Aa
dangers of liver biopsy
I now have a alt of 218. It was 29 in december. I've never in 3+ yrs of testing been over 60. I am now concerned for liver condition even though all the other lfts (besides 109 ast) are always normal. I had a biopsy 3+ yrs ago showing nothing grade0 stage 0. When I had the biopsy I had a vaso vagus response and blood pressure plummeted 50/30 example. I had the blood test last fall and had a grade 0 stage 0 no inflammation. Things have changed in the past 3 months and today for the 1st time I have liver pain and not just liver cringing or what ever that feeling is. My liver is not swollen below my rib cage. Should I have another biopsy? These may sound like dumb questions but... I have a VERY cold nose when there is just a chill in the room, is that anything? I do know I have cryglobulenemia. It may give some of you a laugh, I don't know? Also...What do you think of Prednisone for asthma? I used it for 4 days and it's day 6 and I can't breath again. Thank you! anyone? Pam
Litbee,
Thanks for all the information. Times are much clearer now.
Wow you have had HCV for over 30 years and no liver damage (grade0 stage 0). That's amazing! You must be one of the lucky one that progresses very slowly.
It just so happens that years ago I took most of the drugs you are taking so I do have some knowledge about them, bipolar illness and depression.
The good news is all the symptoms you mention can be caused by the mix of meds your taking not HCV or liver disease.
A few things...
Bipolar illness is a hereditary disease that runs in families. So it has nothing to do with HCV.
Second... All the meds you are taking for bipoler disorder and depression are not good for your liver. Not many meds are. Does you psychiatrist know you have HCV and mederate high AST and ALT? She/he need to find drugs for your mood disorder that are gentle on your liver. One or more of the drugs you are taking can be rasing your ALT and AST, causing "brain fog" (lithium), and of course weight gain (lithium), etc. These are all very common side effects of these drugs. And you have another common problem with lithium. Thyroid burnout. Have to talked to the doc who prescribed these meds for you about your symptoms?
Lithium: Causes weight gain, mental skill impairment, liver damage.
Klonipin: Hematopoietic: Anemia, leukopenia, thrombocytopenia, eosinophilia
* Hepatic: Hepatomegaly, transient elevations of serum transaminases and
alkaline phosphatase
WELLBUTRIN SR: Hepatic Impairment: should be used with extreme caution in patients with severe hepatic cirrhosis. In these patients, a reduced frequency and/or dose is required. WELLBUTRIN SR should be used with caution in patients with hepatic impairment (including mild to moderate hepatic cirrhosis) and reduced frequency and/or dose should be considered in patients with mild to moderate hepatic cirrhosis.
All patients with hepatic impairment should be closely monitored for possible adverse effects that could indicate high drug and metabolite levels.
Glad to see you're seeing a Hepatologist. You should coordinate between Hep doc and psychiatrist. Find out what works for your moods while at the same time not stressing your liver with powerful meds.
You might want to check out the biopolar group and get their experience with these meds and the liver also.
Best of luck.
Hector
Thanks for all the information. Times are much clearer now.
Wow you have had HCV for over 30 years and no liver damage (grade0 stage 0). That's amazing! You must be one of the lucky one that progresses very slowly.
It just so happens that years ago I took most of the drugs you are taking so I do have some knowledge about them, bipolar illness and depression.
The good news is all the symptoms you mention can be caused by the mix of meds your taking not HCV or liver disease.
A few things...
Bipolar illness is a hereditary disease that runs in families. So it has nothing to do with HCV.
Second... All the meds you are taking for bipoler disorder and depression are not good for your liver. Not many meds are. Does you psychiatrist know you have HCV and mederate high AST and ALT? She/he need to find drugs for your mood disorder that are gentle on your liver. One or more of the drugs you are taking can be rasing your ALT and AST, causing "brain fog" (lithium), and of course weight gain (lithium), etc. These are all very common side effects of these drugs. And you have another common problem with lithium. Thyroid burnout. Have to talked to the doc who prescribed these meds for you about your symptoms?
Lithium: Causes weight gain, mental skill impairment, liver damage.
