Liver Enzyme Problems and low ferritin

[jbrule]

Hi all,



My name is Jen, I had the DS 6 years ago. I've been pretty happy with the results but for the past 1.5 years my liver enzymes have been elevated. I had an ultrasound in December and the results were normal but I'm concerned that I may have an autoimmune problem in the works. Frankly, I am freaking myself out and of course it's Friday. Please help me make sense of this all! Right now I'm thinking all kinds of horrible things.



I would appreciate any opinions from the experts on this. I just had some lab results. For the first 5 years my enzymes were in the 20's and now they are on the high side. It drives me crazy. I will post my last two labs. I also cannot build my ferritin. My iron is good, my hemoglobin is good, but my ferritin never is. The only time it has been is after I had an iron infusion. What is the deal with that? Hopefully the formatting on my labs doesn't go to wonky.



Also, in the past few weeks I have put on 7-8lbs. I don't know why, I can't figure it out. I feel like I need to do a reset diet for a bit. I swear people have talked about that in the past. The DS will always work if you use it correctly, right?







Results:

Date Result Name Value Ind Ref Range

9/23/2015 14:14 WBC 6.32 thous/uL (4.00 - 11.00)

9/23/2015 14:14 RBC 4.28 mil/uL (3.80 - 5.50)

9/23/2015 14:14 Hgb 13.6 g/dL (11.6 - 15.6)

9/23/2015 14:14 Hct 39.0 % (36.0 - 48.0)

9/23/2015 14:14 MCV 91 fL (80 - 100)

9/23/2015 14:14 MCH 31.8 pg (26.0 - 34.0)

9/23/2015 14:14 MCHC 34.9 g/dL (30.0 - 36.0)

9/23/2015 14:14 RDW-CV 13.7 % (11.7 - 14.3)

9/23/2015 14:14 RDW-SD 45.6 fL (36.0 - 48.5)

9/23/2015 14:14 Platelet 232 thous/uL (130 - 400)

9/23/2015 14:14 MPV 10.4 fL (9.5 - 10.5)

9/23/2015 14:14 Neutro % 62.3 % (40.0 - 76.0)

9/23/2015 14:14 Lymph % 26.6 % (20.0 - 46.0)

9/23/2015 14:14 Mono % 9.7 % (4.0 - 12.0)

9/23/2015 14:14 Eosin % 0.2 % (0.0 - 5.0)

9/23/2015 14:14 Baso % 0.9 % (0.0 - 3.0)

9/23/2015 14:14 Imm Gran % 0.3 % (0.0 - 5.0)

9/23/2015 14:14 Abs Neutro 3.94 thous/uL (1.60 - 8.40)

9/23/2015 14:14 Abs Lymph 1.68 thous/uL (0.80 - 5.10)

9/23/2015 14:14 Abs Mono 0.61 thous/uL (0.10 - 1.30)

9/23/2015 14:14 Abs Eosin 0.01 thous/uL (0.00 - 0.60)

9/23/2015 14:14 Abs Baso 0.06 thous/uL (0.00 - 0.30)

9/23/2015 14:14 Abs Imm Gran 0.02 thous/uL (H) (0.00 - 0.01)

9/23/2015 14:14 nRBC Abs 0.00 thous/uL (0.00 - 0.00)

9/23/2015 14:14 nRBC % 0.0 /100 WBC's (0.0 - 0.0)

9/23/2015 14:14 Glucose Level 79 mg/dL (60 - 99)

9/23/2015 14:14 BUN 9 mg/dL (8 - 20)

9/23/2015 14:14 Creatinine 0.7 mg/dL (0.3 - 1.5)

9/23/2015 14:14 Sodium 138 mmol/L (137 - 147)

9/23/2015 14:14 K Plasma 4.20 mmol/L (3.40 - 4.80)

9/23/2015 14:14 Chloride 108 mmol/L (98 - 110)

9/23/2015 14:14 CO2 26 mmol/L (24 - 32)

9/23/2015 14:14 AGAP 4 (L) (5 - 20)

9/23/2015 14:14 AST (SGOT) 54 Unit/L (H) (10 - 37)

9/23/2015 14:14 TBil 0.7 mg/dL (0.1 - 1.1)

9/23/2015 14:14 ALT (SGPT) 99 Unit/L (H) (12 - 78)

