so I am just wondering if many people have had issues with their lab work after surgery! I know I haven't been doing everything right for the last 8 weeks. first off I only eat 300 calories a day second I haven't been able to get any vitamins in till this last week! all my results were in the low range but the one that worries me the most is my ALT Results it went from 23 in may 2010 to 123 this Dec. They said it is caused by the drastic weight loss I have had in 8 weeks( 82lbs) has anyone else had this problem? I am worried they wanna retest me in 2 weeks and if the number stays the same or goes up they wanna do a liver ultrasound! also I am confused they don't want me really losing much weight right now (even though I have 200+lbs still to lose)! Also when I saw the Dr. last week they diagnosed me with after surgery bulimia which I think is incorrect!! They said I am extremely lactose intolerant and that could be what has been irritating my stomach so they gave me probiotics for the next month! what they don't get is yes I count my calories terribly but I would eat the stuff they want me to (like protein) if my stomach was not always upset and sick feeling every time I try to eat! If anyone has any words of wisdom or thoughts on my situation I would be very happy to hear them.. Thank you....

Are the folks evaluating your labs the same folks who did the surgery? It would be good if the labs are evaluated by someone who is used to seeing what happens after VSG.

Getting a liver ultrasound is no big deal, so I wouldn't sweat that one. My NUT seems to be excited about probiotics as well -- I think it's something that's going around -- and it might help.

My suggestion is to avoid the the milk. If that isn't practical, you might investigate Lactaid (not something I know much about, but it might work).

Personally, I'm tired of Protein drinks, so I'm eating ground turkey, ground steak, ground ahi tuna (you get the drift), 50 to 60 grams at a time, trying to get up to my 60 grams of protein a day.

My thoughts are with you!

My doctor will do my labs at 6 months. As one who has elevated liver panels for over 15 years I would not be overly concerned that they will redo the test that soon. It will take at least 30 days before any diet changes may reflect in new labs. For me they did do a liver biospy during my sugery but that is because I had non alcohlic fatty liver disease but the results not anything serious and he was forwarded them to my PCP. I did have a ultrasound a year ago and that procedure was very minor. My sister is lactose intolerant and uses soy and rice milk for a substitute for milk. She can do some cheese but in a very small amount. Since you are 8 weeks out you should be able to eat meat so concentrate on using that to get your protein. Hopefully this will turn around for you so you can start feeling normal soon.

yes I am going through the same thing now. They are just keeping a eye on my levels. they said its from fatty liver (imagine that. lol) but the only way to cure it is loose weight but if its not slowly it dont have time to catch up so it takes longer and sometimes even makes levels a little higher because putting stress on it. my doc will not let me take anything with tyleno at all. Dont stress about it..

My advice to you is to do exactly as your Dr. prescribes. If they expressed for you to slow down the weight loss, then that is what you need to do. You DO have an eating disorder, and the sooner you nip it in the bud the better. You can and will do serious and sometimes permanent damage to your body.

I really don't like sounding harsh, but you really must take this very seriously. You did not ( I assume) have this surgery to trade in one very bad and unhealthy way of life for another.

Those feelings and thoughts your having (and you know which ones I'm talking about) serve you no good purpose. It's not going to happen overnight, but you really must handle them now, or you will continue down the wrong path.

Seek medically professional mental help with this too. You neally need it.

Hugs to you, and I really REALLY hope you feel better soon.

ETA: I did become severely lactose intolerant post surgery. I've been drinking Lactaid for the last week, and I have not had any bad side effects from it. It really does work. I've tried other alternatives (Silk, etc.) and it does not satisfy my taste for milk. Just a suggestion.

