Elevated Enzymes with No Diagnosis Yet

Posted by Lisa on June 01, 1999 at 13:38:21
Hi,
I am a 29 yr old female, non smoker, non drinker, with a 4 month history of elevated liver enzymes. My enzyme counts are as follows:
AST:  68, 48, 44, 68
ALT:  120, 70, 68, 105
ALP:  180, 145, 112, 145
GGT:  290, 170, 105, ?
Bilirubin and PT - normal
I have been tested for autoimmune hepatitis, Wilsons, alpha-1-antitrypsin deficiency, hemachromatosis, as well as some other more specialized blood tests.  I have also had a liver ultrasound.  Everything to date has come back normal.
About six months ago I had my gallbladder removed and about four months ago I had deviated septal surgery which had complications and landed me in the hospital for a week.  As a result of the nasal surgery and subsequent complications, I was put on Tylenol for two to three weeks (2 Extra Strength pills every 3-4 hours).  About three months ago, after the nasal surgery, I came down with the chickenpox and was put on an antiviral drug (Valtrex).  As well, about four to six months ago, I lost about 60 lbs of weight after I had a baby.  I am still about 10 lbs over my normal weight and the only other medication I was on (until about 2 months ago was the Birth Control Pill.  My GP told me to stop the pill to see if this could be a contributing cause to my enzyme elevations).
My questions are as follows:
1)  If the Birth Control Pill is causing the elevations in enzymes, how long does it take before the enzymes return to normal once the Pill is stopped?
2)  Could my rapid weight loss (60 lbs) 4-6 months ago cause my enzyme elevations?  If so, when should the enzymes return to normal?
3)  Could the large quantities of Tylenol and the dose of Valtrex I took 4 months ago have caused the elevations?  If so, how long would it take for the enzymes to return to normal?  
4)  Could the two surgeries I had have played any role in this?  Six months ago I had my enzymes checked before I had my gallbladder removed and they were normal.
5)  Is it possible to have a "leaky liver" where the enzymes leak out but the cells of the liver are still intact?
Any insight would be most appreciated.
Thanks,
Lisa

Posted by HFHSM.D.-D.M. on June 08, 1999 at 17:48:53

Dear Lisa:
I found your story very interesting and I appreciate your question.  I