liver enzymes

I really need as many replies to this as possibe.  Im getting frustrated and I wanna know who had similar problem before surgery...

My cholesteral is very high....263....and also my liver eznymes are double what they should be. I have been diagnosed with "fatty liver" which I am sure many of you had before your surgery. I am supposed to lose 4 lbs a month for the next few months per the NP at my surgeons office. The first month I did it- I lost four lbs- how ever when I had another blood test to submit to insurance for the surgery , my liver enzymes were up even higher! The only thing I can think may have done it is that I took 4 extra strength tylenol earlier that day on an empty stomach and my mom is a nurse and thinks that that did it. How ever, now my GP thinks something else is wrong with my liver even though they have tested me for everything under the sun and it's all negative

Im frustrated because the only thing it is is that I'm obese and she's trying to say I'm having some other problem. I just wanna submit everything to the insurance company so I can get this done! I want a new life, I'm tired of all these health problems and so I'm just curious who had high liver enzymes before the surgery. As many replies as I could get would be very helpful!

Thanks!

Sorry for your health problems. However, you must get to the bottom of your problems before surgery so that you aren't in any danger after surgery. Thats why surgeons do a lot of pre-op testing. Its to protect you.

Your day will come.. Don't you fret. Try and lose as much as you can before surgery. It's very important that you do your best.

Good Luck

I know this but my whole thing is thats the reasons we have this surgery to get in check with our health problems. I have a fatty liver from being obese and having high cholesteral and they are acting like I'm dying and my liver is failing. I just want them to understand that I have been through all kinds of tests and its nothing more than fat on and in my liver. They have even told me this but beause the enzymes went up more, they think something else is wrong now and it's just that I took a bunch of tylenol that day on an empty stomach. I eat healthier and I've lost weight so theres no reason why they should of shot up like that. I am seeing a specialist soon however to appease them since she is giving me a hard time with the surgery in general even though she gave me a referral without a second glance and I'm almost done with everything and ready to sbumit to insurance and now she's throwing this on me. It just stinks. It's been a long process and now this is in the way. thanks.

I had NASH - which is a fatty liver that has fibrosis and cirrhosis.  My enzymes were elevated.  I had already had a liver biopsy.

Work through what the docs tell you.  Don't be surprised if they send you to a liver doctor.  There are some really good ones at Strong Memorial in Rochester. 

Trust me, get it completely checked out.  You'll thank yourself for the delay later.

The surgery puts a HUGE stress on the liver.  You don't want anything to happen to it.

i think im just in the first stages of the fatty liver. I mean, Im only 28. My mom is a nurse and she said that most people who are overweight and obese have a fatty liver its just most don't know about it. I didnt know about it until now and I've been considered obese for about 5 years now and overweight my entire life. I wouldnt of known if I didnt have to have a ll kinds of tests for this surgery. On top of being obese, I also take a lot of tylenol. I have constant head aches and pains, Im sure due to my weight so im thinking this surgery is going to help me a lot. I am going to see a gastroenterologist on the 12th- Im sure the same thing is going to happen and they are going to tell me to lay off the tylenol and start eating better- which i have been doing anyway in prep for the surgery. I honestly think the tylenol is doing more damage to the liver than the fatty liver since it can regenerate so Im only taking tylenol a coupletimes a week now as opposed to a few times a day

Yes, you're young, but at 35 I was vomitting blood and walked into the ER (stubborn guy that I am), I was 7 units of blood low.

It turned out to be esophageal varices caused by my liver.  Docs had never seen it in someone as young as me.


I drank 1-2 beers on Friday and/or Saturday night - by NO means a drinker.

Get it throughly checked out so you don't end up like me.  I was denied by NINE doctors before I found one willing to work on me if I jumped through a few hoops.

I have always have an elevated GGT, they chalked it up to fatty liver, but as an occasional drinker, that can also cause an elevated GGT.  The only think I can suggest is to not drink anything (if you do drink) and go low fat and low carb (knock out the white/wheat carbs) and see if that helps.

Good luck!

whats funny is I do not drink. I mean barely ever! I think I've had probably 2 drinks in the past 3 years if that! I think its mainly due to my cholesteral/fatty liver. I also take a lot of tylenol which Im goingto have to suck it up and deal with the pain and stuff and hopefully that will make it better too. Thanks.

The preop process can be frustrating.
Even when we realize it is in our best interest.
Any delay outside of our expectations is challenging.

So many things can cause liver function elevations.
NASH or fatty liver of course is common in the obese, but that may not be the only issue underlying elevation and even so depending on severity could be problematic if not addressed FIRST before WLS. Even those of a young age can have a potential for fibrosis and cirrhosis.
Liver biopsy is commonly performed pre-wls many times to determine level of disease or underlying isues..

Not all elevted LFTs are due to medications (i.e. tylenol), or diet..could be hepatitis; Patients with acute hepatitis have increased morbidity and mortality associated with surgery.These increases probably occur as a result of the acute hepatocellular injury and associated hepatic dysfunction. As most cases of acute hepatitis are self-limited and symptoms ultimately resolve, elective surgery should be postponed until the patient's clinical, biochemical and histologic parameters return to baseline.

Cirrhosis. In patients with cirrhosis, perioperative risk can be influenced by hepatic dysfunction, portal hypertension and complications such as intra-abdominal varices, ascites, renal dysfunction, and portopulmonary hypertension. Abdominal surgical procedures--such as gastric bypass, biliary procedures, ulcer surgery and colonic resections--increase morbidity and mortality in patients with cirrhosis.Patients with increased preoperative LFTs, hyperlipidemia, and increased BMI are more likely to have non-alcoholic steatohepatitis, fibrosis, or cirrhosis on liver biopsy during weight loss surgery.

There are important clinical ramifications because NAFLD/NASH can progress to cirrhosis resulting in increased liver-related morbidity and mortality, including hepatocellular carcinoma. Biosy can help esp when postop to compare on improvment.

Preop wt loss via low carb and higher protein like diet choices can help shrink liver and ease surgery,s ometimes a enlarged liver is too risky to allow safe surgery.........Surgeons feel better to have an obese pt alive than dead on the OR table. With WLS there have been lingering concerns about the effects of rapid weight loss on the liver...
http://www.aafp.org/afp/990415ap/2223.html
http://www.liverdisease.com/liverenzymes_hepatitis.html

there is a potential of elevated liver enzymes leading to possible cirrhosis of the liver and/or liver failure after RNY.

Fatty Liver Amelioration Through Bariatric Surgery

http://www.obesityhelp.com/forums/rny/cmsID,9457/mode,content/
Keep us posted.