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Elevated Bilirubin and Liver Enzymes

MelissaF
on 4/14/10 5:59 pm, edited 4/14/10 6:07 pm - Northwood, IA
Hi Gang! Ok first let me apologize for my absense from OH. Life has sure gotten busy and I don't check in near as often as I should.  Now I have a problem, where do I turn? OH of course! I need to pick all of your brains.. especially those long-timers out there...

I had surgery 12/2006, lap RNY.  Lost 190ish pounds, stable at a normal BMI.  Had LBL last year.  Did fine.

I have had chronic elevated total bilirubin since my RNY surgery.  Liver enzymes have been pretty much o****il recently slightly elevated per a letter from my physician.  He didn't say how elevated so I can't tell you that for sure.  I am an RN, believe me I want to know but I have to wait to discuss at my f/u appt on May 7th.  Of course my head is spinning.  I know there is a disease called Gilbert's syndrome which is just benign and needs no treatment.  I also know he tested me for an autoimmune liver disease (hepatitis like) and I would think he would have told me in his letter if I had that but who knows.  I would also think if I was positive he would see me sooner than May 7th.  Can you tell my head is spinning with this???

Oh, and I have been cleared with my gall bladder.  Had an ultrasound, no sludge, no stones, no weird bowel movements or abdominal pain.  Asymptomatic in that regard.

Side note, I have been on lipitor in the past before RNY, a couple years.  Maybe that is why?  Also had NASH (fatty liver preop) no longer showing up like that at all now on ultrasound.

Anyone out there have anything similar or could shed some light for me?  Thanks!!!! Appreciate you taking the time to read this long :P

Melissa
Hugs, Melissa 

http://www.onetruemedia.com/shared?p=6166c1bf498224d5a8b93e&skin_id=701&utm_source=otm&utm_medium=text_url

RNY- 12/04/06 with Dr. Matt Glasock

LBL - 4/28/09 with Dr. Rene Recinos


    
vitalady
on 4/14/10 6:03 pm - Puyallup, WA
RNY on 10/05/94
How elevated?

SLIGHTLY elevated seems to be quite common among us. Most of us take milk thistle. I just read an article in a WLS publication (finally!) about it. We've been taking it since 2002.

Do you take dry forms of A, D, E? Or in oil?

Michelle
RNY, distal, 10/5/94 

P.S.  My year + long absence has NOTHING to do with my WLS, or my type of WLS. See my profile.

MelissaF
on 4/14/10 6:06 pm - Northwood, IA
Hi Michelle! I had hope you would chime in!!! Thanks!

No, I have no idea.  The letter he sent was "slightly elevated liver enzymes".  My total bili has been 1.3-1.7ish whenever drawn.  

I take 10,000 units of dry vitamin D daily.  A, E are in my multi that is a chewable bariatric advantage vitamin, that is it.  Nothing in oil as I know we don't absorb.

I know liver enzymes tend to be elevated with us but what about this bilirubin thing if my ducts and gall bladder are clear? Gilbert's syndrome? Usually in Gilberts Liver enzymes are within normal limits.  
Hugs, Melissa 

http://www.onetruemedia.com/shared?p=6166c1bf498224d5a8b93e&skin_id=701&utm_source=otm&utm_medium=text_url

RNY- 12/04/06 with Dr. Matt Glasock

LBL - 4/28/09 with Dr. Rene Recinos


    
vitalady
on 4/14/10 6:21 pm - Puyallup, WA
RNY on 10/05/94
Get your labs and we'll talk.

Hmm, prolly not enough A, D, E, actually. Just reading that other things offset liver issues.

of course, if the numbers are way out there, you need to pursue it medically.

Michelle
RNY, distal, 10/5/94 

P.S.  My year + long absence has NOTHING to do with my WLS, or my type of WLS. See my profile.

MelissaF
on 4/14/10 6:26 pm - Northwood, IA
I will email you when I have numbers.  My vit D level was good in December. As was PTH and serum calcium (the triad).  A and E were not drawn.  The only thing off was total bili at the time.  That is what started this whole thing.  Been looking at gall stones and finally got that ruled out with ultrasound now we are moving on to more liver specific problems.  I have a feeling he is going to want a biopsy. ugh. Thanks so much!  I will be in contact.
Hugs, Melissa 

http://www.onetruemedia.com/shared?p=6166c1bf498224d5a8b93e&skin_id=701&utm_source=otm&utm_medium=text_url

RNY- 12/04/06 with Dr. Matt Glasock

LBL - 4/28/09 with Dr. Rene Recinos


    
vitalady
on 4/14/10 6:32 pm - Puyallup, WA
RNY on 10/05/94
Define: good

OK, duh I read "the thief". LOL

I had a live bx for another reason and i didn't enjoy it all that much. LOL it wasn't miserable but not much fun. Altho the doc who did it referred to me as skinny just about the time the happy juice hit. I went to sleep absolutely delighted! Almost made it worthwhile. LOL

