# Liver enzymes elevated??



## Robocop (Jan 1, 2010)

I have been having headaches for years and usually take whatever I can find to ease the pain. Most often it is tylenol or lately the Excedrine Migrain or Tension headache tablets cure the problem. I also will sometimes take 4 of the Goody Powders and this also seems to help. At times I have taken 4 Tylenols and 4 Goody powders within the same day.

Ok so I slowly grew very tired of these headaches and decided to see a doctor. These are not really headaches like a migrain as I can still function however it is a dull kind of pain that really frustrates me at times.

So I have blood work done and the doc says I look great....cholestorol looks fine...blood sugar is good...white blood count great...he says all is well with one exception. Out of several enzymes tested in the liver I am showing one that is mildly elevated and has been so on two different blood tests. I believe he said the normal range went up to 60 and mine showed 134.

He said not to really be alarmed right now as he has seen people with levels close to 1000 (hepatitis patients) and that most likely my problems were from all of the Tylenol I take for headaches.

Has anyone here had similiar problems or can maybe give me some input on these enzyme tests? I am wondering how long it would take for the levels to return to normal after stopping Tylenol or other over the counter pain meds.....is it even possible for the levels to return to normal or is the liver unable to ever heal? For all I know it may not even be the medication that is the problem however after looking around online this seems to be one good possibility.

I am scheduled for an ultra sound later this month however am now really wondering if I should be worried? Thanks for any information on this as I am really not used to dealing with doctors.


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## Beamhead (Jan 1, 2010)

My liver or ALT has been high for decades, just monitor it every year.
I doubt they will return to low/normal if you quit taking Tylenol but it could happen, if you are truly concerned try to stop taking it.
I am not a Dr. nor do I play one on the interwebs.


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## 65535 (Jan 1, 2010)

Acetometophine has been known to be hard on the liver just as alcohol is, no doubt if you are taking the drug regularly that it could cause reaction in the liver.

If you take lots of tylenol you should try to lay off alcohol. 

If the doctor says it's not a big deal, I wouldn't worry. Normal is just an average.


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## mvyrmnd (Jan 1, 2010)

Sorry to hear of your reaction to the painkillers - maybe you should investigate the source for the headaches in the first place.

I suffered from headaches ranging from a dull throb to a full-blown migraine for many years.

One day, after a few coincidences, I discovered I react to sulphur-based preservatives. I have a threshold-type reaction, so if I only have a little of them, dull throb. If I eat a lot of them, migraine.

Take a look at the foods you eat for preservatives numbered 200 through 220. These are all sulphur based.

Since I've become aware of this, I can monitor my intake, and only rarely have headaches now.

Good luck!


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## Bullzeyebill (Jan 1, 2010)

I have headaches that while not being migrane per se, are very discomforting and _I (sorry hit wrong key) take excedrin and have taken vicadin when they get really bad. So far no elevation in liver functions. Just monitor every six months or so, and if it goes up have a conversation with your MD._ Do not become overy concerned at this time. Just monitor, and continue taking what works for you re these headaches. BTW, I have not stopped drinking, and if you enjoy some alcohol don't stop because some of say so. Carry on with your normal life style, and if it becomes an issue then follow MD recommendations.

Bill


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## will (Jan 1, 2010)

look up MGUS

Monoclonal gammopathy of undetermined significance.

This is one symptom that shows up during lab tests, not serious. There is no needed treatment


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## ANDREAS FERRARI (Jan 1, 2010)

Tylenol is known in the medical community as a 'liver destroyer'.

Up here in Canada you can buy Tylenol 1's over-the-counter for about $8 for one hundred tablets.In most countries you need to have a prescription because they contain codeine which IIRC is converted into morphine in the human body.A lot of drug addicts buy these and eventually destroy their liver by taking 20-50 tablets per day.

I'm guessing that after a few weeks without Tylenol your liver will go back to normal.


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## shuter (Jan 1, 2010)

Your elevated liver enzymes may be normal for your body. As what was previously said, AVERAGE is just an average. Won't hurt to have a Doctor look into it though. What I wonder is what is causing the headaches.

I had severe headaches on an infrequent basis for years and worried that they were migranes. A friend of mine thought they might be sinus headaches. He suggested 800 miligrams of Ibuprofin. It works great for me. Whenever I feel one coming on I take some. The headache goes away and never gets bad. 

