My surgery was Oct 2020. Started having elevated ALP, ALT, and AST levels 6months post op with enlarged liver. In the hospital for a week with no answers to the cause. It's been 3 months since the hospitalization and the ALP is elevated again. All other blood work and vitamins are excellent levels. Doctor ordered an Alkaline Phosphate Isoenzyme test to determine the source of the elevated ALP. The results shows both liver and bone as the source.

Anyone else have this happen? What could possible be the issue?

I had RNY, but my liver enzymes were elevated the first year or so. My PCP said thought it was probably fatty liver, but then I read online (some reliable medical site) that elevated liver enzymes were not uncommon after WLS because the rapid weight loss can be really hard on livers. I had them re-tested later, and they were normal - so I think that's what was going on. Not sure why this possibility didn't occur to my PCP, but maybe she doesn't see many bariatric patients.

I'm not saying this the cause of yours, but I think it was in my case. In any case, mine are normal now.

EDITED to add I just re-read your post and you said your liver was enlarged. So your enzyme levels may be due to something else. I don't know if my liver was enlarged since that was never checked - but my enzyme levels were definitely high.

Edited July 31, 20214 yr by catwoman7

@hope1020 Did you ever figure out what was wrong with your liver? Did your liver enzymes go down again? I am 3 months post op from a DS and mine are higher than I've ever seen them, AST 180, ALT 382.

I'm waiting to hear back from the surgeon on the 28th to know if that's a problem

Edited February 18, 20224 yr by ClareLynn

Hello ClareLynn, My AST and ALT are finally in range as of the last three months. The ALP did decrease but not within the normal range. It has not been as high as last year when I was hospitalized. The last set of liver enzymes taken did show low protein which is new. Bruising on the arms and legs increased in the past six months. My general practitioner, hematologist, gastrologist, and hepatologist have concluded it is the liver function. The next step is a liver biopsy which I will know more about on Monday. I will say I feel good and would never know anything was wrong without the bruising and the bloodwork. I did not have issues prior to the DS surgery and still don't know if it related to it. General Practioner believes the liver is not processing my protein properly. I looking forward to my appt on Monday with the hepatologist.

On 2/19/2022 at 8:26 PM, hope1020 said:

Hello ClareLynn, My AST and ALT are finally in range as of the last three months. The ALP did decrease but not within the normal range. It has not been as high as last year when I was hospitalized. The last set of liver enzymes taken did show low Protein which is new. Bruising on the arms and legs increased in the past six months. My general practitioner, hematologist, gastrologist, and hepatologist have concluded it is the liver function. The next step is a liver biopsy which I will know more about on Monday. I will say I feel good and would never know anything was wrong without the bruising and the bloodwork. I did not have issues prior to the DS surgery and still don't know if it related to it. General Practioner believes the liver is not processing my protein properly. I looking forward to my appt on Monday with the hepatologist.

How did the biopsy go?

On 2/19/2022 at 6:26 PM, hope1020 said:

Hello ClareLynn, My AST and ALT are finally in range as of the last three months. The ALP did decrease but not within the normal range. It has not been as high as last year when I was hospitalized. The last set of liver enzymes taken did show low Protein which is new. Bruising on the arms and legs increased in the past six months. My general practitioner, hematologist, gastrologist, and hepatologist have concluded it is the liver function. The next step is a liver biopsy which I will know more about on Monday. I will say I feel good and would never know anything was wrong without the bruising and the bloodwork. I did not have issues prior to the DS surgery and still don't know if it related to it. General Practioner believes the liver is not processing my protein properly. I looking forward to my appt on Monday with the hepatologist.

How did everything turn out? Did you get any answers?

Hello everyone! My liver biopsy came back normal, and the bruising stopped several months ago. My ALP is goes up and down randomly. I feel great, but continue to get my levels checked every six months. I did find out that taking steroids will through my ALP numbers off. It takes 3-4 months for liver enzymes to level out for some people. No new tests are scheduled. It is a wait-and-see thing now.