Liver markers what do the mean?
I could really use some advice. My liver markers were slightly high in December after a surgery. Then in may they went up more. Now they are over 100. My MO told me to go off all drugs ie tamoxifen gapapentin for two weeks and then retest.
I retest on the 22nd. I could use some advice. What could this.mean anyone have experience? Also should I insist they run scans and tests if they are still high and if so what tests?
They were just saying they would a end me to a gastroentologist but clearly they need to.make sure this isn't cancer right?
Comments
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Hi exercise guru, I don't think you should be worried at this point. Liver markers can be slightly elevated for many reasons, including some meds or even strenuous exercise. Don't do serious cardio exercises for at least 24 hours before labs. I once got mine in 300+ range when I had blood drawn right after gym.
I would just follow your doctor's recommendations, don't drink alcohol the day before test, and see what it is a couple of weeks down the road.
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Surmise nothing, but be proactive. Locate through friends, relative, nurses a gastroenterologist and make an appointment. Lead time on an appointment can be long. Each body part has a specialist. Since you have abnormal values you have a reason to see a GI doc. Many insurances require a referral from MO or PCP. Okay. Your Mo is saying take a break. Not good enough when BC is present. PUSH for both a referral to a GI doc and first an Ultrasound of the upper abdomen----they will tell you a upper abdomen isn't indicated, but at least give it a try. Then settle for an ultrasound of the liver. 2. MRI of the liver.
They will tell you we can't do MRI's of the Liver. Yes, MRI's can be done of the liver. You just need to hold your breath when they tell you too. Been there done that... demand that to prevent radiation exposure. Keywords "to prevent radiation exposure" As a cancer patient docs order way to many CT's and Pet scan's
Why? Because one Ct scan is the equivalent of 200 chest xrays. I have read a variance on this from less than 100-200. The point being USE THE LEAST RADIATION EXPOSURE FOR ANY TEST.
Each specialty of medicine has a body part and their blood work that applies. When there is a cross over into a body part or blood work that they are not absolutely skilled in, errors can be made.
Depending on your age and history, with abnormal liver function that may be functionally or drug induced being followed by a GI doc is relevant. General lead time on a new appointment for a GI doc is 3 months. Most specialties are the same. Even without knowing your age, I would still recommend getting a GI consult if you can. Once seen you are a patient of record. Then if there is an occurrence in the future an appointment is easier to get i.e. a couple of weeks or less. Certainly, in an acute situation. That is always the best scenario. A doc that knows you.
I'm not blaming the docs, it's just that the explosion of information in the last 60 years, makes it hard for docs to keep up on their specialties, let alone other specialties.
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Good info from both sides.
Interesting, Schatzi, that yesterday when I was putting off getting another PET CT my onc told me that one could have 100 scans before the beginning of any side effects. I was thinking, no way and I will find the proof. And I am now reminded, I want to find the proof.
Like you, the least radiation exposure the better.
Exerciseguru, I waited five months for a rheumatologist who did not help me and had to get another and wait two months. Three for a pulmonologist. So yes, I vote when a specialist is needed, get the appointment because you can always cancel or bump it out a month.
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exerciseguru, this does not have to be cancer at all. It could be drug-induced, it could be some other kind of liver irritation. It could just be temporary. 100 isn't very high though it's abnormal.
If the drug holiday doesn't solve the problem then you'll need an MRI or a CT scan.
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or a simple ultrasound to start with. Oncologists have a good process to evaluate liver panel elevations because they deal with it all the time. I would just go with your MOs recommendations unless there are other symptoms or concerning labs that you haven't mentioned.
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thank you so.much for giving me more information. I am 42 and since I had dbl breastfeeding cancer they chose biopsies over MRI. I am so have a crappy gene that can link to pancrea tic and ovarian cancertain so I had my ovaries removed right after chemo.
I suspect my MO would do nothing rather than scan because I live in a small area. I will insist they follow up if they have dropped and if not I will ask for a referral to a gastro and also an ultrasound.
