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Author Topic: Abnormal ALT post -treatment  (Read 8843 times)

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Offline mario555

  • Member
  • Posts: 226
Abnormal ALT post -treatment
« on: May 27, 2015, 01:56:41 pm »
LPortem.  Would you know why I still have high levels of ALT AST even after 24 weeks of treatment? I was UND after 4 weeks of treatment and my enzymes did come down but my ALT is just above the high normal range (it states High). Those enzymes never came back to ''normal''.
When I started the treatment I had variations between 125 to 225 on both enzymes.  My doc says ''very good'' but I look at other people results and they all look ''better''.  Any idea? Could it be that I have 2 diseases at the same time?
60 years old. Likely infected 1975. Geno 1a
F4  8 millions VL,  AST 140  ALT 140
Generally in good health except problems are creeping up rapidly!
2 failed attempts Inf 2000 and Inf-riba 2010
Harvoni 24 weeks
Start 11/13/2014   EOT 4/27/2015
VL2 - UND
VL4 - UND (may 25)
VL12 - UND
VK24 -  UND
Hopefully cured forever!

Offline lporterrn

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  • Posts: 1,969
  • LucindaPorterRN
    • LucindaPorterRN
Re: Abnormal ALT post -treatment
« Reply #1 on: May 27, 2015, 03:28:47 pm »
Hi Mario,
I moved your post since I thought it was a good topic all on its own and didn't want it to get buried in someone else's post.

Most docs don't worry about ALT that is just above normal, particularly if your enzymes have dropped significantly.  Here are a few reasons why yours might be still high:
1) That is your normal. Lab reference ranges are based on the average 150 lb man (I don't know many of those, do you?)
2) Perhaps you are taking a medication or supplement that is raising your enzymes - there are thousands that do, and usually a mild elevation isn't bothersome. If your GGT is normal, then this is less likely to be the reason
3) The presence of another medical problem, likely liver related, but not necessarily. Probably the most common reason is fatty liver, so if you are overweight or eat a lot of unhealthy foods, this should be considered.
Lucinda Porter, RN
1988 Contracted HCV
1997 Interferon nonresponder
2003 PEG + ribavirin responder-relapser
2013 Cured (Harvoni + ribavirin clinical trial)
https://www.hepmag.com/blogger/lucindakporter

Offline mario555

  • Member
  • Posts: 226
Re: Abnormal ALT post -treatment
« Reply #2 on: May 27, 2015, 03:45:27 pm »
LPortem. Thank you very much for your rapid answer. You gave me food for thoughts!

1) My enzymes dropped from 125-225 down to 60
2) I do take valium once in a while. I know it affects my liver but it calms me down. It could be the reason?
3) Although my diet has changed tremendously (for the better), I also pigged out repeatedly in pizzas, French fries and all kinds of other shit food (mmmmmmium..) It had been a fair while since I ate such crappy food but I started lately to better my nutrition
4) Finally, I exercise lightly through walks and power work around the house (ie; will wash the motorhome going up and down, will help my wife with flowers, etc...)

I am 6'2'' and weigh 180 pounds so I would consider myself slim.
3)
60 years old. Likely infected 1975. Geno 1a
F4  8 millions VL,  AST 140  ALT 140
Generally in good health except problems are creeping up rapidly!
2 failed attempts Inf 2000 and Inf-riba 2010
Harvoni 24 weeks
Start 11/13/2014   EOT 4/27/2015
VL2 - UND
VL4 - UND (may 25)
VL12 - UND
VK24 -  UND
Hopefully cured forever!

Offline lporterrn

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  • Posts: 1,969
  • LucindaPorterRN
    • LucindaPorterRN
Re: Abnormal ALT post -treatment
« Reply #3 on: May 27, 2015, 06:58:01 pm »
That is a huge drop - nice! I doubt the Valium is the problem - here is what it says about Valium:
Quote
Elevated liver function tests have been rarely reported. Periodic monitoring of liver function tests is recommended for patients on long-term diazepam (the active ingredient contained in Valium) therapy, particularly for patients with preexisting liver disease.[Ref]

Your weight is great, and occasional pig out is not likely to do this either - Morgan Spurlock ate a steady diet of crap before his enzymes raised in Supersize me.

