elevated liver enzymes for 3 years

[Jenna in FL]

I have had elevated liver enzymes for three years now but they cant find anything wrong with me. Tested 3xs for hep..neg. Discontinued any meds and alcohol, have had 2 ulrasounds and a CT scan. Recently went to liver specialist and he said he doesnt know whats wrong but something is up to have elevated enzymes. Every test inclding copper(had IUD but had it removed) was neg.the only test he didnt order was something called alpha? I think but said he didnt believe was problem. He told me to retest in 6 months and if still up have biopsy. In mean time take milk thistle. Should I seek 2nd opion?or follow up in 6 months.My results with the doc I saw b4 him are AST 69 andALT 101. Any info would be SO appreciated.

[Upbeat]

Those numbers are only slightly elevated.  There is a host of reasons for it.  The doctor is right.  check it again in six months.
                                                Ron

[Forseegood]

hi, i've been seeing lots of negative things about tylenol for pain in terms of liver issues, what do you think is good in place of tylenol? you always have such good info, just wanted  your take...of course none of us are docs...

[NYgirl]

The doctor told me if I had to take anything take Tylenol and not an ibuprofen type (darn I LOVE THEM) but in complete moderation and it was fine.

[Forseegood]

thanks for the tip, and a lot of docs think this way, but supposedly there has been some info lately that tylenol is worse on the liver than advil, (of course we're talking about moderate doses) who knows? now my doc is not as groovy on tylenol...maybe some others have heard something else...

[Upbeat]

I must be the only person who has never had a tylenol or buffern or any over the counter paid meds.  Its nothen I ever planned it just worked out that way.  When I was a child I would get the odd asprin now and then.  That was before tylenol was around.  Am I old or what?
                                                  Ron

[Forseegood]

yeah, I tend to agree with you, you'll hear studies on this one that one, best try to do Upbeats thing if you can (of course, not on tx yet) and not take anything except heating/cold pads...I watch your progress and pay special attention to your posts because we have similar issues, so sorry about your nerve damage pain, I know how horrible that can be because I have friends who have that...

[NYgirl]

My understanding of this tylenol vs. advil situation was that advil changes your blood chemistry or something like that and tyelenol does not.

But face it...when you have to take one of them (and you know when you do) you just have to.

As always I believe it's all moderation and from all of the many articles I've read you have to take a LOT of tylenol for it to be really bad for you.

I only take either of them when I MUST and I try not to let it freak me out.

[Forseegood]

of course I'm not on tx yet, once that happens, I believe you have to take what ever you need to get through it - but of course you have to try to use moderation...maybe I'll do an investigation too...

[cuteus]

interesting thing about Tylenol. my hepatologist did a presentation in a wellness program and stated that Tylenol was easier on the liver if taken as prescribed. Went as far as saying that there are more cases of fulminant hepatitis with ibuprofen every yr. than with tylenol.
Kind of scare me to hear that one, and I guess we can do a web search on 'fulminant hepatitis causes' to verify the statement, but I don't want to. You have to take what works well and take chances, I guess.

[PKCO]

cuteus,

your doc is dead on. Up to 2000 mg. of Tylenol per day for cirrhotics and twice that for everyone else is safe when used in the absence of alcohol. It has the safest profile of any NSAID for those with impaired liver function. That said, if you are on tx you can switch between Tylenol and ibuprofen during the day to have more consistent dosing and pain relief without overdoing either one even if you are cirrhotic. As mentioned it usually does come down to moderation.

Best regards,
PK

[Forseegood]

Please do not be offended, we are all different people with different opinions and I'm not out to offend anybody...but I respectfully disagree with your doctor in that blanket statements like these (2000 mg for anybody including cirrhotics and even more)could be harmful to some ouf us... because it's not taking into account those of us who are very, very drug sensitive and there are a lot of us....I'm the type of person who could take a baby aspirin for a pain and be helped by it...(although aspirin is not indicated for people with liver disease of course.) One of the reasons I've been so afraid to treat but I'm trying to get around that....

I think this might be a contributing reason why there are so many incidents of allergic reactions and overdose in OTC meds and prescription meds....much more overdosing (small overdosing to large overdosing) goes on in this population then street drugs, you can look up the statistics....

Hence, I feel, that these meds should be prescribed on a case by case basis....2000 mg of anything would maybe put me in the ER as strange as that sounds....

As far as tylenol there is some controversy of late...but of course everyone should do what they think is best, and that includes which docs they want to listen to as well...respectfully...

[PKCO]

The Tylenol recommendation is quite standard. Call your local transplant hospital.
And what was your point ? There are ALWAYS those that are the exception regardless of WHAT drug we are discussing. Should the makers of Tylenol pull all of their products off the shelves and re-label the dosing instructions to read: "Take up to 500 mg, ever 2 hours or as need UNLESS you are forseegood. Then stay away from it." Quit being ridiculous.

