Raised Enzymes

[aray]

Hello. I had a liver test a week ago and my enzymes were elevated significantly.

Here are the facts:

Right side pain for almost two years.
Full gamut of tests in 2004: pretty much everything that can be tested in the torso; ultrasound, gallbladder function, CT, liver enzymes, small bladder, colonoscopy, endoscopy, and probably a couple of others I can't think of off hand.
All tests were normal.

The side pain has continued and in September of 2005 I began taking Lortab for the pain. The Dr. pescribed me some with high acetaminophen and for a couple of months I was taking around the limit of 4000 mg per day.

Finally, I was changed to Norco which had me taking around 2400 mg each day. Then, for the last month I was taking Norco that had me at around 1500 mg of acetaminophen each day.

Considering all of the tylenonl it probably isn't suprising that my liver enzymes are up; but that combined with the pain has me worried.

Here are my questions.

1. I'm taking Lexapro 10 mg, Abilify 2.5 mg, oxycodone 45 mg (no acetaminophen because of the elevated enzymes), and Xanax XR 2 mg each day. Do you think these are killing my liver? If so, which are the worst?

2. My enzymes were elevated and I don't remember exactly the numbers, but to give you an idea: one that was supposed to be around 75 was around 210, and one that was supposed to be around 15 was around 75. Given the fact that all of my tests were normal in 2004, what are the chances this indicates something serious such as hepatitis or cirrosis?

Anyway, I guess my main question is about the drugs, but I also wonder how I would know if I have something serious.

Besides the side pain I feel fine. No jaundice I don't think, and no nausea. I don't drink or smoke although I used to do both.

I'm going to have a follow-up test in a couple of weeks after I've been off the acetaminophen for a while.

3. If my liver enzymes are still elevated in two weeks what should I do?

I'd love to hear your thoughts on this.

Thank you.

[sgib3]

My husband who just turned 30 went to the Dr. for some blood test, his liver enzymes was high, so the Dr. told him to come back in 2 weeks for another blood test, which he did and the level was still high, My husband told me that he now has to go in for an ultra sound.  My questions is what should I be expecting?  Why would his levels be high?, he does not drink and hasn't for several years, he works out 4 days a week.  I'm not sure if my husband is being honest with me (trying to spare my feelings, or not get me worried.  He will not let me go to the Dr. with him which makes me suspecious.  I have a feeling this is not very good news to have high liver enzymes, and I really don't know what to expect.  Any informations will be greatly appreciated.  Thank you

[aray]

Forgot to mention I'm 33. Also, what chance is there that symptoms indicate something life-threatening? Don't mean to sound paranoid, because I'm not; but I would guess a lot of us wonder this.

[Kevin Pho, MD]

To answer your questions:
1) Any medication has the possibility to damage the liver.  I looked at your medications, and both the Abilify and the Lexapro both have the uncommon chance of causing hepatitis and raising the liver enzymes.  

2) With the comprehensive tests that you have had, that would evaluate for many of the more serious conditions leading to your symptoms.  If the liver enzymes continue to be elevated, you can consider a liver biopsy for a more definitive diagnosis.  

3) If the liver enzymes continue to be elevated, I would pursue the liver biopsy.

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.

Kevin, M.D.
kevinmd_b