Klonipin: Hematopoietic: Anemia, leukopenia, thrombocytopenia, eosinophilia
* Hepatic: Hepatomegaly, transient elevations of serum transaminases and
alkaline phosphatase
WELLBUTRIN SR: Hepatic Impairment: should be used with extreme caution in patients with severe hepatic cirrhosis. In these patients, a reduced frequency and/or dose is required. WELLBUTRIN SR should be used with caution in patients with hepatic impairment (including mild to moderate hepatic cirrhosis) and reduced frequency and/or dose should be considered in patients with mild to moderate hepatic cirrhosis.
All patients with hepatic impairment should be closely monitored for possible adverse effects that could indicate high drug and metabolite levels.
Glad to see you're seeing a Hepatologist. You should coordinate between Hep doc and psychiatrist. Find out what works for your moods while at the same time not stressing your liver with powerful meds.
You might want to check out the biopolar group and get their experience with these meds and the liver also.
Best of luck.
Hector
It is true that I am not a doctor............but I did stay at a holiday Inn express last night. (lol)
The "sack" that holds the liver can be felt and if the liver is inflammed you could feel some upper right quadrant discomfort. But that biopsy was not that long ago so I serious doubt your liver is failing you...unless, of course you took something that has poisoned you. Tylenol overdose can send ALT/AST into orbit and seriously damage your liver...even cause death. I am just a regular Joe on the hep C board so you need to get to that Hepatologist soon. Perhaps certain drug interactions are causing these stresses, but only a real pro can get to the bottom of it. Timing is a clue of course, did the ALT/AST levels start going up when you started prednisone or lithium? A drastic change in eating habits? You need a good doc to start unravelling this mystery. Sorry i cannot help beyond that but keep us uodated. Gods peace. -Geof
The "sack" that holds the liver can be felt and if the liver is inflammed you could feel some upper right quadrant discomfort. But that biopsy was not that long ago so I serious doubt your liver is failing you...unless, of course you took something that has poisoned you. Tylenol overdose can send ALT/AST into orbit and seriously damage your liver...even cause death. I am just a regular Joe on the hep C board so you need to get to that Hepatologist soon. Perhaps certain drug interactions are causing these stresses, but only a real pro can get to the bottom of it. Timing is a clue of course, did the ALT/AST levels start going up when you started prednisone or lithium? A drastic change in eating habits? You need a good doc to start unravelling this mystery. Sorry i cannot help beyond that but keep us uodated. Gods peace. -Geof
Hector,
Thanks a lot for the reply and opinion. I am 49 next week and I BELEIVE I have had this for 34 or 32 yrs. IV drug experimentation, a couple of times. It could be less time but I have had body pain since my early twenties. I am recently diagnosed bipolar 2 and I wonder if the virus could be messing with my brain. I've read about the new knowledge of the virus in the brain and spinal cord. I was drinking about 1 or 2 times a month and then 4- 6 months or so maybe nothing. I now am committed to NEVER doing that again! I requested a low dose of lithium (450 mg.) for manic symptoms about 4-5 months ago. Nothing was working or I couldn't take it. It goes through the liver. I've been on 1 -150mg Wellbutrin for 3+ yrs since my Dad died. I've been on Klonipin ( half of a .05) for 6 mos for insomnia. The lithium killed my thyroid in 2 months so I'm on synthroid and Maybe it's that, that is causing the elevation in the alt and ast. I just got bloodwork results yesterday and alt is 272 and ast is 156. Up from 218 and 109 and 2 months ago it was 172 and 103. This progression has me really concerned that at this rate I WILL have permenent damage. I have an appt with a hepatologist at Hershey Med Ctr in late June. In the mean time I'm nervious. Lithuim and hypothyroid has caused me to go from 125 lbs to 140lbs. I'm 5'2" and have a short waist and this weight I think is causing my liver to be pushed into my ribcage...thus liver sensation( normally it feels like a spasm but kind of a numb feeling). I've had this feeling on occasion for nearly 10 yrs. I really am suffering brain fog with the drugs I was put on. I'm an oil artist and this has REALLY cut into my creativity. My focus now is to find a way to stop this elevation of my alt/ast's and get my choleterol down. Hard to diet on Lithium!
