Vitamin D Rapid Increase?

I am scheduled for hernia surgery on Feburary 15th so I had my pre op labs.  My liver enzymes came back high so they wanted me to see my PCP.  She ordered another another test to confirm the results and for some reason she ordered another Vitamin D level, even though my results had been normal.  In one week my D level went from 78 to 51!  What would cause such a drop?  
My liver enzymes continued to go up as well.  I have an appointment with my PCP this Thursday and I'm sure she will order more tests but does anyone have any ideas?  Could this be why I have been feeling so lousy lately?
I have posted the results for the last several tests.  I hope they come out right.

 

VITAMIN D, 25-HYDROXY - HISTORICAL RESULTS

 

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Component Standard Range 10/14/2010 1/20/2011 7/19/2011 1/13/2012 1/19/2012

VITAMIN D 25 HYDROXY	30-80 ng/mL	42	74	87	78	51

LIVER SET - HISTORICAL RESULTS

 

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Component Standard Range 10/14/2010 1/20/2011 3/31/2011 7/19/2011 1/13/2012 1/19/2012

AST(SGOT)	15-41 U/L	22	37	31	42	83	101
ALT (SGPT)	13-48 U/L	34	56	49	68	164	224

Back in 2005 when I had my gallbladder taken out, I was hospitalized a month or two later with high liver enzymes.  I was diagnosed with a non-viral hepatitis........I think they just gave me some antibiotics along with lots of fluids via IV....I remember staying overnight in the hospital and taking a barium drink test.

I am going to try and find my operative report....i can't pm you, are you deactivated, you are on my friend's list.

But also I noticed your current weight is 100 pounds.  is that right?  is that your normal weight for your height, age, etc.?   if not how did you lose more pounds?  have you been ill?.....I have not been on much but you are in my prayers!

My upcoming surgeries this year will be having the tears in my shoulder fixed (rotator cuff) and breast reduction.   I also need to lose about 40 pounds I gained last year due to depression, anxiety, and lack of exercise and good eating.  I turned 40 last year and just felt blah!......I still feel blah but I am trying to count my blessings!

1...............2............3....oh yea the wls was for me to get my health back not look hollywood forever and be able to eat anything I want because I don't dump...yep that is where the 40 pounds came from...

did you get to 100 pounds gradually or a sudden weight loss...I am sorry if I am asking too many questions here but i can't seem to pm you so if you don't feel comfortable answering, you know me I am not offended...love ya!

Wow, your liver enzymes are really high - I would go to a Gastroenterologist  - not a PCP.  I had high liver enzymes for quite some time and my PCP sent me to the gastro doctor = they not only specialize in digestive disorders but also liver diseases.  When I went to my gastro doc, he told me that as long as they were under 100 not to worry since it was at first due to being weight - fatty liver and then post op, due to rapid weight loss.  They eventually leveled off.  they can also increase from PPI use, statin use, tylenol use.  None of these drugs should make then as high as yours unless you are taking massive doses of tylenol - like 4000mg per day or more - that is the limit before they worry about liver damage.

Do you have abdominal pain?  this can be casued by gallbladder disaese, pancreatitis, hepatitis.  You need to have more specific blood work, a sonogram and CT of the abdomen to check out your gallbladder (if you still have one) but can still get a clogged duct and also your pancreas and liver.  Also an MRCP = is an MRI of the bilary system, ducts and all.

The vitamin - not sure why the drop in just one week, think it might have to do with the liver function = some vitamins are processed in the liver.   I know iron and ferritin are.

Good luck.

I do take 2 ES Tylenol most days, never more.
My PCP will probably refer me to a gastro.  That is how it works.
No gallbladder, gone with the first WLS.
Had viral hepatitis as a teen.  Don't know if it's related.
I do have abdominal pain but I think it related to my hernia or possibly an ulcer.  I have a scope scheduled for next week.  The pain seems too high to be liver related.
I have a feeling if my PCP doesn't refer me out she will schedule an ultrasound.

It is possible to also have stones in the bilary tract - the pancreatic ducts and bile ducts all related to your gallbladder even though you don't have one.  YOu can still get gallstones which seems odd but it is possible.  The really true way to find out is an MRCP - an MRI of the billary tree since we can have an ERCP which is very invasive anyway and cause pancreatitis just from the test.  MRCP is the new way to check for stones in the ducts.  I had one a few years back many years after my gallbladder was removed.

Good luck and I hope you can get some answers.  Didn't you say you have Medicare?  IF so, why do you need a referral to go to a specialist?  Medicare you can go anywhere you want whenever you want which is what I love about Medicare.  I go to specialists when I deem necessary and my primary has no problems with that.  The specialists send her reports of what is wrong to keep her up to date.  We had this conversation when I started using her because my last PCP had a problem with me going to specialists and said he would no longer be my doctor. I found her and love her.  She knows that the specialists are more trained than she is no those areas.  She specializes in pulmonary disease on top of being an Internist.

Good luck with your surgery - I have a large hernia but with my history - I have to live with it unless it becomes unbearable or an emergency.  My surgeon and I both agreed on this.

take care
randi

My PCP prefers to refer even though I know I can go without a referral.  I trust her judgment and want to see someone that she works with so that there is no communication problems.  It is just generally how her practice operates.