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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Having elevated liver enzymes. Cause?

I got a call this afternoon that my blood panel has revealed elevated liver enzymes . I was seen because the PAC s I have had all my life have changed recently, giving me more shortness of breath and what feels like a punch in the chest once every few weeks for a few seconds. My EKG was perfect and my BP is normal: 100/70. Cholesterol was good and thyroid was also good. They want to do an ultrasound on my liver and do more blood work to test for hepatitis . I am wondering what could be causing this and what the treatment is. I do not drink, ever, never have. I am 38 and healthy, overweight by about 10 pounds but certainly not obese. I occasionally take Advil for headaches, and recently I was on an anti-inflammatory for 2 days for an injured nerve and antibiotics for a sinus infection . I also have had issues with my stomach, never diagnosed but what looked to me like some kind of irritation in my intestines, like IBS or something like that. It has not been an issue lately though, and my diet has returned to normal. I don t know if the liver levels relate to my heart or not. I was not able to talk to a doctor and I suspect I may not be able to for a week or so, and I would like answers a bit quicker. Any thoughts are helpful.
Mon, 3 Dec 2012
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Gastroenterologist 's  Response
Hello, bklauk,
The important part of your history is the recent use of antibiotics
and anti-inflammatory drugs. NSAIDs such as Ibuprofen, Naproxen,
can cause temporary elevation of enzymes and rarely severe liver
damage if taken in excess. Same thing is true for Tylenol (Acetaminophen)
taken in overdose can injure the liver.
Antibiotics belonging to the Tetracycline family can also affect the liver.
Your lipd level being normal is good and probably rules out fatty liver.
It is possible to have a very mild fatty liver even when you are ten pounds
overweight, in your case unlikely.
It is possible to have asymptomatic chronic hepatitis B or C from a prior
infection.
If you had a blood transfusion years ago when good screening tests was
not available, people received contaminated blood.
Needle prick, multiple sexual partners, drug abuse (Intravenous), sharing
tooth brush, tattos from a dirty place (Needle) -all are risk factors for Hepatitis.
You definitely need to get a screening blood tests for both Hepatitis B & C.
They can be treated very effectively with newer drugs now.
You are getting the sonogram of the liver and gallbladder which is good.
You can rule out gallstones.
If the level of enzymes are only minimally elevated , I would not worry
about it, especially if related to medications. They will get back to normal
on their own. Taking a good B-Complex vitamin once a day along with
1000mg. of Vit-C daily along with a good high protein, low fat diet is
very good.
I wish you well.
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