9/23/2015 14:14 Alk Phos 73 Unit/L (45 - 117)

9/23/2015 14:14 Calcium 8.5 mg/dL (8.5 - 10.1)

9/23/2015 14:14 T. Protein 6.8 g/dL (6.0 - 8.4)

9/23/2015 14:14 Albumin 3.6 g/dL (3.2 - 4.7)

9/23/2015 14:14 Iron 117 mcg/dL (50 - 170)

9/23/2015 14:14 TIBC 473 mcg/dL (H) (250 - 450)

9/23/2015 14:14 Iron % Saturation 25 % (20 - 55)

9/23/2015 14:14 Ferritin 8.0 ng/mL (8.0 - 252.0)

9/23/2015 14:14 GFR MDRD >60.0 mL/min/1.73m2

9/23/2015 14:14 Vitamin D 25-Hydroxy Total 61 ng/mL (H) (20-50 - )

9/23/2015 14:14 Zinc, Serum 0.55 mcg/mL (L) (0.66-1.10 - )





Results:

Date Result Name Value Ind Ref Range

12/19/2014 14:59 WBC 5.91 thous/uL (4.00 - 11.00)

12/19/2014 14:59 RBC 4.15 mil/uL (3.80 - 5.50)

12/19/2014 14:59 Hgb 13.1 g/dL (11.6 - 15.6)

12/19/2014 14:59 Hct 36.3 % (36.0 - 48.0)

12/19/2014 14:59 MCV 88 fL (80 - 100)

12/19/2014 14:59 MCH 31.6 pg (26.0 - 34.0)

12/19/2014 14:59 MCHC 36.1 g/dL (H) (30.0 - 36.0)

12/19/2014 14:59 RDW-CV 13.8 % (11.7 - 14.3)

12/19/2014 14:59 RDW-SD 43.8 fL (36.0 - 48.5)

12/19/2014 14:59 Platelet 265 thous/uL (130 - 400)

12/19/2014 14:59 MPV 10.5 fL (9.5 - 10.5)

12/19/2014 14:59 Neutro % 59.9 % (40.0 - 76.0)

12/19/2014 14:59 Lymph % 29.9 % (20.0 - 46.0)

12/19/2014 14:59 Mono % 9.1 % (4.0 - 12.0)

12/19/2014 14:59 Eosin % 0.2 % (0.0 - 5.0)

12/19/2014 14:59 Baso % 0.7 % (0.0 - 3.0)

12/19/2014 14:59 Imm Gran % 0.2 % (0.0 - 4.9)

12/19/2014 14:59 Abs Neutro 3.54 thous/uL (1.60 - 8.40)

12/19/2014 14:59 Abs Lymph 1.77 thous/uL (0.80 - 5.10)

12/19/2014 14:59 Abs Mono 0.54 thous/uL (0.10 - 1.30)

12/19/2014 14:59 Abs Eosin 0.01 thous/uL (0.00 - 0.60)

12/19/2014 14:59 Abs Baso 0.04 thous/uL (0.00 - 0.30)

12/19/2014 14:59 Abs Imm Gran 0.01 thous/uL (H) (0.00 - 0.00)

12/19/2014 14:59 nRBC Abs 0.00 thous/uL (0.00 - 0.00)

12/19/2014 14:59 nRBC % 0.0 /100 WBC's (0.0 - 0.0)

12/19/2014 14:59 Glucose Level 80 mg/dL (60 - 99)

12/19/2014 14:59 BUN 8 mg/dL (8 - 20)

12/19/2014 14:59 Creatinine 0.7 mg/dL (0.3 - 1.5)

12/19/2014 14:59 Sodium 138 mmol/L (137 - 147)

12/19/2014 14:59 K Plasma 3.9 mmol/L (3.4 - 4.8)

12/19/2014 14:59 Chloride 107 mmol/L (98 - 110)

12/19/2014 14:59 CO2 25 mmol/L (24 - 32)

12/19/2014 14:59 AGAP 6 (5 - 20)

12/19/2014 14:59 AST (SGOT) 44 Unit/L (H) (10 - 37)

12/19/2014 14:59 TBil 0.8 mg/dL (0.1 - 1.1)

12/19/2014 14:59 ALT (SGPT) 97 Unit/L (H) (12 - 78)

