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Avatar universal

AST/ALT Elevated..

About a month ago I had a terribly sore back and neck and had headaches.  I finally went to the Dr. (because my sinuses were killing me too) and he sent me for routine bloodwork.  My blood work came back great except for elevated AST/ALT levels.  AST was 120 ALT was 155.  He sent me for a lyme disease blood test and it came back positive for "short term" (???) lyme disease.  He said it is a more recent infection so that is why it was one antibody and not the other.  But because my liver enzymes were elevated in my initial bloodwork he is sending me to a liver specialist and now I am worried about everything under the sun.  Has anyone else had experience with liver enzymes being elevated with a positive Lyme test?  
4 Responses
Avatar universal
Greetings and welcome to MedHelp --

Your doc is quite observant to think of Lyme ... it's often way down a doc's list of possible causes of ailments and symptoms.

His reference to 'short term' Lyme disease probably meant he thinks it's a relatively recent infection, and the sooner it's caught, the better.  There are two measures in a standard Lyme test, one that appears early on and the other that appears later -- but not everyone's immune reaction is the same, so the test is just a helpful rule of thumb, not the last word.  

Specifically, the immune system produces IgM (immunoglobulin M) early in a Lyme infection, and then that reaction fades as the immune system begins to produce IgG (immunoglobulin G).  This procession gives docs a rough idea of how long you've been infected.  Problem is, it's not exact, because (among other things) Lyme disease also suppresses the immune system, which throws off the body's schedule and production of IgG and IgM antibodies.  Result:  plenty of people who actually have Lyme show negative on the tests, because Lyme is suppressing the immune system reaction to Lyme that the tests are looking to measure.  

So the good (?) news is that your tests have identified the situation and your doc understands it.  Lyme affects everyone in different ways, and it may be that you have liver involvement.  That's not something I had, but again, everyone is different.  Some people have more cognitive (thinking) issues, others more joint and muscle involvement.  Many of us have significant fatigue.  So I would not panic over the liver involvement, but do follow up with the doc for further guidance and for treatment.

Another aspect of Lyme is that the same ticks often (perhaps half the time) carry additional diseases unrelated to Lyme, called generically 'co-infections'.  These require different tests and often different medication from Lyme disease, and that's something your doc, if he's wise to Lyme as he seems to be so far, will also follow up on.

The biggest risk in my experience is that many docs do not understand Lyme for the tricky beast that it is, and the docs can fail to diagnose the co-infections (which are sometimes obscured by the Lyme effects).  A good Lyme doc will keep watch as treatment progresses to see what other symptoms may appear, leading to discovery of a quietly lurking co-infection.

Don't worry, this doesn't go on forever. ... I had Lyme and babesiosis (a cousin to malaria), both carried by the same tick (which I never saw), and I was pretty sick.  Someone else in my family had the same infections, but was only a little tired, and never saw a tick or rash either.  We were both treated with antibiotics, first for the babesia and then for the Lyme, over a period of perhaps 9 months or so, and we are both fine several years later.

Everyone is different, and sometimes it takes a while to unravel what the ticks have brought, but it's very doable with a good, flexible, aware MD.  Sounds like you are off to a good start with your doc.

This is more than you asked for about liver enzymes, but it's big picture stuff about Lyme.  See what the tests bring back, and what your Lyme doc says, and reassess.  

Know also that anxiety is a symptom of Lyme, because it uses up the magnesium in your body.  If you are particularly anxious or is just getting in your way day to day, try adding magnesium supplements daily, any good brand ending in '-ate', such as magnesium malate, orotate, aspartate, citrate, etc., and be sure your doc knows you are supplementing.  It can help a lot with anxiety ... tho I've read that the calcium/mangnesium combo (such as CalMag brand) is not very absorbable, so I stick with the Mg "-ate" approach, even now after I don't have Lyme.

Enough for now.  Keep us posted on what the doc says -- we're happy to contribute what we've learned.  Best wishes --
Avatar universal
One more thing.  If your doc gives you doxycycline for a few weeks and says that will cure you, come back and talk to us some more.  Doxy is the old standard treatment for Lyme, but it only works if given almost immediately after the infection occurs, because the Lyme bacteria have the ability and inclination to create and hide in areas of the body where the immune system does not see the bacteria to attack ... these areas are called 'bio-films.'  

Doxy does not penetrate bio-films, and different meds are needed.  Regular docs believe a few weeks of doxy is all anyone needs, regardless of how lousy they continue to feel.  Lyme specialists however take a different view, which is that longer treatment (as I had) and a combo of antibiotics (one to pierce the bio-films and another to kill the now-exposed bacteria) are both needed.  In addition, any co-infections often need different meds from what kills Lyme.  

Your doc so far is exhibiting good solid Lyme-specialist qualities, but it will take a bit longer to see where he takes testing and treatment approaches.  Yes, this is all very strange, but welcome to LymeWorld.
1763947 tn?1334055319
I want to mention that I was bit over 20 years before I started treatment. At that time my liver enzymes were (and still are) elevated and many of my blood tests were abnormal. Lyme does that, messes with many things in your body.

Avatar universal

Yes, mine were elevated too! Pretty high according to the liver specialist because of how small I am. They didn't seem over the top to me but he said since I am so small, mine should be at the low end of normal to begin with. So to have them OVER the max amount of normal was a big deal.  I first found that out when I went to the ER because of my Lyme symptoms (I didn't know I had Lyme at that time and they never tested me for it).  I was sent to a liver specialist too who said let's wait another month and see if they go down.  At that time, I took myself off all herbs I had been taking in hopes of fixing what was wrong with me (many herbs/supplements/and meds will elevate your liver enzymes).  After a month, I took more blood work and they were about a couple points away from the "normal" range so he said get it checked again in 6 months. Which I haven't since I've been on doxy for over a month and I'm sure my liver levels are going to be elevated because of that.

It's okay to be nervous, trust me I was a wreck. I'm pretty sure another person on here posted recently about elevated liver enzymes and Lyme so I really am beginning to think there's a connection there.
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