PK

[Forseegood]

I guess by your logic I'm the only one who is sensitive to drugs in the entire land...I merely pointed out that there are many, many people who get ill from these types of blanket recommendations...better to "titer up" to a particular dosing a person can withstand easily, I would think....

You said anyone, including cirrhotic people could take this dose...you made no qualifications, I, in fact, did, that was my main point...

All doctors are not infallible in making their drug/dosing recommendations, my mother contracted a rather bad case of high blood pressure (after always registering normal) from Vioxx in just 1 1/2 weeks...as to what is considered "standard" that can also vary depending on who your talking to...I've learned that much from just reading these boards...

As to who is deemed "ridiculous" I would never be so rude as to label someone that just because they didn't agree with a point I was trying to make...best leave that judgment to the reader of this exchange, whether they agree with my points or not...with all due respect....

[PKCO]

It is ridiculous and still is. There will always be exceptions to everything. The subject was Tylenol.I stated that it is recommended that people with cirrhosis take one half the recommended dosage. This opinion is shared by many doctors. It is a recommendation. It is assumed by all thinking adults that every drug has potential side effects. That does not change the recommended dosage for everyone else. You are nitpicking and it's making you look petty.

[Forseegood]

You were saying that it's recommended that cirrhotics can take up to 2000 mg of Tylenol a day and that people who are not cirrhotic (that includes people who have hep c but are not cirrhotic I can only assume) can take "twice" that amount safely...

I'm just saying that sounds like it could be a tad excessive, even for people who might not be as drug sensitive as I am...

Oddly enough, I'm no doctor and even though I saw you state that you sit on consultation boards and you are really "tight" with a lot of renoun hepatologists...since you didn't say you were a doctor as well...I can only assume that you are not a doctor either...

Now I don't know about you but I've been lead astray and been misinformed by more than a few doctors in my patient career, renoun "big city" doctors with lots of sheepskin on their walls from major universities...in New York and Los Angeles...

I feel that part of the purpose of these boards is to have a forum for patients to exchange information on doctors recommendations, etc. as part of our overall hep c patient experiences...to perhaps get a more comprehensive viewpoint of this disease and it's treatments so we can better navigate these waters, hopefully...

and btw, I would never pop a bunch of drugs into my mouth, I don't care what it said on the bottle...until I researched it a bit...the days of me just blindly trusting docs or drug lit are long gone...call me parnoid if you'd like...

I for one wouldn't take that kind of a dosage recommendation from a patient on this board (especially one I didn't know like you) but I didn't really write that proviso for myself...I figured a newbie might benefit from a word of caution after a recommendation like that...perhaps not...

I do feel that your manner (as far as I can see) indicates someone who feels the need to disparage the person they are debating with...there seems to be so many people like this and I can't always figure this out...do you feel that this somehow strenthens the merits of your arguments? I think not...what it does possibly do is alienate and/or offend some people...perhaps newly diagnosed people who come here scared and confused only to find a bunch of tit for tat diatribes...I don't really care that you find me ridiculous or petty, what does that have to do with anything? If you don't agree with my viewpoints tell me why...why can't you leave it at that?

[PKCO]

If something is ridiculous I will call it such. If you feel disparaged, so be it. If I say something is recommended you can bet your last dollar I can back it up.

Aren't you the one who is a Mannetech supporter ?

PK

[PKCO]

I gave you info on how to verify the recommendation. Call any transplant hospital and ask for yourself. ANY ONE you choose.On top of thatyou can Google it and find plenty of info from many doctors who say the same. A newbie will find the same info. I don't just post **** for the sake of posting it. I can back it up and if you had taken the time to do a quick search you could have proven it to yourself. Apparently that is too much work for you. Especially when after being given the info on how to verify this recommendation you post the following:

"I for one wouldn't take that kind of a dosage recommendation from a patient on this board (especially one I didn't know like you) but I didn't really write that proviso for myself...I figured a newbie might benefit from a word of caution after a recommendation like that...perhaps not..."

I think your time would be better spent policing the board for
bad info from all of the internet doctors here. Start with kalio.

My profession is none of your business. And it should not matter. Do you mean to tell me that if I identified myself as a doctor you would give more weight to my postings ? I would hope not. Let me say this once again: If I post ANYTHING hcv-related
other than an expressed opinion, I can back it up or I wouldn't have posted it in the first place. You can take that to the bank honey.
PK

[Forseegood]

Obviously you don't get "my" point, that being that I DON'T CARE  that you have doctors that are recommending these dosages, and that you can back up these claims, doctors give out bad prescriptions every day (they also give out a great many good prescriptions, but that doesn't necessarily cancel out the former for "some" people)...as we speak in fact...