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Tamoxifen us notorious for elevating liver enzymes in some people. Hoping your numbers go down doon
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I elevated my liver enzymes once a few years ago by taking too much aspirin. I was on arimidex: horrible joint pain, and then after all that aspirin went and got my regular 6 month check up blood test. My MO asked me some questions and then had me test in 2 weeks. All was fine the second time around. I also called my husband's friend who is a cardiologist, and he said just taking too much advil or aspirin can cause these kinds of elevations. I hope all is well.
Claire inAZ
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Hi guys thanks my test after one month off of Tamoxifen was about the same and so I ask my MO to send me to a gastroenterologist. Hopefully he will.
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exercise Gu..
Check your insurance. You may be able to self refer. I don't need any doctor to refer me to see a specialist. I can see who I please. Your policy may be similar
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Thanks everyone for the great advice. I had my MO refer because I was hoping I could get in sooner and possibly get into a gastro who gest the cancer connection just in case.
sas-schatzi you were so right it is a month out from an appt. My MO does not want custody of this he wanted to send me back to my pcp I assume because if it is something simple like a gall bladder he doesn't want custody of it. I told him to just send me to the gastro. This means I am another 6 weeks from an ultrasound...sigh
In the meantime I am working to reduce any strain on my liver and see what I can. The big problem is do I stay on Tamoxifen as going off of it didn't do anything.
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Exercise guru - did you find out anything from the gastro? I found this searching through the site - I am waiting for a breast MRI (in January), and I just got notified that my liver enzymes are elevated, and my vitamin D levels have dropped. I was diagnosed with widespread DCIS and had DMX 2-1/2 years ago. I am also PALB2 (46 at dx, 47 had TAH/BSO, now 49). I hope you have gotten some answers. I am curious about the elevated numbers, since I almost never drink, am a very healthy weight, and am not taking any meds or herbal supplements. My PCP is having me checked again in 2 weeks. Please let me know how you are doing
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Hi We have similar stats in the TAH area and such. I was just going to update today but please pm me for support that sucks that you are having this stress.
So on the advice of the other members here I insisted that they send me to a Gastro and my MO made the referral this helped me to get in. The Gastro guy was far more willing to test everything so he ran every blood test possible. Cholesterol, Hepatitis, Thyroid,Glucose, Fasting Panel etc. He ordered an ultrasound of the entire abdomen. It took awhile and between my MO's test without Tamoxifen and my new test I cut every bit of sugar I could from my diet and ate a high fiber Breast cancer muffin every day.Orange Bran Flax Muffins but I used oat fiber instead of oat bran because I knew my cholesterol was high. Well on the retest 4 weeks later my liver markers had dropped significantly. This is a good sign that it isn't cancer. Also the liver ultrasound looked clean so they think it is the beginning of fatty liver disease.The Gastro suspects its an estrogen problem so he wants me to go to a dietitian and see if there is anything I can do. He wants me to lose a bit of weight to see if it will drop my liver markers. He said even a small amount of weight loss will drop the enzymes if I lose it slowly over 3 months but not to starve because it will cause them to artificially spike. I also stayed off of all medications for that month to see if that would help. That was over strong objections of my MO but I did it. Not recommending it but I did it. Now I am back on Tamoxifen because the AI was too hard on my bones even though I am only 44.
He will see me again in 3 months.If I develop any pain or if my markers don't continue to drop with my lifestyle changes they will biopsy my liver but there was nothing on the ultrasound noticeable so not sure what the heck they would biopsy but its not on the table for 3 months. If my enzymes go back up then I guess I need to try something else again.
Oh and my vitamin D levels were shot. The MO put me on 50'000 IU every monday for 12 weeks and they came up to normal. I now take 5000IU every monday and 2000IU every day. This was something he felt strongly about and he told me to change vitamins to one without folic acid so I did.
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