High liver enzymes?

[111 118]

I have a question: Could your liver enzymes rise after being on the 800 calorie diet for over 3 weeks? My liver enzymes have never been high before, according to my doctor. I've followed my diet to the T and suddenly my blood work shows that my liver enzymes are elevated. I've also been on a 1200 calorie diet from the middle of July to the middle of October. My 800 calorie diet started in the middle of October. My PCP ordered more blood work and an ultrasound of my liver. I'm negative on the hepatitis panels and my ultrasound shows a fatty liver. How could I get a fatty liver after months of strict dieting? Why are my enzymes so high? I'm confused. Why now? Has anyone else experienced this?

Edited November 11, 2016 by Evenya

[chonchis 15]

I had the same problem but didn't have an answer I got sleeved with no problem on 11/2

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[RickM 1,753]

I'm no expert on this (I leave that to the surgeon, who is a liver guy...) but rapid weight loss does tax the liver, so that increase in diet severity could lead to altered numbers. This is a good part of the reason that my surgeon has a strict no alcohol during weight loss policy - the liver is stressed enough as it is metabolizing the fat that we are losing. My suspicion would be that it is just the dietary change, but it would be best to run that by your surgeon to see if he has any concerns about it. We didn't have the pre-op diet so it wasn't an issue then but I suspect that my numbers may have been a bit out of whack post op while losing but it was never brought up as an issue by either my PCP or the surgeon.

[ppressey24 254]

How far ago @@rickm did you have your surgery if there wasnt a pre op diet then?....lol. Heck some drz today dont make their patients go on the diet. Mine was 14 days of just Water and 3 Protein shakes per day. I see some people can have 1 meal a day and only have to for 1 wk. My girlfriend had the bypass and didnt have to do a pre op diet and we had the same surgeon so idk why they do what they do

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[jess9395 5,450]

I had no pre op diet three years ago.

Non alcoholic fatty liver disease is quite common when we are obese and the liver enzymes are elevated. Unlike some of the things that get better immediately (diabetes, blood pressure) it can actually get worse before it gets better for the reasons stated above--the liver is taxed during weight loss.

My liver is only now starting to normalize at three years out!

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[RickM 1,753]

How far ago @@rickm did you have your surgery if there wasnt a pre op diet then?....lol. Heck some drz today dont make their patients go on the diet. Mine was 14 days of just Water and 3 Protein shakes per day. I see some people can have 1 meal a day and only have to for 1 wk. My girlfriend had the bypass and didnt have to do a pre op diet and we had the same surgeon so idk why they do what they do

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That was about five and half years ago, and my wife was on the same basic program for her DS eleven years ago. As far as I know, they still don't impose any such diets, even on very high BMI patients. Talking with another DS surgeon in a different practice, the reason he doesn't use them is that he wants his patients as strong and healthy as possible when they go into the OR, and fasting for weeks ahead of time doesn't do it.

I can see where some surgeons vary the requirement by BMI and others by procedure - many are very experienced with the bypass but still relatively new to the sleeve, so they may need the extra help that such diets are supposed to provide. Also, the sleeve does more work underneath the liver where things are crowded while the bypass operates more at the top of the stomach and avoids some of that crowded space down there. Also, docs who have been doing the DS for some years, which is a sleeve plus intestinal rerouting, tend to have more experience doing sleeves and working around a lot of the fiddly bits under the liver where the switch occurs, so I suspect that they may have developed techniques that negate the need for such diets, which the bypass guys haven't found yet.

Whatever their protocols, you want to follow your surgeon's directions as you want them to be as comfortable as possible when they are fiddling around with your insides!

[shedo82773 1,236]

Heck, I'm 3 years out and I had to do 2 weeks of Protein drinks preop and 4 weeks postop. They usually put you on a preop diet to help shrink your liver. Because most peeps that are overweight have fatty liver. And they pre op diet helps shrink the liver so the Surgeon can move it out of the way easier. Without causeing bleeding etc.

[jess9395 5,450]

Lots of studies are showing that two weeks isn't long enough to make a difference with fatty liver. So many surgeons do not do the pre op diet. Some do because they figure any change is better than none and some have other reasons (demonstrating compliance, getting your head ready for it) and thus use a pre op diet. Some even base it on your starting BMI whether you do one or not.

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