elevated liver enzymes off and on for 13

[suedouglas]

I am a 37 year old female and mother of 3.  I am currently overweight at  5'8" 185 lbs but that has not always been the case.  I do have elevated cholesterol at times which seems to be higher when my liver functions are off.  My total cholesterol is anywhere from 180 to 260.  Triglycerides are  139 to 189 and sometimes much lower.  HDL is 35 to 37.  LDL is about 100 to 150.  I do not ingest more than 200 milligrams of cholesterol per day and my weight gain is from drinking pop as we eat no processed foods and lots of fruits and veggies.  I have not been exercising regularly as I have no energy (hormonal problems).  I have had elevated alt and ast enzymes off and on for 13 years with no known cause.  I do not drink any alcohol, smoke or do drugs of any kind.  I have had tons of blood work for hep/hiv/metals/ fatty liver and autoimmune diseases, ultrasounds, catscans and 2 liver biopsies all of which have been normal.  I have no symptoms other than symptoms that I have from hormonal imbalances.  My latest liver panel is ast 89 and alt 106.  I have never had elevated bilirubin.They have gotten as high as 700 and still have no symptoms with that.  My doctors thought maybe my gallbladder was the cause and removed it shortly after delivering my daughter 3 years ago.  I didn't have any pain, but did have some stones.  Liver enzymes went to normal and then back up again, just like always.  My doctors have adopted the wait and see attitude and say not to worry.  I am seeing a gastroenterologis and internal medicine physicians.  I have suggested a hepatologist, but they say it wouldn't do me any good as I do not show any symptoms.  I am very worried.  I have 3 very young babies and a husband whom I want to be here to enjoy for a very long time.   I am now trying to exercise and drop the weight, but I am not sure what else to do.  Please help!!!!  I am not sure where to go from here and want to be very proactive in my health.

[Thomas D Schiano, MD]

it sounds like you could have fatty liver.  However, fatty liver would definitely not cause the AST or ALT to go to 700--that sounds like autoimmune hepatitis. You should definitely see a hepatologist if the diagnosis could potentially be autoimmune hepatitis.

[suedouglas]

I was also tested for fatty liver.  Is that something that they should keep testing me for also?  So worrysome.  Well I think I will definitely look into a hepatologist.  My doctors have been great, but they are not sure what is happening and so maybe a hepatologist will have a bit more insight.  Thank you so much for your time.

[suedouglas]

Thank you for your response.  I was tested for autoimmune hepatitis and the results were negative.  Is that something that they should keep testing me for?

[suedouglas]

Woops, I forgot to say that the only medication that I am on is a daily vitamin and for the last 4 weeks I have been taking prescription vitamin D (50000 iu) once a week due to a low Vitamin D level of 15.  I am supposed to take this for 16 weeks.  I do not take tylenol or ibuprophen or other otc regularly.  I maybe take a tylenol or ibuprophen 1 to 2 times per year only for high fever with flu or something like that and I rarely get headaches that require medication.