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Elevated Liver Enzymes & Low Thyroid

gbsinsatx
on 1/13/12 7:14 pm - San Antonio, TX

I have been diagnosed with elevated liver enzymes and low thyroid (Hypothyroid) as of September 2011. 

 

I had to go off of Methotrexate for Rheumatoid Arthritis and Depakote for Bi-Polar 1 Disorder. I was put on Armor Thyroid for the Hypothyroidism. 

 

I still have not seen improvement so now I am waiting for insurance approval to see a specialist. 

 

Has anyone else experienced this since having RNY? I had RNY in March 2010. Can this be a result of RNY in some patients or is it totally unrelated? Thanks in advance for any input I may receive! 

Age at RNY: 55, Height: 5'3.5", Consultation Weight: 331-12/1/2009, Super Morbidly Obese BMI 56.8, RNY Surgery Weight: 281-3/22/2010, Goal Weight Reached: 141-6/23/2011, Lowest Weight: 126-12/11/2011

Current Age: 60, Current Weight: 134-11/1/2014Normal BMI 23.4, Relative Risk from ABSI of 0.7, Total Weight Loss Maintained: 197 Pounds, Measurements: 36D Bust, 28" Waist, 38" Hips.  

                                      

Sharyn S.
on 1/13/12 8:37 pm - Bastrop, TX
RNY on 08/19/04 with
*sigh*

This question gets answered several times a week, if not daily.  The vast majority of people who have had WLS experience elevated liver enzymes, especially during the rapid weight loss phase.  Fat is metabolized by the liver.  They usually return to normal range a short period after weight loss stops. 

Low thyroid has nothing to do with WLS and affects many women after the age of 35 or so.

Sharyn, RN

RIP, MOM ~ 5/31/1944 - 5/11/2010
RIP, DADDY ~ 9/2/1934 - 1/25/2012

hlacy
on 1/13/12 9:13 pm, edited 1/13/12 9:14 pm - Chandler, AZ
RNY on 08/17/11 with
Hi Shayrn,

gbsinsatx
 is almost two years out; would she still be experiencing the phase you describe? From her ticker info she is in maintenance now. Could it possibly be the result of the meds she was on? I recall that elevated liver enzymes can result from taking depakote. I am not familiar with the other medication.
"Keep a green tree in your heart and perhaps a singing bird will come"           

gbsinsatx
on 1/14/12 3:18 am, edited 1/14/12 3:20 am - San Antonio, TX
Hello Sharyn,
While I appreciate your reply, I am almost 2 years out and developed these 2 issues. And yes, I have seen your reply to similar questions regading elevated liver enzymes. I am looking to see if anyone else has experienced both of these issues together, about the same time after RNY, as a complication down the road. Respectfully, I thank you for your reply.
*sigh*

Age at RNY: 55, Height: 5'3.5", Consultation Weight: 331-12/1/2009, Super Morbidly Obese BMI 56.8, RNY Surgery Weight: 281-3/22/2010, Goal Weight Reached: 141-6/23/2011, Lowest Weight: 126-12/11/2011

Current Age: 60, Current Weight: 134-11/1/2014Normal BMI 23.4, Relative Risk from ABSI of 0.7, Total Weight Loss Maintained: 197 Pounds, Measurements: 36D Bust, 28" Waist, 38" Hips.  

                                      

Sharyn S.
on 1/14/12 3:37 am - Bastrop, TX
RNY on 08/19/04 with
Sorry for the snarkiness.  I didn't notice that you were 2 years post-op.  Methotrexate is notoriously hard on the liver.  I presume you were being monitored every three months while on that med???

Do you have RA, Lupus, MS, or some other autoimmune disease???  There are other medications that are effective.