12/19/2014 14:59 Alk Phos 91 Unit/L (45 - 117)

12/19/2014 14:59 Calcium 8.4 mg/dL (L) (8.5 - 10.1)

12/19/2014 14:59 T. Protein 7.2 g/dL (6.0 - 8.4)

12/19/2014 14:59 Albumin 3.7 g/dL (3.2 - 4.7)

12/19/2014 14:59 Phosphorus 3.5 mg/dL (2.0 - 5.0)

12/19/2014 14:59

Cholesterol

120 mg/dL



( - <=200)

12/19/2014 14:59



Triglycerides

50 mg/dL



( - <=150)

12/19/2014 14:59



HDL

65 mg/dL

(H)

(40 - 60)



12/19/2014 14:59

LDL, Calculated

45 mg/dL



( - <=100)



12/19/2014 14:59

VLDL

10 mg/dL



(4 - 50)



12/19/2014 14:59

Iron

73 mcg/dL



(50 - 170)



12/19/2014 14:59

Ferritin

9.2 ng/mL



(8.0 - 252.0)



12/19/2014 14:59

TSH

1.790 microInternatl.Unit/mL



(0.358 - 3.740)



12/19/2014 14:59

Folate

8.1 ng/mL



(>=2.8 - )



12/19/2014 14:59

Vitamin B12

1,512 pg/mL

(H)

(193 - 986)



12/19/2014 14:59

GFR MDRD

>60.0 mL/min/1.73m2





12/19/2014 14:59

Intact PTH

44 pg/mL



(12-72 - )



12/19/2014 14:59

Phosphorus (PTH)

3.8 mg/dL



(2.7-4.5 - )



12/19/2014 14:59

Creatinine (PTH)

0.6 mg/dL



(0.5-1.3 - )



12/19/2014 14:59

Calcium (PTH)

9.0 mg/dL



(8.9-10.5 - )



12/19/2014 14:59

Vitamin D 25-Hydroxy Total

81 ng/mL

(H)

(20-50 - )



12/19/2014 14:59

Zinc, Serum

0.76 mcg/mL



(0.66-1.10 - )

[west4thavenue]

Hello, Jen, and welcome.

Unfortunately, I am not well versed in the problems you describe, but I want you to know that I am in your corner.  It is sometimes quiet here on the weekends, but no doubt one of the vets on the board will be able to respond to your questions.

Keep us posted, please.  We are all here to learn from one another.

[goodkel]

I wouldn't call myself an expert, but I just posted about my iron intake and ferritin levels, too. From my first set of labs, my ferritin has always been low. I finally had an infusion last year that turned everything around and I am feeling better than ever. You've had an infusion before, why haven't you had one again? Many people struggle with iron and require regular infusions. You have to do what works for you. If an infusion does the trick then that should be made a regular part of your routine.

Can you post what dosages of vitamins you were taking to get your most recent lab results?

What does your daily diet look like? Grams of protein? Grams of carbs?

Do you drink alcohol?

Do you still have your gallbladder?

Yes, the DS never stops working. A 7-8 pound gain in a couple of weeks looks like you could be building up fluid, especially if your diet hasn't changed. Are your ankles swollen?

I'm glad you came here, we'll do what we can to help you out. Welcome!

Kelly

[newyorkbitch]

Get an MR Spectroscopy of the liver.
Get an iron infusion - have you seen a hematologist?
Eliminate simple carbs and reduce your complex carbs.
You need more protein in your diet.
Get a pre albumin level.
Take more calcium.
List (completely) all supps you are taking - types and quantities
I don't see A, E, and K levels in your labs.

Sept 26, 2015 0:26:57 GMT -5 jbrule said:

Hi all,



My name is Jen, I had the DS 6 years ago. I've been pretty happy with the results but for the past 1.5 years my liver enzymes have been elevated. I had an ultrasound in December and the results were normal but I'm concerned that I may have an autoimmune problem in the works. Frankly, I am freaking myself out and of course it's Friday. Please help me make sense of this all! Right now I'm thinking all kinds of horrible things.



I would appreciate any opinions from the experts on this. I just had some lab results. For the first 5 years my enzymes were in the 20's and now they are on the high side. It drives me crazy. I will post my last two labs. I also cannot build my ferritin. My iron is good, my hemoglobin is good, but my ferritin never is. The only time it has been is after I had an iron infusion. What is the deal with that? Hopefully the formatting on my labs doesn't go to wonky.



