I had lab work back in March and everything was normal except my cholesterol levels. I changed my diet and started walking more. I lost 20lbs, but then started having some right upper abdomen pain and nausea along with extreme fatigue. I was seen in the ER and noted on the CT scan that my liver was abnormal. I had more labs drawn and my ALT/SGPT was high at a 99, my alkaline phosphatase was high at a 130, my AST/SGOT was high at a 181, my platelet volume was high at a 11.5, and my bilirubin level was high at a 1.30. I had a follow up visit with my PCP and she said that this is all due to me being over weight. I am overweight, but I am not huge by any means and all this tested normal when I was at my heaviest. Why would the levels jump significantly after I lose weight and should I be concerned?
Yes, I had these same test ran multiple times and prior to the weight loss they were all normal. I did press my PCP for answers and that is all she would offer. The levels started out only slightly elevated and then over the course of two more testings they began to rise more each time the test was ran. The ER doctor looked at previous tests and compared them to what he saw on the tests he ran and informed me that he was concerned and definitely saw the need for me to have further evaluation and that I should call my PCP. Just frustrating that the only answer I got was you're overweight.
I did get the IUD placed the end of April, however the symptoms started before that. I know it's not gallstones because I had my gallbladder removed in 2012. Thanks for all your insight and help so far!
I was not placed on any medication for the cholesterol and I am not diabetic. My A1c was within normal limits. I do not consume ANY alcohol, never have and I don't smoke. When I say I changed my diet I mean I cut out all junk foods, cookies, chips, pastries, etc I stopped drinking everything except water. I drink 3-4 bottles a day. I cut out red meats and now eat skinless chicken and pork. I added more veggies and have cut out all bread products as well. I don't use any artificial sweeteners. I was tested for hepatitis when these enzymes came back elevated and I tested negative for that.
I think these are very good questions for your PCP. And if you don't get good answers, get a second opinion.
I'm not saying this as a cop-out or as a non-answer. The combination of your symptoms, your CT, and your blood tests suggest that something else might be going on, and if your PCP isn't taking you seriously, find someone who will.
ETA: Get a new PCP for a second opinion.
If your ER doctor was concerned, yes, you should be concerned. Nausea and constant fatigue and pain OF COURSE should be concerning to you. Why wouldn't it?
The liver is a tricky organ. If your diet has changed, keep a food journal. and an exercise journal. If animals (I say this loosely, my cat had fatty liver disease when he stopped eating which then triggered pancreatitis, so this isn't something to 'wait and see' on) make their bodies start burning more fat (instead of nutritional food), then there is a chance that the liver can get overwhelmed. I don't know what to make of the numbers, but I'd suggest that if she can't give you any more information, that she is not the doctor you need for this. And yes, go see a hepatologist. This isn't something to wait around on. Ask for a referral today and insist on moving forward in finding out what's going on.
Honestly, I would ask for a referral to a Hepatologist and see if a liver biopsy is warranted. Not to be a doomsayer or anything, but I would be checked for Fatty Liver Disease and also cancer. I don't know that your symptoms necessarily line up with either of these, but honestly my uncle was just moved today to Hospice . . . he went to his PCP with complaints of fatigue, pain similar to yours, also ended up in the ER after the pcp told him to lose weight (he was heavy but not on the "obese" end) only to find out it was something much more serious. I am sure that drs. tell folks all the time "lose weight" and the majority of the time they are right. However, there are those times they are not.
I must say that I am a little tired of doctors blaming every damn physical complaint a person has on either smoking or weight. I know that those are HUGE contributing factors, but sometimes it simply is more than that. I am not overweight, nor do I smoke, but I do feel like the current trend is dismiss folks' pain/issues as "nothing" if they are either smokers or overweight.
I hope you are able to get some really good answers.
https://labtestsonline.org/
this site will tell you what your lab test results mean. you have to understand before you look into it that they list every possible thing just to cover their butts so not every reason is your reason.
i would learn a bit about the results and then go back to the pcp armed with knowledge. asking why it was all blamed on being overweight and why a diet change and losing 20 lbs would cause abnormal resluts. if you don't get answers then get a new pcp.
Losing some weight can shake out all sorts of things.
My Mom dropped a lot of weight and suddenly she had kidney stones.
It's not that they weren't there before but when she lost the weight, they had room to start traveling - it was painful.
It might be the same with gall stones.
Also - fat absorbs things like hormones - so when you drop that weight - what ever was absorbed is released and it can take awhile for you to feel good again.
Over all - losing some weight is usually a good idea - but there can be some fall out from that so give it some more time for you to reach a new normal.
Just my opinion but high cholesterol is not the end all and be all of health care.
I really think in 50 or so years (or when ever the profit goes out of it) they will come around and admit that messing around with your cholesterol levels is a bad thing to do.
