Question: Hi, I went in last Tuesday (5/6) to have a checkup with my primary care doctor because I have had some itching on my hands, feet, and even in my urethra. The itching is not severe, but it is annoying and started fairly recently (5/3).

I should add that I was quite sick the week of 4/27 to 5/3. I think it was a cold, but I also had some allergy symptoms mixed in. I was taking ibuprofen (every day), Cold-Eeze (zinc lozenges, 5 per day), and Claritin (every other day). I had also been taking a bunch of supplements recommended to me by my naturopathic doctor, and I had been taking them daily since about 04/12, ~1 month.

I had a blood test done last Tuesday and it came back with elevated AST, ALT, and ALP levels. My primary care doctor asked me to go to urgent care to have the tests redone on Thursday, so I did that. They came back elevated again:

AST = 234, standard range: 15-56 U/L
ALT = 625, standard range: 15-65 U/L
ALP = 209, standard range: 39-117 U/L
Bilirubin Total = 2.0, standard: 0.0-1.0 mg/dL
Bilirubin Conjugated = 0.2, standard: 0.0-0.3 mg/dL

As mentioned above, I have been taking a lot of supplements over the past month that were recommended to me by a naturopathic doctor, including a liver detox vitamin that contains: Burdock root (300 mg), Dandelion root (300 mg), Milk thistle seed extract (80% silymarin)     (100 mg), Celandine leaf (100     mg), Fringe tree bark (100     mg), Beet root (100 mg), Other ingredients: NP capsule (pullulan and water), cellulose, silicon dioxide, and L-leucine.

Both my primary care doctor and my urgent care attending physician believe that this liver detox "vitamin" above is the culprit. I have stopped taking all supplements and just try to watch my diet, eat healthier, drink lots of water, etc. I have no symptoms other than the itching and occasional sneezing. I have generally very good energy, feel strong, no jaundice, etc.

My questions are:

Are these vitamins the culprit? Is the damage done reversible and when should I go back to check to see if the supplements are working their way out of my liver? Again, I've been taking them for about a month.

Next, is the itching related to all of this, particularly the itching in my urethra? It is most annoying and pronounced after ejaculation. All my blood/urine tests came back negative for hepatitis, UTI, and most other major causes.

Please let me know your thoughts as well as how I should proceed from here. Thank you.

Thank you, Dr. Klerida.

As mentioned previously, I have stopped taking the supplements as of last Wednesday (5/7). I have not had jaundice, bleeding, or any other symptoms that would indicate that my condition has gotten more severe, but I still have itching generally across my body (not severe), and particularly my hands and my feet. If the itching is related to the acute non-viral hepatitis, when should I expect these symptoms to subside? And how long should I wait before I go back for another blood test?

As for the urethral infection, my itching only gets annoying after an ejaculation, but never otherwise (I don't even know it's there when I urinate or just hang around). Also, about a week ago, I could not even think about sex without feeling nauseous, whereas I have begun to feel arousal again. Additionally, my urine analysis exam came back clean. Any thoughts on what this could be? I will attempt to attach my results as well.

Thank you again for your help, Dr.