Hope you get it figured out.

Happy New Year!


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## TorchBoy (Jan 1, 2010)

Robocop said:


> He said not to really be alarmed right now as he has seen people with levels close to 1000 (hepatitis patients) and that most likely my problems were from all of the Tylenol I take for headaches.
> ...
> I am scheduled for an ultra sound later this month however am now really wondering if I should be worried?


I can easily imagine it could be linked, as paracetamol in high doses can cause liver damage (I'm amazed at the quantities in which paracetamol can be bought in North America - our paracetamol packets are 20 tablets only), but no, you shouldn't be worried if your doctor isn't. Your doctor's advice is worth a lot more than random people on the Internet from the other side of the world. 

As for your headaches, there are all sort of causes. The sulfur preservatives link isn't one I've heard of before, but I know one particular one can give me asthma. Is something out in your neck? I get headaches when I go caving if I tilt my head back a lot for low passages. Physical causes, chemical causes, stress and emotional causes, what else?



65535 said:


> If you take lots of tylenol you should try to lay off alcohol.


Probably a good idea anyway. :tired:


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## Robocop (Jan 1, 2010)

I have never drank alcohol at all so I know that is not the problem. The only medication I take daily is also over he counter Prilosec for acid indegestion.

Thanks for the advice on this and we shall see shortly if I have reason to be concerned. I did speak to a nurse friend of mine who said she was suprised Tylenol had not been taken off the market by now.....she said as many of you have said that it is really hard on your liver in larger doses.


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## ypsifly (Jan 1, 2010)

Ask your Dr about Milk Thistle. IIRC it helps repair liver damage.


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## cmtp0592 (Jan 1, 2010)

I've had elevated enzymes for a couple of years, recently followed up w/ a new MD, got an ultrasound and referral to a GI man. Diagnosis so far is a fatty liver (no ETOH or drug use for me but poor diet). GI MD suggested milk thistle, nothing else pending further blood tests. Comsumerlab.com recently tested nine milk thistle products. Only one (Jarrow Formulas® Milk Thistle 150 mg extract) out of nine passed their tests which mostly covesr making sure there is 150 mg of product that is claimed and no contaminants.


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## DoctaDink (Jan 1, 2010)

There are a many reasons for elevated liver function tests. Yours doesn't sound very significant, but it does warrant follow up. It could be related to your Tylenol use, but also many other things can be responsible. Your doc will probably want to repeat the test is 2 to 4 weeks and see if it persists, worsens or reveals any other elevations. He may want to get a liver ultrasound as well. If you are taking Prilosec for "indigestion", you may have something other than "indigestion" such as cholelithiasis (gall stones), that can obstruct the duct from the liver, and cause elevated enzymes. 
Also, if you are taking pain meds regularly for headaches, you may actually be causing your headaches - a phenomenon called "analgesic rebound headaches" (you can do a search and find lots of info. eg: MayoClinic.com). 
The cause of chronic, severe, new onset, or unusual headaches should be investigated further; some causes are serious, some not. The treatment should be based on the cause.


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## mdocod (Jan 2, 2010)

Others beat me to it, but I have also heard that milk thistle is recognized by a growing percentage of the medical community as being one of the few, if only substances readily available that can penetrate the liver and produce a "cleansing/healing" effect. Of course, since it is a naturally occurring substance, it is not available in a pharmacological type drug, can not be patented, etc etc, so many doctors will not be aware of it's alleged benefits...

Personally, when making decisions and doing research about natural cures ("homeopathic?") vs pharmacological cures, I try to take claims from both sides of that isle with a grain of salt. (One would be wise to take my entire post with plenty of grains of said seasoning) 

A good doctor IMO is one that can help a patient make an informed decision on treatment, sifting through the rubbish on both sides of the "isle" and helping weigh the risks vs the benefits from as neutral a position as possible.

Sounds like you probably don't have too much to be concerned about as the numbers aren't completely out of whack. You may find that all you need to do to get the number back into a more "normal" range is simply be more aware of the usage of Tylenol, and make a point to minimize it's use and take with food and water when it is necessary.