FROM THE MAYO CLINIC:

http://www.mayoclinic.com/health/rheumatoid-arthritis/DS00020/DSECTION=treatments-and-drugs

  • NSAIDs. Nonsteroidal anti-inflammatory drugs (NSAIDs) can relieve pain and reduce inflammation. Over-the-counter NSAIDs include ibuprofen (Advil, Motrin, others) and naproxen (Aleve). Stronger NSAIDs are available by prescription. Side effects may include ringing in your ears, stomach irritation, heart problems and liver and kidney damage.
  •  
  • Steroids. Corticosteroid medications, such as prednisone, reduce inflammation and pain and slow joint damage. Side effects may include thinning of bones, cataracts, weight gain and diabetes. Doctors often prescribe a corticosteroid to relieve acute symptoms, with the goal of gradually tapering off the medication.
  •  
  • Disease-modifying antirheumatic drugs (DMARDs). These drugs can slow the progression of rheumatoid arthritis and save the joints and other tissues from permanent damage. Common DMARDs include methotrexate (Trexall), leflunomide (Arava), hydroxychloroquine (Plaquenil), sulfasalazine (Azulfidine) and minocycline (Dynacin, Minocin, others). Side effects vary but may include liver damage, bone marrow suppression and severe lung infections.
  •  
  • Immunosuppressants. These medications act to tame your immune system, which is out of control in rheumatoid arthritis. Examples include azathioprine (Imuran, Azasan), cyclosporine (Neoral, Sandimmune, Gengraf) and cyclophosphamide (Cytoxan). These medications can increase your susceptibility to infection.
  •  
  • TNF-alpha inhibitors. Tumor necrosis factor-alpha (TNF-alpha) is an inflammatory substance produced by your body. TNF-alpha inhibitors can help reduce pain, morning stiffness, and tender or swollen joints. Examples include etanercept (Enbrel), infliximab (Remicade), adalimumab (Humira), golimumab (Simponi) and certolizumab (Cimzia). Potential side effects include increased risk of serious infections, congestive heart failure and certain cancers.
  •  
  •  
Other drugs. Several other rheumatoid arthritis drugs target a variety of processes involved with inflammation in your body. These drugs include anakinra (Kineret), abatacept (Orencia), rituximab (Rituxan) and tocilizumab (Actemra). Side effects vary but may include itching, severe abdominal pain, headache, runny nose or sore throat.

Sharyn, RN

RIP, MOM ~ 5/31/1944 - 5/11/2010
RIP, DADDY ~ 9/2/1934 - 1/25/2012

gbsinsatx
on 1/14/12 3:47 am - San Antonio, TX
Thanks for your reply.
I have Rheumatoid Arthritis.
I am still on Plaquenil and also take Cimzia by injection for RA.
I was on Methotrexate for 3 years and Depakote for 7 years. I had my blood tested every 2 months without incident until recently.
This why I am baffled by this turn in events 

Age at RNY: 55, Height: 5'3.5", Consultation Weight: 331-12/1/2009, Super Morbidly Obese BMI 56.8, RNY Surgery Weight: 281-3/22/2010, Goal Weight Reached: 141-6/23/2011, Lowest Weight: 126-12/11/2011

Current Age: 60, Current Weight: 134-11/1/2014Normal BMI 23.4, Relative Risk from ABSI of 0.7, Total Weight Loss Maintained: 197 Pounds, Measurements: 36D Bust, 28" Waist, 38" Hips.  

                                      

Sharyn S.
on 1/14/12 8:43 pm - Bastrop, TX
RNY on 08/19/04 with

The effect of these drugs are cumulative.  So, if you're just now having issues, after a 3 year run, you've done pretty good.  Your rheumatologist will be able to recommend another of the above medications.  My partner has RA and took methotrexate for a few months, but didn't tolerate it well.  She now takes leflunomide, with good results.  As you know, it is trial and error with these autoimmune diseases.  Good luck.

Sharyn, RN

RIP, MOM ~ 5/31/1944 - 5/11/2010
RIP, DADDY ~ 9/2/1934 - 1/25/2012

gbsinsatx
on 2/28/12 6:28 am - San Antonio, TX

Hi! I was diagnosed with Autoimmune Hepatitis. I am now scheduled for a liver biopsy next week to see what stage I am in to determine the best course of treatment needed. I am seeing a Hepatologist. Besides my immune system attacking my joints and thyroid, now it’s my liver. Ah, the joys of growing older...

Age at RNY: 55, Height: 5'3.5", Consultation Weight: 331-12/1/2009, Super Morbidly Obese BMI 56.8, RNY Surgery Weight: 281-3/22/2010, Goal Weight Reached: 141-6/23/2011, Lowest Weight: 126-12/11/2011

Current Age: 60, Current Weight: 134-11/1/2014Normal BMI 23.4, Relative Risk from ABSI of 0.7, Total Weight Loss Maintained: 197 Pounds, Measurements: 36D Bust, 28" Waist, 38" Hips.