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What causes elevated liver enzyme issue and lower back back ache?

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Practicing since : 2007
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Situation: I was just told I had elevated liver enzymes after a blood test. I originally complained of pain under my right rib cage, as well as a pain in my lower right side of my back. I also feel fatigued and weak at times, but it hits me hardest after I eat, usually. I'm 39 years old, male, and several years back, had Papillary Thyroid Cancer, which my thyroid was successfully removed-to the point where my endocrinologist didn't feel as though we'd even have to do any radiation therapy, but I do take 175mcg of Synthroid daily. Also, I would like to mention that a while ago, I did have bouts with bloody stools, although currently I don't have any issue with that. It went away on its own. I do, however, always seem to have soft, loose, stools, and I have to defecate at least 4-5 times on an average day. I am a pretty big guy (about 255lbs and 6'1" large diet isn't the best, and I do drink alcohol-3-4 drinks, maybe 3 nights a week. My question is, based on the additional info I gave you, what would be your best idea of what is wrong with me regarding the elevated liver enzyme issue and pain in my side and lower back?
Posted Tue, 31 Dec 2013 in Liver and Gall Bladder
Answered by Dr. Jorge Brenes-Salazar 23 minutes later
Brief Answer: Rule out hepatitis Detailed Answer: Dear XXXXXXX Thanks for the query. With symptoms of discrete right upper quadrant pain and elevated liver enzymes, it is likely that it is related to liver inflammation, the cause is not clear and there are several possibilities. First, infections need to be ruled out, particularly Hepatitis B and C. Second, all liver offending medications, particularly acetaminophen, should be discontinued. Third, alcohol has to be discontinued, as it inflammes the liver. Fourth, the most common cause of elevated liver enzymes in a middle aged adult is non alcoholic steatohepatitis, or fatty liver infltration, which is a consequence of bad eating habits, lack of exercise and developing overweight or obesity. A liver ultrasound can be quite useful to see if there is fat deposited in the liver. If fatty liver seems to be the cause, then abstaining from all liver toxins, regular exercise and weight loss of around 8-10% of total body weight are the keys to success; serial liver tests should be followed. Vitamin E supplementation is also useful if fatty liver is the cause. Hope this helps, wish you the best, Dr Brenes-Salazar MD Mayo Clinic
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