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I "had" Acute Alcoholic Hepatitis, liver enzymes were returni...
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I "had" Acute Alcoholic Hepatitis, liver enzymes were returning to normal, now my latest set were a shock - Please help, I am frantic!!!

Hi,

I posted this in another part of this forum, and I think I posted it in the wrong place, so I hope this is the right place for my question (& anxieties!!) -

I wonder if you could please help me?

I was rushed in to hospital in July 2010 with Acute Alcoholic Hepatitis.  The Doctors expected the worst, but after I was put on a course of Predisolone, I responded, and began to get better.

I was discharged on 9th August after 19 nights in hospital, and brought straight to Rehab, where I have been ever since.

I have not touched a drop of alcohol in eleven months, and don't ever intend to again.

I had regular LFT's, and the results are as below -

October 2010 -
ALT - 51 - Slightly raised
AST - 48 - Slightly raised
Biliruben - 7 - normal
ESR - Wasn't told
ALP - Wasn't told
GGT - 93 - Raised
WBC - 10.2 - Slighty raised
AP - 84 - normal

November 2010 -
ALT - 33 - normal
Biliruben - 10 - normal
GGT - 81 - Raised
These are the only results I was told in November - My Doctor told me I was well on the road to a full recovery.

I haven't had any further LFT's until last week (14/6/11), and I was shocked! -
ALT - 61 - Raised (it's nearly DOUBLED since November!!!)
Biliruben - normal
ALP - normal
ESR - normal (not even heard of this enzyme!!)
GGT - 71 - Raised, but still the lowest result so far
WBC - normal

So, I am VERY concerned that my ALT levels have gone up from 33 to 61 in seven months.  I expected all LFT's to come back as being in "normal" range, especially as the hospital discharged me, stating I had a full bill of health.

I've spoken to my GP, as I am worried, and they said something as simple as a virus could have knocked my ALT levels up.  Funnily enough, I was in bed for a week before I had my latest bloodworks done, and was given strong painkillers (30mg Codeine/500mg Paracetamol tablets) as I was suffering with migraine type headaches too.

The virus seemed to disappear on the 12th June, and I had my latest set of LFT's taken on the 14th June.  Whilst I was ill, I took the painkillers, but was VERY careful with them, and only took them when absolutely necessary, as I know paracetamol especially can be hard on the liver.

So, my question is, could my ALT levels have been affected by this virus and the medication, or could it suggest the hepatitis, which I was told had gone by the hospital, has returned and is now chronic?

I am a worrier, and I won't settle until I know something!!!  My Doctor told me to have more LFT's in 3 months time (so can they be that worried, leaving it for three months?), but I can't wait three months, I will do nothing but worry myself stupid, hence me asking your advice?

I feel healthy, I look healthier than I have in years, and I am exercising at least five times a week.  I don't suffer with bouts of tiredness, nausea, or anything like that, I don't have ascites, but one thing I have noticed - Even thought I've exercised very well for 14 weeks now, instead of losing weight, I've actually gained 9lbs - That can't be right!! (I've had a thyroid test, my thyroid is fine).

So please, please, can you give me any indication as to what may be going on?  I simply can't wait three months to find out, I will be an utter wreck by that time.

Hoping to hear from you soon.

Kindest regards,
Natalie
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96938_tn?1189803458
To give some sense of proportion, ALT's for some people in some conditions can be in the several hundreds, even higher than a thousand.  ALT of 61, when normal is about 45, is not alarming.  Many things can increase ALT like a variety of drugs (you've been on some), muscle injury and physical exertion (you work out a bunch), alcohol (but you don't drink).  Since the reason does not seem to be specific and the level is not really that high that's why the doc said "see you in a few months".  The doc also probably noticed that the billirubin was normal which made the ALT even less attention-getting.  Go to the beach and try to relax.
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96938_tn?1189803458
To give some sense of proportion, ALT's for some people in some conditions can be in the several hundreds, even higher than a thousand.  ALT of 61, when normal is about 45, is not alarming.  Many things can increase ALT like a variety of drugs (you've been on some), muscle injury and physical exertion (you work out a bunch), alcohol (but you don't drink).  Since the reason does not seem to be specific and the level is not really that high that's why the doc said "see you in a few months".  The doc also probably noticed that the billirubin was normal which made the ALT even less attention-getting.  Go to the beach and try to relax.
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96938_tn?1189803458
Muscle is heavier, by volume, than fat.  So, after working out very well for 14 weeks could result in you being the same size (the volume of you) but being heavier because you have less fat and more muscle.  Congrats on your turn-around over the past year.
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1715604_tn?1332093176
Thank you for your reply.  That helps a lot, I've been panicking so much, that after I read a few articles on the web, I nearly passed out, twice!!!, and had to lay down.  I've got myself in to a right state!!

Kindest regards,
Natalie
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1715604_tn?1332093176
Hi again!

Well, the Consultant at the hospital has had his Secretary call me today, and she said to me that he had told her I had nothing to worry about.  Apparently, LFT's can fluctuate for any number of reasons, and as the ALT is only slightly raised, he is not concerned.

He also said, if my GP becomes concerned, then to refer me back to the hospital, but I am not going to worry about it any more.  I've spent over a week worrying, and it gets me no where.

