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High Liver Enzyme Count and a normal liver
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High Liver Enzyme Count and a normal liver

Blood tests show that I have a high liver enzyme count.  Everything has been ruled out.  I had a liver ultrasound (normal); a liver biopsy (normal).  No history of hep c or alcohol.  What could be causing the high count?
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87972_tn?1322664839
There are many possible causes for elevated liver enzymes; this list is from the Mayo Clinic:’

http://www.mayoclinic.com/health/elevated-liver-enzymes/MY00508/DSECTION=causes

Certain prescription medications, including statin drugs used to control cholesterol
Hepatitis A
Hepatitis B
Hepatitis C
Nonalcoholic fatty liver disease
Obesity
Over-the-counter pain medications, including acetaminophen (Tylenol, others)
Alcoholic hepatitis
Autoimmune hepatitis
Celiac disease
Cirrhosis
Cytomegalovirus (CMV) infection
Dermatomyositis
Epstein-Barr virus
Gallbladder inflammation (cholecystitis)
Heart attack
Hemochromatosis
Hypothyroidism (underactive thyroid)
Liver cancer
Mononucleosis
Muscular dystrophy
Pancreatitis
Polymyositis
Toxic hepatitis
Wilson's disease

As you can see, the list is extensive; your doctor needs to evaluate to give you a proper diagnosis.

--Bill
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If your current doctor can not discover the cause of elevated liver enzymes, ask for a referral to a specialist in a major academic medical center. They see a lot more complicated patients than average doctor does and have much better ability to make correct diagnosis.

The main thing, do not let them just brush you off with the statement that they can not discover why your enzymes are up. Elevated liver enzymes is the cause for concern, and it is important to make correct diagnosis. You need to get to the bottom of this.

How high are you liver enzymes?
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338734_tn?1377163768
One of the most common causes of elevated liver enzymes is medications. Over-the-counter meds like Tylenol and NSAIDs like Ibuprofen and Naproxen Sodium can also cause elevated liver enzymes. Statins taken for cholesterol often cause elevated liver enzymes and also some common antibiotics.

Exposure to certain toxins in the home or workplace can be the cause also.

Here's an article that lists some medications that can result in elevated liver enzymes:

http://www.medicinenet.com/drug_induced_liver_disease/page8.htm

Don't forget that alcohol ingestion is a common cause of elevated enzymes.
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Avatar_m_tn
Oddly enough, ALT and AST are not only produced by the liver. They can be released by almost any inflamed or irritated tissue.

The whole reason they found my Hep C was due to a curious chain of events. I had gone back to the gym after an extended time off, and way overworked myself. Every muscle in my body was so sore and stiff I could barely move.It just so happened that my annual physical exam was 4 days later.

Well, it turns out my ALT/AST were about 20 times the normal level - up around 800 or so. I quickly did some reading on the web, and discovered that the liver is not the only place these chemicals come from.

To make a long story short, have you experienced any muscle trauma recently? If you have, this can greatly elevate the same enzymes. The key is to look for a marker called CPK in the blood. This is present in muscle injury.

In my case, my CPK was skyhigh as well. So, my readings were the result of muscle injury.

Perhaps yours are too.
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338734_tn?1377163768
Good point. That is why the liver panel is often accompanied by the GGT test, which is specific to the liver, unlike the ALT and AST, I believe.
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87972_tn?1322664839
Thanks, all; even if the original poster doesn't return, I sure continue to read and learn :o)

Bill
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Avatar_m_tn
Heh, I just realized I never finished my "story".

So, my enzyme readings were sky high as a result of my severe muscle trauma caused from a foolish workout. I should know better, but hey, we still think we're 20 years old.

In a month, the readings came down to just above the normal range, maybe 5 points for both ALT and AST. They refused to go any lower. My doc said we really should investigate further, I was like, no need to, I work out regularly, probably just continual low-grade muscle injury.

He insisted. And so, here we are, diagnosed. At least now I have a chance to cure it. I am grateful to my doctor for being so persistent with me.

Good luck my friend.
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