Did you push your pcp to talk about specifics of your testing? Or did you think of questions after the visit that you now need answered? If you pushed your pcp to talk about the testing and she wrote it off to your weight then I think you could do with a new pcp. Just because someone is overweight doesn't mean they don't have a real medical problem that needs to be looked into. If you thought of questions after then give the office a call and let the staff know that you have questions about your testing done back in March. The doctor or someone on the staff should be able to give you the answers you are looking for.
Realistically if could very well be that your change in diet and habits have triggered a reaction in your system and it will settle down once this becomes your new normal however your doctor isn't giving you any info other than to say 'sorry but since your overweight there's nothing I can be expected to do for you' which is not a real answer
How much alcohol do you consume?
How much do you smoke?
what medications are you on?
How much water do you consume daily?
What is your A1C?
Do you have Hepatitis?
are you taking any antibiotics?
when you had your blood drawn - was there any white in it? The white indicates an EXTREMELY high cholesterol.
What did you change in your diet? Are you eating healthier or just less of what you consumed before?
I have more questions than answers for you, obviously.
I would get the tests run again and compare. I would stop consuming alcohol, as that is what usually triggers a high ALT/SGPT count.
Keep a food journal and an activity journal. Wait 2 weeks and go back to the doctor for another round of blood draws. If there is NO CHANGE?? Push for them to find the cause...and not just blame it on obesity.
Watch your diet for hidden sugars....sugar puts a huge stress on the liver...even natural ones like honey, agave, and maple syrup. If you use Stevia make sure it is a pure liquid form of the plant and not processed. (Stevia is the only approved sweetener of MD Anderson (big cancer hospital in Houston).
Artificer sweeteners can also really cause issues...my DH used a lot of Splenda and at one point we thought he was having a appendicitis. He cut it out completely and no more abdominal pain.
All I can think is it sounds like your liver needs a bit of a detox it is working overtime to get all the built up toxins out of your system.
Don't do anything without your doctors approval but maybe research foods that help your liver function better and add them to your diet.
Good luck!!
Did you get that IUD? I would actually start there.
Did you have these same specific tests before you lost weight? What I'm wondering was were they high then and you just didn't know. Maybe it's not linked to the loss of weight.
I tend to go by Mayo Clinic's website if it's something I just want the basics on - but keep in mind, if you Google anything, they list anything and everything that could be wrong with you. Best person to ask is your doctor for more info, or get a second opinion.
http://www.mayoclinic.org/symptoms/elevated-liver-enzymes...
ETA: read your updated info. Sorry that your PCP isn't being more help. I would be frustrated too.
You mentioned cholesterol levels. They didn't put you on medication for that did they? Because some cholesterol drugs will elevate those levels (reason why I attached that link - it's number one on the list).
Added: Reading through your added info - if it were me, I'd go back to my PCP and ask for more tests (I think even Celiac's disease can raise enzyme levels). If she says no they are not necessary - at least get her to explain her logic. If not happy, then say you'd like a second opinion or to see someone specialized for follow up. We've had to do that before. Hope you can get it sorted out :)
When you say you changed your diet - did you switch to whole fruits and vegetables, lean proteins like chicken and fish, etc, or did you start consuming sugar-free, artificially sweetened foods, protein powders, supplements, and "diet" foods?
Some people are incredibly sensitive to sorbitol, Nutrasweet, Splenda, and all of the artificial processed ingredients in fat-free foods. Some people consume large quantities of diet powders and processed protein powders and they don't digest them well.
So what guidance did you use for your change in diet, and what is your daily intake of food and beverages like?
First of all - CONGRATS on the weight loss.
Did anyone mention your gallbladder to you? Weight loss can lead to gallbladder issues? You need to head back to your PCP. Ask him.her if they can have the CAT scan reviewed for possible gallstones. Do you have any reflux/heartburn? That can be a symptom as well.
Feel better!
Are you taking statins? If she put you on statins, and THEN all this started, you could be having a reaction to the statins. Sometimes it can be life threatening. There are some peope (a small minority) who have to have to go to the hospital and get their blood cleaned (I don't know what you call it, sorry!) because the statins are like a poison to them.
If you are NOT on statins, then don't be afraid of statins. I take them everyday and I have no negative affects from them. Then are great for people who make too much of the bad cholesterol. I just want you to make sure that if you started taking them that this is not the issue...
I would seek a second opinion. Docs tend to be highly respected and when our doc says it's okay or that's that we often just accept it and don't think twice.
When it just doesn't sit with us then we need to see someone else. We have been going to a cardiologist for years with my husband. His cardiologist had hit a wall, nothing he was doing was making a difference. So he decided to refer my husband to a completely different type of cardiologist, one that deals with a completely different heart issue. This new doc spent about 5 minutes with my husband and put him on a new med. The other cardiologist hadn't heard of this new med and hadn't used it on any patients.
Because he knew he didn't know what to do and got another doc to give an opinion medical help was found.
That's my point. Some docs clam up and say that's that because they don't know where else to go, they feel like they have done all they can do because they don't understand what is going on. Some won't refer you and some will.
I'd call my insurance provider and ask what sort of doc to go to for this and then who they have a contract with for this exam.
This is a mama question.
