possible hepatitis or something going on?

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Emoney12
Regular Member


Date Joined Mar 2004
Total Posts : 100
   Posted 12/4/2006 7:54 PM (GMT -7)   
How is everyone doin? I was hoping to get some feedback or even possible ideas of what is going on. It all started 7 years ago when I got diagnosed with Crohn's Disease. I was put on 6mp, which is an immunmodulator, and remicade. I have been in remission since. At least there is something good right? about 2 years ago my Bilirubin and ALT became elevated. I belive my total bili was 3.9 and my ALT was 69. My doctor said it was no big deal and didnt want to take me off of the 6mp because he thinks that since my bilirubin is predominantly unconjugated he is sayin it is Gilbert's Syndrome and the mild elevation on the ALT is nothing to be concerned with. As time went on I became more yellow and tired and my new tests were bilirubin at 5.1 and ALT at 103. It was then we decided to stop the 6mp and within 2 weeks my ALT came down to 26 and my bili came down to 2.5, which it always stays because of this supposed Gilbert's. During this time i tested negative for hep a,b, and c. I also had a negative ANA test. Also all of my other liver enzymes are normal. All of my cbc's are normal. Today I had a doctors appointment and peaked at my last blood test and noticed that my ALT is back up to 50. Although this is in the normal range I am shocked to see it raise 2 fold. I am not on any medications that can cause elevated liver enzymes (asacol, remicade, metamucil) Everything is normal but my billi is still at 2.5. From your experiences does this sound like something wrong with the liver? Can this be a thyroid problem? Is it possible that all I have is Gilbert's syndrome and a naturally high ALT due to medication? All I read is elevated bilirubin is seen in liver failure! Just looking for some advice.

Thanks,
Eric

Marg57
Regular Member


Date Joined Dec 2005
Total Posts : 446
   Posted 12/5/2006 5:20 AM (GMT -7)   
Hi ERic,

Welcome.

Ask your doctor if you have concerns. People here are supportive but we're not doctors. I'm surprised that you "peeked" at your blood results. They are YOUR results. The doctor must share them with you.

Personally, I think decreased liver function is characterised by elevated bilirubin and liver enzymes but liver failure results from non treatment of the problem at that stage and ascites and edema become aparent. Decreased liver function is something that must be investigated. You can't let it reach a stage of cirrhosis before you get treatment.

I would firstly ask your doctor some questions then if you are not satisfied, ask to be referred to a heptologistg who can give you the information you need.

Good luck. Keep us informed of your situation.

Marg
 


wheredidigo
Veteran Member


Date Joined Mar 2006
Total Posts : 605
   Posted 12/5/2006 8:22 AM (GMT -7)   
welcome Eric,
Marg has answered this great,so please just keep us updated on what you find out. good luck
trish
 
 
Life should NOT be a journey to the grave with the intention of arriving safely in an attractive and well preserved body,but rather to skid in sideways,chocolate in one hand,wine in the other,body used up ,totally worn out and screaming"WOOOOHOO WHAT A RIDE!!!" 


Emoney12
Regular Member


Date Joined Mar 2004
Total Posts : 100
   Posted Today 3:23 PM (GMT -7)   
well got my blood test results back today from my appt.  Everything is normal except for Total Bili.  Doctor inists I have Gilbert's syndrome and told me to not worry at all.  He said I looked great, blood work is great, and whatever I am doing now to keep doing it now because everything looks good.  My ALT was 32 and my AST was 21.  In Novemeber they were ALT 51 and AST 26.  Both tests were in the reference range but I was a little concerned that that 51 was in the upper limits of normal.  Doctor said anything from food, alcohol, to being sick can cause different levels.  Is it normal for the ALT to fluctuate?  Why are some reference ranges on the ALT test only up to 40 and the one's from quest up to 60?  Is this because they are using a different test?  Do you think I should ask for further evaluation or just over reacting now?   

wheredidigo
Veteran Member


Date Joined Mar 2006
Total Posts : 605
   Posted Today 7:55 PM (GMT -7)   
well,your dr said nothing to worry about,so if you have doubts maybe you should get a second opinion,though it sounds like he knows what hes talking about. hope all turns out well
trish
 
 
Life should NOT be a journey to the grave with the intention of arriving safely in an attractive and well preserved body,but rather to skid in sideways,chocolate in one hand,wine in the other,body used up ,totally worn out and screaming"WOOOOHOO WHAT A RIDE!!!" 


