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Epileptic. On Dilantin. Having high levels of liver parameters. On good diet, exercise. Reason?

I am 48 years old, female and healthy. I am epileptic and take 200 mg of Dilantin daily. I am active - I live at an altitude 9000 ft & I run a couple miles 2-4 times a week. I work long hours (desk job). I try to eat organic whenever possible, and I eat what I believe is a well-balanced diet of fruits & veggies. And I do not drink alcohol. In the last 6 months I applied for life insurance & was turned down - they sent me the results of my blood tests - a couple of results stood out to me - Alkaline Phosphatase = 139; GGT = 343; AST 30. What little I ve read on this I understand these particular tests are for my liver function. My neurologist does not think it has anything to do w/ my Dilantin, however I ve been taking this drug since I was 15 years old and it s the only thing I can think of that would cause these wacky high numbers. I had another follow-up ALP & GGT test run just 2 days ago but have not received back the results. I ve changed my diet to include beets and a liver supplement called Livaplex, so I hope this helps. But do you have any additional thoughts? Thank you, Kim
Asked On : Mon, 11 Mar 2013
Answers:  1 Views:  57
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Gastroenterologist 's  Response
Hello! Thanks for putting your query in HCM. I am a Gastroenterologist (DM).

Derranged LFT may be due to dilantin or may be due to some other causes so I will advise to see for other causes for derranged LFT and if it is not there then you may have to replace dilantin with other least hepatotoxic antiepileptic.

You should test for:
1.If you are obese or overweight you need to reduce your weight
2.Other common and treatable causes like Hepatitis B and C virus, Serum ceruloplasmin for wilson disease especially if you are young, ANA and SMA for autoimmune disease
3. Lipid profile and Ultrasound abdomen to see for liver echotexture, billiary tract

One thing is little bit confusing why you have taken dilantin for such a longer period of time (33 years!). Usually antiepileptic are given for 3 years if there is no seizure. If there are seizure intermittently on dilantin, then also it has to be replaced. So regarding this I will advise you to discuss with your treating doctor

Also upload the reports of repeat LFT which you have already done.

I hope I have answered your query and this will help you. Remain in touch and get-well soon.
Answered: Tue, 23 Jul 2013
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