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Post by ms2mrsmyers on Dec 16, 2014 17:04:45 GMT -5
Hi all,
I am 30 months post virgin DS with Dr. Inman. Prior to my surgery I did a lot of research and knew to expect my liver enzymes to be elevated directly after surgery and possibly during the rapid weight loss phase. At my 6 month labs my AST was 25 which is normal ( range 8-40) and my ALT was slightly elevated at 42 (range 3-35). This was great, no problem. Fast forward and each time I have gotten my labs done (always in 6 month intervals) my ALT and AST have continued to climb. In June at my 2 year labs my AST was 163 and my ALT was 278 so I went to see my surgeon. I felt as if my surgeon totally blew me off and acted as if it was not a big deal. She stated that it was probably because I had been taking omeprazole and she took me off of it and advised me to be retested in 3 months. In October they were checked again and my AST was then 250 and my ALT was 352. My PCP noticed the trend and thought a liver ultrasound was in order. I had this completed and it came back completely normal. I just had my 2.5 year labs drawn this month and now my AST is 656 and my ALT is 773 meaning they have doubled just since having them checked 2 months ago. I have no jaundice, no abdominal pain, no symptoms whatsoever. I feel as if my surgeon minimizes it and my PCP does not have a clue what is going on. Has anyone else heard of / experienced this post DS? In case anyone is wondering I do not drink any alcohol. I take the vitalady vitamin regimen but with this happening I did decrease my dosage of vitamin A as a last ditch effort to see if that was causing hepatotoxicity but the enzymes doubled with that change so that does not appear to be the problem. I guess I will go back to my surgeon but I'm honestly not real hopeful that she is going to be too concerned about it. Just bouncing this off you guys and seeing if anyone has any experience.
Thanks,
Steph
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Post by caprice on Dec 16, 2014 17:23:14 GMT -5
I did not have elevated numbers.
One product I used pretty religiously from early out was Inositol powder. I get it from Jarrow Formulas, but I'm sure that other places manufacture it as well. Although, the Jarrow product is manufactured in Japan, so that was a selling point for me.
This was recommended by my alternative health care advisor - it's a nutritional supplement only. She felt that it would help my liver.
As with many supplements, who can say how effective they are? But, my experience was that i faithfully took it, and my liver seems to be in good shape. No complaints, anyway.
The container says: "Promotes liver function and cellular detoxification", but I just did a quick look online and everything is about anxiety relief and reducing the effects of PCOS. Who knows, it's the Internet.
Anyway, just throwing it out there. It's a powder, rather sweet, actually, and it was great in my morning yogurt/chia seed slurry.
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Post by goodkel on Dec 16, 2014 23:33:27 GMT -5
I didn't know anything about this so I looked it up. You really need to light a fire under your pcp to begin ruling out causes. No more "we'll check again in three months." Some of these can be checked immediately with a blood test. Other than during the rapid weight loss phase, I have never heard of this in relation to the DS. From the Mayo Clinic site: www.mayoclinic.org/symptoms/elevated-liver-enzymes/basics/causes/SYM-20050830 Many diseases and conditions can contribute to elevated liver enzymes. Your doctor determines the specific cause of your elevated liver enzymes by reviewing your medications, your signs and symptoms and, in some cases, other tests and procedures. More common causes of elevated liver enzymes include: Certain prescription medications, including statin drugs used to control cholesterol Heart failure Hepatitis A Hepatitis B Hepatitis C Nonalcoholic fatty liver disease Over-the-counter pain medications, including acetaminophen (Tylenol, others) Other causes of elevated liver enzymes may include: Autoimmune hepatitis (liver inflammation caused by an autoimmune disorder) Celiac disease (small intestine damage caused by gluten) Cirrhosis (liver scarring) Cytomegalovirus (CMV) infection Dermatomyositis (inflammatory disease that causes muscle weakness and skin rash) Epstein-Barr virus Gallbladder inflammation (cholecystitis) Heart attack Hemochromatosis (too much iron stored in your body) Hypothyroidism (a thyroid disorder) Liver cancer Mononucleosis Muscular dystrophy (inherited disease that causes progressive muscle weakness) Pancreatitis (pancreas inflammation) Polymyositis (inflammatory disease that causes muscle weakness) Toxic hepatitis (liver inflammation caused by drugs or toxins) Wilson's disease (too much copper stored in your body) |
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Post by fullhousemom on Dec 17, 2014 8:21:36 GMT -5
Are there any medications that you have regularly taken in the past which could have caused liver damage? I know of two people who used tylenol two to three times a week, over a period of years, one for back pain and I can't remember the other. They both were hospitalized, near death, and it had to do with liver damage.
