Hi all - new to this forum and thought it was worth trying to get some additional input based on others experiences.
I am a 39 year old healthy male, my only 'chronic' condition being that I'm overweight. I am not a heavy drinker, maybe 1-2 times per week. I am 5'9'' tall and on average around 205lbs. For the past 10 years or so, I have had LFT's (AST and ALT) above upper limits on and off as seen at my annual physical. When I weighed more, they were moderately elevated -- for example in 2019 when I was at 215lbs my ALT was 90 (upper limit 61) and AST was 42 (just above the upper limit of 37). In 2014 when I weighed closer to 190lbs, AST and ALT were both in range and closer to the low end of normal (healthy). So for the last ~10 years the LFT's have scaled with my weight and no other issues. We did an ultrasound in 2019 and it showed very mild fibrosis (F1).
I had my annual physical last November and ALT was 120 and AST 49, weight was about
215 lbs. Bilirubin was at 2.0 which is right at upper limit. I redid test 2 weeks later and results were about
the same. I was then referred to a gastro who asked me to lose weight and exercise suspecting Fatty Liver disease or NASH. I took this seriously (probably moreso than years past) and am now closer to 195lbs. I redid my labs last week and much improved -- ALT 37 and AST 17 and bilirubin dropped to 1.8 (in range and close to my normal over last 10 years). So the doctor was very pleased and this was confirming fatty liver disease. He also ran antibody tests to try and rule out autoimmunity. All of those tests were normal except for Smooth Muscle Antibody / F-actin which came back at 1:160 suggesting auto immune hepatitis (AIH), even though no other tests point to that.
My question is - does anyone else have fatty liver or NASH and see elevated Smooth Muscle Antiobdies? I have read that ~30% of people with fatty liver/NASH show these antibodies but do not have AIH upon biopsy.
One other complication was that last September/October I was on minocycline for ~ 2 months. Minocycline is known for creating drug induced liver injuries. So it's possible that I had a drug interaction on my liver enzymes as well. And wondering if anyone's seen a drug interaction triggering AIH or Smooth Muscle Antibody elevation?
Appreciate your time.
Kyle
Post Edited (KyleK40) : 1/18/2022 9:30:05 AM (GMT-7)