Elevated Liver Enzymes
Hi everyone. I am a 30 year old male, who has just begun the path to surgical weight loss. I recently found out, that my liver enzymes were quite elevated. A few years back, I was told I had fatty liver disease, and after seeing a gastroenterologist, he believes I have steatohepatitis.
My primary care provider informed me today, that that diagnosis may halt my progression, in getting the RNY.
From what I can read, weight loss is what you do to attempt to reverse this condition.
I was just wondering what any of your experiences may have been with this issue, elevated liver enzymes, and if that affected your ability at all for sugical weight loss.
Thanks
Jason
My primary care provider informed me today, that that diagnosis may halt my progression, in getting the RNY.
From what I can read, weight loss is what you do to attempt to reverse this condition.
I was just wondering what any of your experiences may have been with this issue, elevated liver enzymes, and if that affected your ability at all for sugical weight loss.
Thanks
Jason
I found out I had fatty liver disease 3 days prior to surgery... my doc just said it was typical among obese people... but other than that he didnt act like it was a major deal.. but I cannot tell you what the "number" was and if it makes a difference depending on the range of how bad it is, if they do surgery or not. Hope everything works out for you.
I just did some research online for you and luckily for you, your PCP is wrong. If you type into your browser, "Can I have weight loss surgery with Steatohepatitis? and all the sites that it lead to on my computer said that weight loss surgery are actually a current treatment for the disease. Almost all obese people have a fatty liver with elevated liver enzymes and the liver enzymes actually temporarily get even higher at first due to the rapid weight loss but they go down to normal once you stop losing weight.
Other things that you want to ask yourself that cause elevated liver enzymes, are you on any of the following medications? Cholesterol medications, PPI's (acid reducing medications), tylenol products? or do you drink alcohol? These things can all elevate your liver enzymes. Once you lose your weight, you most likely wont need the cholesterol medication. Unfortunately PPI's are required for atleast 6 months and some surgeons require them for a year or more to prevent reflux and ulcers. In your instance, you might be willing to put up with the reflux which is actually pretty rare after 6 months but the risk of ucers is very serious and you need to supress the acid for that period of time. If you have any pain issues, you can only take tylenol products which in small amounts are probably okay for you but you would need to check it out with your gastro doctor. And finally, alcohol is absolutely not allowed at all for you - none of us should have it for atleast a year.
Another question? Have you lost any significant weight recently preparing for your weight loss surgery? This can really increase your enzymes.
How elevated are they? You might want to consider taking some milk thistle - this is really good at lowering liver enzymes. I am not sure of the dose - you might want to post separately to ask this question.
But, I wouldn't not hesitate to have to surgery due to this problem. In the long run, it will really help you. It may just take a little while to get through the hoops. And you have to be a little more strict than others.
Other things that you want to ask yourself that cause elevated liver enzymes, are you on any of the following medications? Cholesterol medications, PPI's (acid reducing medications), tylenol products? or do you drink alcohol? These things can all elevate your liver enzymes. Once you lose your weight, you most likely wont need the cholesterol medication. Unfortunately PPI's are required for atleast 6 months and some surgeons require them for a year or more to prevent reflux and ulcers. In your instance, you might be willing to put up with the reflux which is actually pretty rare after 6 months but the risk of ucers is very serious and you need to supress the acid for that period of time. If you have any pain issues, you can only take tylenol products which in small amounts are probably okay for you but you would need to check it out with your gastro doctor. And finally, alcohol is absolutely not allowed at all for you - none of us should have it for atleast a year.
Another question? Have you lost any significant weight recently preparing for your weight loss surgery? This can really increase your enzymes.
How elevated are they? You might want to consider taking some milk thistle - this is really good at lowering liver enzymes. I am not sure of the dose - you might want to post separately to ask this question.
But, I wouldn't not hesitate to have to surgery due to this problem. In the long run, it will really help you. It may just take a little while to get through the hoops. And you have to be a little more strict than others.
Thank you!
Luckily I do not drink any alcohol. Thanks for the advise on the milk thistle.
