form of hepatitis. If you are infected with viral hepatitis, your body normally reacts by producing antibodies that are specifically tailored to fight whatever form of hepatitis you have. If one of these tests picks up the presence of, say, a high level of hepatitis C antibodies, then that could indicate you either were, or still are infected with hepatitis C (but you can test + for hep C antibodies and still be negative for the virus itself).

As far as whether your insurance company went as far as to check you out for hepatitis, I wouldn't know. They may have simply observed you had high enzymes and stopped looking any further right there. High enzymes can also be suggestive of heavy drinking, which also might trigger the warn-o-matic "do not insure" red flag on one of their bureaucratic CYA spreadsheets. They may not care if you have hepatitis, the enzymes alone may rule you out as being too risky (although it shouldn't). I would ask them if they did perform a hep screen, but don't be terribly surprised if they didn't. So again, obviously you'd want to follow up with a good GI doctor to get to the bottom of it. Meanwhile take care of yourself by not drinking or doing anything to tax your liver any further.

Best of luck.

[LiveOutLoud]

Ok ... will do ... when you say "GI doctor" ... what does "GI" mean?

[LiveOutLoud]

I've probably had 15-20 Bud Lights since January 1, 2007.  I'll hold off on that until I know what's up.

Besides alcohol, what else 'taxes' the liver?  Can I run/workout or no?

[wyntre9]

A GI is a Gastro-Enterologist.

[copyman]

first off you would not be offered life insurance if you had hepatitis, not even at the lowest level. they test for hepatitis when applying.  many things besides hepatitis can cause elevated liver functions, alcohol, tylonol, herbs/supplements, medicines, etc. i would have my primary doc re-test and see if they are still elevated, if they are see a liver specialist (hepatologist)

[copyman]

mrmeet was not sure if they test for hepatitis when applying for insurance but i'm 100% sure that it is part of their standard testing along with hiv. so i think it is safe to assume that you do not have hepatitis or they would not have offered you a policy. like i posted earlier i would re-test and if still elevated go to a GI or hepatologist.

[rosebud57]

i hope you don't mind my asking. but if someone like one of us previously had hep c but it cleared with tx. would we be "uninsurable"?? like because they find antibodies or something.. i guess more simply is will this follow forever when it comes to life insurance.

[LiveOutLoud]

Thanks ... that makes sense.  I'll be seeing a doctor next week.  The statement from the insurance company to my insurance broker was something like this "because of the elevated liver function and no APS (Attending Physicians Statement), the decision was based solely on the lab results" ...

Basically when my insurance broker submitted my info, he submitted me as a Standard Rating (NOT Preferred Best since since only like 3% can get this rating) ... and for the most part said that I'm a healthy individual with no medical conditions, etc.  (had check-ups/physicals in Sept. '01 at the age of 23 and Dec. '04 at the age 26). So, because the insurance company didn't have anything from a physician justifying the 'elevated liver function', that's why they rated me the way they did.

It's great that there's a community for people to chat like this.  My thoughts and prayers are with everyone.

[mremeet]

I don't have any experience applying for life insurance, so I don't know if insurance companies (in general) would deny you coverage in the event you were HCV antibody +, but negative for the virus (i.e. you were SVR). But from my experience insurance companies tend to be fairly conservative entities, so I'd think they might shy away from someone who tested HCV antibody + , even if they were clear of the virus itself.  Possible reasons for this: if someone did have the virus but was successfully treated, that doesn't preclude the possibility that their liver has experienced significant damage (and perhaps even to the level of cirrhosis). And they might figure a damaged liver would be more likely to cause potentially serious health problems for that person, and possibly even cancer (HCC) somewhere down the road. Another reason might be due to the increased statistical likelihood that an HCV antibody+ person was or is an IV drug user (when compared to the general population that is). Obviously they'd want to shy away from insuring an IV drug user due to the possibility of premature/untimely death. Another possible reason to deny coverage could simply be out of sheer ignorance. Considering the fact that there's a lot of practicing doctors out there who don't know squat about HCV, I could see where some insurance company doctor (or mere statistical technician) would just err on the safe side and deny coverage because they just suspect something is wrong with the applicant, or even outright misinterpret the HCV antibody+ test alone as a sign of an active infection.

