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Is consumption of alcohol while liver is still recovering from elevated ALT recommended?

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General & Family Physician
Practicing since : 2009
Answered : 9400 Questions
Hi! I'm femail, 40 years old that have got elevated ALT because of starting take Valproate. I took it for over 2,5 month and the ALT was normal(0,79) all the time, doctor then raised the dosage to final/end dosage and less then two weeks later I took bloodtest again. My ALT had then been raised to 7,1(Sweden). I stoped taking Valproat right away and three days later ALT was 5,75, three days later again I had 5,09(I think it's around 250(a bit lower)in the way you count it). I'm feeling well, was a little bit tired last week and the week before. The levels had gone up in less then two weeks, so I haven't gone with it for a long time. Do the levels usually decrease faster if they have not been elevated for a long time? How long time do you think it will take? Today I'm purifying the liver with a one day program and I have also start taking Chlorella yesterday, can not take milk thistle because of interaction with the other medicin that I was suppose to change to Valproat. I'm in a quite boring situation. I'm going to celebrate Christmas and new year with my family in India and would really like to take some beer(I do only drink a couple/and only beer if I drink). I hope this is nothing to worry about at that time(not now) as my levels are always normal and when it also seemes like they are going down quite fast. Thank you in advance! Best regards XXXX, Sweden
Posted Wed, 8 Jan 2014 in Liver and Gall Bladder
Answered by Dr. Shoaib Khan 2 hours later
Brief Answer: Yes; 2-6 weeks; avoid alcohol or keep to minimum Detailed Answer: Hello XXXX and welcome. Thank you for writing to us. Well yes, the levels do drop quicker when they have not been elevated for long, and especially quickly if the source of the problem has been removed (as is in your case). The liver usually takes some time to completely recover, but I reckon it should take about 2-6 weeks to normalize at the most. Christmas is just around the corner, and as I should medically advise against the consumption of alcohol while your liver is still recovering, I should say it will be fine if you consume a tad bit of beer, but it would be a sincere request to keep it to the minimum, as this will only hinder your recovery and affect your health. I hope you find my response helpful. Please feel free to write back to me for any further clarifications, I would be more than happy to help. Best wishes.
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Follow-up: Is consumption of alcohol while liver is still recovering from elevated ALT recommended? 7 hours later
Hi again! Can you help me with how to recalculate Swedish ALT levels to International and vise-versa? It should have been great to know how to count if I would like to make a ALT test in India. I nerver got any good explenation why it went this way. Is it because of interaction between primidone and Valproat(enzyme induced) or is just some people alergic against/to Valproate? Does it help to drink much water? What can I do to help the values decrease faster? Is it good to drink acerbic/acetic water? There must be something to do? Medication for it? I have been walkink very fast every working day since I got the bad answer but the other day I read that exercise instead can increase high liver values? I'm really greatfull for all tips. It's not feeling good to go to a foreign country for a long time with this. Thank you once again! Regards XXXX
Answered by Dr. Shoaib Khan 2 hours later
Brief Answer: All queries addressed ma'am Detailed Answer: Hello once again ma'am. ALT/SGPT is calculated around the word in the form of 'units per liter of serum', and the international reference range is between 7-56 U/L (units per liter of serum); whereas the reference range in India is usually an average 4-40 U/L. Based on the above information, if you give me the units by which the ALT/SGPT is calculated in Sweden, I can help you with the conversion method and technique. But usually, the unit is internationally accepted. I am sorry for not providing the explanation for this query in my last response, but all medications pass through the liver and so some/most of them can affect the normal functioning of the liver. Although in my opinion, the cause for your raised ALT/SGPT is the valproate, as a common documented side effect of this medication is elevation of liver parameters and albumin in about 44 % of patients using this medication. For the same reason, this particular medication is contraindicated in patients with liver dysfunction. Yes, drinking water will help reduce the concentration of the medication in your system, and help early excretion of the drug from your body. Although exercise does not really help much by either improving or worsening of the liver function. There are medications called hepatoprotectors that you can take, which may be available only with a doctors prescription in Sweden, but is available over the counter in India (eg. LIV 52 which is a herbal hepatoprotector). I understand your anxiety and am here to help. Do not worry, your levels are not raised by much, and shall soon normalize ma'am. In the meantime keep yourself hydrated and check if you can initiate a hepatoprotector after discussing the same with your doctor. I hope you found my response both helpful and informative, please feel free to write back to me for any further clarifications. Best wishes.
