Very high liver enzymes (don't drink - very healthy)

Hi,

I am so confused - now waiting a few weeks before I can get in to see a gastro so trying to get as educated as I can.  

I seem to be having liver problems. It is functioning fine but here are my scary stats:
Alkaline phosphatase is 271 (supposed o be 99-115)
AST is 97 (supposed to be 10-30)
ALT is 167 (supposed to be 6-40).  T

I have already been tested for celiac, lupus, lyme disease, R/A, all the heps and seems to be no fear of diabetes. All negative.  I have been tested for Wilsons and the other heridtary liver disorders. Negative. Had a sono- all looked fine.

The GGT (which she didn’t test for last time) came back high 168 (3-50)
ESR, Westergren (not sure what that is) is 25 when it should be (0-20)
Also the smooth muscle AB titer is positive 1:20 when it should be under 1:20 so it is just borderline.

Does anyone have any info to help guide me?

I have been taking (stopped now) a prenatal vitamin for a few years - doc said that wouldnt do this.  I was fasting and had excersized (moderate) the morning of the blood work (doc said that wouldnt do it) and I eat Edy's low fat ice cream very often (lol- just grasping at straws.)   I may have taken two extra strength tylenol - maybe even after having a glass of wine - three days before the blood work (doc says that wouldnt matter either.)

She is leaning towards something autoimmune but i have been tested for so many of them so am very confused. Fear cancer of course- was somewhat relieved that the sono of abdomen looked fine but sounds like that may not be conclusive.

No major symptions- tired, achy at times -but have three kids and run a business and dont sleep much. So not sure those are symptoms.
I have always had dry eyes and drink a ton - i see this Sjorns thing but i dont have any other symptoms.

Liver enzymes were high about a year and half ago (but only very slightly high). But then about 8 months ago they were fine.

[mikesimon]

If you Google "elevated alkaline phosphatase" GGT AST ALT you'd probably find some possibilities.
I do think you need to follow up promptly and I believe that, if your doctor isn't a hepatologist, you should see one if there is one in your area. The next best would be a gastroenterologist. I think you need a diagnosis of what is causing these numbers.
I wish you good luck.
Mike

[tillyonline]

Thanks Mike -
Yes, been googling since I found out. But the weird thing is that tests already seem to rule out so many of the possibilities.  Hoping someone here can relate.

I was referred to a gastro - go on Oct 13.  he apparently specializes in liver.  

[mikesimon]

I think your doctor is right that autoimmune issues should be explored.
Good luck,
Mike

[tillyonline]

How high are my numbers? Are these indicative of a really severe problem? Doc said she doesnt think cancer (not sure why) - but I can't help freaking out about this. I am calm for a bit and then see online that many people have elevated numbers just by 10 points - mine are so high.

Thank you again, again so much.

[mikesimon]

I sent you a personal message. Mike

[Dayzdreamer]

Checking the immune system is a good start. A GI is a good doctor to see for this. Some things that can cause the enzymes to be high is fatty infilteration of the liver.   The commonest causes of fat in the liver are overweight, diabetes or, of course, alcohol. Some drugs can also cause this, as can some viruses.  I have read that a bad diet can make the alt/ast higher.

I have cirrhosis and was checked for cancer. The GI first had a blood test done that pretty much said I probably didn't have cancer but when I had my CT Scan they new for sure I didn't. That was a relief. Mayber your doctor performed the blood test and you didn't realize it. I don't know what they would see in a sonogram as far as cancerous or not.

Here is a good site to check out for you labs. Type in lab test on line if this link doesn't work. http://labtestsonline.org/

[mikesimon]

"In most cases, the only way to be certain that liver cancer is present is to take a biopsy (sample of the tumor tissue) and look at it under a microscope.But in some cases, if imaging studies (CT or MRI) show a tumor mass that is likely cancerous and a blood test reveals the AFP level is very high, a biopsy may not be needed."
http://tinyurl.com/4o5qff    

" The only way to absolutely diagnose any cancer is by getting a piece of it for analysis, that is a biopsy of the tumor. This biopsy may be obtained by a fine needle under local anesthesia, in the radiology department using ultrasound or CAT scan to guide the needle into the tumor. Several samples are usually taken for accuracy."
http://www.canceranswers.com/Liver.Cancer.html

[lrhy5]

5 years ago this happened to me. after many blood tests and a liver biopsy I found out I had autoimmune hepatitis.  It is a genetic disorder that causes your body to attack you liver.  It was really scary at first but if you catch it early, like you may have, it is highly treatable.  Make sure your dr. explores that.

