Doctors Lounge - Gastroenterology Answers
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Forum Name: Liver Diseases
|dmr02d - Thu May 31, 2007 11:39 am||
I'm here in search of some answers and/or guidance. Here's my information and story in a concise format:
1. 23 years old, 180 lbs., 5'11", 14% body fat
2. Asymptomatic for the most part, gas and abdomen pains are common
3. Recently went to doctor for physical
My test results came back abnormal.
1. AST = 43 (range 10-40)
2. ALT = 97 (range 9-60)
3. Cholesterol = 56 (range 125-200)
4. Everything else came within normal range.
Based on this, we decided to perform further tests.
1. AST = 47
2. ALT = 105
3. Cholesterol = 59
4. Hep B and Hep C negative
5. Normal iron, ferritin, TSH, UIBC, TIBC
6. Low ceruloplasmin
Based on this, we decided to run further tests for Wilson's Disease because of the low ceruloplasmin.
1. No copper rings in eyes (K-F rings)
2. Performed 24 hour urine test, everything is normal. The normal range is 10 to 30 mcg/24 hr. Mine were 16.3 and 13.7 mcg/24 hr.
My doctor says this is nothing I should be concerned about -- that it is normal FOR ME to have elevated enzymes and low cholesterol.
I've put myself on milk thistle, but I'm honestly a little concerned over everything I've read. Is there ANYTHING you think this could be? Thanks for your help, I truly appreciate it.
|Dr. Chan Lowe - Sun Jul 08, 2007 9:58 pm||
Your liver enzymes are very minimally elevated. I would recommend you retest them in a month or so to see if they have resolved. They really are not elevated to the degree I would expect if you had hepatitis.
The low ceruloplasm is interesting. If there is truly concern for Wilson's disease there are more tests that are more specific. The most sensitive test to rule out Wilson's disease is actually a liver biopsy. Normal liver copper levels essentially rules out WD. Elevated levels is very suggestive of WD but can be found in other conditions. A 24 hour total urine copper level can be tested as well.
I am more stumped by your low cholesterol. Cholesterol levels that are too low can lead to impaired cellular membrane formation and stability. This may be normal for your but it is certainly lower than I would expect.
I would recommend you see a GI specialist for further evaluation.
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