DD's Elevated Liver Enzymes

MBombardier · Post by **MBombardier** » Tue Jan 10, 2012 1:46 pm

I found an old thread on elevated liver enzymes, but the posts of the thread author were gone. So, since you all know my daughter, Lauren, who is a member of this board, I decided to start a new thread.

Lauren has had two liver enzyme tests in the past several weeks. The first one showed her levels were very high, and the second showed that they had climbed even higher. In the meantime, she also was tested for hepatitis, I think B and C, and those tests were negative. She does not drink, so these test results are not linked to alcohol.

Lauren is currently in a place where her access to a computer, etc., is limited, which is why I am posting about her. We have discussed that her liver may be reacting to the gluten in her diet, and the doctor wants to do a celiac blood test. I told Lauren that considering her lifestyle and her genetics, any negative result is likely a false negative. If it is negative, and if her enzyme levels do not decrease, a liver biopsy has been mentioned. Naturally, she is scared.

I have urged her to do a gluten challenge, but since she is not in control of her diet, she is reluctant to ask for special treatment. I told her that her health is more important than "being nice" and she agrees, but that doesn't mean that she will actually follow through.

Is there any more research besides that on the old thread that I should be reading and printing out for her and her doctor?

Post by **tex** » Tue Jan 10, 2012 2:22 pm

Marliss,

Has she by any chance been using acetaminophen? Has she been checked for thyroid disorders? Have you considered some of the other possibilities, such as the ones on this list?

http://www.elevatedliverenzymes.net/

Tex

Zizzle · Post by **Zizzle** » Wed Jan 11, 2012 9:51 am

Marliss,
Let me start by saying I hope this is not the case, but just in case...here goes. I am being monitored for possible future development of Autoimmune Hepatitis (AIH). It commonly happens to young women, and ultimately results in a lifetime of taking steroids and related drugs to stop the damage. The reason it is suspected in me is that I have had high ANA and Anti-Smooth Muscle Antibody levels (ASMA is also known as Anti-Actin Antibody) for several years. I was getting liver enzymes checked every 6 months, but they were always normal, so now I go once a year. A year after starting the GF/DF diet, my ANA dropped by two thirds, but my Anti-Actin level stayed the same (Anti-Actin may also be indicative of gut damage). I'm on this diet not just for MC, but to prevent AIH. I can't stress how important the GF diet is, expecially given your genetics. When I started researching, I realized there is a "celiac hepatitis" which is exactly the same thing as AIH. But most people with AIH don't make the connection. It's a crying shame.

Please make sure your daughter gets tested for the auto-antibodies related to AIH (namely ASMA). I sure hope she doesn't have it. But if she does, I have hope that a GF diet may someday stop the attack on her liver, and allow her to go drug free. If keeping your liver isn't enough reason to go GF, I don't know what is.

Does she have any other symptoms? The symptoms most common to AIH are an extended painful upper abdomen, jaundice, Enlarged Liver, Itchiness, Fatigue, joint pain, skin rashes, nausea, vomiting, loss of appitite, dark urine, pale or grey stools.

MBombardier · Post by **MBombardier** » Wed Jan 11, 2012 11:43 am

Tex, thanks for that list. I had seen it once when I was checking out my own mildly-elevated liver enzymes, but forgot about it. Lauren does not have diabetes, and her thyroid levels are normal. That was surprising because she is a large woman who resembles me physically quite closely. My father and I are both hypo, so IMO it is probably just a matter of time before Lauren is also. The MD has ruled out non-alcoholic fatty liver because the rest of Lauren's metabolic panel doesn't match that diagnosis, or something. I will have to ask her about the acetaminophen. She knows about ibuprofen, but I wouldn't be surprised to find out she's still taking that or the acetaminophen in appreciable amounts during her period.

Zizzle, thanks for this information. I was hoping you'd chime in.

I tried to do a search on liver and your name but came up with so many hits it was daunting. When Lauren called the lab last week to find out the results of the hep and new enzyme tests, the lab assistant said, "Oh, you are the one we're checking for autoimmune hepatitis." Lauren told her no, because the MD is currently looking at celiac disease. But we both thought that was interesting. And worrisome.

I will call her this afternoon and ask her about other symptoms she may be having. I do know that she has random itchiness, rashes, nausea, and vomiting, and she sleeps a lot. So we'll see. She's 34 years old, so she is no longer a spring chicken. I wonder if her excess weight is bringing health problems on sooner than I had them. I maintained a pretty good weight until my thyroid went nut-so about 10 years ago, and as near as I can tell, the MC started a few years after that.

Thanks again, y'all--once again, this board has proved invaluable.

Zizzle · Post by **Zizzle** » Wed Jan 11, 2012 11:52 am

Wow Marliss,
Those symptoms sound mighty suspicious. From what I read, 80% of people with AIH can achieve remission through daily steroids and/or immuran, but I truly believe a GF diet can do just as much (eventually) to aid in remission. I assume the docs have it covered, given what they said, but you might want to make sure they ordered the ANA and SMA tests. Of course with any liver issues, I imagine acetaminophen is totally contraindicated, given its liver-toxic qualities, so if she's taking any at all, tell her to stop ASAP.

Zizzle · Post by **Zizzle** » Wed Feb 01, 2012 12:20 pm

Marliss,
Any test results back on your DD? I hope she's feeling OK.

MBombardier · Post by **MBombardier** » Wed Feb 01, 2012 11:24 pm

I haven't heard back from her. Well--about the liver stuff anyway. Thanks for asking!

