High Liver Enzymes Without Symptoms: Navigating B Hepatitis Management

Q: High Liver Enzymes Without Symptoms: Navigating B Hepatitis Management

Hello Ms. <br>Ting： Please follow up on <a href="https：//adoctor.tw/article/36392">#36392</a>; regarding the changes in liver function and E antigen. <br>If necessary, Tenofovir (a type of hepatitis B virus suppressor) is more suitable for use in pregnant patients, but there are

There is no feeling of fatigue or jaundice, but liver enzyme levels are as high as 400 to 500?

Hello Dr.
Chen,
I was healthy during my childhood, but during a health check in college, I discovered that I am a carrier of hepatitis B.
However, for several years afterward, my lifestyle was normal without any special issues.
In September of this year, during another health check, I found that my liver enzyme levels were extremely high, with GOT and GPT over 500 and 400, respectively.
During that time, I was quite busy with work, experiencing stress and poor sleep.
After discovering this, I adjusted my routine and took more rest.
Since then, I have been going to the hospital for blood tests every week to every two weeks, but my enzyme levels have not decreased; the most recent test showed around 350, with a viral load reaching 10 to the ninth power.

Despite this, I do not feel particularly fatigued and have no symptoms such as jaundice.
The outpatient physician advised that I cannot allow my liver to continue to be inflamed like this, as it could lead to cirrhosis if it persists for more than three months.
If my test results at the end of December are still this high, I will need to take medication to force the enzyme levels down.
However, since I have been married for over a year and am planning to have children, the doctor mentioned that once I start medication, I cannot conceive for 1 to 3 years.

During this time, in addition to liver-protective medications, I have been taking traditional Chinese medicine from the hospital's TCM clinic, drinking clam soup, and consuming some herbal remedies, but there has been no significant improvement.
I would like to ask Dr.
Chen what I should do next.
Thank you for your response!

Ting, 30~39 year old female. Ask Date: 2008/12/08

Dr. Chen Shidian reply Gastroenterology and Hepatology

Hello Ms.
Ting: Please follow up on #36392; regarding the changes in liver function and E antigen.
If necessary, Tenofovir (a type of hepatitis B virus suppressor) is more suitable for use in pregnant patients, but there are considerations regarding drug resistance.
Please discuss medication options with your gastroenterologist.
Changhua Hospital cares about your health.
Chen Shidian

Reply Date: 2008/12/08

More Info

Managing high liver enzymes in the context of chronic Hepatitis B can be a complex and concerning issue, especially when symptoms are not apparent. Your situation, as a chronic Hepatitis B carrier with elevated liver enzymes (GOT and GPT in the 500-400 range), indicates that your liver is under stress, likely due to ongoing inflammation or viral activity.
Firstly, it’s important to understand that elevated liver enzymes can be a sign of liver inflammation, which may not always correlate with the presence of symptoms. In your case, despite feeling relatively well and not exhibiting symptoms like fatigue or jaundice, the high enzyme levels suggest that your liver is still experiencing significant stress. This is particularly concerning because prolonged inflammation can lead to complications such as liver fibrosis or cirrhosis over time.

Given your history of being a Hepatitis B carrier and the recent spike in liver enzymes, it is crucial to closely monitor your liver function. Regular blood tests are essential to track the levels of liver enzymes, viral load, and other relevant markers. Your healthcare provider has indicated that if your liver enzymes remain elevated for more than three months, you may need to consider antiviral therapy to help suppress the virus and reduce liver inflammation.

Regarding your concerns about starting antiviral medication, it is understandable to be apprehensive, especially with plans for starting a family. However, it is essential to weigh the risks of untreated chronic Hepatitis B against the potential implications of antiviral therapy. While some antiviral medications can affect fertility and pregnancy, there are options available that may be safer during this period. For instance, medications like tenofovir are often considered safe for use in women of childbearing age and can effectively reduce viral load without significant risks to future pregnancies.

In addition to medication, lifestyle modifications can play a significant role in managing your liver health. Maintaining a balanced diet, avoiding alcohol, and managing stress are all critical components of liver care. It’s also advisable to avoid any unproven herbal remedies or supplements without consulting your healthcare provider, as these can sometimes exacerbate liver issues.

If you are hesitant about starting antiviral therapy due to concerns about pregnancy, it is crucial to have an open discussion with your healthcare provider. They can provide guidance on the best course of action, considering your personal and family planning goals. They may also refer you to a specialist in liver diseases or a hepatologist who can offer more tailored advice based on your specific situation.

In summary, while your current lack of symptoms may provide some reassurance, the elevated liver enzymes indicate that your liver requires careful monitoring and possibly intervention. Engaging in a proactive dialogue with your healthcare team about your treatment options, lifestyle changes, and family planning will be essential in navigating your Hepatitis B management effectively. Remember, early intervention can significantly improve outcomes and reduce the risk of long-term complications associated with chronic Hepatitis B.

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