[lrhy5]

another thought.  If it's AIH it is nothing you are taking.  I was in a pain managment program for a horrible neck injury and was on MANY medications when I had highly elevated liver function tests.  My dr didn't think any of them would have caused it.  Just to be safe he took me off everything and repeated the tests after a few months and things were worse.  Check you family history for ANY other auto-immune diseases.  After I looked into it I found alot,but on a smaller scale.  Hope this helps.

[tillyonline]

Thanks so much for responding. I am not taking any medication although may have taken just 2 extra strength tylenol a few hours after having a glass of wine - just a few days before the test. Not sure if that could have mattered. Also was taking prenatal vitamins for about 2 years after my child was born - also dont think that could have done it.

We dont seem to have any autoimmune in the family. Such a mystery and so hard to wait.  

Mostly thank you for a ray of light in a very scary time.  Just the thought of something being treatable is so great to hope for right now.

Best wishes for health to you all.

[janen9]

I have a liver problem too, an am waiting for a biopsy next week.  My doctor found my liver enlarged during a routine exam.   I feel fine!   I have had blood tests which showed normal liver function and normal enzymes.   The ultrasound and CT scan, however, have showed some type of lesion or mass.   I don't know what they actually saw yet.   I am scared.   Of course, you always think the worst.   I wonder, can you have normal liver tests and still have cancer or cirrhosis???

If anyone knows anything about this please send a reply.

[palfour]

Taking tylenol and  wine  just before  you had  blood tests  can rise those levels. have  a new liver  enzymes  test  done after  you have had no  paracetemol products  for a week and do not take tylenol again, paracetemol in  high doses is  a liver-toxin .

I took lots of  paracetemol, panadol, panadeine forte, codral forte when i was younger   and now  I have  fatty liver and suffer fromm liver pains

[suebee33]

I plan to speak to my doc about prenatal vitamins causing my elevated enzymes because that is the ONLY possible thing I can think of as I have NO other symptoms or "habits" that should cause elevated enzymes.  Liver ultrasound was normal, but blood keeps coming back w/ elevations in my enzymes & this all started about the same time as the prenatal vitamins.  I have read that too much iron can cause toxicity & affect the liver, so it might be reaching at straws, but it's all I have right now.  Good luck to you!

[tillyonline]

Hi everyone. First, an update-
I was seen on Monday by an endocrynologist who ran blood work including the basic liver functions again and they came back normal! I wanted to share hte good news becaues I know people come to these sites when panicked and it is often hard to find resolutions.
Not sure I have resolution yet but that was good news. Next - I went to a liver specialist - sent me for more blood work and an MRI. Will know more next week.

But suebee33- i really wanted you to know that now, almost 4 weeks after stopping the prenatal vitamins... my numbers appear normal. All of the docs, inlcuding big time liver specialist dont think it could be the vitamins but I am not so sure.

Can you stop taking them? If you are planning to become pregnant and eat healthy - maybe you can just take folate for now?

[tillyonline]

Back again- have been checking my numbers every four weeks or so. They never went back up to where they were when so high but have only been normal once on these tests. The rest of the time they are what is considered slightly elevated.

I have been through every test - tons of blood tests, MRI, ultrasound and everything, thankfully, came back normal.

So they want to keep testing me. But I am confused...no one says what we are testing for. I guess if they get high, high again they will want to do a biopsy. It seems with the levels where they are and the tests all normal - it does not warrent a biopsy.  


Yet they tell me no wine - so it is not like when your cholesterol is a tad high and they say - try to avoid bad foods. This seems more serious yet no one has a clue.

lrhy5= how did they finally make the diagnosis? What does it mean for you?  How do you manage it?

We dont have any autoimmune disorders int he family besides a grandmother who had a hyperactive thyroid. That was it. So still baffled.

I do feel 100% better than I did in the summer when the numbers were 5 times what they should have been. Still wonder what in the world that was. Still think getting off the vitamins helped in some way.

[zoey031312]

Hey tillyonline,

I just saw your comment about stopping the prenatal vitamins has lowered the Liver enzymes. I was wondering if it ever went up again.
I have been taking the prenatal for years and all of a sudden the liver enzymes went up and my doctor asked me to stop it and go for another test in 6 weeks.
So I am doing some research and your posts came up.