Also, in the past few weeks I have put on 7-8lbs. I don't know why, I can't figure it out. I feel like I need to do a reset diet for a bit. I swear people have talked about that in the past. The DS will always work if you use it correctly, right?




Results:

Date Result Name Value Ind Ref Range

9/23/2015 14:14 WBC 6.32 thous/uL (4.00 - 11.00)

9/23/2015 14:14 RBC 4.28 mil/uL (3.80 - 5.50)

9/23/2015 14:14 Hgb 13.6 g/dL (11.6 - 15.6)

9/23/2015 14:14 Hct 39.0 % (36.0 - 48.0)

9/23/2015 14:14 MCV 91 fL (80 - 100)

9/23/2015 14:14 MCH 31.8 pg (26.0 - 34.0)

9/23/2015 14:14 MCHC 34.9 g/dL (30.0 - 36.0)

9/23/2015 14:14 RDW-CV 13.7 % (11.7 - 14.3)

9/23/2015 14:14 RDW-SD 45.6 fL (36.0 - 48.5)

9/23/2015 14:14 Platelet 232 thous/uL (130 - 400)

9/23/2015 14:14 MPV 10.4 fL (9.5 - 10.5)

9/23/2015 14:14 Neutro % 62.3 % (40.0 - 76.0)

9/23/2015 14:14 Lymph % 26.6 % (20.0 - 46.0)

9/23/2015 14:14 Mono % 9.7 % (4.0 - 12.0)

9/23/2015 14:14 Eosin % 0.2 % (0.0 - 5.0)

9/23/2015 14:14 Baso % 0.9 % (0.0 - 3.0)

9/23/2015 14:14 Imm Gran % 0.3 % (0.0 - 5.0)

9/23/2015 14:14 Abs Neutro 3.94 thous/uL (1.60 - 8.40)

9/23/2015 14:14 Abs Lymph 1.68 thous/uL (0.80 - 5.10)

9/23/2015 14:14 Abs Mono 0.61 thous/uL (0.10 - 1.30)

9/23/2015 14:14 Abs Eosin 0.01 thous/uL (0.00 - 0.60)

9/23/2015 14:14 Abs Baso 0.06 thous/uL (0.00 - 0.30)

9/23/2015 14:14 Abs Imm Gran 0.02 thous/uL (H) (0.00 - 0.01)

9/23/2015 14:14 nRBC Abs 0.00 thous/uL (0.00 - 0.00)

9/23/2015 14:14 nRBC % 0.0 /100 WBC's (0.0 - 0.0)

9/23/2015 14:14 Glucose Level 79 mg/dL (60 - 99)

9/23/2015 14:14 BUN 9 mg/dL (8 - 20)

9/23/2015 14:14 Creatinine 0.7 mg/dL (0.3 - 1.5)

9/23/2015 14:14 Sodium 138 mmol/L (137 - 147)

9/23/2015 14:14 K Plasma 4.20 mmol/L (3.40 - 4.80)

9/23/2015 14:14 Chloride 108 mmol/L (98 - 110)

9/23/2015 14:14 CO2 26 mmol/L (24 - 32)

9/23/2015 14:14 AGAP 4 (L) (5 - 20)

9/23/2015 14:14 AST (SGOT) 54 Unit/L (H) (10 - 37)

9/23/2015 14:14 TBil 0.7 mg/dL (0.1 - 1.1)

9/23/2015 14:14 ALT (SGPT) 99 Unit/L (H) (12 - 78)

9/23/2015 14:14 Alk Phos 73 Unit/L (45 - 117)

9/23/2015 14:14 Calcium 8.5 mg/dL (8.5 - 10.1)

9/23/2015 14:14 T. Protein 6.8 g/dL (6.0 - 8.4)

9/23/2015 14:14 Albumin 3.6 g/dL (3.2 - 4.7)

9/23/2015 14:14 Iron 117 mcg/dL (50 - 170)

9/23/2015 14:14 TIBC 473 mcg/dL (H) (250 - 450)

9/23/2015 14:14 Iron % Saturation 25 % (20 - 55)

9/23/2015 14:14 Ferritin 8.0 ng/mL (8.0 - 252.0)

