Why Is My Liver Function Getting Worse Despite Taking Hepatic Medications?

Q: Why Is My Liver Function Getting Worse Despite Taking Hepatic Medications?

Hello Ms. <br>Crystal： This is your first time using Gan An Neng, and it's rare to develop resistance so soon (usually it appears after more than 9 months). <br>Please be patient and cooperate with your physician. <br>Additionally, a bilirubin level of 1.1 is not high; jaundice i

Taking Hepatoprotective agents can lead to an increase in GPT levels and bilirubin instead of a decrease?

Hello Doctor: I am a carrier of hepatitis B.
Recently, my liver function tests showed abnormal results, with a GPT level as high as 377, and a bilirubin level of 0.8.
Following my doctor's advice, I started taking Hepa-Merz, and I have been on it for five weeks.
However, my GPT level has continued to rise, reaching 468, and my bilirubin level has increased to 1.1, with a viral load of over 28,000.
I often feel fatigued, have nausea, and my eyes appear yellow.
Could you please explain why my levels are still rising despite taking the medication? Is the medication ineffective for me, or could I have developed resistance? Is there a risk of liver failure? If my levels continue to rise, what should I do? What steps can I take to improve my condition?

Shuǐjīng, 20~29 year old female. Ask Date: 2008/03/03

Dr. Chen Shidian reply Gastroenterology and Hepatology

Hello Ms.
Crystal: This is your first time using Gan An Neng, and it's rare to develop resistance so soon (usually it appears after more than 9 months).
Please be patient and cooperate with your physician.
Additionally, a bilirubin level of 1.1 is not high; jaundice is typically considered when levels are above 2-3.
Please maintain a regular routine.
Changhua Hospital cares about your health, Chen Shidian.

Reply Date: 2008/03/03

More Info

It sounds like you are experiencing significant concerns regarding your liver function and the effectiveness of your current treatment regimen for hepatitis B. Given your elevated GPT levels and the symptoms you are experiencing, it's crucial to address these issues comprehensively.

Firstly, it's important to understand that liver function tests (LFTs) such as GPT (ALT) and GOT (AST) are indicators of liver health. Elevated levels can suggest liver inflammation or damage, which can be caused by various factors, including viral infections, alcohol consumption, medication effects, or underlying liver diseases such as fatty liver disease or cirrhosis.

In your case, despite taking hepatic medications like "肝安能" (likely referring to a liver protective agent), your GPT levels have continued to rise. This could be due to several reasons:
1. Inadequate Response to Treatment: It is possible that the medication you are taking is not sufficiently effective for your specific condition. Not all patients respond to antiviral medications in the same way, and some may require a different medication or a combination of therapies to achieve better control of the virus and improve liver function.

2. Viral Resistance: There is a possibility of developing resistance to antiviral medications, especially if the virus mutates. This can lead to treatment failure, where the virus continues to replicate despite medication. Regular monitoring of viral load (HBV-DNA) is essential to assess the effectiveness of your treatment.

3. Underlying Liver Conditions: Other liver conditions, such as non-alcoholic fatty liver disease (NAFLD), autoimmune hepatitis, or even alcohol-related liver disease, could be contributing to your elevated liver enzymes. If you have not been evaluated for these conditions, it may be worthwhile to discuss further testing with your healthcare provider.

4. Medication Side Effects: Some medications can cause liver enzyme elevations as a side effect. If you are taking multiple medications, it is important to review them with your doctor to determine if any could be contributing to your liver issues.

5. Lifestyle Factors: Diet, alcohol consumption, and overall lifestyle can significantly impact liver health. Even small amounts of alcohol can exacerbate liver issues, and a diet high in fats and sugars can lead to fatty liver disease. Ensuring a balanced diet, maintaining a healthy weight, and avoiding alcohol can help improve liver function.

Given your symptoms of fatigue, nausea, and jaundice (yellowing of the eyes), it is crucial to seek immediate medical attention. These symptoms may indicate worsening liver function or potential liver failure, which requires urgent evaluation and management.

Recommendations:
1. Consult Your Hepatologist: Schedule an appointment with your liver specialist to discuss your current treatment plan, the rising liver enzyme levels, and your symptoms. They may recommend adjusting your medication or adding additional therapies.

2. Regular Monitoring: Ensure that you have regular blood tests to monitor liver function and viral load. This will help your doctor assess how well your treatment is working and make necessary adjustments.

3. Lifestyle Modifications: Focus on a liver-friendly diet rich in fruits, vegetables, whole grains, and lean proteins. Avoid alcohol and limit processed foods high in sugar and fat. Regular exercise can also help improve liver health.

4. Consider Additional Testing: If not already done, discuss the possibility of further testing to rule out other liver conditions or complications.

5. Stay Informed: Educate yourself about hepatitis B and liver health. Understanding your condition can empower you to make informed decisions about your treatment and lifestyle.

In conclusion, while it can be concerning to see worsening liver function despite treatment, there are many factors at play. Working closely with your healthcare provider to evaluate your treatment plan and make necessary adjustments is essential for improving your liver health.

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