Brief Answer: Kindly provide the reports of your lab tests Detailed Answer: Hi, Your transaminases are really high. Before running into final conclusions, can you please upload your test results? That could help me assist you further. Apart the viruses that resulted negative, there are many other factors causing high TA including; - other viruses (citomegalovirus, Epstein Barre) - medications you regularly use - coffee is not a cause because it is rich in antioxidants and is favorably influencing the liver - carbonated drinks do not cause it unless their ingredients (saccharin, etc.) or other colorings or preservatives might cause it. Looking forward to have your lab results! Thank you! Dr.Klerida

---

Brief Answer: Causes to very high transaminases... Detailed Answer: Hi back, Thank you for following up. I have seen the reports you uploaded and I have noticed that your transaminases were really high. However, I did not see any ultrasound report. It is a must to have abdominal echo report because your test results (high TA and high alkaline phosphatase) were really high, indicating for possible liver and gallbladder problems. I usually hospitalize patients with such high TA or can ask to repeat the tests every 2-3 days to prevent fulminant hepatitis. The very first thing is to determine what is causing such high TA to you: - have you been using any drug recently (e.g. paracetamol in high doses)? - apart using coffee, do you drink tea or other drink on daily basis? - have you been smoking Shisha (Middle East smoking pipe)? For the time being, I'd advise to: - conduct a healthy diet regimen - start taking a multivitamin supplement (vit.b1,b6 and c) Looking forward to have the requested data! Thank you! Dr.Klerida

---

Brief Answer: Further determinative lab tests advised... Detailed Answer: Hi again, Thank you for following up. I have read your ultrasound report and indeed, you have an enlarged liver. Fortunately, there is no liquid in the abdomen. As long as you are mentioning to have be hep.A,B,C negative, I'd suggest to run other tests for : - autoimmune disease - Anti-nuclear antibodies (ANA) - Anti-mitochondrial antibodies (AMA) - Immunoelectrophoresis - Ceruloplasmin and Cupremia to exclude XXXXXXX Disease - Ferritinemia and sideremia for iron-overload - HIV All these tests are necessary to understand why your liver is enlarged with very high transaminases. Depending on the results, further specific treatment would be prescribed. Dr.Klerida

---

Brief Answer: Kindly provide the requested data.... Detailed Answer: Hi Al Balushi, Thank you for following up. I can admit that your case is really delicate and difficult at the same time. I'd like to know other data of yours: - what kind of job are you doing? Is it related to exposure to any chemicals? - is the place you live with high rates of air-pollution? - have you experienced any severe hypotension recently (passing out/fainting)? - have you been suffering of any rheumatological disease recently? - are you sure about the purity of the coffee you have been using for long time? I also suggest to discuss with your GI specialist to do hepatic biopsy and to do a further consultation with rheumatologist. Some types of rheumatological diseases are associated with increased TA as in your case. Thank you for your kind collaboration! Dr.Klerida

---