9/23/2015 14:14 GFR MDRD >60.0 mL/min/1.73m2

9/23/2015 14:14 Vitamin D 25-Hydroxy Total 61 ng/mL (H) (20-50 - )

9/23/2015 14:14 Zinc, Serum 0.55 mcg/mL (L) (0.66-1.10 - )





Results:

Date Result Name Value Ind Ref Range

12/19/2014 14:59 WBC 5.91 thous/uL (4.00 - 11.00)

12/19/2014 14:59 RBC 4.15 mil/uL (3.80 - 5.50)

12/19/2014 14:59 Hgb 13.1 g/dL (11.6 - 15.6)

12/19/2014 14:59 Hct 36.3 % (36.0 - 48.0)

12/19/2014 14:59 MCV 88 fL (80 - 100)

12/19/2014 14:59 MCH 31.6 pg (26.0 - 34.0)

12/19/2014 14:59 MCHC 36.1 g/dL (H) (30.0 - 36.0)

12/19/2014 14:59 RDW-CV 13.8 % (11.7 - 14.3)

12/19/2014 14:59 RDW-SD 43.8 fL (36.0 - 48.5)

12/19/2014 14:59 Platelet 265 thous/uL (130 - 400)

12/19/2014 14:59 MPV 10.5 fL (9.5 - 10.5)

12/19/2014 14:59 Neutro % 59.9 % (40.0 - 76.0)

12/19/2014 14:59 Lymph % 29.9 % (20.0 - 46.0)

12/19/2014 14:59 Mono % 9.1 % (4.0 - 12.0)

12/19/2014 14:59 Eosin % 0.2 % (0.0 - 5.0)

12/19/2014 14:59 Baso % 0.7 % (0.0 - 3.0)

12/19/2014 14:59 Imm Gran % 0.2 % (0.0 - 4.9)

12/19/2014 14:59 Abs Neutro 3.54 thous/uL (1.60 - 8.40)

12/19/2014 14:59 Abs Lymph 1.77 thous/uL (0.80 - 5.10)

12/19/2014 14:59 Abs Mono 0.54 thous/uL (0.10 - 1.30)

12/19/2014 14:59 Abs Eosin 0.01 thous/uL (0.00 - 0.60)

12/19/2014 14:59 Abs Baso 0.04 thous/uL (0.00 - 0.30)

12/19/2014 14:59 Abs Imm Gran 0.01 thous/uL (H) (0.00 - 0.00)

12/19/2014 14:59 nRBC Abs 0.00 thous/uL (0.00 - 0.00)

12/19/2014 14:59 nRBC % 0.0 /100 WBC's (0.0 - 0.0)

12/19/2014 14:59 Glucose Level 80 mg/dL (60 - 99)

12/19/2014 14:59 BUN 8 mg/dL (8 - 20)

12/19/2014 14:59 Creatinine 0.7 mg/dL (0.3 - 1.5)

12/19/2014 14:59 Sodium 138 mmol/L (137 - 147)

12/19/2014 14:59 K Plasma 3.9 mmol/L (3.4 - 4.8)

12/19/2014 14:59 Chloride 107 mmol/L (98 - 110)

12/19/2014 14:59 CO2 25 mmol/L (24 - 32)

12/19/2014 14:59 AGAP 6 (5 - 20)

12/19/2014 14:59 AST (SGOT) 44 Unit/L (H) (10 - 37)

12/19/2014 14:59 TBil 0.8 mg/dL (0.1 - 1.1)

12/19/2014 14:59 ALT (SGPT) 97 Unit/L (H) (12 - 78)

12/19/2014 14:59 Alk Phos 91 Unit/L (45 - 117)

12/19/2014 14:59 Calcium 8.4 mg/dL (L) (8.5 - 10.1)

12/19/2014 14:59 T. Protein 7.2 g/dL (6.0 - 8.4)

12/19/2014 14:59 Albumin 3.7 g/dL (3.2 - 4.7)

12/19/2014 14:59 Phosphorus 3.5 mg/dL (2.0 - 5.0)

12/19/2014 14:59

Cholesterol

120 mg/dL



( - <=200)

12/19/2014 14:59



Triglycerides

50 mg/dL



( - <=150)

12/19/2014 14:59



HDL

65 mg/dL

(H)

