Just Got My Liver Enzymes Checked And They Are Elevated

koreus

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My Alanine transferase is way out of range which is worrying:

Alanine transferase 220 IU/L (range 50 - 150)
Gamma-GT 45 IU/L (range 34-335)
Albumin 44 g/L (range 34 - 52)
Alkaline phosphatase 81 IU/L (range 0 - 130)
Globulin 30 g/L (range 19 - 35)
Bilirubin 9 umol/L (range 0 - 40)
Total protein 74 g/L (range 63 - 87)


Been suffering from fatigue for months now and this may be the cause. Any ideas what causes markedly raised Alanine Transferase when all the others are normal?
 

Motif

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Any other symptoms?
What diet?
The earlier tests have always been good?
 

Maljam

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Have you had any other blood tests such as a full blood count? Ultrasound of your liver? Do you take any pharmaceuticals? Alcohol use?
 

Hans

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My Alanine transferase is way out of range which is worrying:

Alanine transferase 220 IU/L (range 50 - 150)
Gamma-GT 45 IU/L (range 34-335)
Albumin 44 g/L (range 34 - 52)
Alkaline phosphatase 81 IU/L (range 0 - 130)
Globulin 30 g/L (range 19 - 35)
Bilirubin 9 umol/L (range 0 - 40)
Total protein 74 g/L (range 63 - 87)


Been suffering from fatigue for months now and this may be the cause. Any ideas what causes markedly raised Alanine Transferase when all the others are normal?
Since your other liver enzymes are normal, the elevated ALT is due to liver damage. It's most likely an indication that there is damage elsewhere in the body. Have you had any other tests done?
 

koreus

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Any other symptoms?
What diet?
The earlier tests have always been good?
Pain in the area of my chest where the liver is for the past year before symptoms of fatigue set in. Normal high PUFA diet most of my life, Keto for 2 months then Peaty for the past 3 months, orange juice, milk, beef, rice, eggs, fortnightly beef liver.

Have you had any other blood tests such as a full blood count? Ultrasound of your liver? Do you take any pharmaceuticals? Alcohol use?
I have had Thyroid tests which returned raised antibodies:

Thyroid peroxidase antibodies (TPOAb) 86 kIU/L (range 34 - 200)

So I've been tracking my TSH which has gone 1.6 six months ago to 2.25 a month ago to 2.94 this month (mIU/L)

The only thing I take is Doxycycline for acne but I haven't taken that in a while. I don't drink alcohol and I eat around 2000 - 2500 calories a day at 85KG 191cm. I have about 20% body fat according to my smart scale.
 

Maljam

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Pain in the area of my chest where the liver is for the past year before symptoms of fatigue set in. Normal high PUFA diet most of my life, Keto for 2 months then Peaty for the past 3 months, orange juice, milk, beef, rice, eggs, fortnightly beef liver.


I have had Thyroid tests which returned raised antibodies:

Thyroid peroxidase antibodies (TPOAb) 86 kIU/L (range 34 - 200)

So I've been tracking my TSH which has gone 1.6 six months ago to 2.25 a month ago to 2.94 this month (mIU/L)

The only thing I take is Doxycycline for acne but I haven't taken that in a while. I don't drink alcohol and I eat around 2000 - 2500 calories a day at 85KG 191cm. I have about 20% body fat according to my smart scale.

I'd look into getting a full blood count, showing things like WBC and CRP if I were you to try help work out what's going on.
 

koreus

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Since your other liver enzymes are normal, the elevated ALT is due to liver damage. It's most likely an indication that there is damage elsewhere in the body. Have you had any other tests done?

When you say liver damage, does that mean like physical damage to the liver? As I said above I have elevated thyroid antibodies but all my other blood-work comes back normal. I've done Advanced iron profile, Testosterone profile (free or unbound), HbA1c (Diabetes), Cholesterol (Lipid profile), Thyroid profile, Vitamin D. My Triglyceride/HDL ratio is fairly high at 2.02:1, my LDL is 3.2mmol/L and HDL is 1.1 mmol/L, Triglycerides 2.22 mmol/L

My liver enzymes were 'very slightly above range' according to my doctor 8 months ago before I knew to get my own blood work and write down the numbers so they seem to be on a steep upward trajectory. I've made an appointment with my regular Doctor to try and hash out what they were exactly 8 months ago and what action to take.
 

koreus

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I'd look into getting a full blood count, showing things like WBC and CRP if I were you to try help work out what's going on.

