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Elevated Liver Enzymes, On Aleve For Tooth Pain, Birth Control, Milk Thistle Medication, Blood Test, Ultrasound Normal, AST, ALT Elevated. Treatment ?

Posted on Fri, 8 Jun 2012

Question: I am 37 year old female, with elevated liver enzymes, My ASt and ALT were high, 151 and 391 the first time then 2 weeks later thay dropped to 101 and 191 but still were high, then a month later they dropped to 61 and 101 but still elevated, this was the lastr test I did a month ago. the month before taking the first blood test, I was taken a Aleve for a toothache I had while working abroad, becasue I coukd not get to the dentist until a month later. I was taking 5 to 6 aleve tablets at a time 2 till 3 times a day. I have not taken aleve since XXXXXXX 30 and I got off my birth control medicine as well. I am still abroad working but I am taking Milk Thistle capsule and I have been drinking daily detox tea for the past 4 weeks. Do you think the enzyme levels should be normal by now. All blood tests that have been given to me have been normal, the ultra sound was good as well, the doctor can not find nothing that is the problem.

Answered by Dr. Vaibhav Banait (25 hours later)

Hello

Thanks for posting query.

You seem to have Acute (duarion of liver abnormality less than 6 month) hepatic dysfunction. This could be due to

1. Viral infection (Hepatitic A, B, C, E viruses)
2. Though hepatic damage due to NSAIDs (Naproxen) is rare, occassional cases of acute liver injury due to the drugs has been described.

I would recommend, you should repeat liver function test. If enzymes are normal, this has to be confirmed by repeat enzyme testing after three months as fluctuations may occur.

If abnormal, you should test for viral markers in consultation with Gastroenterologist. Negative viral marker should lead to further tests to know the exact cause of liver abnormality.

Milk thistle is of doubtful utility.

Hope I have answered your queries adequately. Should you have any more doubts, I am available to address them.

Regards.
Dr. Vaibhav Banait.

Above answer was peer-reviewed by : Dr. Jyoti Patil

Follow up: Dr. Vaibhav Banait (2 hours later)

I have taken the hepatis tests and they were all negative. The only thing I did out of the ordinary is working overseas in Iraq and taking aleve and Birthcontrol.

Answered by Dr. Vaibhav Banait (16 hours later)

Hi again,

Thanks for the reply.

As viral markers are negative, it is clear that it is not viral hepatitis. So it is most possibly related to drugs.

Now that you have stopped these drugs long back, your enzymes should be normal now. So repeat test should be a good idea to get reassured.

If the enzymes are still abnormal, you should be investigated for other causes of liver diseases eg non alcoholic fatty Liver disease, aucommune liver disease , wilson's disease etc.

Hope I have answered your queries adequately.

Regards,
Vaibhav Banait

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Above answer was peer-reviewed by : Dr. Shanthi.E