When my Enzymes were checked my AST was 84, and my ALT was 148. The gastroenterologist I was referred to was a real jerk. Walked in the room didn't introduce himself, shake my hand, just sat down, and said to me "How old are you, you look young." I replied "30" he said "Why did you let yourself get so obese." At first I didn't know how to respond. I told him that it wasn't a conscious decision I made one day, deciding I want to be obese.
I told him that I work as a nurse, so I do have a general knowledge of what the numbers could mean. He shot me down like I had no education, and the appt was just awful. The result was I was to go on a 1600 calorie diet, low carbs, no saturated fat. I am also a Type II Diabetic, and my Hgb A1C had come back at 9.8, and also had a very high triglyceride level. Obviously my diabetes was under horrible control.
I think he felt like as a nurse, he thought I should have done better to my body, and he could very well have a point. Once I got the Diabetes however is when the weight really started to pack on.
Anyway back to the Liver- I started on the diet 2 weeks ago, I have lost 4 lbs, and have finally got a grasp on my blood sugars, and with insulin, I have them under very tight control.
I'm set up for a CT with contrast on Tuesday of next week, he also drew probably a thousand dollars of labs at the appt, checking for autoimmune disorders, etc. Nobody has called me on those results yet.
It is good to know that this problem shouldn't prevent me from surgery. I am just beginning the program, and don't have my education day until August, so I know I have some time to go yet.
I appreciate your research and advice.
Thank you
Luckily I do not drink any alcohol. Thanks for the advise on the milk thistle.
When my Enzymes were checked my AST was 84, and my ALT was 148. The gastroenterologist I was referred to was a real jerk. Walked in the room didn't introduce himself, shake my hand, just sat down, and said to me "How old are you, you look young." I replied "30" he said "Why did you let yourself get so obese." At first I didn't know how to respond. I told him that it wasn't a conscious decision I made one day, deciding I want to be obese.
I told him that I work as a nurse, so I do have a general knowledge of what the numbers could mean. He shot me down like I had no education, and the appt was just awful. The result was I was to go on a 1600 calorie diet, low carbs, no saturated fat. I am also a Type II Diabetic, and my Hgb A1C had come back at 9.8, and also had a very high triglyceride level. Obviously my diabetes was under horrible control.
I think he felt like as a nurse, he thought I should have done better to my body, and he could very well have a point. Once I got the Diabetes however is when the weight really started to pack on.
Anyway back to the Liver- I started on the diet 2 weeks ago, I have lost 4 lbs, and have finally got a grasp on my blood sugars, and with insulin, I have them under very tight control.
I'm set up for a CT with contrast on Tuesday of next week, he also drew probably a thousand dollars of labs at the appt, checking for autoimmune disorders, etc. Nobody has called me on those results yet.
It is good to know that this problem shouldn't prevent me from surgery. I am just beginning the program, and don't have my education day until August, so I know I have some time to go yet.
I appreciate your research and advice.
Thank you
I am so sorry you had a terrible experience with your gastro doctor. It is so important to have a good experience with your doctor. I love my gastro doc. My first set of advise at this point is don't wait for them to call with results. I would call them first thing Tuesday morning and ask for the results. they may make you come back in if they find something or they may give them to you over the phone. Either way, please insist that they give you copies of all the reports. Unfortunately, many times doctors tell us all is normal when we are in fact not or we are borderline and need to be retested in a couple of months and they say nothing. About 10 years ago, I used a Gyn that I hated, so I switched. When I got to my new one that I love, she told me that I had 4 years of abnormal paps and asked me if anything was done about it, since nothing in my chart reflected further testing. I never knew they were abnormal. I was told they were all normal. Thankfully, she did a biopsy and all was fine, just inflamation. So, now I get copies of everthing.
Your AST isn't that high but your ALT is higher than they would like. I know my gastro doctor told me as long as it is under 100, then no further testing was needed. So, he is right in doing the testing he is doing. You might also want to switch to a new gastro doctor once he done since you want to feel comfortable with your doctors. Do you have a good teaching hospital nearby? They tend to have really good specialists that are really trained in all the up to date diseases and treatments.