Thanks for the advice, I will order these tests. I suppose the purpose of a full blood count is to detect if there is an infection of some kind? I was on a course of fairly strong antibiotics for a cyst recently so I figure if it was a bacterial infection that would have nuked it.
 

Maljam

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Thanks for the advice, I will order these tests. I suppose the purpose of a full blood count is to detect if there is an infection of some kind? I was on a course of fairly strong antibiotics for a cyst recently so I figure if it was a bacterial infection that would have nuked it.

Yes, exactly, for an infection. What were the antibiotics and how long since you stopped? Some antibiotics can cause elevated liver enzymes that take time to resolve after you stop taking them.
 

Maljam

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When you say liver damage, does that mean like physical damage to the liver? As I said above I have elevated thyroid antibodies but all my other blood-work comes back normal. I've done Advanced iron profile, Testosterone profile (free or unbound), HbA1c (Diabetes), Cholesterol (Lipid profile), Thyroid profile, Vitamin D. My Triglyceride/HDL ratio is fairly high at 2.02:1, my LDL is 3.2mmol/L and HDL is 1.1 mmol/L, Triglycerides 2.22 mmol/L

My liver enzymes were 'very slightly above range' according to my doctor 8 months ago before I knew to get my own blood work and write down the numbers so they seem to be on a steep upward trajectory. I've made an appointment with my regular Doctor to try and hash out what they were exactly 8 months ago and what action to take.

What was your vitamin D? Iron? Any other out of range results? The more info you give us the better.
 

koreus

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Yes, exactly, for an infection. What were the antibiotics and how long since you stopped? Some antibiotics can cause elevated liver enzymes that take time to resolve after you stop taking them.
I was prescribed Flumoxycillin 500mg 4 times a day for a week. After googling it you are right this antibiotic can cause liver damage! I sincerely hope it is the only factor and that I will recover now I have finished my course.

What was your vitamin D? Iron? Any other out of range results? The more info you give us the better.

Total iron-binding capacity (TIBC) 58 umol/L (range 41 - 77)
Normal

Unsaturated iron binding capacity (UIBC) 31 umol/L (range 22.3 - 61.7)
Lower end of Normal

Ferritin 144 ug/L (range 30 -200)
Normal

Iron 26.9 umol/L (range 5.8 - 34.5)
High end of Normal

Transferrin saturation 46% (range 20 - 50)
Normal

Vitamin D: 68nmol/L (range 50 - 175)
Slightly low. Strange since I am taking @haidut 's EstroBan daily which contains 2000IU of vitamin D. I live in cloudy UK though so perhaps I need a higher dose vitamin D supplement.

Free T4: 14.2pmol/L (range 12 - 22)
In range but trending down, 15.2 six months ago, 14.7 last month.

Total Cholesterol: 5.3mmol/L (range 0 - 5.2)
Slightly out of range and I already mentioned my other cholesterol values.

HbA1c: 34 mmol/mol (range 20 -42 )
Optimal

Testosterone: 19.22 nmol/L (range 8.4 - 29)
Normal

SHBG 42 nmol/L (range 18.3 - 54.1)
Upper end of normal


You could try betaine/Trimethylglycine to see if it can help with the fatigue and liver issue.

Betaine improves nonalcoholic fatty liver and associated hepatic insulin resistance: a potential mechanism for hepatoprotection by betaine

Are you french by the way?

Thanks for the suggestion :) I'm also considering: Dandelion Leaf, Milk Thistle, TUDCA, Schisandra Berry, Chinese Licorice Root, Stinging Nettle (abundant where I live, no need to buy them), Cascara, Kutki and UDCA.

I'm British/Irish. What made you think I was French? :p:
 

BearWithMe

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I have the same symptoms and also my blood test results are very similar.

Do you experience a lot of stress / anxiety? How is your dental health?
 

koreus

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I have the same symptoms and also my blood test results are very similar.

Do you experience a lot of stress / anxiety? How is your dental health?

Wow, amazing to find someone with the same profile.

I was in a state of chronic stress for the past three or four years before catching flu twice last winter and then fully burning out about eight months ago and being forced to take three months off work due to fatigue. I was not sleeping much during that time, probably three or four hours a night.

I feel a lot less stressed since I started a Peat inspired diet and found a less stressful job but apparently my body is still in a bad state. I still get bouts of fatigue, my dental health is awful (just had eight fillings, three close to the root and I'm 25) and obviously my liver is not doing so well either. I never drank that much and I have always had a healthy BMI so both myself and my Doctor are struggling to understand the cause of the liver damage.
 