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Follow-up: Is consumption of alcohol while liver is still recovering from elevated ALT recommended? 1 hour later
Thank you so much for your answer! As I can see, we use catalytic activity to scale the SI-unit(cat = mol/s) in Sweden. Dosen't tell me much. But maybe you do understand. The International standard use non catalytic SI unit and scales enzymes/L bloodplasma I think? The range of the later one is in Sweden 4-45, that because of that Sweden did raise the upper normal level because to many people had higher than normal. So almost everyone had to high levels.. Otherwise I now have the range usel in India and that's god enough for me:) I can buy Liv52 on the internet on Swedish sites. I have been looking at it segertal times. But now I'm soon leaving to India and hopefully kan buy it there without prescription? Than you once again! XXXX
Answered by Dr. Shoaib Khan 25 minutes later
Brief Answer: So range is almost same; yes without prescription Detailed Answer: Hi XXXX Yes, so Sweden follows the same range, and so you should not have a problem with comparison in India or any other country as well. Internationally accepted unit of measuring has already been provided to you. And the range in India is not very different from that in Sweden (i.e. India 4-40 and Sweden 4-45). Yes LIV 52 will be available in any medical store over-the-counter (i.e. without a prescription). Wishing you good health and nothing less. Please feel free to write back to me anytime regarding anything, I would be more than happy to help you. Best wishes and a safe journey.
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Follow-up: Is consumption of alcohol while liver is still recovering from elevated ALT recommended? 1 hour later
Thanks a LOT! i have one last question that I forgot to ask you about. What do you think of taking Milk thistle agains elevated ALT? Do you have any experience? And as I wrote, I have it at home but did read at a site that there was an interaction with Primidone(increased metabolism of primidone(fenobarbital). Do you really think it's anything to worry about? I would really like to use them, if I can. Thanks for all god advice, it has really been helpful to "talk" to you. I have been feeling very alone in this issue and it's. Wish you a XXXXXXX Christmas and a Happy New Year! - and all the best. XXXX
Answered by Dr. Shoaib Khan 9 minutes later
Brief Answer: Milk thistle helps promote liver health Detailed Answer: Hello once again XXXX And thank you so much for the kind words, appreciation from my patients is all I really seek. Well milk thistle has shown to improve the health of the liver in patients who are on phenobarbitals, and even on those who are not on any medication and just need a little help with their liver health. I would ask you to go ahead with the milk thistle, as this may also mildly help by contributing to improved health of your liver. I wish you lots of luck, a safe travel, and my best and most sincere Christmas and New Year wishes. Take care and wishing you a healthy life hereafter.
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Follow-up: Is consumption of alcohol while liver is still recovering from elevated ALT recommended? 16 hours later
I'm Reading and reading...and now found out that Acetylcystein is very good for the liver to protect and normalize it. Is this true? I have a lot of Acetylcystein at home. My P doc wrote it out to me in the summer against depression. I took 250mg x 5 twice a day. Today I'm going to take bloodtest again to check ALT. Will get the answer in the afternoon. Sorry for writing again :( Sincere XXXX
Answered by Dr. Shoaib Khan 40 minutes later
Brief Answer: Yes, it can help, but careful administration Detailed Answer: Hello once again XXXX Please do not apologise at all, as I have mentioned earlier please never hesitate to write to me, no matter what the query. Yes, acetylcysteine does help to a certain extent but as with all other hepatoproctectors, this is going to have only a mild effect on the health of the liver. But I am unsure whether we should prescribe the same dosage you were previously taking. As you were prescribed this medication to tackle depression as well, it would be a little tricky to initiate this medication for you, and if we do, we may have to make alterations to the dose. For this,it would be best to revisit your doctor. Also, if you experience any of the common side effects like nasal congestion, flu-like symptoms, headaches, runny nose, etc; do report them to your doctor. I hope you find my response helpful XXXX. Please feel free to write back to me anytime, for any queries, please do not hesitate. I am here to help you, and always available to do so. Best wishes.