As a DSer, we get regular bloodtests, and can see problems developing. I cannot tell you if the two individuals that were hospitalized (for long periods of time), had a gradual increase in their liver enzymes, or a sudden spike.
I do take tylenol for headaches, at my doctor's recommendation, but am not a regular user. I certainly don't mean to scare anyone away from tylenol. If I were you, I would look at the medications I have taken previously, and read the fine print about possible interactions. And I would make sure I found a dr who would jump on this. Keep your lab results on a spreadsheet so that they can easily see the trends. Do not hand a dr multiple sheets of paper with your lab results. Those trends amidst all the other lab results, are hard to identify.
On my spreadsheet, anything out of range I put in red, so the information "pops" out quickly.
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Post by ms2mrsmyers on Dec 17, 2014 14:27:55 GMT -5
Thank you everyone. I do not use tylenol or any rx medications. I only take my vitamins. Kelly I appreciate your comprehensive response. I am concerned about possible autoimmune causes which is included in your list due to my lack of any other symptoms. I will keep you all updated on this, but I will admit it has me frightened. I appreciate your support.
Steph
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Post by goodkel on Dec 17, 2014 16:52:08 GMT -5
Do you take copper? That can build up in your bloodstream and was one of the causes listed.
I didn't mean to frighten you, but I don't think that you should accept the complacent attitude of your doctor, anymore either.
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Post by newyorkbitch on Dec 17, 2014 17:35:55 GMT -5
Speak to a gastroenterologist, but first I suggest you send emails to Herron, Gagner, and Pomp and ask them about this issue.
Do not get a liver biopsy - do not. They are risky. If you decide you need to check out your liver, get an MRI with spectroscopy.
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Post by ms2mrsmyers on Dec 17, 2014 22:08:42 GMT -5
NYB-
Are these surgeons? I'm asking so I can figure out how to get into contact with them.
Thank you
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Post by ms2mrsmyers on Dec 17, 2014 22:10:07 GMT -5
Yes Goodkel I do take copper and I may d/c it for the te being to see if that helps.
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Post by songbird177 on Dec 18, 2014 6:05:41 GMT -5
I'm 2 years post op and just noticed mine starting to increase, though not as high as yours. I'm curious to see if it is DS related. I don't think so but it's strange. Keep me updated on what you find out.
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Post by newyorkbitch on Dec 18, 2014 7:31:53 GMT -5
NYB- Are these surgeons? I'm asking so I can figure out how to get into contact with them. Thank you Gagner is in Canada. Herron and Pomp are in NYC. You can google them and find the websites for their centers, and find their email addresses. You could also write to Rabkin in California. I'm just suggesting that you raise the issue with surgeons who have many years of patients under their belts and ask about this. I have seen many DSers have elevated liver enzymes over the years, but the sudden and dramatic increase in yours is unusual and needs investigation. |
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joanlaptods
Full Member
DS Mar 9,2011 Dr Gagner
Posts: 192
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Post by joanlaptods on Dec 20, 2014 17:18:55 GMT -5
Steph,
I had elevated liver enzymes, AST and ALT discovered about 15 months ago when I was 3 1/2 years post DS. I tried cutting out omeprazole and stopping copper, decreasing vitamin A but it was not related to any of that it turned out. I was diagnosed by a gastroenterologist after an Enhanced MRI with primary schlerosing cholangitis ( believed to be an autoimmune disorder) this past spring. I have wonderered about a connection with autoimmune disorders and the DS, are they more prevalent ?
