High Liver Enzymes: What to Do When Levels Reach 900-1690?

Liver enzyme levels ranging from 900 to 1690 indicate a significant elevation. It is crucial to consult a healthcare professional for a thorough evaluation and appropriate management. Possible steps

I recently had my liver function tests done, and the results were shockingly high, ranging from 900 to 1690.
Is this an acute exacerbation of chronic hepatitis B? I'm really worried.
Could this lead to fulminant hepatitis? I have chronic hepatitis B, and for the past week, I've been feeling fatigued, nauseous, and have lost my appetite.
My urine has been darker, and while some of these symptoms have improved, my liver enzymes remain elevated.
I also notice a slight yellowing in the whites of my eyes.

What should I pay attention to regarding my health at this time? I am currently taking the medication prescribed by my doctor and trying to rest more.
Will my condition improve? What else should I monitor? Thank you.

P.S.
I apologize for not wanting to be hospitalized immediately.
I understand the need for hospitalization, but I have many considerations.
Please respect my decision.
I would like to know what to do next if I choose not to be hospitalized.
Thank you.

Wang, 20~29 year old female. Ask Date: 2004/11/30

Dr. Li Xuanshu reply Gastroenterology and Hepatology

Hello! You are a carrier of hepatitis B, and such values are indeed concerning.
Whether it could evolve into fulminant hepatitis requires further evaluation of more data.
Sometimes, symptoms do not necessarily correlate with laboratory results, so you must not neglect follow-up just because you feel some improvement in symptoms, especially since your current condition is not very stable and requires close monitoring.
Whether hospitalization is necessary should be assessed by a physician.
However, the most important thing is to cooperate with your doctor and not to self-medicate.
Of course, it is also essential to get plenty of rest.

Reply Date: 2004/11/30

More Info

When liver enzyme levels soar to alarming heights, such as between 900 and 1690, it is crucial to understand the implications and necessary steps to take, especially for someone with a pre-existing condition like chronic Hepatitis B. Elevated liver enzymes, specifically alanine aminotransferase (ALT) and aspartate aminotransferase (AST), indicate liver cell damage and inflammation. In your case, the significant increase in these enzymes suggests a severe exacerbation of your chronic condition, potentially leading to acute liver failure if not managed properly.

Given your symptoms of fatigue, nausea, loss of appetite, and jaundice (yellowing of the skin and eyes), it is evident that your liver is under considerable stress. The fact that you are experiencing these symptoms alongside elevated liver enzymes is concerning and warrants immediate attention. While you may feel that your symptoms have improved, the high enzyme levels indicate that your liver is still in a compromised state.

What to Do Next
1. Continue Medication: It is essential to adhere strictly to the antiviral medications prescribed by your doctor. These medications are designed to suppress the Hepatitis B virus and can help reduce liver inflammation over time. Do not stop or alter your medication without consulting your healthcare provider.

2. Regular Monitoring: Since you are concerned about your liver health, regular monitoring of your liver function tests (LFTs) is crucial. This includes checking your ALT, AST, bilirubin levels, and other relevant markers. Keeping track of these levels will help you and your doctor assess the effectiveness of your treatment and make necessary adjustments.

3. Diet and Hydration: Focus on a liver-friendly diet. This includes avoiding alcohol, processed foods, and high-fat meals. Instead, opt for a balanced diet rich in fruits, vegetables, whole grains, and lean proteins. Staying well-hydrated is also vital, as it helps your liver function more effectively.

4. Rest and Stress Management: Your body needs ample rest to recover. Ensure you are getting enough sleep and managing stress levels, as stress can exacerbate liver issues. Gentle activities like walking or yoga can be beneficial, but avoid strenuous exercise until your liver function improves.

5. Avoid Over-the-Counter Medications: Be cautious with over-the-counter medications, especially acetaminophen (Tylenol), as it can be harmful to the liver, particularly when liver function is already compromised. Always consult your healthcare provider before taking any new medications or supplements.

6. Watch for Warning Signs: Be vigilant for any worsening symptoms, such as increased jaundice, severe abdominal pain, confusion, or significant changes in your mental state. If you notice any of these, seek medical attention immediately.

7. Consider Lifestyle Changes: If you smoke, consider quitting, as smoking can further strain your liver. Engaging in regular, moderate exercise can also improve overall health and support liver function.

Conclusion
While it is understandable that you may have reservations about hospitalization, it is crucial to recognize that severe liver enzyme elevations can lead to life-threatening complications. If your condition does not improve or worsens, you may need to reconsider your decision regarding hospitalization. Your health and safety should always come first.
In summary, managing chronic Hepatitis B with high liver enzymes requires a comprehensive approach that includes medication adherence, lifestyle modifications, and regular monitoring. Stay in close communication with your healthcare provider to ensure you receive the best possible care tailored to your specific situation.

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