Elevated Liver Enzymes 1 year Post Diagnosis

[Micki]

I never had elevated liver enzymes, but they showed up at my one year check up with celiac disease. I never had the typical celiac symptoms. I am 50 years old, 5’3”, and 118 pounds. I do a 30/20/10 (seconds) walk/run/sprint circuit routine for exercise 4 -5 days a week. I was following the autoimmune Paleo protocol a year ago and saw a functional medicine doc to help me figure out which foods were still causing me trouble (egg whites and tomatoes were a problem along with cow dairy but I can eat goat and sheep dairy). I look at what my diet has turned into, and while I eat almost nothing that is processed (starches make me jittery), what used to be grains on my plate is now filled more with proteins instead of more vegetables.  I confess. Bacon added flavor to several things. 

The only thing not normal on my tests were AST (SGOT) was a 58 in Aug and retested to 51 early Dec. Normal high is 40. ALT (SGPT) was a 75 in Aug and retested to 81 in early Dec. Normal high is 56 for ALT. I’m finding it has to be 4 times normal high for the docs to get worked up, but I was put through a bunch of tests because I am a celiac.

They scanned (ultrasound) my liver, pancreas, gall bladder, kidney, and whatever else is on the right side. All came back normal in September. I was blood tested for Hep A, B, C, autoimmune hepatitis, Epstein Barr. All came back  negative. 

I am officially in menopause as of a month ago, and I have seen some research link elevated enzymes temporarily to drop in estrogen with menopause, but it’s not long term elevations. 

I feel fine. Check my eyes every day ? and they are sparkly white. I have had subtle and passing aches right below my lowest right rib ever since going gluten-free. It sometimes is a moving pain, so I know that’s something I ate giving me trouble. I do not eat out. My kitchen is gluten-free. I take probiotics (gluten-free), Vit D, and a low dose multi-vitamin (gluten-free). I do not eat fried foods. I eat mostly whole food, but grains have been missing. I have found purity protocol oats seems to be agreeing so I’m working on diet even though my doc never suggested a thing. He was also the one that told me when I was diagnosed to “just go gluten-free, there are plenty of options these days.” ? I’m trying to get grains on my plate and switching animal proteins to less beef and pork and more turkey, chicken, and fish. It’s actually kinda depressing that our food supply has so much garbage in it that it works against our bodies.

Anyway...any ideas? I feel healthy, but I felt healthy before the celiac diagnosis. I’m not exactly on speaking terms with my body. It keeps hiding things from me. We have a trust issue. ?

[cyclinglady]

On 12/30/2017 at 9:59 AM, Micki said:

I never had elevated liver enzymes, but they showed up at my one year check up with celiac disease. I never had the typical celiac symptoms. I am 50 years old, 5’3”, and 118 pounds. I do a 30/20/10 (seconds) walk/run/sprint circuit routine for exercise 4 -5 days a week. I was following the autoimmune Paleo protocol a year ago and saw a functional medicine doc to help me figure out which foods were still causing me trouble (egg whites and tomatoes were a problem along with cow dairy but I can eat goat and sheep dairy). I look at what my diet has turned into, and while I eat almost nothing that is processed (starches make me jittery), what used to be grains on my plate is now filled more with proteins instead of more vegetables.  I confess. Bacon added flavor to several things. 

The only thing not normal on my tests were AST (SGOT) was a 58 in Aug and retested to 51 early Dec. Normal high is 40. ALT (SGPT) was a 75 in Aug and retested to 81 in early Dec. Normal high is 56 for ALT. I’m finding it has to be 4 times normal high for the docs to get worked up, but I was put through a bunch of tests because I am a celiac.

They scanned (ultrasound) my liver, pancreas, gall bladder, kidney, and whatever else is on the right side. All came back normal in September. I was blood tested for Hep A, B, C, autoimmune hepatitis, Epstein Barr. All came back  negative. 

I am officially in menopause as of a month ago, and I have seen some research link elevated enzymes temporarily to drop in estrogen with menopause, but it’s not long term elevations. 

