Paging Dr. Hive -update 3.12 in 1st post

[lauraw4321]

Sorry, this is a long one. I have chronic high liver enzymes (AST and ALT) and in a pattern that is generally not linked to alcohol consumption. My PCP did bloodwork that ruled out viral hepatitis and did an ultrasound of my abdomen. The ultrasound and bloodwork was normal. He referred me to a gastroenterologist. 

The gastro said that another test they had performed (although it's not in my electronic chart) was an ANA. The results were 1:320 in a speckled pattern. He said that was "interesting." He then ordered a fibrin test (which will measure liver damage and liver inflammation) and a panel of inborn errors (although he thinks it very unlikely I have those since I've lived to 40 without any signs of them). So it's either nothing, fatty liver disease, or autoimmune hepatitis.

When I pressed him on the ANA, he shrugged and said "if you're worried, see a rheumatologist." I'm a little perturbed that this abnormal lab wasn't even brought to my attention by my PCP. 

My grandmother had RA, and I do have some symptoms of Sjogren's (it's been suggested as a diagnosis to me by an ophthalmologist before). 

A friend whose father is a gastro had told me to get thyroid levels checked as well, as there seems to be some correlation between liver enzymes and thyroid hormones? I asked the gastro if he would order it, and he refused.

My plan is to go back to my PCP and ask for the thyroid test and the referral to the rheumatologist. Is there anything else I should do?

[Note, I just finished up another really long exhausting medical odyssey because I keep having one pupil blow (dilate abnormally). After a CT, MRI, neurologist consult, ophthalmologist consult, and neuro-ophthalmologist consult (how long was he in school?!?) the final diagnosis? Abnormal ocular migraine. PLUS I had a mammogram followed by a breast ultrasound this year (all normal). Basically my insurance ain't making money off of me this year!]

Update 3.12 - My fibrin test showed no fibrosis and 1 out of four for inflammation. All other tests normal. I did get PCP to order thyroid tests but lab seems to have lost them. Not sure what’s next steps are. I feel like “chronic” or mild inflammation has been the story of my life. I once had to get a cervical biopsy (in the days before HPV tests) and the result?  “Chronic cervicitis”. I did get a referral to a rheumatologist, but of course it’s in July. We’ll see if gastro has any other thoughts. In the meantime I’m relieved my liver isn’t fibrotic. 

Edited March 13, 2021 by lauraw4321

[Pawz4me]

My liver enzymes were elevated before I was diagnosed with hypothyroidism. After I was well medicated they returned to normal. So, yeah . . . get that checked. And I'd ask for a referral to a rheumy. I don't know much about ANA results, but if there's anything remotely questionable about yours, and combined with the ophthalmologist's suggestion of Sjogren's, and family history of RA . . . I'd want a rheumy's opinion.

[Kassia]

I have had elevated liver enzymes for quite a while now and no one knows why.  I had an u/s with normal results.  I've had numerous other weird health issues and no one can figure out what is going on.  My PCP referred me to GI, a kidney doctor, an endocrinologist, a neurologist, a vascular specialist, and another specialist (I can't even remember now because there were so many).  I've seen two specialists so far and can't hop from specialist to specialist.  No resolution.  I spoke with my gynecologist about it (wacky unexplained hormone levels too) at my well visit last week and she said I'm a "mystery."  

Hope you get yours resolved.  This has been an extremely frustrating experience for me.  Medicine is definitely not an exact science.  

 

[lauraw4321]

5 hours ago, Kassia said:

I have had elevated liver enzymes for quite a while now and no one knows why.  I had an u/s with normal results.  I've had numerous other weird health issues and no one can figure out what is going on.  My PCP referred me to GI, a kidney doctor, an endocrinologist, a neurologist, a vascular specialist, and another specialist (I can't even remember now because there were so many).  I've seen two specialists so far and can't hop from specialist to specialist.  No resolution.  I spoke with my gynecologist about it (wacky unexplained hormone levels too) at my well visit last week and she said I'm a "mystery."  

Hope you get yours resolved.  This has been an extremely frustrating experience for me.  Medicine is definitely not an exact science.  

 

I'm sorry for the frustration. I totally understand. So much of the work of it is put on us as patients. I'm praying for answers for both of us.

[lauraw4321]

Bumping this with update in the first. Does anyone have recommendations of the best way to consume ginger? All of my research indicates it's likely very beneficial for the general health issues I'm facing, so I'm wondering how to make sure I get some every day. I often make tea with ginger added, but not every day. Anyone take it as a supplement? Favorite brand?