Managing Elevated Liver Enzymes: Treatment Options and Lifestyle Changes - Gastroenterology and Hepatology

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Managing elevated liver enzymes, particularly in the context of chronic hepatitis C and potential fatty liver disease, requires a comprehensive approach that includes both medical treatment and lifestyle modifications. Your current liver enzyme levels, with GOT at 71 and GPT at 178, indicate liver inflammation, which can be caused by various factors including viral infections, alcohol consumption, and metabolic conditions like fatty liver disease.

Understanding Your Condition:
Given your history of hepatitis C infection from a blood transfusion, it is crucial to monitor your liver health closely. Elevated liver enzymes suggest that your liver is under stress, and this can lead to further complications if not addressed. Fatty liver disease, which you mentioned, can exacerbate liver inflammation and is often associated with obesity, diabetes, and high cholesterol levels.

Treatment Options:
1. Antiviral Therapy: Interferon therapy has been a traditional treatment for hepatitis C, but it is not the only option available today. Direct-acting antivirals (DAAs) have become the standard of care due to their effectiveness and fewer side effects. If your doctor has suggested interferon, it may be worth discussing the possibility of DAAs instead, especially if you are concerned about the time commitment required for treatment.

2. Monitoring: If you are not ready to start antiviral therapy immediately, regular monitoring of your liver enzymes and overall liver function is essential. This will help you and your healthcare provider assess the progression of your liver disease and determine the best time to initiate treatment.

3. Lifestyle Modifications:
- Diet: Focus on a balanced diet rich in fruits, vegetables, whole grains, and lean proteins. Avoid high-fat, sugary, and processed foods, which can contribute to fatty liver disease.

- Weight Management: If you are overweight, losing even a small percentage of your body weight can significantly improve liver health. Aim for gradual weight loss through a combination of diet and exercise.

- Exercise: Regular physical activity can help reduce liver fat and improve overall liver function. Aim for at least 150 minutes of moderate-intensity exercise each week.

- Avoid Alcohol: Alcohol can further damage your liver, especially when it is already inflamed. It is advisable to avoid alcohol entirely to protect your liver health.

4. Stress Management: Given that you are preparing for graduate school, managing stress is crucial. Chronic stress can negatively impact your liver health. Consider incorporating relaxation techniques such as yoga, meditation, or deep-breathing exercises into your routine.

5. Regular Check-ups: Continue to have regular check-ups with your healthcare provider to monitor your liver function and discuss any changes in your condition or treatment options.

Conclusion:
While it is understandable that you may want to delay treatment due to your current academic commitments, it is important to prioritize your liver health. Elevated liver enzymes can indicate ongoing liver damage, and delaying treatment could lead to more significant issues down the line. Discuss your concerns with your healthcare provider, who can help you weigh the risks and benefits of starting treatment now versus later. Remember, managing your liver health is a long-term commitment that involves both medical treatment and lifestyle changes.