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Follow-up: Is consumption of alcohol while liver is still recovering from elevated ALT recommended? 28 minutes later
I Do not take Acetylcystein now. Stopped taking it in the end of september. Just Telling you if you thought that I was taking it now, I don't XXXX
Answered by Dr. Shoaib Khan 1 hour later
Brief Answer: I understand XXXX Detailed Answer: Hi XXXX No, I understood that you are currently not on the medication. But as it was advised for another condition, taking it now for improved liver health should not interfere with the previous condition or cause an imbalance of any kind. That is all that concerns me, otherwise it would have been a helpful medication. Hope this is vlear XXXX. Do not worry, and keep me informed about the latest ALT/AST level. We shall decide our plan of action after that. Best of luck.
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Follow-up: Is consumption of alcohol while liver is still recovering from elevated ALT recommended? 4 hours later
Hi again! :) Here comes my bloodtest resaults: 4 dec ALT was 284. Took my last dosage if Valproat the 6 of december. 9 dec ALT was 230 12 dec ALT was 204 And Today 16 dec my ALT was 160 So if I start counting dåfrom the day After I took may last dosage with Valproate ALT has gone down 124 in nine day. What I don't understand is why it's sometimes go down much fast another time slower? What Do you think? I will take one more bloodtest on tuesday before I'm going India, leaving at friday. Best regards! XXXX
Follow-up: Is consumption of alcohol while liver is still recovering from elevated ALT recommended? 35 minutes later
Edit: By the way, in Sweden you can buy Acetylcystein without a recipie :)
Answered by Dr. Shoaib Khan 7 minutes later
Brief Answer: Various factors influence the liver profile Detailed Answer: Hi XXXX This is great news. Well the answer to your question is that there are many factors influencing the normalization of your liver profile. Life lifestyle, diet, fluid intake, enzyme production, metabolism of the liver, etc. These factors are all random, and thus randomly influence your liver function, which is why the different drop in levels at a different time. Either way, this is all good news, and you should continue whatever you were doing, so that the level continues to drop at a rapid rate. Do keep me informed about the report on Tuesday, and if you wish you could get tested in India as well. Wishing you nothing but good health and a safe journey. By the way, where in India are you traveling to? Just curious. And yes, acetylcysteine is available over-the-counter, as it is not considered a strong influence on ones health, and cannot cause any serious dependence issues or any serious harm, this puts it in the over-the-counter medication category. Take care XXXX, and praise the lord as your recovery is going very well.
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Follow-up: Is consumption of alcohol while liver is still recovering from elevated ALT recommended? 2 hours later
Great! My neurologist just called me, she had seen that I had been taken a bloodtest today. She was so happy! :) thinking it was SO good resaults. The ASAT had also gone down to the half(much lower than ALT, I don't know much about ASAT). We are going to Mumbai and Goa(Candolim, Baga and Palolem). Going to stay in Mumbai just for three nights. Some shopping and culture. I'm praying and will also keep doing it! Thank you so very much! If you knew how tankfull I am for your answers!! Take care! XXXX
Answered by Dr. Shoaib Khan 6 minutes later
Brief Answer: Great news!!!! Detailed Answer: Hi XXXX Sounds like an amazing trip. I was down in Goa when I last visited India, my fiance is in Mumbai right now, doing some shopping as well. Although, I am originally from Bangalore, if you ever decide to visit, let me know, I shall get family and friends to show you around. Please don't mention it, it was completely my pleasure to be of assistance. Also great news to learn about your AST levels as well. Wishing you nothing but good health. Keep safe and god bless.
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Follow-up: Is consumption of alcohol while liver is still recovering from elevated ALT recommended? 14 minutes later
Very kind of you!! I will remember :) it's always more intresting to be with the "locals" than with the tourists. Learn the culture, the people and so on. We use to hang a lot with the people from the country we visit, i gives a lot! Of course I will not mention it! Fredly if you! Thank you ones again for everything!! I let you now how the bloodtest went on tuesday. Have a great time!
Answered by Dr. Shoaib Khan 32 minutes later
Brief Answer: Best regards Detailed Answer: Surely XXXX Although I don't live in India, I have friends all around. Please do not ever hesitate to ask me for any assistance. Do keep me posted about the blood tests and wishing you lots of luck. Pass my love to my country. :) Best wishes.