Also, I have spoke with a few people in the medical field who agree with the following practice for using OTC painkillers: 
Switch back and forth from an ibuprofen to acetaminophen as this will help split the load of metabolizing between the liver and the kidneys, (ibuprofen is metabolized in the kidneys as I understand). Also, by switching back and forth, one is less apt to develop "tolerances" that require dosing increases to achieve a desired effect. Of course, this is only advised for people who are not sensitive to ibuprofen (some peoples bodies have a hyper reaction to it that can shut down the kidneys). Take with food/water!

-Eric


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## Icebreak (Jan 3, 2010)

Note to self: 

Always follow your instincts.

I get so irritated with the medical community's reasoning sometimes. A while back I had conversations with my doctors about pain management in regard to surgeries. Finally one listened and got close to what I wanted but it's still not quite right.

I told them over and over and over I did not want Tylenol in my system. I could feel it as an acrid poison. Then I explained that if I took the pain prescription at its prescribed rate I'd be close to toxic with Tylenol. 

Now, a few of them, if I have a surgery, will prescribe OXYCODONE 5-325. See that 325? That's Tylenol. I don't want that unless I decide to use it. What some insist on is HYRDOCODONE 7.5-750. See that 750? Tylenol. Good Lord, get that away from me. And what if I have a cough due to cold and take a liquid cold medication? Better read that label and get DM.

In 2007, thinking that I might have to take a Cholestrerol drug, I quit drinking hard liquor to lower my liver levels. Apparently 2 or 3 (or 4) shots of Crown Royal every night aint good for me. The levels did drop even though I switched to a glass of Cabernet every night. Doctors and nurses were so happy about it.

Last time I went in and got a lab they called me back and asked me if I was drinking whisky again. NO! WHY? Liver levels. My nurse reminded the doctor that I had 9 (minor but painful) surgeries in 2009 and had been given a lot of pain meds. Well, I don't know but I think anything that kills pain like a Percocet does must not be good for you but it was all that nasty Tylenol that was attacking my liver.

It makes me want speak in a language that inserts expletives into the center of normal words such as Freakin' Tylefreakinol. 

OT on December 29 2009 I made my first year of quit smoking, cold turkey, not one puff. Now my want to quit list only includes two prescription meds.

I'll be following this thread, Robo. Thanks for starting it. I've learned a lot. Now I want to go see if they have Milk Thistle at Whole Foods.


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## Kiessling (Jan 3, 2010)

Robo ... to be very open ... I'd be more concerned about your intake of painkillers right now.
Apart from the known side effects of such drugs you have an additional problem, which is drug-induced headaches. Too much and too often used painkillers for headaches will cause headaches themselves one day, and this is a problem you do not want to encounter for sure. That's nasty and there's hardly a cure for this problem.

Go see a neurologist for your headaches and reduce the med intake. And eventually have the headaches checked out, in case there's some illness behind those. 

bernie


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## sunspot (Jan 3, 2010)

Robo. Cease your work out routine a week or so before your next test. That can sometimes spike your Liver enzymes.

I think the max daily dose for Tylenol is 3 grams for a healthy non-drinker. I could be wrong. I use Advil except when a headache gets really bad then I reach for the Tylenol 3's.


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## kelmo (Jan 3, 2010)

Hey Robo,

Acetominiphen (sp?) is hard on the liver. The enzyme system that breaks it down (cytochrome P450) is the same that detoxifies ethanol. You should also be aware that food supplements can also have detrimental effects when taken with certain medications. If you take supplements list them all and talk to your liver specialist. 

You should really find the root cause of your headaches. Are you shining your lights into your eyes for kicks?!


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## gorn (Jan 4, 2010)

The maximum daily dose for acetaminophen is 4g. You would have to take that dose daily for years to destroy your liver. You may find that you just have naturally elevated levels. You may have your doctor test for the CMV virus. Most people have the virus without having any issue with it. It does cause elevated levels on some though. My wife had to deal with that. After a regiment of strong antibiotics it was taken care of.

From the Mayo Clinic web site:

Cytomegalovirus (CMV) is a common and widespread virus that can infect almost anyone. Most people with CMV don't even know they have it, because it rarely causes symptoms.


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## bshanahan14rulz (Jan 4, 2010)

Icebreak said:


> I get so irritated with the medical community's reasoning sometimes. A while back I had conversations with my doctors about pain management in regard to surgeries. Finally one listened and got close to what I wanted but it's still not quite right.
> 
> I told them over and over and over I did not want Tylenol in my system. I could feel it as an acrid poison. Then I explained that if I took the pain prescription at its prescribed rate I'd be close to toxic with Tylenol.
> 
> Now, a few of them, if I have a surgery, will prescribe OXYCODONE 5-325. See that 325? That's Tylenol. I don't want that unless I decide to use it. What some insist on is HYRDOCODONE 7.5-750. See that 750? Tylenol.



