Liver Health: Concerns About Elevated Enzymes and Symptoms

Q: Liver Health: Concerns About Elevated Enzymes and Symptoms

Hello： Seventy percent of hepatitis cases are asymptomatic, unless it is acute hepatitis (with GPT levels exceeding 500), which may lead to fatigue or loss of appetite. <br>Therefore, the symptoms you described may be related to gastrointestinal issues or emotional stress, and ar

Liver

Hello, doctor! On May 25, 2003, I had a blood test showing GOT 50 and GPT 109.
I have hepatitis B and was given a one-month supply of medication to take home (brown, 2 cm long soft gel capsules with a strong taste).
I would like to ask...
Recently, I often feel a tightness in my chest (in the middle of the upper abdomen) and it is very uncomfortable.
I have to breathe very deeply to feel somewhat better, and this mostly happens when I am fatigued or haven't slept well.
Is this related to my liver? Do I have to wait three months before I can have another blood test? Is fasting required? If my liver enzymes do not decrease, what complications could arise? Thank you.

Xiao Huang, 10~19 year old female. Ask Date: 2003/06/27

Dr. Yang Peizhen reply Gastroenterology and Hepatology

Hello: Seventy percent of hepatitis cases are asymptomatic, unless it is acute hepatitis (with GPT levels exceeding 500), which may lead to fatigue or loss of appetite.
Therefore, the symptoms you described may be related to gastrointestinal issues or emotional stress, and are not connected to your current liver enzyme levels.
Since you are a carrier of hepatitis B, liver inflammation levels may fluctuate, and the medication you are currently taking is merely a general liver protection supplement.
True antiviral medications must be used at the appropriate time to achieve significant effects.
This is why blood tests are conducted approximately every three months.
If the enzyme levels remain persistently elevated, it could lead to long-term liver damage, potentially progressing to cirrhosis, which significantly increases the risk of liver cancer.
To avoid such sequelae, it is best to choose an appropriate time to eradicate the hepatitis B virus.
Best wishes for your health from Dr.
Yang Pei-Chen, Gastroenterology Department, Taoyuan Hospital, Ministry of Health and Welfare.

Reply Date: 2003/06/27

More Info

Elevated liver enzymes, such as GOT (AST) and GPT (ALT), can be indicative of liver dysfunction or damage. In your case, with GOT at 50 and GPT at 109, these values suggest that there may be some level of liver inflammation or injury. Given that you have a history of B-type hepatitis and are currently on medication, it is essential to monitor your liver health closely.

1. Understanding Elevated Liver Enzymes: Elevated levels of liver enzymes can result from various conditions, including viral hepatitis, fatty liver disease, alcohol-related liver disease, and autoimmune liver disorders. In your case, since you have B-type hepatitis, the elevated enzymes could be a direct result of the viral infection affecting your liver. The liver is responsible for metabolizing substances and detoxifying the blood, so any damage to liver cells can lead to the release of these enzymes into the bloodstream.

2. Symptoms and Their Relation to Liver Health: You mentioned experiencing chest discomfort, particularly in the upper stomach area, which can be concerning. While this discomfort may not be directly linked to liver function, it is essential to consider that liver issues can sometimes manifest as referred pain or discomfort in the upper abdomen or chest. Additionally, fatigue and lack of sleep can exacerbate feelings of discomfort, making it harder to distinguish between symptoms related to liver health and those related to general fatigue or anxiety.

3. Follow-Up Testing: It is generally advisable to wait at least three months before retesting liver enzymes after starting treatment for hepatitis, as this allows time for the medication to take effect and for the liver to potentially heal. However, if your symptoms worsen or if you experience new symptoms, it may be prudent to consult your healthcare provider sooner. Blood tests for liver function do not always require fasting, but it is best to follow your doctor's specific instructions regarding preparation for the test.

4. Consequences of Persistently Elevated Liver Enzymes: If liver enzyme levels remain elevated, it could indicate ongoing liver damage or inflammation. This situation can lead to more severe complications, such as liver fibrosis, cirrhosis, or even liver failure if not addressed. Chronic liver disease can also increase the risk of developing liver cancer. Therefore, it is crucial to maintain regular follow-ups with your healthcare provider to monitor your liver function and adjust treatment as necessary.

5. Lifestyle Considerations: In addition to medication, lifestyle changes can significantly impact liver health. Maintaining a balanced diet, avoiding alcohol, and managing weight can help support liver function. Regular check-ups and open communication with your healthcare provider about any new or worsening symptoms are essential for managing your liver health effectively.

In summary, while your elevated liver enzymes and symptoms warrant attention, they can be managed with appropriate medical care and lifestyle adjustments. It is crucial to stay in close contact with your healthcare provider to monitor your condition and make necessary changes to your treatment plan.

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