(40 - 60)



12/19/2014 14:59

LDL, Calculated

45 mg/dL



( - <=100)



12/19/2014 14:59

VLDL

10 mg/dL



(4 - 50)



12/19/2014 14:59

Iron

73 mcg/dL



(50 - 170)



12/19/2014 14:59

Ferritin

9.2 ng/mL



(8.0 - 252.0)



12/19/2014 14:59

TSH

1.790 microInternatl.Unit/mL



(0.358 - 3.740)



12/19/2014 14:59

Folate

8.1 ng/mL



(>=2.8 - )



12/19/2014 14:59

Vitamin B12

1,512 pg/mL

(H)

(193 - 986)



12/19/2014 14:59

GFR MDRD

>60.0 mL/min/1.73m2





12/19/2014 14:59

Intact PTH

44 pg/mL



(12-72 - )



12/19/2014 14:59

Phosphorus (PTH)

3.8 mg/dL



(2.7-4.5 - )



12/19/2014 14:59

Creatinine (PTH)

0.6 mg/dL



(0.5-1.3 - )



12/19/2014 14:59

Calcium (PTH)

9.0 mg/dL



(8.9-10.5 - )



12/19/2014 14:59

Vitamin D 25-Hydroxy Total

81 ng/mL

(H)

(20-50 - )



12/19/2014 14:59

Zinc, Serum

0.76 mcg/mL



(0.66-1.10 - )

[jbrule]

Sorry! I wasn't getting emails that I had responses so I didn't realize anyone had answered me. My A and K labs are not back yet. Did not test E this time around as they have never changed in 6 years.

I think I was definitely retaining fluid because I started some liver detox herbs and lost 6 lbs.in two days. In July 2012 my liver enzymes were 19 and 19 (ALT AST) and from what I have backtracked, I then started carbonyl iron. In Oct 2012 my enzymes went to the 30's and have been steadily climbing since. Not sure if it could be related.

I rarely drink alcohol, less than a drink per week, usually none.

I will admit that I try to eat high protein, it's always what I eat the most of but I don't count grams. I am going to add a protein shake again and see what happens.

I do not have my gallbladder.

The highest my ferritin has ever been was 31 3 weeks after an 8 hour infusion.

Supplements I take daily (unless noted) are

A 100,000
D 50,000 (cut back on this one a few months ago when liver enzymes were elevated to see if it would make a difference)
E 400 IU every 2 days
K 100 md
Zinc 50 mg
Carbonyl Iron (vitalady) 120 mg
K2 alternate every 2 days with MK4 500 mcg and MK7 100 mcg
Calcium carbonate 1200 mg
5 Loxin 150 mg (think I'm going to stop this for awhile to see if it has an effect on liver)

I am calling to make an appointment with my surgeon tomorrow. I'm also hoping he can point me in the direction of a better hematologist or just order me an infusion. I have had a hard time getting anyone to be very concerned about my ferritin. It had been holding it's own in the high teens until my most recent lab and that has been decent for me.

I'm concerned because as my liver enzymes go up my albumin goes down and now my AGAP is low. I'm trying to interpret all of this as a lay person and I had myself pretty scared. I realize now that it is most likely me heading down a road to malnutrition if I don't fix it.

I hope I didn't miss anything! Just ask away if I did!

Thank you!

I really appreciate it!

Jen

[newyorkbitch]

You are taking the wrong kind of calcium.
Read the vitamin section of this board.
You need more protein. Keep track and count grams.
Get a prealbumin level.
Get an iron infusin.
Get an MR spectroscopy to rule out NAFLD

[jbrule]

Sorry, I was wrong about the calcium, it's citrate. I was going by memory (not very well apparently).

When I call my surgeons office tomorrow I'll ask for them to order a prealbumin test. The rest I'll talk to him about when I see him.

In the meantime I will drink some protein shakes and cut back on carbs.

[newyorkbitch]

Sept 27, 2015 17:51:19 GMT -5 jbrule said:

Sorry, I was wrong about the calcium, it's citrate. I was going by memory (not very well apparently).

When I call my surgeons office tomorrow I'll ask for them to order a prealbumin test. The rest I'll talk to him about when I see him.

In the meantime I will drink some protein shakes and cut back on carbs.

You need more calcium citrate. Get up to 2400 daily.