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What Causes Elevated Liver Enzymes?
Hi, I saw my internist this morning for a pre surgical work up. (Bunion surgery next week conscious sedation). Labs done on Monday were back. AST and ALT were double normal. I had a lumbar lam with fusion at L 4-5 on September 2. On Oct 13 labs were elevated but I didn t think much of it because of pain meds. I m not on pain meds anymore and I would have thought they would have been normal now. I now am concerned about elevated liver enzymes again! I have had some pain in that sore bunion just before the labs were drawn and took the only pain med I had left from previous surgery. Oxycontin . Would that have caused my enzyme spike??
Mon, 7 Jan 2019
Hello,
Oxycontin may indeed raise the liver enzymes but this is not an adequate explanation for your case. Actually it's not a good explanation for any case of increased liver enzymes. Attributing any symptom or finding to a drug without excluding (or at least considering) other potential causes first is not right.
There are many potential causes for a rise in the liver enzymes. Drugs, various viral infections, fatty liver disease etc are common causes of liver enzyme levels elevation. Less common causes may include autoimmune disorders, tumors, etc.
If you're symptom-free then you can measure the liver enzymes again in a few days to see whether they're getting back to normal or not. Basic testing would include a liver ultrasound scan, repeat measurements of the liver enzymes and investigation for infectious and autoimmune causes (like viral hepatitides or autoimmune hepatitis). Overweight patients commonly have fatty liver disease (particularly if they're diabetic as well). Fatty liver disease is a very common cause of liver enzyme levels elevation. If no good explanation can be found after adequate investigation then a drug or other potentially toxic factor can be blamed.
So in conclusion, the drug is a potential offender in your case but an investigation for other causes (infectious, autoimmune, etc) has to be done.
Hope I have answered your query. Let me know if I can assist you further.
Regards,
Dr. Panagiotis Zografakis,
Internal Medicine Specialist
Oxycontin may indeed raise the liver enzymes but this is not an adequate explanation for your case. Actually it's not a good explanation for any case of increased liver enzymes. Attributing any symptom or finding to a drug without excluding (or at least considering) other potential causes first is not right.
There are many potential causes for a rise in the liver enzymes. Drugs, various viral infections, fatty liver disease etc are common causes of liver enzyme levels elevation. Less common causes may include autoimmune disorders, tumors, etc.
If you're symptom-free then you can measure the liver enzymes again in a few days to see whether they're getting back to normal or not. Basic testing would include a liver ultrasound scan, repeat measurements of the liver enzymes and investigation for infectious and autoimmune causes (like viral hepatitides or autoimmune hepatitis). Overweight patients commonly have fatty liver disease (particularly if they're diabetic as well). Fatty liver disease is a very common cause of liver enzyme levels elevation. If no good explanation can be found after adequate investigation then a drug or other potentially toxic factor can be blamed.
So in conclusion, the drug is a potential offender in your case but an investigation for other causes (infectious, autoimmune, etc) has to be done.
Hope I have answered your query. Let me know if I can assist you further.
Regards,
Dr. Panagiotis Zografakis,
Internal Medicine Specialist
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