Cholesterol is 239 and I don't know which drug for this condition is safe. I'm finding much more info on this site concerning the hepc, drugs and supplements then mt MD could ever offer. I'll make a list to take to the hep doc in June. Maybe it's all thyroid?
Thanks again Hector, Pam
Thanks a lot for the reply and opinion. I am 49 next week and I BELEIVE I have had this for 34 or 32 yrs. IV drug experimentation, a couple of times. It could be less time but I have had body pain since my early twenties. I am recently diagnosed bipolar 2 and I wonder if the virus could be messing with my brain. I've read about the new knowledge of the virus in the brain and spinal cord. I was drinking about 1 or 2 times a month and then 4- 6 months or so maybe nothing. I now am committed to NEVER doing that again! I requested a low dose of lithium (450 mg.) for manic symptoms about 4-5 months ago. Nothing was working or I couldn't take it. It goes through the liver. I've been on 1 -150mg Wellbutrin for 3+ yrs since my Dad died. I've been on Klonipin ( half of a .05) for 6 mos for insomnia. The lithium killed my thyroid in 2 months so I'm on synthroid and Maybe it's that, that is causing the elevation in the alt and ast. I just got bloodwork results yesterday and alt is 272 and ast is 156. Up from 218 and 109 and 2 months ago it was 172 and 103. This progression has me really concerned that at this rate I WILL have permenent damage. I have an appt with a hepatologist at Hershey Med Ctr in late June. In the mean time I'm nervious. Lithuim and hypothyroid has caused me to go from 125 lbs to 140lbs. I'm 5'2" and have a short waist and this weight I think is causing my liver to be pushed into my ribcage...thus liver sensation( normally it feels like a spasm but kind of a numb feeling). I've had this feeling on occasion for nearly 10 yrs. I really am suffering brain fog with the drugs I was put on. I'm an oil artist and this has REALLY cut into my creativity. My focus now is to find a way to stop this elevation of my alt/ast's and get my choleterol down. Hard to diet on Lithium!
Cholesterol is 239 and I don't know which drug for this condition is safe. I'm finding much more info on this site concerning the hepc, drugs and supplements then mt MD could ever offer. I'll make a list to take to the hep doc in June. Maybe it's all thyroid?
Thanks again Hector, Pam
I progressed to stage 2 in under 5 years, but I had a habit of drinking 2 beers at once, prior to dx. Walrus did you drink alcohol/take drugs to progress through the stages at this rate? Regards Emi
A total amateur opinion, but I think taking prednisone would be a bad thing with HCV in general.
I have taken a lot of prednisone over the years for sports injuries, bronchitis, etc. and I know that if you stop abruptly without tapering off the dose, you can have a reaction that would be like the asthma coming back. Could be that happened to you?
Also, just based on personal experience, I progressed from Stage 1 to Stage 4 (cirhossis) in about 5 years after being infected for over 30 years. You should check it out with the doctor. Maybe a biopsy would be wise. I have had about 4 biopsies now and had no ill effects except for a little brusing and tenderness after. Of course there are some risks associated with the biopsy that your doctor should inform you about (bleeding, infection, et. al.)
Good luck!
I have taken a lot of prednisone over the years for sports injuries, bronchitis, etc. and I know that if you stop abruptly without tapering off the dose, you can have a reaction that would be like the asthma coming back. Could be that happened to you?
Also, just based on personal experience, I progressed from Stage 1 to Stage 4 (cirhossis) in about 5 years after being infected for over 30 years. You should check it out with the doctor. Maybe a biopsy would be wise. I have had about 4 biopsies now and had no ill effects except for a little brusing and tenderness after. Of course there are some risks associated with the biopsy that your doctor should inform you about (bleeding, infection, et. al.)
Good luck!
"I had a biopsy 3+ yrs ago showing nothing grade0 stage 0." I have liver pain and not just liver cringing or what ever that feeling is.