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Post by Simba on Dec 20, 2014 17:53:14 GMT -5
Hi all, I am 30 months post virgin DS with Dr. Inman. Prior to my surgery I did a lot of research and knew to expect my liver enzymes to be elevated directly after surgery and possibly during the rapid weight loss phase. At my 6 month labs my AST was 25 which is normal ( range 8-40) and my ALT was slightly elevated at 42 (range 3-35). This was great, no problem. Fast forward and each time I have gotten my labs done (always in 6 month intervals) my ALT and AST have continued to climb. In June at my 2 year labs my AST was 163 and my ALT was 278 so I went to see my surgeon. I felt as if my surgeon totally blew me off and acted as if it was not a big deal. She stated that it was probably because I had been taking omeprazole and she took me off of it and advised me to be retested in 3 months. In October they were checked again and my AST was then 250 and my ALT was 352. My PCP noticed the trend and thought a liver ultrasound was in order. I had this completed and it came back completely normal. I just had my 2.5 year labs drawn this month and now my AST is 656 and my ALT is 773 meaning they have doubled just since having them checked 2 months ago. I have no jaundice, no abdominal pain, no symptoms whatsoever. I feel as if my surgeon minimizes it and my PCP does not have a clue what is going on. Has anyone else heard of / experienced this post DS? In case anyone is wondering I do not drink any alcohol. I take the vitalady vitamin regimen but with this happening I did decrease my dosage of vitamin A as a last ditch effort to see if that was causing hepatotoxicity but the enzymes doubled with that change so that does not appear to be the problem. I guess I will go back to my surgeon but I'm honestly not real hopeful that she is going to be too concerned about it. Just bouncing this off you guys and seeing if anyone has any experience. Thanks, Steph First I noticed you had elevated ALT & AST, but have you had your GGT and 5 nucleotidase blood work, these are liver specific enzymes and should be ordered, you need to see a liver specialist with and ALT & AST in your level, I would want that worked up. Your surgeon is following you? your surgeon and PCP? both, I would say forget Inman, she is a surgeon, remember that, while not inclusive they are ususally horrible for follow ups. what is great you have no symptoms-jaundice, pain etc. Ask your PCP if that were his/her results on blood work what would he/she do? while I think an ultrasounds is great, it is not at all inclusive. So I would tell your PCP that you want to see a liver specialist, ask your liver specialist about ordering the liver specific enzymes and see where you are. they can also recommend other things to be done. Explain to your liver specialist your DS, bring in a picture, explain everything to him/her so they can understand, bring in your operative report, and make sure you understand what was done with your DS so you can ask quetions. Dont assume they will know or even better that the "DS is the same as gastric bypass". hopefully you will get some answers real soon. |
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Post by goodkel on Dec 20, 2014 20:49:39 GMT -5
I am fascinated by what seems to me to be people coming out of the wood work with elevated liver enzymes when I don't recall it ever being mentioned as an issue before. Interesting and I am learning something new. Thank you for sharing.
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Post by newyorkbitch on Dec 21, 2014 8:14:38 GMT -5
I think elevated liver enzymes are quite common for DSers, but mildly elevated. When there is sudden and dramatic increase….that's cause to investigate.
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razbry
Junior Member
Posts: 56
Surgery Type: DS
Surgery Date: March 17, 2002
Surgeon: Dr. Douglas Hess (retired)
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Post by razbry on Jan 10, 2015 10:22:20 GMT -5
Here is my experience with elevated liver enzymes. They were the first thing to go out of whack on my way down the tubes into severe malnutrition. I saw specialists, had dozens of tests, but at the end (when I had to be put on TPN) the levels returned to normal. Recently I noticed my Alk Phos level creeping up, and along with it a drop in my protein levels. I amped up my protein pronto. Alk Phos now back to normal. Look at your protein intake.
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Post by ms2mrsmyers on Jan 30, 2015 8:58:16 GMT -5
Hi all,
Just an update my liver enzymes have all returned to normal levels and the physicians believe I hav a virus (non-hepatitis) that has now resolved. This issue was not DS related. Thank you all for the concern and advice :-)
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Post by newyorkbitch on Jan 30, 2015 9:20:42 GMT -5
Great news.
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