My Question Is I’m A Symptomatic But Have Some Elevated Liver Enzymes Could This Be Gall Bladder Related?

Posted on Fri, 11 Apr 2025

Question: My question is I’m a symptomatic but have some elevated liver enzymes. Could this be gall bladder related? Medicine related? I’m just worried about what could be causing it

Answered by Dr. Dr.P.Ratnakar Kini (7 hours later)

Brief Answer:
Need more information

Detailed Answer:
Hi,
Thanks for posting your query.
I am Dr.R.K and I am pleased to assist you.
I went through the report.
Your ALT and AST are both significantly elevated.
ALT is more than AST.
Your A/G ratio is normal indicating you do not have chronic liver disease like cirrhosis.
All these point towards hepatitis ( liver cell injury).
The most common cause is nonalcoholic fatty liver disease.
I would like to have the following information -
1. When was the lab test done and why was it done?. Any older liver panel results available? Kindly upload them.
2. When did you start taking Methimazole and Flecainide?
3. What is your BMI?
4. Ultrasound scan done? Kindly upload the report?
Regards,
Dr.R.K.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Dr.P.Ratnakar Kini (11 hours later)

I have attached blood work from XXXXXXX 3, 2000. Liver enzymes normal then. I have been on methimazole for about 10 yrs and flecainide for 2 yrs.
I am 5’3. Weight was about 147 at my dr visit on 12/3. On a chart it looks like BMI of 26.
I am scheduled for an ultrasound tomorrow.
I have regular blood work every 6 months for Grave’s disease.
This abnormal liver enzyme level was seen on regular blood work for my yearly physical.
I feel great and would have never suspected any abnormalities.

All other blood work was normal. Hepatitis blood work showed no hepatitis.

The only abnormalities have been the ALT, AST and GGT

Thank you for your advice and recommendations.

Answered by Dr. Dr.P.Ratnakar Kini (13 hours later)

Brief Answer:
Need more information

Detailed Answer:
Hi,
Thanks for the additional information.
Your liver panel in 2010 was normal and you started taking methimazole 10 years ago.
From when did the liver panel start getting deranged?
Regards,
Dr.R.K

Above answer was peer-reviewed by : Dr. Vaishalee Punj

Follow up: Dr. Dr.P.Ratnakar Kini (7 hours later)

My liver functions have been normal up until 12/3/2020
So normal when I started taking the methimazole and while I’ve been on it. Just a few days ago when I had a yearly physical did the abnormal counts shows up

Answered by Dr. Dr.P.Ratnakar Kini (1 hour later)

Brief Answer:
Answer given below

Detailed Answer:
Hi,
Thanks for the information.
Methimazole is known to cause liver injury.
But since you have been taking it for the past 10 years and liver enzymes were normal all these years, it is unlikely that methimazole is the cause for the elevated liver enzymes.
As mentioned earlier nonalcoholic fatty liver disease is the most common cause of elevated ALT.
Kindly get a ultrasound scan done to see whether you have fatty liver.
Regards,
Dr.R.K.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Dr.P.Ratnakar Kini (11 hours later)

Can fatty liver develop quickly? My labs were normal 6 months ago?

Answered by Dr. Dr.P.Ratnakar Kini (13 hours later)

Brief Answer:
Answer given below

Detailed Answer:
Hi,
Fatty liver can remain as simple fatty liver with normal labs or it can progress to steatohepatitis ( fatty liver with raised liver enzymes).
Regards,
Dr.R.K.

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Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar