Suggest Treatment For Elevated Liver Enzyme Levels

Posted on Thu, 11 May 2017

Question: Dr. Maheshwari. Your advice has been very helpful. Taking my meds. In AM & only Escalapram @nite has been good. One thing I didn’t mention, was my blood work showed high liver enzhemes . my doctor told me to stop taking Tylenol and watch my alcohol intake. I stopped taking Tylenol, but still like to have a glass of
Chardonnay in evening. She said my cholesterol was good, but I’ve been on Avarstatin (spelling?) so I asked to get off that med and then see if my cholesterol stays @ good level without it. I read up on statin and since I have that amyloid antipathy problem, it said that taking statins my increase my susceptibility to hemorrhages. What do you think about all this. I appreciate you concise information. Thank you.

Answered by Dr. Dr Sameer Maheshwari (1 hour later)

Brief Answer:
Please see detailed answer

Detailed Answer:
Hi,
Welcome back.
Its really pleasant to hear that my answer was helpful to you.
Coming to current problem, elevated liver enzymes need further evaluation to rule out any associated liver disease. I'll recommend you for a ultrasound abdomen to detect abnormality if any.
Statins(Atorvastatin) has to be stopped if liver enzymes are very high. Statins (Atorvastatin) are drugs to control increased cholesterol & are very good medicines. They rarely cause hemorrhage so you can safely take them but only when liver enzymes improve.
Tylenol should also be stopped if liver enzymes are high.
Please tell the exact value of liver enzymes.
We generally recommend patients with deranged liver enzymes to stop alcohol at all which may cause further damage to liver. So I'll advice you the same, to stop alcohol completely till liver enzymes improves. Also avoid fat in diet.
If you have any more question, I'll be happy to help.
Thanks & take care
And get well soon

Above answer was peer-reviewed by : Dr. Prasad

Follow up: Dr. Dr Sameer Maheshwari (1 hour later)

I understand my liver enzymes were about 45 (?) is that really bad. that was when I was taking the statins and Tylenol and wine. I haven't taken statin or Tylenol for about a month. when should I have more lab work and what.?
Thank you again for the specific information. I don't like not have a glass of wine in the evening, though.
XXXX

Answered by Dr. Dr Sameer Maheshwari (1 hour later)

Brief Answer:
Follow up answer

Detailed Answer:
Hi Mrs XXXX,
Welcome back.
Liver enzymes of 45 is not bad & just slightly above normal. Their is no need to discontinue statin at this level as per the guidelines but the liver enzymes should be monitored weekly. Tylenol should be discontinued as you have rightly done. Again about wine, we generally do not encourage our patients to continue alcohol if liver enzymes are abnormal. Still if you want to take take only small amount preferably red wine. Fatty diet should be minimum.
So please check the liver enzymes again as soon as possible so that if they are not rising or decreased than you can continue your statin & can take wine. Liver enzymes should include SGOT, SGPT, GGT, ALP.
Thanks & take care

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Above answer was peer-reviewed by : Dr. Prasad