worried about hepatitis and liver results
March 11, 2010 10:05 AM Subscribe
i'm a relatively healthy 30-something woman with grave's disease. i just got some worrysome blood results and my new (soon to be former) primary care physician is not being helpful.
she ran a full blood work panel and my liver results were elevated for the first time in my life: AST 42, ALT 58, Alkaline Phosphase 125. my doctor didn't give me any potential explainations for the numbers, asked me if i drink a lot, and said "maybe hepatitis." i don't drink (maybe 1 drink a year), i don't do drugs, i've had a few hep shots before traveling to central/south america, no high risk sexual behavior. should i be worried? my graves disease is under control according to my bloodwork.
she ran a full blood work panel and my liver results were elevated for the first time in my life: AST 42, ALT 58, Alkaline Phosphase 125. my doctor didn't give me any potential explainations for the numbers, asked me if i drink a lot, and said "maybe hepatitis." i don't drink (maybe 1 drink a year), i don't do drugs, i've had a few hep shots before traveling to central/south america, no high risk sexual behavior. should i be worried? my graves disease is under control according to my bloodwork.
IAAD, IANYD.
Minor LFT elevations can occur from Graves, and are nothing that needs to be treated apart from treating the thyroid problem directly. These are minor elevations, and while they may warrant some follow-up: repeating the tests to seee that they're stable, or perhaps improving with treatment of your thyroid condition, they don't warrant much additional investigation at this time.
from the web:
The LFTs can give the impression of viral hepatitis. For example in one survey of 81 thyrotoxic patients, three-fourths had some LFT abnormality, including 31% with elevated bilirubin, 24% with elevated SGOT, 13% with elevated LDH, 26% with elevated SGPT, and 67% with elevated alkaline phosphatase (which of course may reflect bone metabolism). Cholesterol is often depressed. The abnormalities clear with treatment.
posted by cameradv at 10:21 AM on March 11, 2010
Minor LFT elevations can occur from Graves, and are nothing that needs to be treated apart from treating the thyroid problem directly. These are minor elevations, and while they may warrant some follow-up: repeating the tests to seee that they're stable, or perhaps improving with treatment of your thyroid condition, they don't warrant much additional investigation at this time.
from the web:
The LFTs can give the impression of viral hepatitis. For example in one survey of 81 thyrotoxic patients, three-fourths had some LFT abnormality, including 31% with elevated bilirubin, 24% with elevated SGOT, 13% with elevated LDH, 26% with elevated SGPT, and 67% with elevated alkaline phosphatase (which of course may reflect bone metabolism). Cholesterol is often depressed. The abnormalities clear with treatment.
posted by cameradv at 10:21 AM on March 11, 2010
I found this article that seems to indicate unusual liver numbers are common in people with Graves Disease. Your doc should have known this. I hope you find a new doc who is up to speed.
posted by mareli at 10:29 AM on March 11, 2010
posted by mareli at 10:29 AM on March 11, 2010
I'm not a doctor (or your doctor)...
But I had elevated ALT. I was really worried as you are when hepatitis was thrown out as a potential diagnosis. Like you, I haven't engaged in risky behaviors, have my Hep B shot, etc.
After agonizing until the results came back in, it turns out that (by exclusion) I probably had a mono-like virus. Lead to a minor blip, and after 6 months resolved itself. Lab results use different scales for liver function in different countries, and what's important is the ratio between the different levels, but it doesn't seem that your numbers are crazy high... as a normal viral hepatitis infection causes.
I'm also pretty sure that Graves can increase many test results (anecdotally from a friend who had it).
Hope I've provided some data points. Dump that doctor and find a new one - confidence in your primary care physician is so important. They're the only ones who'll actually be able to clear this up for you.
posted by Vantech at 10:29 AM on March 11, 2010
But I had elevated ALT. I was really worried as you are when hepatitis was thrown out as a potential diagnosis. Like you, I haven't engaged in risky behaviors, have my Hep B shot, etc.
After agonizing until the results came back in, it turns out that (by exclusion) I probably had a mono-like virus. Lead to a minor blip, and after 6 months resolved itself. Lab results use different scales for liver function in different countries, and what's important is the ratio between the different levels, but it doesn't seem that your numbers are crazy high... as a normal viral hepatitis infection causes.
I'm also pretty sure that Graves can increase many test results (anecdotally from a friend who had it).
Hope I've provided some data points. Dump that doctor and find a new one - confidence in your primary care physician is so important. They're the only ones who'll actually be able to clear this up for you.
posted by Vantech at 10:29 AM on March 11, 2010
In my experience you need an Endocrinologist. GPs and primary care folks are good at general issues, but for long-term thyroid issues and plans (are you planning on doing the radioactive iodine treatment?) you really should see a specialist. There are so many ways to play with these numbers, medicines, plans, etc., that *most* GPs really cannot keep up with them all. This includes diagnosing aberrant bloodwork related to Grave's and other thyroid issues.
posted by barnone at 2:22 PM on March 11, 2010
posted by barnone at 2:22 PM on March 11, 2010
Do see another doctor. Some doctors are just jerks. My dad had a PSA test and biopsy and the doctor called him in a few days later and said "well, Mr. IndigoRain's Dad, we need to talk about how we want to treat your cancer." He started crying and the doctor got angry and said "well we can't help you at all until you stop crying!" My dad went into a full-blown panic attack and they had to call my mom at work to come be with him... yes, they didn't even bother to tell him to bring someone with him.
It's important to your health that you don't dread going to your doctor. If his bedside manner isn't for you, find another.
posted by IndigoRain at 10:41 PM on March 11, 2010
It's important to your health that you don't dread going to your doctor. If his bedside manner isn't for you, find another.
posted by IndigoRain at 10:41 PM on March 11, 2010
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posted by crapmatic at 10:19 AM on March 11, 2010