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Moderately elevated liver enzymes in otherwise healthy young girl
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Moderately elevated liver enzymes in otherwise healthy young girl

I am 25 years old and have always considered myself pretty healthy.  I recently went to the doctor hoping to get on Adderall (adderrall) because I have friends who take it and report feeling more focused (and less hungry) than ever.  I told the doctor that I have recently experienced fatique and a lack of motivation in my personnel life and in my career.  As such, he ordered some routine blood tests and then informed me that my liver enzymes were elevated.  My AST enzymes were 253 and ALT enzymes were 117.  

Concurrently with the doctor's lab running hepatitis tests on my blood, I researched all the possible causes of elevated enzymes online and self-diagnosed myself with a case of Hepatitis A.  I have been vaccinated against Hep B and perhaps Hep C after an outbreak in my town when I was in high school (apx 8 years ago).  About 3 weeks before my blood tests, I had the worse case of the "flu" that I ever had.  After researching Hep A online, I discovered that these systems were consistent with the onset of Hep A.  Put very bluntly, symptoms I experienced were as follows:

- I think I had a slight fever, my head was warm to the touch but I never took my actual tempature
- fatique - I slept on and off for at least the first 4 days straight
- diarrhea - gross but the worse case of my life, also it seemed abnormally charcoal gray and lumpy
- sharp pain in the mid-right hand side of abdomen
- loss of appetite, I hardly ate anything for the first 5 days of symptoms
- vomiting - I vomited 2 to 3 times.  Vomiting on an air plane was my first symtom.  
- muscle aches
- bone and point aches

Also, after having symptoms for 6 days and having a moment of feeling significantly better, I had sex with my husband.  The sex may or may not have any connection, but immediately after I noticed a good amount of blood.  It was similiar in nature to the onset of a heavy menustral period but it was not my time of the month and after this episode, I did not bleed anymore.  I thought at the time that I could have had a miscarriage due to being so sick but when I took a pregnancy test the next morning, it came back negative.  I would have expected it to be 'positive' if I had been pregnant.  

Much to my surprise, my entire hepatitis kit came back negative.  I am a healthy weight (140 and 5 foot 7), drink only the occasional glass of wine in the bathtub or cold beer after gardening, and rarely take tylenol or similiar medications.  I took Wellbutrin 300 XR off and on (but mainly off), and Yaz birth control off and on (mainly off).  I haven't take either in at least a month.  I do not take any herbal supplements.

Besides the 10-day 'flu' that I had a month prior to my elevated liver enzymes, I haven't had any other symptoms.  

I have an appointment to go back to the doctor to check my enzymes again after one month.  In the meantime, what could be wrong with me?  

What do my levels of ALT / AST indicate?  

What are the typical reasons ALT / AST could be elevated for someone young of a healthy weight and healthy lifestyle?  

Could my hepatitis A test have been a false negative?

Should my hepatitis B or C test have been positive since I have vaccinated against these diseases?  

Are enzymes elevated to my level (253 AST and 117 ALT) ever a fluke and not due to any underlying disease or condition?  

What can I do to help my enzymes return to normal?  I won't drink alcholol or take any medications but are their foods or beverages that will help your liver?  
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Avatar m tn
You bring up multiple issues, but to deal with a few:

(1) There could be many causes for elevated enzymes besides Hepatitis A, B or C.

(2) If you happen to be in the acute (very early) stage, it's possible that you did not develop antibodies yet, therefore the suggestion to test again in a month.

(3) There is no vaccine for Hepatitis C. Only a vaccine for Hepatitis A and B. If you were vaccinated against either Hep A or Hep B, then yes, that should have shown up in your blood work, assuming the vaccines took. Sometimes they don't take, meaning you have to take the series again.

(4) Diagnosing Hepatitis C can be tricky, especially in the acute stage, if indeed this is what is going on. Even tricker over the internet, not to mention that we don't have any doctors here. Even most GP's and many gastros aren't up to the task. Ideally, the doctor you want to see is a liver specialist also called hepatologists. They can usually be found in your larger, teaching hospitals. If a friend had your symptons, that would be my advice. Go see a hepatologist.

Good luck!

-- Jim
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