All I said it is best to titer up to a good tolerance level when youre talking about those types dosages and not just take things willy-nilly because a doctor, or a fellow member of this forum, told you to...what possible harm could titering up do? Just what is your objection to that and doing some investigation into the drug itself?

That's one of the purposes of these forums, to discuss these types of things...would you do every darn thing a doctor told you to? without investigation? perhaps, but I just added a word of caution to the newbies...of course they will end up doing what ever they feel like anyway but at least they got the benefit of my viewpoint as well as yours, which is the main "purpose" anyway...

As far as your beef with another member, I have nothing to do with that and she's pretty good at defending herself anyway...think we have exhausted and bored enough people with our back and forth redundancy...what I really objected to is your name calling in the beginning of this discussion, there is really no need for it...have the last word if you want, but I'm checking out of this...good day to you...

[Forseegood]

a few qualifications and I promise I'll let up...you didn't call what I said ridiculous or petty, you called "me" those things, big difference and uncalled for at any rate, you must be an angry person and I feel bad for this fact...and no, I don't sell or promote Mannatech, although what that has to do with the this particular conversation here I don't know...I just didn't want you intimating as such...

[PKCO]

ARE you the one who defended the right of a snakeoil salesman to take advantage of desperate,sick people with the glyconutrient scam beiong operated by Mannatech ??? It is YOU isn't it ? And the relevance ??? It speaks to character (or lack of actually).

You can argue the semantics all you want . Any reasonable person knows what is meant by a recommended dose. If you want to view all recommended dosages on all of the drugs ever made as "blanket statements" then have at it.lol

I'm not the angry one. Seems you are a bit defensive though. I found your remarks to be ridiculous. I said as much.

You ARE the one, aren't you ?

[Forseegood]

you should see somebody...

[PKCO]

Yes it WAS you. At J&F's. You came to the defense of some despicable scum trying to peddle his snake oil there. You should be ashamed of yourself. There is no one lower on the face of the earth than those people who sell snake oil and make money off of sick,desparate, and oftentimes poor, people. And YOU defended this person. people who defend their practice are no better. Did you notice how fast they left the site once I called them out for their scam ? You never bothered to check out the facts then and you still seem unwilling to accept facts now. Glyconutrient anyone ??? lol You, my dear, have been hoisted upon your own petard.

[PKCO]

"but my guess is eventually it will be"

kalio see there's the problem right there. You tell people about HCV and its symptoms based on your "guesses". If you don't know the answer to something you just make one up instead of finding the real answer. I deal in known, provable, facts. And I already knew you'd be the type to exploit my openess. I made a fool out of you all the way . Every time you opened your ill-informed mouth, I revealed a little more about my condition, and my knowledge of it, each time making you eat your words. You are a very poorly informed individual when it comes to HCV. You misinform people here daily, expressing your opinions as truth, and not telling both sides of tx. You lie outright and are too dumb/lazy to lift a finger and actually read about it before you pop off about something you know nothing about.

And you, my dear, are the epitome of the saying " A LITTLE knowledge is a dangerous thing." Just because YOU may be new to hcv doesn't mean there isn't a wealth of knowledge out there. HCV has been studied now for nearly TWENTY years. You should quit wasting your time "guessing" about HCV ,go read, and actually learn what is already known FIRST.

You internet docs sure get vicious when someone threatens "your practice".  lololol

[Forseegood]

I'm just going to try to go Zen on this and figure there is a lot of free floating anger in this world and plenty of people to vent it off on you if you let them...whole point is...don't let them, just don't let it in...(although I must admit, I picture some guy out there curling his mustache while he's spewing these speeches!) Sorry, that'll be my only cheap shot...anyway, beautiful night out here and my dog met a little kitty and he was playing with it, he finally likes cats! I'm soooo happy! beem training him to like cats for awhile, so that makes my day! Be well, hope you have a good week, same to anyone reading this!

[cuteus]

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12044533&dopt=Abstract

http://tinyurl.com/bzpb6

http://tinyurl.com/8eo5k

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=15990694&query_hl=1

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=15654780

damn these researchers, for not breaking down results by liver damage! if they did, we would not have to put up with these non believers!  How dare you feel ill with only stage one!

I see insults coming....dodge!

[cuteus]

this guy reminds me of Andy a little.  at first I thought it was our friend TBY, but it looks like it is a guy.

I definetely do not want any disc surgery, maybe there are new treatments in the horizon? I can probably wait, since I am at stage one disc damage...;-)

stay well

[Forseegood]

we're on the exact same page there, verbiage, syntax, and hyberbole almost exactly alike, but Andy doesn't like Janis...I'll trip if he's from Canada too, (maybe they are cousins?) been there before, people seem so subdued and gentle...whatever!