I forgot to ask one important question - do you have cirrhosis or even stage 3 liver disease? If so, this

If not, and if it were me, I wouldn't worry about it at this point unless my doc did. But to answer your question, could you have 2 diseases at the same time? Yes. If it is a real issue, it will present itself. Has your doc offered to monitor you?
Lucinda Porter, RN
1988 Contracted HCV
1997 Interferon nonresponder
2003 PEG + ribavirin responder-relapser
2013 Cured (Harvoni + ribavirin clinical trial)
https://www.hepmag.com/blogger/lucindakporter

Offline mario555

  • Member
  • Posts: 226
Re: Abnormal ALT post -treatment
« Reply #4 on: May 27, 2015, 08:56:51 pm »
My doctor treats me a little bit like a Guinea pig. Not much interaction at all. Living in eastern Canada with our type of health system forces you to take what is given to you.
During my last biopsy in 2010, I was told I was F2 with a borderline F3. When I started treatment back in November, I had a fibroscan done (actually I had two in 2 weeks) where the results showed a number (420 if I remember correctly. My doctor's nurse (who is an angel) looked at a chart and said it corresponded to a F4.
I have no idea about another test to know more on my liver. I read in these posts about the gravity of the cirrhosis symptoms and I have none of those (yet).
Based on that, I was prescribed 24 weeks.
Seeing many people having very low level of enzymes compared to my very top of the range for normal. I think I'm just worrying but it's interesting
60 years old. Likely infected 1975. Geno 1a
F4  8 millions VL,  AST 140  ALT 140
Generally in good health except problems are creeping up rapidly!
2 failed attempts Inf 2000 and Inf-riba 2010
Harvoni 24 weeks
Start 11/13/2014   EOT 4/27/2015
VL2 - UND
VL4 - UND (may 25)
VL12 - UND
VK24 -  UND
Hopefully cured forever!

Offline lporterrn

  • Member
  • Posts: 1,969
  • LucindaPorterRN
    • LucindaPorterRN
Re: Abnormal ALT post -treatment
« Reply #5 on: May 28, 2015, 01:03:22 pm »
If you are F4, that explains your liver enzymes.

You said you don't have symptoms, so that suggests early cirrhosis, thank goodness. There is evidence that some people with early cirrhosis have either reversed liver damage or kept it from progressing. So now you really have incentive for a clean diet and healthy lifestyle, so you can be one of those people.

Are your platelets low? Found on the CBC, the plts usually drop with cirrhosis - keep an eye on them if they get below normal.
Lucinda Porter, RN
1988 Contracted HCV
1997 Interferon nonresponder
2003 PEG + ribavirin responder-relapser
2013 Cured (Harvoni + ribavirin clinical trial)
https://www.hepmag.com/blogger/lucindakporter

Offline apache

  • Member
  • Posts: 52
Re: Abnormal ALT post -treatment
« Reply #6 on: May 29, 2015, 01:21:25 am »
Hi Lucinda,

Quote
Quote
Here are a few reasons why yours might be still high:
1) That is your normal. Lab reference ranges are based on the average 150 lb man (I don't know many of those, do you?)

Is this just for ALT reference ranges, or is the 150 lb man a USA lab standard for all blood test reference ranges?

Thanks in advance.

Offline lporterrn

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  • Posts: 1,969
  • LucindaPorterRN
    • LucindaPorterRN
Re: Abnormal ALT post -treatment
« Reply #7 on: May 29, 2015, 12:18:57 pm »
It is the standard for many lab reference ranges, but some are adjusted for gender, race/ethnicity, age, weight, and medical condition
Lucinda Porter, RN
1988 Contracted HCV
1997 Interferon nonresponder
2003 PEG + ribavirin responder-relapser
2013 Cured (Harvoni + ribavirin clinical trial)
https://www.hepmag.com/blogger/lucindakporter

Offline Mugwump

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  • Posts: 776
  • My number of posts means nothing, piscor ergo sum!
Re: Abnormal ALT post -treatment
« Reply #8 on: June 03, 2015, 03:00:07 am »
I just wonder if my level of cirrhosis will ease up if I stop looking like this in a while?

Caution shameless self promotion below :-)
https://www.hepmag.com/article/eric-reesor-27742-782589663
DING DONG MY DRAGON (HCV) IS FINALLY DEAD!

 


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