It usually takes DECADES for your liver to progress from stage 0 to stage 4. So unless you are poisoning yourself with alcohol and drugs your liver is still fine.
Liver pain appearing in 3 months? The liver has no nerves. Remember when you had a biopsy. They stuck a needle into it and cut out little pieces of your liver. If we had nerves in our livers...Oooch!!! For your liver to be enlarged you have to have an inflammed liver and an advanced stages of fibrosis which probably won't happen for another 20-30+ years.
As far as your ALT and AST. Something is going on. I'm not sure what.
ALT levels are usually not as high in chronic hepatitis, often less than 4 times the highest normal level: in this case, ALT levels often vary between normal and slightly increased, so doctors typically will order the test frequently to see if there is a pattern.
A shot or injection of medicine into the muscle tissue, or strenuous exercise, may increase ALT levels.
Many drugs may raise ALT levels by causing liver damage in a very small percentage of patients taking the drug. This is true of both prescription drugs and some “natural” health products. If your doctor finds that you have a high ALT, tell him or her about all the drugs and health products you are taking.
AST is also increased after heart attacks and with muscle injury, usually to a much greater degree than is ALT.
I would check it out with your doctor if I were you.
Good luck!
Hector
It usually takes DECADES for your liver to progress from stage 0 to stage 4. So unless you are poisoning yourself with alcohol and drugs your liver is still fine.
Liver pain appearing in 3 months? The liver has no nerves. Remember when you had a biopsy. They stuck a needle into it and cut out little pieces of your liver. If we had nerves in our livers...Oooch!!! For your liver to be enlarged you have to have an inflammed liver and an advanced stages of fibrosis which probably won't happen for another 20-30+ years.
As far as your ALT and AST. Something is going on. I'm not sure what.
ALT levels are usually not as high in chronic hepatitis, often less than 4 times the highest normal level: in this case, ALT levels often vary between normal and slightly increased, so doctors typically will order the test frequently to see if there is a pattern.
A shot or injection of medicine into the muscle tissue, or strenuous exercise, may increase ALT levels.
Many drugs may raise ALT levels by causing liver damage in a very small percentage of patients taking the drug. This is true of both prescription drugs and some “natural” health products. If your doctor finds that you have a high ALT, tell him or her about all the drugs and health products you are taking.
AST is also increased after heart attacks and with muscle injury, usually to a much greater degree than is ALT.
I would check it out with your doctor if I were you.
Good luck!
Hector
According to my doctor, the ALT and AST levels go up and down pretty much daily. If you were to be tested next week, they will most likely be different again. Many factors contribute to this. Not being a doctor, I can't tell you what they are, but there are certain precations my doctor told me about..
For example, don't breathe gas fumes at the pumps and avaoid spilling it on your skin, because your skin is porous and just about everything penetrates it. Careful with bug spray, weed spray, inhaling glue, hair spray and so on. Stay very very clear of stress in your life...
Magnum
For example, don't breathe gas fumes at the pumps and avaoid spilling it on your skin, because your skin is porous and just about everything penetrates it. Careful with bug spray, weed spray, inhaling glue, hair spray and so on. Stay very very clear of stress in your life...
Magnum
Please... Dear Gauf,
Can you tell me what you think of an alt that goes from 175 to 218 to 272 in 2 mos? I'm not drinking but I take 1 half of klonopin @night and 150 well butrin in the am. Is this a process of destruction I have entered? Just got my labs today and besides the 272, the ast is 156 and cholesterol is 239.
Bun (from lithium maybe?) is 1 point above normal. I may not be drinking enough water. I know your not a Doc (I think), but you know alot. PAM
Can you tell me what you think of an alt that goes from 175 to 218 to 272 in 2 mos? I'm not drinking but I take 1 half of klonopin @night and 150 well butrin in the am. Is this a process of destruction I have entered? Just got my labs today and besides the 272, the ast is 156 and cholesterol is 239.
Bun (from lithium maybe?) is 1 point above normal. I may not be drinking enough water. I know your not a Doc (I think), but you know alot. PAM
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