Elevated liver enzymes

[LondonScot]

Hi all, looking for some advice/reassurance! I'm 22w+5 and routine blood test shows elevated AST 47 and ALT 87. No protein or sugar or infection in urine and feeling well. Still elevated on the retest. ESR is elevated and blood count a little low since Dec so taking iron tablets. Liver tests were fine in December. Blood pressure is fine and no itching.
Online searches seem to refer to HELLP and pre-eclampsia but I don't seem to have any of the other symptoms.
Any ideas?
I'm having more bloods to test for hepatitis and a scan of liver and gallbladder but I have to wait for this.
PS I'm taking baby aspirin and Clexane blood thinners but these should not be causing it.
Thank you

Have you had your bile acid tested?

Not yet. Had a bunch of blood tests today but they would not tell me what they were. I wasn't told to fast which looks like a requirement for bile acid test? I'd like to think they would test for that but if not I will ask.
That's a test for ICP right? Thanks for your response, I appreciate it.

You definitely need testing for icp, bloods and bile acids.

Yes, bile acids is the test along with ALT’s for bile acids.

I do have ICP, and on medication, which is controlling my bile acids but not my ALT’s. I’ve had all types of liver tests and a scan but they can’t seem to find anything wrong.

Do you have any itching or pain?

Apologies I missed this message. My latest test had ALT of 116 and bile acid of 6 (normal). Liver and gallbladder scan normal, all other bloods normal including negative hepatitis and CMV. No itching or pain.
Consultant is retesting and if ALT still high I'll be referred to a liver specialist. Fingers crossed. I'm almost 25 weeks.

Are you taking any medications/supplements? I had elevated ALT and AST (over 100) in the first trimester and was taking high dose vitamin b6, phenargan, folic acid, progesterone and the occasional paracetamol. Pretty harmless individually but they all get processed through the liver. The levels came down during the second trimester when I dropped a lot of the supplements.

The enzyme levels did stay a tiny bit higher for the rest of the pregnancy (+5 points or so) but I never developed preeclampsia, Hellp or OC. Had a good pregnancy till the end and healthy baby. They did run a complete liver panel but didn’t find anything aside from a false positive for CMV. Gave me a good scare and had to go back for additional testing but everything turned out to be fine.

That's interesting. I'm taking aspirin and Clexane but Dr says it won't be that. I'm also taking iron tablets and pregnacare max including the fish oil. She said it wouldn't be those either. I'm heterozygous MTHFR gene also.

@LondonScot sorry, I realise this post is very old but I’m wondering if you ever got to the bottom of this? I am having an identical issue right now. I was also taking Pregnacare Max but have now stopped as it seems to be the only thing I can think of that could be causing it.

[quote AW1990]@LondonScot sorry, I realise this post is very old but I’m wondering if you ever got to the bottom of this? I am having an identical issue right now. I was also taking Pregnacare Max but have now stopped as it seems to be the only thing I can think of that could be causing it.[/quote]
Hello, actually I'm now 30w pregnant with my second. Not having the same issue so far.

With my son, my ALT snd AST went up and down but blood pressure fine and no protein in urine. Then at 37w I went for routine prep 1 week ahead of planned CS and I pushed for them to retest my levels. Thankfully I did as they had rocketed but this time my bile acid was very high too. Was still fine for blood pressure and protein but they kept me in and decided to do emergency CS later that day. By time I was about to go into theatre I did start to have protein in urine and they put it down to suspected HELLP with aytypical presentation.
In hindsight I had felt a bit light headed the day before and noticed my stools were a bit challky/light in colour.
Everything was ok in the end but they were worried at one point and pleased I pushed for the bloods.
I would advise you ask them to keep a close eye on your levels and pay close attention to how you are feeling and do not hesitate to get checked.

@LondonScot thank you so much for taking the time to reply. Congratulations on your second pregnancy and very pleased to hear all turned out well with the first. I’ll make sure to keep a very close eye on any potential HELLP symptoms and to insist they monitor my levels carefully. I feel fine at the moment if a little tired but I know it can change quickly. Thanks again and all the best with baby number 2.

@AW1990 hello how did you get on in the end? I’m having this issue and also wondering if it’s connected to pregnacare