Liver enzymes high: ultrasound clear - what next?

[FluffyCubs]

Hello, I posted here before concerning liver function test which were three times upper limit of normal. (aLt and ast enzymes - all others were fine, plus ok for blood sugar, thyroid)

I had a liver ultrasound this week and my innards are totally fine, no enlargement, no fatty liver, nothing at all with liver gallbladder kidneys etc.

But my liver had a faint ache to it, and I'd really like to know what else should be considered. I was so relieved about the U.S. and thought it was psychosomatic but it's still hurtin.

All thus came about as part of a test for Coeliac disease....plus I have severe psoriasis and have had it for five years now. What should be considered next?

[millymae]

Not sure if my story will be of any help but it may stop you worrying a little.

After a CT scan showed a healthy liver and a whole batter of tests could find nothing wrong with me elsewhere my Consultant reached the conclusion that my highly deranged liver enzymes (his words, not mine) were probably as a result of a past infection, and would right themselves eventually. He asked my GP to keep a watchful eye on things, and as a result I had blood tests every couple of months. Things improved slowly and after 18 months my liver enzymes had returned to more normal levels although not quite within the standard range and my GP could see no point in further testing as I was generally well. I can't recall ever having any discomfort in the area of liver but I did initially lose lots of weight, looked awful and was certainly tired and lethargic for several months.

Fast forward 5 years or so and I was back at the hospital for a totally unrelated condition which required blood tests. All were within normal range apart from my liver enzymes which my Consultant didn't bother investigating further as he said they were moreorless as they were previously and were therefore normal for me!

[Elibean]

Just in case the medics didn't think to do it (they should have, and would imagine they did, but): make sure you've been tested for hepatitises. Especially Hepatitis C (HCV). Its curable, but needs to be spotted and treated.

[kronenborg]

was your bilirubin normal?
what meds are you taking?
how much (if any) alcohol do you consume?

[SomedayMyPrinceWillCome]

Has anyone mentioned Gilbert's syndrome?
It involves abnormal LFTs in an otherwise healthy person. It is essentially that their "normal" LFTs are different to everyone else's. I have it & other than looking a bit yellow when I am ill / pale I'd never know

[kronenborg]

gilbert's is normally characterised by raised bilirubin, rather than transaminases - doesnt sound like that is the issue here.

common things are common - so first things to rule out would be medication, drugs and infection.

[FluffyCubs]

I don't really drink that much, probably a glass of wine a week, averaged out. Taking Prozac.

I was tested for Lupus a couple of years ago .... MY ANA levels were 1:640 homogenoous which is indicative of Scleroderma but DSDNA antibodies came in at 6.9 which discounted that, thankfully.

Can psoriasis cause high enymes? I'vee asked GP to test me again for ANA. I do think these results all point to autoimmune issues, just not sure if I have something else as well.

[FluffyCubs]

Millymae, can I just ask which liver enzymes were deranged?
Elibean - Ive had hepatitis before following glandular fever...I couldn't drink for a year. This doesn't feel like it. For a start im freezing as usual!!

Kronenbourg - Ive posted my results.

[kronenborg]

prozac can cause raised liver enzymes of the pattern you have - it is not common, but a known side effect...usually occurring in the first few months of treatment.

i have not heard of psoriasis per se causing LFT rises, however many of the meds used to treat psoriasis certainly can...

[Maesgwyn09]

Hello all, I’m going through raised ALT and GGT currently with both biopsy and CT coming back perfectly normal. Did have c section 20 weeks ago but surely things should be out of my system by now. Looking to see if the 2 people who have the same on here have had any new diagnosis and if the levels came down on their own in the end?
Thanks!

[petalflowers95]

Hi there,
I thought I would post my current experience as I’m still going through investigation. (Context: I’m in the UK, I’m 27 and have normal BMI).

I had a blood test in early 2021 (for a different reason - a fatty lump on my belly - which turned out to be just a harmless small lump!) but this blood test showed a raised ALT level. The doctor then repeated the tests a month and two months later and the ALT level continued to rise. The three tests showed ALT levels of 34, 45, then 134!

The doctor then ordered one ultrasound mid 2021 and another ultrasound late 2021. Both looked totally fine.

So now I’m having another blood test tomorrow and now a Fibroscan which is apparently a liver-specific ultrasound-type scan.

I have no symptoms, no abdominal pain, I eat healthily and exercise twice a week so I’m stumped as to why my ALT levels aren’t behaving!

[OnTwoWheels]

Wondering if any of your have had any conclusive results as I'm in the same boat, raises ALT and AST but clear ultrasound. @FluffyCubs @petalflowers95

[petalflowers95]

Hello! Thanks for your message. I never had any sort of conclusive results, unfortunately. I asked my doctor whether I could have yearly blood tests to check the levels but he said no! I guess I could pay to go private. What tests have you had so far?
Best wishes!