Sorry. Clarification needed... What is surgery bulimia?

so I am just wondering if many people have had issues with their lab work after surgery! I know I haven't been doing everything right for the last 8 weeks. first off I only eat 300 calories a day second I haven't been able to get any Vitamins in till this last week! all my results were in the low range but the one that worries me the most is my ALT Results it went from 23 in may 2010 to 123 this Dec. They said it is caused by the drastic weight loss I have had in 8 weeks( 82lbs) has anyone else had this problem? I am worried they wanna retest me in 2 weeks and if the number stays the same or goes up they wanna do a liver ultrasound! also I am confused they don't want me really losing much weight right now (even though I have 200+lbs still to lose)! Also when I saw the Dr. last week they diagnosed me with after surgery bulimia which I think is incorrect!! They said I am extremely lactose intolerant and that could be what has been irritating my stomach so they gave me probiotics for the next month! what they don't get is yes I count my calories terribly but I would eat the stuff they want me to (like protein) if my stomach was not always upset and sick feeling every time I try to eat! If anyone has any words of wisdom or thoughts on my situation I would be very happy to hear them.. Thank you....

Yup, I'm 1 year out now and still am having issues with the liver enzymes. . doctor states it's because of the severity of the surgery. . Vitamin D is another problem along with PTH is low, they are doing bone density tests right now. . malabsorption they call it. . . go figure I eat everything! have a potassium/sodium problem as well as B12. . .my hair is still falling out, it's so thin I think it lost more weight then I have! . . . i'm just one big mess, but i'm taking vitamins as needed and go on living. . . I have a lot of nausea as well, doctor says he doesn't know why . . . but i just carry on and ignore it most times. I find that when my stomach hurts like that I'm usually hungry so I'll have something for me it's usually string cheese, but don't eat that if your lactose intolerant, find your food that helps your tummy. . i figure as long as i'm waking up every morning i'm doing great! Good luck !

You really have to fix your eating problem...and yeah, 300 calories 8 weeks out sounds bulimic to me too, even if it is because you have stomach issues

I had a liver ultrasound to diagnose fatty liver some time back; it really is nothing to be concerned about. It's not even uncomfortable; I almost fell asleep during mine!

I have heard that very rapid weight loss can be a strain on the liver, but I don't know if I've ever heard of permanent damage being done from drastic weight loss. I am not a doctor, but I'm a concerned layman who's been tracking his own liver health for some time.

The most likely cause of elevated liver enzymes is fatty liver. I'm not sure if the metabolism of the fat capsules on the liver can lead to elevated ALT/AST, but I do know that *healthy* weight loss is one of the best things you can do for your liver; my liver functions were always borderline "abnormal" pre-sleeve, and now they're all perfect.

So, I'll echo what others have said: follow your doctor and nutritionist's advice to the letter. If you're always nauseous and that makes it hard to eat, TELL them -- make sure you're heard! -- they may be able to propose a solution (maybe a change of dietary habits, or an antinausea medicine, or something... who knows, maybe they'll prescribe THC!). But the bottom line is that elevated ALT by itself is not something to lose a great deal of sleep over. As the quote below shows, some hepatitis patients have ALT levels of a thousand or higher and yet recover with no liver damage after treatment.

What do elevated liver tests (AST and ALT) mean?

AST (SGOT) and ALT (SGPT) are sensitive indicators of liver damage or injury from different types of disease. But it must be emphasized that higher-than-normal levels of these liver enzymes should not be automatically equated with liver disease. They may mean liver problems or they may not. For example, elevations of these enzymes can occur with muscle damage. The interpretation of elevated AST and ALT levels depends upon the entire clinical evaluation of an individual, and so it is best done by physicians experienced in evaluating liver disease and muscle disease.

Moreover, the precise levels of these enzymes do not correlate well with the extent of liver damage or the prognosis (outlook). Thus, the exact levels of AST (SGOT) and ALT (SGPT) cannot be used to determine the degree of liver disease or predict the future. For example, individuals with acute viral hepatitis A may develop very high AST and ALT levels (sometimes in the thousands of units/liter range). But most people with acute viral hepatitis A recover fully without residual liver disease. To the contrary, people with chronic hepatitis C infection typically have only a little elevation in their AST and ALT levels. Some of these individuals may have quietly developed chronic liver disease such as chronic hepatitis and cirrhosis (advanced scarring of the liver).

It is, therefore, worth mentioning that these liver enzymes do not give an indication of the function of the liver. Sometimes they are mistakenly referred to as “liver function tests” or LFTs, but it is a misnomer commonly used even by most physicians.

http://www.medicinenet.com/liver_blood_tests/page2.htm#4whatdo