You aren't the only one, but it won't get better. Doctors are trying to be safe for their own sake, since they could get in a lot of trouble for writing a prescription for better pain meds that do not utilize added acetaminophen. They could lose their license. Sure, you might be in more pain, but at least they are still working. I guess that's good in the big picture, but I still feel like they should be way less harsh on the doctors so that they can prescribe the medications that adequately control pain, leaving the doctor to worry about the medical side of things instead of having to investigate and infer about the patient's background, etc. just to prescribe 5 pcs. of roxicet without being sent to jail.



> OT on December 29 2009 I made my first year of quit smoking, cold turkey, not one puff. Now my want to quit list only includes two prescription meds.


always deserves a congrats and a pat on the back :twothumbs


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## PhantomPhoton (Jan 4, 2010)

gorn said:


> You may have your doctor test for the CMV virus. Most people have the virus without having any issue with it. It does cause elevated levels on some though. My wife had to deal with that. After a regiment of strong antibiotics it was taken care of.



Sorry to go a bit OT here, but why would antibiotics have helped in any way if it's a virus?

Very interesting discussion here. Hope you get it all sorted out Robo. I'd agree that you need to find the root cause of the headaches. The potential is there to end up in the cycle of taking pharmaceuticals to alleviate the side effects of other pharmaceuticals and it all gets pretty nasty from there.


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## saabgoblin (Jan 4, 2010)

ypsifly said:


> Ask your Dr about Milk Thistle. IIRC it helps repair liver damage.


+1 on Milk Thistle and and Artichokes, both in the same family.
Also checkout Astragalus, a root that can be found in pill form in health food stores or in root form to make a tea.


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## Mdinana (Jan 4, 2010)

Icebreak said:


> Note to self:
> 
> Always follow your instincts.
> 
> ...


 
Just FYI, you can get oxycodone/ibuprofen combos....


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## Icebreak (Jan 5, 2010)

Mdinana said:


> Just FYI, you can get oxycodone/ibuprofen combos....


 
Thank you. I looked up combunox. In the olden days Percodan was with aspirin. I don’t hear that term any more. I'll take a closer look at oxycodone/ibuprofen combos.



bshanahan14rulz said:


> You aren't the only one, but it won't get better. Doctors are trying to be safe for their own sake, since they could get in a lot of trouble for writing a prescription for better pain meds that do not utilize added acetaminophen. They could lose their license. Sure, you might be in more pain, but at least they are still working. I guess that's good in the big picture, but I still feel like they should be way less harsh on the doctors so that they can prescribe the medications that adequately control pain, leaving the doctor to worry about the medical side of things instead of having to investigate and infer about the patient's background, etc. just to prescribe 5 pcs. of roxicet without being sent to jail…snip.


 
It doesn’t seem right to me either. My GP for sure is concerned about litigation. I asked him why that was even though he knew I’d never cause him legal problems. (He’s not perfect but he’s very good.) He said he was sure I wouldn’t but also said family members have a funny way of coming after doctors if someone overdoses on pain meds.

I’m guessing an attorney would ask if there were other pain relief measures tried that may have given relief so that the patient wouldn’t be inspired to take those extra few pills that put them in an overdosed state. I don’t know this. I’m just following your info and applying it to my conversation experiences.

I’ll go ahead and tell you that one of my surgeries was on my scalp for skin cancer. It was the plastic surgery close that was a son-of-a-gun. I found out later that when a very famous musician’s hair caught fire during a performance it was the follow up surgeries on his scalp that caused enough pain to inspire him to seek strong meds and ultimately led to his addiction. Before I had that surgery I’d say it was a character flaw but now I’m not so quick to judge. I’m telling you it felt like an angry pterodactyl had landed on my head, inserted his talons and danced to “Billie Jean” for two weeks.


Oh and thanks for the attaboy on the smoking thing.


Sorry for the OT, Robocop. I want to know all about liver enzyme levels and it’s better for me to hear from people I kinda know. So, this is a highly useful topic for me.


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