BearWithMe

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Wow, amazing to find someone with the same profile.

I was in a state of chronic stress for the past three or four years before catching flu twice last winter and then fully burning out about eight months ago and being forced to take three months off work due to fatigue. I was not sleeping much during that time, probably three or four hours a night.

I feel a lot less stressed since I started a Peat inspired diet and found a less stressful job but apparently my body is still in a bad state. I still get bouts of fatigue, my dental health is awful (just had eight fillings, three close to the root and I'm 25) and obviously my liver is not doing so well either. I never drank that much and I have always had a healthy BMI so both myself and my Doctor are struggling to understand the cause of the liver damage.
Man, I have lost 6 teeth during last year and 3 more is about to go. Also, ALT is always the only enzyme that come up elevated in my bloodwork.

I have spent almost 4 years looking for answers. I don't have a definitive answer yet, but I suspect the stress might be at root of all this.

I have met multiple people on this forum and also in various Facebook groups with eerly similar symptoms and similar progression - Major psychological stress -> Strange liver and digestive issues, being diagnosed as healthy by healthcare professionals -> Major fatigue -> Insanelly fast and seemingly unstoppable tooth decay, usually starting by randomly cracked molar at the right side (Sounds weirdly specific but I'm not joking).

The most important advice I could give you is to never, under any circumstances, take anything, that could boost the metabolism to the point of triggering stress reaction.

Thyroid, synthetic androgens, pregnenolone, caffeine, and probably also niacinamide and aspirin are the worst offenders.

Most of these are really beneficial to the liver, but in metabolic states like this, I think the cons clearly outweight the benefits.

It is Catch-22 kind of situation. You need to heal the liver to fix your health, but anything, that is supposed to heal the liver, triggers massive stress reaction, which started all these issues in the first place.
 
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koreus

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Man, I have lost 6 teeth during last year and 3 more is about to go. Also, ALT is always the only enzyme that come up elevated in my bloodwork.

I have spent almost 4 years looking for answers. I don't have a definitive answer yet, but I suspect the stress might be at root of all this.

I have met multiple people on this forum and also in various Facebook groups with eerly similar symptoms and similar progression - Major psychological stress -> Strange liver and digestive issues, being diagnosed as healthy by healthcare professionals -> Major fatigue -> Insanelly fast and seemingly unstoppable tooth decay, usually starting by randomly cracked molar at the right side (Sounds weirdly specific but I'm not joking).

The most important advice I could give you is to never, under any circumstances, take anything, that could boost the metabolism to the point of triggering stress reaction.

Thyroid, synthetic androgens, pregnenolone, caffeine, and probably also niacinamide and aspirin are the worst offenders.

Most of these are really beneficial to the liver, but in metabolic states like this, I think the cons clearly outweight the benefits.

It is Catch-22 kind of situation. You need to heal the liver to fix your health, but anything, that is supposed to heal the liver, triggers massive stress reaction, which started all these issues in the first place.

We should give the condition a name and try and gather everyone who has it into a forum or forum thread

As you might imagine I've been using lots of metabolism boosting substances since discovering Peat's work including asprin, niacinamide, caffeine and pregnenolone + DHEA. I also tried T3, T3 + T4 and NDT, (I have elevated thyroid antibodies but normal TSH which is odd). All of these substances gave me an initial boost but then stopped working. Currently I am taking only niacinamide because of its liver specific regenerative properties and I try to have it with a good sized breakfast to get enough calories.

It seems to me that elevating the metabolism would be fine with adequate nutrition since it would not trigger a stress response so something must be preventing nutrient absorption. That would also explain the digestive issues. I have tried antibiotics and they didn't help so my guess is it has to be fungal. There are three other things that make me think it is a fungal infection:
1. I was also on antibiotics (Doxycycline) for acne for a number of years continuously.
2. A Keto diet improved my symptoms massively (Candida feeds on carbs and sugar)
3. Candida can be triggered by stress

I'm getting a Candida test and will report back.
 

koreus

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Update:

Got ALT checked again after four days of taking 500mg niacinamide and it has halved!

Alanine transferase 100 IU/L (range 50 - 150)

I'm also feeling much better.

Getting the opinion of a hepatologist on how this is possible. My Doctor thinks chronic stress + COVID triggered the liver problems and my ALT was probably sky high at the beginning of the year and has been dropping.
 
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