Liver enzymes high..who to see?

I am eight months out and my liver enzymes are higher than they normally see.  My AST is 89 IU/L with limits of 0-40 and my ALT is 342 with limits of 0-40 also.

The sugeon ( Dr. Smith) had signed off on my labs and said they were great, but my GP got worked up over my liver enzymes and told me to call Dr. Smith and ask about it.  Dr. Smith looked at my labs and said the Liver Enzymes are higher than he sees so he wants me to come in.  My GP was going to send me for a Liver Ultrasound so I kind of wanted to let the GP handle this, but Dr. Smith's office really wants to see me.  His office is a big pain for me to get to so I really want to go  to my GP.
My questions are, am I ok to go through my GP and what else could this be?  I do not drink or take tylenol.  My GP already looked over medications and I guess did not think that was the cause.

I doubt Dr Smith can do anything for you other than perhaps suggest a specialist who is DS or WLS savvy. Our AST and ALT can run high as we lose weight but they don't usually run into the 300s.

--gina

 Agree with MajorMom.  Losing weight as rapidly as you are is taxing on the liver, and this reaction is normal.

They don't normally see them run as high as mine!  I am so nervous about this because my neighbor had WLS and then had to have a liver transplant.  I am not sure if they were related or if e already has liver damage.  He is not a drinker either.

I am 8 months out so 8 months ago I had a normal liver biopsy come back.  I wonder why one reading is sooo high?

It is over an hour and a pain to get to Dr. Smith's office so I really don't want to go in.  I hope my GP will contact him if I don't see him.

At 18 months post op my liver enzymes were still elevated.  This was never the case prior to surgery.  I discussed this with my surgeon and he said that it could take a few years for them to normalize after rapid weight loss and he wasn't concerned.  I did start on Milk Thistle and it may be helping as they are dropping.  Probably would have happened anyway but decided to try to help things along.

Hi Mel,

I'm about 2.5 years out and my liver enzymes are still high. I've tried milk thistle and it didn't help. After my last visit with my DS doc in Ohio, he told me to hook up with a GI doctor (where I live in NC)  to see if we can find out what is going on.So I've had an abdominal ultra sound that shows dialted common bile duct, a one inch mass on one kidney and a couple of stones.  Those results led to a CT scan with contrast which showed no one inch mass (thank God) but  a buttload of stones on both kidneys, and a dilated common bile duct. (no more fatty liver) Blood was drawn for oodles of tests and I go back for those results on March 28. I also had a liver biopsy during my DS and those results are being sent to my GI doc.

I'm on pain meds that can have a lot to do with my liver enzymes on the fritz. I do not take Tylenol, or NSAIDS. Pain meds have been switched to ease the taxing on my liver.  Everything is being scrutinzed and ruled out, which is a good thing. My symptoms are fatigue, rash like bumps, red palms (had that for years),  and upper right abdominal pain so bad at times I double over and must lay down until it passes. It's a wait and see that can drive you crazy... if you let it.

It is normal to have high enzymes during and after your wls--it's hard on your body to lose weight rapidly. It should taper off down to normal range after 1 to 1.5 years. Mine never did. Wish you the best and will save a pinch of that luck for me. *lol*

Just what I would do if I were you:  Ask Dr Smith to consult with your GP.  WITHOUT an office visit to Marietta.

What can he do with you in his office that he can't do long distance?  Whatever tests/specialists/etc he wants to order he can do via your pcp.

~Becky

Thanks everyone!