I feel fine. Check my eyes every day ? and they are sparkly white. I have had subtle and passing aches right below my lowest right rib ever since going gluten-free. It sometimes is a moving pain, so I know that’s something I ate giving me trouble. I do not eat out. My kitchen is gluten-free. I take probiotics (gluten-free), Vit D, and a low dose multi-vitamin (gluten-free). I do not eat fried foods. I eat mostly whole food, but grains have been missing. I have found purity protocol oats seems to be agreeing so I’m working on diet even though my doc never suggested a thing. He was also the one that told me when I was diagnosed to “just go gluten-free, there are plenty of options these days.” ? I’m trying to get grains on my plate and switching animal proteins to less beef and pork and more turkey, chicken, and fish. It’s actually kinda depressing that our food supply has so much garbage in it that it works against our bodies.

Anyway...any ideas? I feel healthy, but I felt healthy before the celiac diagnosis. I’m not exactly on speaking terms with my body. It keeps hiding things from me. We have a trust issue. ?

Hey Micki!

Your posting seems to have overlooked most likely due to the holiday season.   Sorry about that!  

Is your celiac disease active?  Are your celiac  antibodies coming down (was that tested when you went for that follow-up visit?  Liver issues are common with celiac disease and we know that healing can take months to years.  

I am on a grain free, Whole Foods diet too.  I also have diabetes and grains tend to elevate my blood sugar.  So, I am not a dietitian, but your diet sounds great.  

[Micki]

Cyclinglady,

This is my first post, so I’m not sure if I’m replying right. I have not seen blood tests for my celiac antibodies. I know he took one originally, but I never saw the results. I went through a huge battery of tests in September. My Vit D has almost doubled to upper 50s and my iron is now 140 when it was 6.7 18 months ago. I’m finding my docs don’t know as much as I do, but I’ve got skin in the game. 

A recent development has me wondering if my intense exercise might be triggering these. I’m experimenting now. 

Thanks for replying. It’s nice not to feel so alone. ?

[cyclinglady]

I would not think that exercise could raise your enzyme levels, but autoimmune can.  I am like you.  Seriously, are we sisters?  I run, swim and cycle.  I am heading out to teach water aerobics.  I have been active my whole life.  I can tell you that as I have aged, I have slowed down (injury prevention and I want to keep my knees!).  Extreme exercise can be as bad as no exercise!   When my ferritin (iron stores) and hemoglobin were very low, I tried to blame it on heel strikes.  I was really reaching!  It was really my Thals and celiac disease.  

Please ask for celiac follow-up testing. Based on your improved labs, it sounds like your small intestine is healing, but it can take years for celiac antibodies to come down.  My theory is while they are elevated, they could be trigger (or compounding) elevations of other antibodies.     My PC always looks at my constantly elevated thyroid,  Immunoglobulin A and other inflammatory factors and tells me (while shaking her head) that it is not good.  While I can control the antibodies that react to gluten, I can do nothing for the others and I am not going down the lane with immune suppressants yet.  

As a diabetic, I am consuming more FATS, not protein as they do not increase my blood sugar based on my meter.     I did not see any fats discussed by you.  Too much protein for me, makes my liver (any liver) convert it to glucose after my blood sugar levels.  That might be your issue since your diet is the one thing that seems to have changed dramatically.  You may be stressing your liver too much.  Eat a normal amount of protein and add veggies and fruit for carbs.  Too many carbs like soda, juices and added sugars has been known to contribute to fatty liver and now protein could be a suspect too.   Google it.  

Follow-up testing is recommended:

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Since you have celiac disease, rule it out as the culprit for sure — no guessing.   If active you might have non-responsive celiac disease or refractory.  You do not sound like you have refractory, but That is a much stronger possibility that over the exercise theory.  I like the “too much protein” theory and other autoimmune theories too, but I am not a doctor.  Research and talk to your doctors.  

Take care!  

[Micki]

We are thinking a like. Most of my fats were animal fats which is why I was reworking the diet. Although nut butters have been in all my smoothies because I deeply dislike protein powders. I had considered non-alcoholic fatty liver disease because women my age are just lucky that way. I cook with olive oil, avocado oil, and macadamia nut oil. Trying to shift to a Mediterranean diet.  I will check with my doc about tests he has completed. Thanks for the advice! Thanks for the encouragement! Thanks for reaching out!