I am glad that you started your diet and have started to lose weight.
As far as the diabetes is concerned, are you seeing an Endocrinologist? With an HemA1C that high, you need a specialist. A PCP isn't trained to treat someone with diabetes that severe. It is also very dangerous to have an A1C that high, it is show that your blood sugars are dangerously high probably all the time. It should be around 6. I was diagnosed about 6 months before my surgery, so I wasn't that bad - 6.2 at its worst and within 6 months after my surgery I was at 5.4. By 1 year out and almost at goal, I was at 4.9 which is where I remain and I eat sugar. Our bodies change after surgery. An Endocrinologist is also someone good to have since they tend to also treat other things like thyroid which really need to be followed for us post op. If you don't already have thyroid disease now, it is very common to develop hypothyroid within the first year. I am not sure why but it happens. It could just be coincidental that it would have happened anyway - I think it happens more for women than men. They will also help you with your cholesterol and tryglicerides. I know there is a new medication for really high tryglicerides, it starts with an L but can't remember what it is called. They advertise it alot of tv. You might also want to try taking fish oil - that helps cholesterol and tryglicerides.
For your diabetes and it will also help you get used to eating properly post op, it is best to eat 5-6 small meals every 2-3 hours. This helps maintain blood sugar (no dips or surges), increases your metabolism and decreases hunger. Post op, we all drink protein shakes but our tastes change afterwards, so it really isn't good to get too used to them before hand. You can try a few but don't get alot. If you are interested, I can send you a few recipes of homemade ones that are delicious - or atleast I think so.
Good luck with all your tests. Keep me posted and if you have any questions, feel free to PM me
Your AST isn't that high but your ALT is higher than they would like. I know my gastro doctor told me as long as it is under 100, then no further testing was needed. So, he is right in doing the testing he is doing. You might also want to switch to a new gastro doctor once he done since you want to feel comfortable with your doctors. Do you have a good teaching hospital nearby? They tend to have really good specialists that are really trained in all the up to date diseases and treatments.
I am glad that you started your diet and have started to lose weight.
As far as the diabetes is concerned, are you seeing an Endocrinologist? With an HemA1C that high, you need a specialist. A PCP isn't trained to treat someone with diabetes that severe. It is also very dangerous to have an A1C that high, it is show that your blood sugars are dangerously high probably all the time. It should be around 6. I was diagnosed about 6 months before my surgery, so I wasn't that bad - 6.2 at its worst and within 6 months after my surgery I was at 5.4. By 1 year out and almost at goal, I was at 4.9 which is where I remain and I eat sugar. Our bodies change after surgery. An Endocrinologist is also someone good to have since they tend to also treat other things like thyroid which really need to be followed for us post op. If you don't already have thyroid disease now, it is very common to develop hypothyroid within the first year. I am not sure why but it happens. It could just be coincidental that it would have happened anyway - I think it happens more for women than men. They will also help you with your cholesterol and tryglicerides. I know there is a new medication for really high tryglicerides, it starts with an L but can't remember what it is called. They advertise it alot of tv. You might also want to try taking fish oil - that helps cholesterol and tryglicerides.
For your diabetes and it will also help you get used to eating properly post op, it is best to eat 5-6 small meals every 2-3 hours. This helps maintain blood sugar (no dips or surges), increases your metabolism and decreases hunger. Post op, we all drink protein shakes but our tastes change afterwards, so it really isn't good to get too used to them before hand. You can try a few but don't get alot. If you are interested, I can send you a few recipes of homemade ones that are delicious - or atleast I think so.
Good luck with all your tests. Keep me posted and if you have any questions, feel free to PM me
I have the same problem. Elevated enzymes and NASH. No one mentioned a problem having surgery. I am one week post-op - HOWEVER, I turned up jaundice 3 days ago. I think that it is common to have surgery with NASH - as WL is the cure for it. Docs did a bunch of tests - hopefully will get results tomorrow.
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