denied life insurance but otherwise healthy

[Fledic]

I am a 28 yr old female and I was just denied life insurance for having abnormal liver enzymes - AST = 273,  ALT = 73.  All other tests were normal.  What could cause this and should I be concerned?  



Symptoms that I have struggled with for the past five years are very dry skin and dry vagina, fatigue, tendonitis that never quite got better, constipation, allergies, and in the past year chronic hives.



Up until now, I drank about one alchoholic drink per day and maybe three or four drinks socially (once a month).  However I did drink a lot in my first and second year of college '93- '95.  I ran a marathon last year so I am in good shape.  I was taking prescription NSAIDS (relafin?)for tendonitis in 1998-99.   After stopping Relafin (because I heard about the side effects), I frequently took ibuprofin for headaches and muscle aches.  However since getting the test results I have stopped all alcohol consumption & have cut back on caffiene.  I do not use drugs. and now I have switched to aspirin.  PS - is aspirin better than ibuprofin for your liver?

[Kevin Pho, MD]

Alcohol by itself can raise the liver enzymes - typically the AST:ALT ratio would be in a 2:1 ratio.  I would also check the GGT as well.  



In addition to the alcohol, NSAIDS such as relafin can less commonly affect the liver function.  Both aspirin and NSAIDs can raise the liver function tests.  



I would repeat the tests complete off medication and alcohol for 3 months.  If it continues to be elevated, I would check a hepatitis panel as well as undergo a liver ultrasound - looking for fatty liver or any other obvious liver diseases.  If those tests are negative, more specialized testing such as tests for hemochromatosis or a liver biopsy can be considered.  



Followup with your personal physician is essential.



This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.



Thanks,

Kevin, M.D.

[yoshi]

have you checked your thyroid??

[TJV]

  I beleive ibuprofen can cause liver cell damage- i don't think it's associated with chronic liver disease though-



Nsaids has been demonstrated to cause abnormal readings in liver tests-in a very small percentage of people-- but the incidence of significant liver problems associated with NSAID use is extremely low --to almost nil .  



I'd say aspirin is way  better than ibuprofen for your liver definately Stay away from Cox 2 inhibitors, although they are better for the stomach



Acetaminophen (Tylenol) can lead to severe liver failure if a patient takes very very high doses- or especially drink with it. Birth control pills could possibly contribute to altered readings



  Wondering if you've had an ultrasound of your liver --or been tested for the various types of hepatitis.

[Fledic]

My thyroid was tested and was normal about two or three years ago.  I have had no other liver tests.

[TJV]

You should get an ultrasound and blood tests to further evaluate the liver for hepatitis etc.



  If you have now eliminated alcohol and other bad medications, the liver enzymes could go down on their own possibly.