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Follow-up: Is consumption of alcohol while liver is still recovering from elevated ALT recommended? 2 days later
Hi! :) Today I'm not happy with the resault:( from 160 to 148 in three days :( Tomorrow I'm leaving to India. Do you think that I shall continue with Milk Thistle and Chlorella? As you alredy know I'm taking a anticonvulant with the active ingredient Primidone that are mostly methabolise to phenobarbital in the liver. So just wonder if it's ok to take Milk thistle. How long will i usually take until they do any different/the work? I told you that I had ALT 284 the 4:th of december. I didn't, she had told me wrong. I had 306. I have been very stressad this week, not feeling well because of that and had been sad now and then. I'm probably most stressed over the ALT. Can stress make the process to slow down? I was really hoping to get a huge different in my ALT today. We "talked" aboute drinking alkohol in the beginning. I have now read that there are actually very few people that get high ALT levels of alcohol. Around 10-25%. As you probably already has understand, I like to drink some beer(not working days, nerver ever). And I am going to take some in the evenings when I'm away. I am also going to take ALT tests in India, of course. I usually drink tons of water when it's warm. I eat as you shall and I am swimming a lot. What more can I do to make this as good as possible! Tips/advice? Yes I Do know that alkohol is no good but I am going on a vacation/holiday. I did spoke to a nurse about my "can not drink alcohol" issue. I told her that going on holiday with not the posibility to take any alcohol was for me like not have a holiday. She told me: Of course you shall drink, but drink with responsibility. Follow your heart, go with your feelings! And then the told me: of course, your ALT will/can go up a bit. But when you are comming home again it will go down in some weeks, so Wait for a while with taking bloodtest. I'm not an alcoholic, and my liver has always worked fine before. To have rased ALT levels for a while, can it really be SO dangerous? I mean, look at alcoholics that goes with superhigh ALT almost all their life and feeling quite well... I think it's ruff and sad to hear so many frightening words about it. Can you understand me in my situation? If I instead should had been at home, I had not bother about it at all. Hope everything is really find with you! Best regards XXXX
Answered by Dr. Shoaib Khan 32 minutes later
Brief Answer: Please do not worry at all; drink limited amounts Detailed Answer: Hi XXXX. Do not worry XXXX, the last part of the normalization takes some time, do not worry about it at all. Please continue with the milk thistle and also purchase the LIV 52 syrup from India. I am sure everything will be fine. Yes ma'am, you can continue with the milk thistle. The Milk thistle does not contribute by a large amount, so it may only contribute mildly, mostly resulting in the natural amount of time to reach normal levels. Stress usually does not contribute to this, so do not worry ma'am. I am sure your levels will soon reach a within normal level. As for the alcohol, please try to consume as less as possible, it may interfere with the regularization/normalization process, but should not make the health of the liver worse; so my previous advise still stands. You may consume beer, but try to keep it to a minimum level. Please stop stressing ma'am, the liver and lungs are two organs that take a lot of time to heal, so please do not stress about this. No ma'am, your ALT levels are not so high as to cause any damage to your liver. And more over, they are slowly regularizing/normalizing so the liver would not have suffered any damage. I can understand your stress ma'am, but please do not worry about it, as it is not so serious and nothing to worry about. The levels will soon normalize ma'am, stop worrying about it and get as much rest and relaxation as possible. Best wishes and safe journey.
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Follow-up: Is consumption of alcohol while liver is still recovering from elevated ALT recommended? 3 hours later
Thank you for all!!! I'm very greatfull for all good answers! It has been given me so much! I will leav the thread open in case of if I have something to ask you aboute when I'm away. Have a lovely Christmas and New Year! :)) I'm so glad that I found just you.
Answered by Dr. Shoaib Khan 6 hours later
Brief Answer: Just enjoy your vacation, forget about the rest Detailed Answer: Hi XXXX. You are a gem of a person yourself. Its who and how you are that makes this so easy for me, that I hardly need to try. I cant ask for more from God than satisfaction, happiness and good health for all my patients. Wishing you a lovely and memorable vacation. Stay safe and stress free, leave that to me okay? God bless. Lots of love and best wishes to you too.
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