Bottomline is that it's probably wise to shop around. Just because one insurance company denies coverage that doesn't mean another won't offer you a policy.

[LiveOutLoud]

It's a whole new world to me ... You learn about so many things in school that are not "real world" stuff and this is the type of thing that would be good to know about.  I'm surprised to hear a lot of doctors are not up on this topic as much as they probably should.

[LiveOutLoud]

I've probably had 15-20 Bud Lights since January 1, 2007. I'll hold off on that until I know what's up.

Besides alcohol, what else 'taxes' the liver? Can I run/workout or no?

[Really Rose]

Hi
I was diagnosed with Hep C antibodies in Dec 06 through an insurance medical.  I was given the "flick" immediately.  However, I signed a waiver that any unusual results would be sent to my family doc.  He was notified and the roller coaster started then for me.  I came back positive when I tested again for another confirming test.

However, I found that since the summer I was struggling with fatigue and had all kinds of reasons for the symptoms.  I was a "amatuer" runner (5 k three times a week) and found in October I couldn't continue my running by half way mark.  I was exhausted and knew that I there was something wrong and i had to stop and walk out the last half of the run.  This happened to me twice in a row and the exhaustion was horrible.

I was convinced by my friends and family that running was too strenuous for me and "at my age" (51) I must find an alternative means of exercise.  My exhuastion was devastating.  I geared it down to walking.  I miss the exhilaration of the run.  I will be asking that same question when I see a specialist, however, I do wonder if I'll ever build it back up or even have the energy to do it again.
Take Care
Rose

[mremeet]

There are tons of things that can cause liver toxicity - chemical exposures, poisonous mushrooms, alcohol, OTC drugs taken in excess or in inappropriate combinations etc etc etc. I wouldn't get overly worried about it, just don't take any herbal supplements, or "megadosing" of vitamins etc. And if you are taking any vitamins, you might want to avoid any with iron in it until you get this thing sorted out. Excess iron is known to collect in the livers of some people who are infected with HCV (and some who aren't, for that matter), and it also can increase viral replication. Otherwise just eat a typical healthy diet with fruits and veggies, whole grains, lean meats/fish and drink plenty of fresh water. Obviously avoid smoking, drugs, alcohol etc etc. The old boring common sense stuff your mom told you will always steer you straight.

As far as exercise - Usually exercise is a very good thing and is an important part of maintaining good health. But from what I've heard, really overdoing it with super intense workouts like running marathons or really hitting the weights can cause liver enzymes to elevate. Extreme exercise apparently can tax the liver in some way, although I don't recall the biological mechanism offhand that causes this (my memory is shot right now because I'm taking harsh drugs for the hep C, lol). But it has to be sustained extreme exercise for this to happen.

When liver cells are damaged, they rupture and release their inner contents into your bloodstream. These contents contain the enzymes that are detected in the AST/ALT test, so the higher the AST/ALT level, in general the more ongoing liver damage there is. Also, your muscle cells have enzymes within them that are chemically similar to liver enzymes. From what I've heard, if large groups of muscle tissues are damaged or broken down during heavy weightlifting, then a considerable amount of muscle enzymes can be released into the bloodstream. My layman's understanding is that these enzymes can mimic liver enzymes and be picked on liver enzyme tests, falsely giving the impression of some form of ongoing liver damage (when in fact there is none).

But again, for these scenarios to happen, as far as I know you really have to be hitting it HARD. If you're being reasonable to your body, then there's nothing healthier than a good mix of aerobics and resistance training.

Hope this helps a little, good luck with your followup tests.