Of course if any one has any info re this, please feel free to post on here, because reading about this on the internet, goes from "nothing to worry about", to "a death sentence" !!! - I just don't know what to believe, so I am not going to read any more.

But if any one knows anything re this, please please enlighten me, I like to know what's going on with my body, and am going to ridiculous lengths to protect my health after all the abuse I have given my poor body.  I really don't know how I'm still here, but I am, and I am so grateful, and I intend to enjoy every single day, and not worry about something which is probably nothing.

Thanks, and Kind regards,
Natalie x

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There is no virus involved in what happened to your liver. What happened to you is commonly known as "alcohol poisoning". The word hepatitis is used to describe  "inflammation of the liver".

"Alcoholic hepatitis" is an acute form of alcohol-induced liver injury that happens due to drinking large amounts of alcohol over a period of time. It can have no symptoms other then changes to blood test results. Or can result in liver failure and death.

It appears you were lucky and your liver will be able to recover from it injury from alcohol.

* The main thing is to never drink again. "Abstinence" is the cornerstone of treatment of alcoholic liver disease.
* Almost all patients with alcoholic hepatitis have some amount of malnutrition. It could be why you are gaining weight. See a Dietitian or nutritionist who specializes in treating alcoholics as you may need certain nutrients that you haven't been getting.

FYI * "Exercising at least five times a week" is not a good routine for either building stamina or muscle mass. The body must go through a recovery period of rest for exercise to be effective. Search and read about exercise and workout routines to find out more.

Glad you stopped before it was too late.
Good luck. Stay healthy.
Hector
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1715604_tn?1332093176
Hi Hector,

Many thanks for your reply.

It appears I fully recovered - the hospital discharged me in February of this year, and said there was no damage to my liver.  I am so very, very grateful, and relieved.

I will never drink again.  I had a total breakdown after losing my father, and turned to alcohol as a way to cope.  I'm not using that as an excuse, I can see now that is the worst thing I could have done, and have learned the hard way.  It nearly cost me my life, so there is no way on this earth a drop of alcohol is ever passing my lips again.
I am also very careful with medication, as I know some meds can kncok the liver hard, so I am very cautious there.  My poor liver has been through enough without me giving it even more toxins to deal with.

I'm on Calcium and D3 as I was on a high does of predisolone (sp?), so I have to take those for a while to protect my bones.  I also take Thiamine, Vitamin B Stong, and Folic Acid.  I don't take any other vitamins.

I was given a course of buil up drinks (Fortisip), but have stopped those now.  My protein was very low, so that had to be monitored for some time, but has now returned to normal.

I was overweight from drinking, and also taking Risperidone, which the Doctor prescribed for anxiety - That drug is terrible for putting weight on, so along with drinking, I gained four stone.

The weight started to come off around Otober of last year, pretty much when I stopped the steroids, and I went down to 10st 12bs.  Then, for now reason (I did not change my diet), it started to creep back up again, so I started exercising.

I'm now 11st 10lbs, so I am still overweight, and I am finding it very hard to move the weight, even though I eat a healthy diet, and exercise regulary.  I don't want to gain muscle, I just want to lose the fat!

I don't think I'm over exerting myself, or am I?

As I was told in February I had made a full recovery, I presumed it was ok to return to normal things like exercise, am I wrong?

I feel better now the Consultant has told me that a slightly raised ALT level is nothing to worry about, as every other enzyme is back to normal, as is my WBC count, which was very high.

I feel very fortunate, in fact, I thank God every night for giving me another chance.  I don't know how on earth I managed to scrape through this, but I did, and am doing everything possible to maintain good health.  I realise now how very precious life is.

Anyway, thank you once again for your message, I really appreciate you taking the time to answer me :o)

Kind regards,
Natalie x
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206807_tn?1331939784
This is the forum you should go to. Good Luck
http://www.medhelp.org/forums/Weight-Loss--Healthy-Lifestyle/show/360
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1715604_tn?1332093176
Thank you very much, I will most certainly be looking on there!  

Warmest regards
Natalie
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374652_tn?1311302831
congratulation on your recovery and your decision to never drink again, SMART
dont worry to much about your weight, be grateful for what you have and good luck.
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1715604_tn?1332093176
Hi!

Thank you!  I'm ashamed of what I did, not only to myself, but to my loved ones.  Never ever again!!  Even the thought of alcohol makes me feel physically sick, I've never craved it since I was hospitalized.  I don't take drugs to stop any cravings, I just do not have them, which I am very grateful for.

I suppose the shock of nearly dying was enough to put the fear of God in to me, and that alone will ensure I never drink again.

It's time I started giving back - I was selfish whilst drinking, so I now have some making up to do, and am thinking of ways to do this!!

Thanks again, and Warmest Regards,
Natalie x
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374652_tn?1311302831
Yahoo, what a great way to be thinking, I wish you all the best and stay on track, the road may be hard, but its never easy, all you have to do is be good and kind, loving and keep picking yourself up.
Love, M
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374652_tn?1311302831
Oh yeah, and a lot of faith in the supreme goodness within yourself and in the billions of universes.  
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