MBombardier · Post by **MBombardier** » Wed Mar 14, 2012 10:53 pm

Lauren has autoimmune hepatitis, positive diagnosis today. She took herself gluten-free two weeks ago in anticipation, and is already experiencing an improvement in her GI tract. The doctor said that he wanted her on the gluten-free diet and that he will re-do her liver tests in three months to see how she is doing. For some reason, even though she is not diabetic, he wanted to put her on Metformin. She turned it down and told him that she wants to do this drug-free.

She told me that she is GF for life, whether it helps with her liver enzymes or not. I'm happy.

Post by **tex** » Thu Mar 15, 2012 8:30 am

I'm sorry that diagnosis was confirmed, but I'm glad that she's being proactive with her treatment.

Thanks for the update.

Tex

Zizzle · Post by **Zizzle** » Thu Mar 15, 2012 8:54 am

Wow, I'm amazed the doctor suggested the GF diet. I didn't realize docs were connecting AIH to gluten yet. No steroids or other meds? Would you mind asking your daughter what her Anti-Actin (Smooth Muscle) Antibody titer was? Mine is 56 and I'm curious to know how that compares to someone with active disease.

I'm glad she has answers. I truly hope the GF diet is all she needs to get it under control.

Noodler · Post by **Noodler** » Thu Mar 15, 2012 5:30 pm

I've been a bit worried by my liver enzymes and had raised Gamma GT. I drink a bit but not to the point of getting a buzz. My ASMA was borderline. Maybe gluten has been thrashing my liver as well as my guts. My ANA is normal though.

MBombardier · Post by **MBombardier** » Sat Mar 17, 2012 11:02 pm

Lauren says she doesn't have a hard copy of her test results yet. She doesn't remember them checking the ASMA. She thinks her AST was 293.3 and the other AGT (I'm not sure she has the initials right) was 350.0 in January.

At this point, Lauren is not questioning the doctor, I don't think. I would be asking how he came up with AIH other than eliminating all the other forms of hepatitis. But I have little to no familiarity with the issue. I will see her next weekend, so maybe I can get some better answers.

Zizzle · Post by **Zizzle** » Tue Apr 03, 2012 8:47 am

Marliss,
Just curious, do you know if your daughter ever received the Hepatitis B vaccine? I did in college when I was a healthcare worker, and my "IBS" developed soon after. I've always distrusted the Hep B vaccine series, but recent reading has me even more convinced that it may explain my anti-liver (ASMA) antibodies. I allowed my son to get the series, but not at birth. I opted out completely for my daughter and spaced out the rest of her vaccines (3 more to go before kindergarten! but I have to file a religious exemption form for the missing Hep B). I had no idea, but one of the leading researchers on the dangers of the Hep B vaccine is a geneticist I used to work with, Mark Geier. The OB/GYN I worked for was a satellite practice if his, doing prenatal testing. One article I read clearly demonstrated that the vaccine had liver-toxic qualities and could initiate anti-liver autoimmunity.

I had no idea he was doing this research, but I may have to give him a call!

Some examples of his publications:

Geier DA, Geier MR. Hepatitis B vaccination and adult
associated gastrointestinal reactions: a follow-up analysis.
Hepatogastroenterology 2002;49:1571–5.

[14] Geier MR, Geier DA. Immunologic reactions and hepatitis B
vaccine. Ann Intern Med 2001;134:1155.

[15] Geier DA, Geier MR. Chronic adverse reactions associated
with hepatitis B vaccination. Ann Pharmacother 2002;36:
1970–1. http://www.whale.to/a/geier.html

[16] Geier DA, Geier MR. Comment: hepatitis B vaccination
safety—Authors’ reply. Ann Pharmacother 2002;36:1649–50.

[17] Geier DA, Geier MR. Cutaneous immunologic reactions to
hepatitis B virus vaccine—in response. Ann Intern Med
2002;136:780– 1.

[18] Geier MR, Geier DA. Hepatitis B vaccination safety. Ann
Pharmacother 2002;36:370– 4.

[19] Geier M, Geier DA. Arthritic reactions following hepatitis B
vaccination: an analysis of the Vaccine Adverse Events
Reporting System (VAERS) data from 1990 through 1997.
Clin Exp Rheumatol 2000;18:789–90.

[20] Geier DA, Geier MR. Hepatitis B vaccination and arthritic
adverse reactions: A follow-up analysis of the Vaccine
Adverse Events Reporting System (VAERS). Clin Exp
Rheumatol 2002;20:119.

[21] Geier DA, Geier MR. Cutaneous immunologic reactions to
hepatitis B vaccine. Ann Intern Med 2002;136:780– 1.

Post by **tex** » Tue Apr 03, 2012 11:08 am

Zizzle,

Have you seen this recent research concerning stress in the activation of the hepatitis B virus? I suspect that this has broad implications.

“The lack of DNA building blocks can cause a kind of stress in specific cells, which shows in the activation of a stress protein called p38”, says Felix Hoppe-Seyler. “In liver cells, p38 very effectively activates the replication of hepatitis B viruses. “

http://www.dkfz.de/en/presse/pressemitt ... iruses.php

Tex

Zizzle · Post by **Zizzle** » Tue Apr 03, 2012 11:33 am

Tex,
Hopefully that knowledge can be translated into better treatments for Hep B infection, and/or a better understanding of why some Heb B carriers never get sick from it. Hopefully this will hapen before my non-vaccinated daughter grows up and *perhaps* is exposed to Hep B along the way. Of course I'm selfishly relying on herd immunity to protect her among her peers. Interestingly, the autoimmune activation after Hep B vaccination cited by researchers nearly always happens in women, not men. I wonder, is it our general predisposition to autoimmunity compared to men, estrogen/vaccine catalysts, or something else that explains this?