Emoney12
Regular Member


Date Joined Mar 2004
Total Posts : 100
   Posted 12/8/2006 11:20 AM (GMT -7)   
 Is it normal for the ALT to fluctuate between 30 and 50?  Why are some reference ranges on the ALT test only up to 40 and the one's from quest up to 60?  Is this because they are using a different test?  I called my Doctor and I told him my concerncs about possibly having hep and he said he has been monitoring all my bloodwork for the last 3 years every 2 months.  If I had hep then he would have saw something during the acute phase that would have pointed to it.  He also sound it is very uncommon to have an elevated bilirubin when you have chronic hep, especially unconjugated.  Would an ultra sound ruke out hep?  I made him schedule me for one on Monday.   

hep93
Elite Member


Date Joined Jul 2005
Total Posts : 12014
   Posted 12/8/2006 10:25 PM (GMT -7)   
To put your mind at ease, I would specifically ask for testing for hep B and C.  Also, I think a second opinion would be helpful.
 
P.S.  As far as I know, a sonogram will show cirrhosis or tumor, but not hepatitis.  Hepatitis is a virus in your blood stream and there are specific blood tests for it.

Post Edited (hep93) : 12/10/2006 8:37:43 AM (GMT-7)


Marg57
Regular Member


Date Joined Dec 2005
Total Posts : 446
   Posted 12/13/2006 3:48 AM (GMT -7)   
Hi emoney12,
My heptologist told me just last week that the indicators for my liver problem - autoimmune hepatitis - were elevated bilirubin, and INR and low albumin. My LFT's, ALT and AST are slightly elevated still but the others are in the normal range so things are OK. Of course if the AST and ALT were to be very elevated (at my worst mine were above 450) this is a cause for concern.

If you are still worried get a second opinion and insist on further testing.

Hope you get the medical help you are seeking. good luck
Marg
 


Emoney12
Regular Member


Date Joined Mar 2004
Total Posts : 100
   Posted 12/17/2006 9:28 PM (GMT -7)   
well, my ultra sound came back perfectly normal, no abnormalities or signs of scarring or inflammation. He told me to stop reading so much on the internet because I will drive myself insane, which I think I kind of did. Gilbert's seems like the main cause of the bilirubin elevation. My albumin levels are actually borderline high not low. He ran tests just to rule out celiacs, wilsons, and hemochromatosis. Does anyone know why different labs have so different ranges? Like some only go up to 40 where others go up to 60?

hep93
Elite Member


Date Joined Jul 2005
Total Posts : 12014
   Posted 12/30/2006 12:46 AM (GMT -7)   
" Does anyone know why different labs have so different ranges? "

They just do. Furthermore, different labs can use differing scales of measure.

Marg57
Regular Member


Date Joined Dec 2005
Total Posts : 446
   Posted 12/31/2006 7:54 PM (GMT -7)   
You can never have too much information, just be careful the information you have is reliable. Not everything you read on the internet has been checked.

Glad youe tests are good. May you continue in good health for many years to come.
MARG
 


bunk
New Member


Date Joined Dec 2006
Total Posts : 1
   Posted 12/31/2006 11:13 PM (GMT -7)   
Is anyone there there to talk to now!!!!!!!!!!!!!!!

wheredidigo
Veteran Member


Date Joined Mar 2006
Total Posts : 605
   Posted 1/1/2007 2:03 PM (GMT -7)   
well,hello bunk,,I wasnt here then but I am now,what do you need to talk about??
trish
 
 
Life should NOT be a journey to the grave with the intention of arriving safely in an attractive and well preserved body,but rather to skid in sideways,chocolate in one hand,wine in the other,body used up ,totally worn out and screaming"WOOOOHOO WHAT A RIDE!!!" 

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