Michelle
RNY, distal, 10/5/94 

P.S.  My year + long absence has NOTHING to do with my WLS, or my type of WLS. See my profile.

spedcon
on 4/14/10 6:12 pm
RNY on 05/05/09 with
We do? We take Milk Thistle? Why didn't you all tell me? I'm very concerned about my liver too...it had cirrhosis prior to surgery but my levels have been fine since but I'm early out. Hope it's ok Melissa!      Connie
vitalady
on 4/14/10 6:26 pm - Puyallup, WA
RNY on 10/05/94
MD's get all upset about it. It's more of a naturopathic thing. I will hint at it. But I can't say definitively that it CURES live issues. Usually, if they are slight, and the MD is running around in circles, you've got some time to maybe trim it with the MT before undergoing a liver bx or something.

Not all herbs actually DO something but now with 8 yrs of history and not just us, I'm standing behind it more and more. It's not medical advice.

Actually, most docs consider herbs to be hocus-pocus. LOL

Michelle
RNY, distal, 10/5/94 

P.S.  My year + long absence has NOTHING to do with my WLS, or my type of WLS. See my profile.

H.a.l.a. B.
on 4/14/10 7:26 pm
RNY on 05/14/08 with
herbs work- they stabilize the system and help regenerate -
When buying herbs - like any other products - make sure you get them from a good source - since herbs are "living" and they got old and loose the potency were quickly. 

BTW - since liver regenerate at night - it is best to take liver herbs before bed. 

I use a lot of Gaia herbs - IMO - they  really have good quality product.  I have been in their fields - they grow most of the herbs locally in US

Check this:
http://www.gaiaherbs.com/product.php?id=38

http://www.umm.edu/altmed/articles/milk-thistle-000266.htm

H.a.l.a RNY 5/14/2008    

Need to bitch?  or Rave?  To find new R&R - 3.0 group..- send a PM -  to get included...

"Failure is not falling down, It is not getting up once you fell..."

 "So pick yourself up, dust yourself off, and start all over again...." 

rebeka C.
on 4/14/10 7:34 pm - SC
RNY on 07/17/06 with
Dang you.  I'm in nursing school & we're covering liver right now!

Bilirubin elevation can be caused by:
(direct)  obstructive jaundice caused by stones or neoplasms, hepatits, cirrhosis of the liver, infectious mononucleosis, liver cancer, Wilson's diesease
(indirect)  erythroblastosis fetalis, sickle cell, transfusion rxn, hemolytic anemias, pernicious anemia, malartia, septicemia, CHF, decompensated cirrhosis

drugs that may elevate bilirubin:  antibiotics, sulfonamides, diuretics, isoniazid, Valuim, narcotics, barbituaties, flurazepam, Indocin, Aldomet, Pronestyl, steroids, oral contraceptives, Orinase, vitamans A C & K

Antibiotics can raise ALT & AST, so can narcotics.  I have no idea what meds you're on, but that's it in a nutshell.

(This is per "Handbook of Laboratory & Diagnostic Tests with Nursing Implications" by Joyce LeFever kee)  Hope that helps!
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rbb825
on 4/14/10 7:37 pm - Suffern, NY
Elevated total bilirubin can be caused by a few things - viral hepatitis, infectious mononucleosis, reaction to certain medications, obstructive jaundice due to bile regurgitation, hemolitic jaundice due to recent blood transfusion or pernicious anemia.

Gilberts is due to high levels of indirect unconjugated bilirium levels not total bilirium levels.

 

bubbylucy
on 4/15/10 5:42 am - Raleigh, NC
I am also an RN, isn't it amayzing how bad we do at taking care of oursleves lol. I had elevated liver enzymes and my bilirubin was so elevated my surgeon asked if I looked jaundiced yet. Mine was 4.9. I am only 4 months out but my liver specialist is happy as my enzymes have returned to normal and my bilirubin is just 1.7 I think. He seems to believe it was steratohepatitis (I think this is how it is spelled). This may be in your case even though you are so much further in your journey. I also saw about Gilberts Disease. I think id your bilirubin stays under 2 and the AST and AGT look OK that might be it. I think our livers are definitly affected not only by our weight but by the dramatic weight loss.
Hope all goes well
Audra

  

MelissaF
on 4/15/10 8:46 am - Northwood, IA
Thanks to all of you for your input, I really appreciate you taking the time.  I am anxiously waiting to know more. 
Hugs, Melissa 

http://www.onetruemedia.com/shared?p=6166c1bf498224d5a8b93e&skin_id=701&utm_source=otm&utm_medium=text_url

RNY- 12/04/06 with Dr. Matt Glasock

LBL - 4/28/09 with Dr. Rene Recinos