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Dr. Andrew Rynne

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Having elevated liver enzymes. On prilosec for GERD and simvastatin for high cholesterol. Reason for elevated values?

Answered by
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Dr. Roopa Hiremath

Infectious Diseases Specialist

Practicing since :2002

Answered : 877 Questions

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Posted on Fri, 15 Nov 2013 in Women's Health
Question: I have elevated liver enzymes - alt, ast (initially 5-8x high normal, now at about 2x high normal), alk. phos. (initially 2x high normal and now just slightly above high normal) and ggt (significant elevations at about 10-15x high normal). I was made aware if this after blood work for life insurance, which was declined. Elevations have waxed and waned over the last 6 months, but are still above normal. My PCP has have done ultrasound, ct with contrast, and now my blood is at Mayo for possible PBC (ordered by liver specialist).

Only notable thoughts are that I had a root canal this past week and the endodontist told me it was likely the cause of some jaw pain that I have had for a few months. He said it was pretty bad, although an abscess wasn't noted. Could the tooth problem be the cause of elevated values if an infection were present for this period of time (no tooth pain until the last month)? And, over the course of the last 3 1/2 years I have lost 93 lbs. with diet and exercise. CT said I did not have fatty liver, but the liver specialist disagreed.

History of cancer on one side of my family (all kinds - throat, lung [small plueral spot in lung on ct, noted as insignificant with no f/u needed], stomach, liver, etc.) and heart disease on the other side. My full blood brother has had 4 heart attacks within the last 2 years and he is 52 (I am 51). My uncle had coronary bypass, as did my grandfather, who ultimately passed of CHF. I am not hypertensive since losing the weight, and only known health issues are Thyroid disease [Hashimoto's], migraine [weather/pressure induced], add, and allergies [allergic to dust mites, ragweed, and mold spores]. Drugs taken are Levoxyl, Furosemide, spironolactone, sulfamathoxole (sulfa antibiotic for cystic/nodular acne), gabapentin (small dose at night as a migraine preventative, but depressed my system too much for me to function, so only 300 mg. before bedtime), Prilosec for GERD, and previous Simvastatin for high cholesterol (also familial). PCP took me off the Simvastatin until further determination of cause for elevated liver enzymes [not sure I agree with him here because my last lab values were over 300 total cholesterol, and over 200 LDH, my HDL was (and always is) around 65.

Any thoughts on cause so that I can help move the research in the right direction? I am going broke with the medical expenses .... Celiac and Hepatitis have been ruled out. PCP initially thought it was a biliary anomaly, but ct and mri did not reveal anything out of the ordinary.

Thanks for your help.
KMorris XXXXXXX
doctor
Answered by Dr. Roopa Hiremath 13 hours later
Brief Answer:
Elevated liver enzymes and Hepatitis C

Detailed Answer:
Hi Ms. XXXXXXX
Thanks for choosing health care magic for your query.
I appreciate the details you have provided in your query and the uploaded reports will definitely help us understand your problems better.

Elevated liver enzymes point towards inflammation or infection of liver cells.
Most common causes of liver infection include Hepatitis A, B and C viruses. Non infective causes are alcoholic hepatitis and prolonged use of cholesterol controlling drugs.

Your reports indicate waxing and waning of liver enzymes for a period of 6 months which is typically seen in Hepatitis C cases.
I would like to know the tests you have undergone to rule out infective hepatitis.
Please upload the reports if any.

I am suspecting hepatitis C in your case as it is one of the commonest post transfusion hepatitis through out the world. In many cases the source of infection cannot be traced.
And these patients become positive for antibodies after about 5 months after infection.
Many of them are asymptomatic the only indication being elevated liver enzymes.
These cases progress to chronic stage which is characterized by waxing and waning liver enzymes.

I suggest ELISA test for antiHCV antibodies to rule out Hepatitis C.

I hope I have answered your query satisfactorily.

Please get back if any more clarifications required.

Thanks.
Above answer was peer-reviewed by : Dr. Yogesh D
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