Cholesterol

[liveaboard15 1,292]

So i decided to order my own lipid panel last week to see where i am at 6 months post surgery with cholesterol levels. before surgery they were in the red. Very high where they were going to put me on medication. I got my results back today and all my cholesterol levels are in the green (normal range) gotta love it. But one thing that did come back high was something called bilirubin. It involves the liver mainly (Gall bladder too) By levels before surgery were normal. So will show them to my surgeon in 2 weeks when i have my 6 month follow up and see what they say. My surgeon sent me off today to get Vitamin blood test done so i am curious to see how they come out and see if my Iron (which was slightly low) has gone up with the extra iron supplement i am taking.

[SpartanMaker 676]

High bilirubin has been reported post-op in many patients. The obvious reason would anemia due to an Iron deficiency. Other deficiencies such as Vitamins B1, B12, folate, A, K, D, and E and copper may cause hematological abnormalities as well. I agree that checking your Vitamin levels is a good idea.

That said, it could be unrelated to any nutritional deficiencies and if you are asymptomatic, may not be cause for concern?

[Arabesque 6,480]

It could just be up because of your weight loss & the stress of weight loss on your liver but it’s probably best to monitor it for a while. There are tests to ensure it’s not related to cirrhosis, fatty liver, gallstones, hepatitis, bile duct blockages. Will be interesting to see what your doctor says.

My bilirubin levels were high & still are three plus years on. My surgeon asked if there was Gilbert’s in my family as a sign of that is high bilirubin levels. I discovered I did have an aunt with Gilbert’s & I also had a lot of the symptoms of Gilbert’s too (explained a lot actually) so my surgeon believes I likely have it too.

[kcuster83 1,502]

My liver enzymes have been SUPER high since about a month after surgery. No one knows why, I am seeing a Hepatologist to try to figure it out. He is currently monitoring it with regular blood work and then we will go from there. If they are still high at my next blood work, the next step is a liver biopsy.

I have been tested for all liver related diseases too, all negative!

My surgeon says there is nothing related to surgery that would INCREASE your liver enzymes, if anything they would get better if they were already high. My doctor doesn't have a clue and was the one who referred me to the Hepatologist.

The Hepatologist and my PCP both reviewed my past years of blood work and they have never even been slightly elevated. Now both tests are like triple what they should be.

Surgery related or coincidence? Who knows!

[catwoman7 10,866]

3 hours ago, kcuster83 said:

My liver enzymes have been SUPER high since about a month after surgery. No one knows why, I am seeing a Hepatologist to try to figure it out. He is currently monitoring it with regular blood work and then we will go from there. If they are still high at my next blood work, the next step is a liver biopsy.

I have been tested for all liver related diseases too, all negative!

My surgeon says there is nothing related to surgery that would INCREASE your liver enzymes, if anything they would get better if they were already high. My doctor doesn't have a clue and was the one who referred me to the Hepatologist.

The Hepatologist and my PCP both reviewed my past years of blood work and they have never even been slightly elevated. Now both tests are like triple what they should be.

Surgery related or coincidence? Who knows!

high liver enzymes level do seem to be common the first few months after surgery, though...I see postings on that a lot. Mine were as well - then about a year out, they were back to normal. My PCP was freaked out about it, but I did read online that it wasn't that uncommon, and it was due to the rapid weight loss (which is hard on livers). Interesting your surgeon said that, though.

EDITED to add: unless he meant it wasn't anything related to the surgery per se, but just rapid weight loss in general? (as in...even if your rapid weight loss wasn't due to surgery?). Not sure.

here's an article about temporary spikes in liver enzymes after weight loss:

https://www.mdedge.com/endocrinology/article/53013/obesity/liver-enzyme-spike-after-weight-loss-deemed-transient

Edited October 25, 2022 by catwoman7

[kcuster83 1,502]

1 hour ago, catwoman7 said:

high liver enzymes level do seem to be common the first few months after surgery, though...I see postings on that a lot. Mine were as well - then about a year out, they were back to normal. My PCP was freaked out about it, but I did read online that it wasn't that uncommon, and it was due to the rapid weight loss (which is hard on livers). Interesting your surgeon said that, though.

EDITED to add: unless he meant it wasn't anything related to the surgery per se, but just rapid weight loss in general? (as in...even if your rapid weight loss wasn't due to surgery?). Not sure.

here's an article about temporary spikes in liver enzymes after weight loss:

https://www.mdedge.com/endocrinology/article/53013/obesity/liver-enzyme-spike-after-weight-loss-deemed-transient

Thanks, I have asked him multiple times and he asks about it at every follow up since it happened. So, I agree weird.

Although, I hadn't lost much weight when it started. I think about 20-25 lbs by the time I got blood work.

The blood work was unrelated to WLS blood work also.

It's all weird, but I will read this and point it out next time I see him.

Thank you!

[SpartanMaker 676]

I wanted to clarify something here: Bilirubin (the thing the OP asked about), is not a "liver enzyme", so elevation of just this would not at all be the same as what @kcuster83 mentioned. Elevation of ALT and AST especially, indicate potential liver damage. This is because these enzymes only are present in the liver.

Bilirubin is not actually specifically related to the liver, though it's typically part of the "liver function test". The main purpose of bilirubin is to break down red blood cells and "recycle" them. Excess bilirubin is typically a sign that you are losing red blood cells faster than normal. That may or may not be a problem, but in the absence of elevated liver enzymes, does not by itself indicate a problem with your liver. As I mentioned, anemia is a much more common reason to see high bilirubin in the absence of other abnormal tests.

[liveaboard15 1,292]

2 hours ago, SpartanMaker said:

I wanted to clarify something here: Bilirubin (the thing the OP asked about), is not a "liver enzyme", so elevation of just this would not at all be the same as what @kcuster83 mentioned. Elevation of ALT and AST especially, indicate potential liver damage. This is because these enzymes only are present in the liver.

Bilirubin is not actually specifically related to the liver, though it's typically part of the "liver function test". The main purpose of bilirubin is to break down red blood cells and "recycle" them. Excess bilirubin is typically a sign that you are losing red blood cells faster than normal. That may or may not be a problem, but in the absence of elevated liver enzymes, does not by itself indicate a problem with your liver. As I mentioned, anemia is a much more common reason to see high bilirubin in the absence of other abnormal tests.

Here is a screen shot of some of what you mentioned. I am actually planning on taking another blood test here in a few weeks which is this one just to get more detailed information. Liver Profile #3 Extreme Blood Test Panel | Walk-In Lab (walkinlab.com) But yea i see my surgeon in less than 3 weeks and my primary care in almost the same time. So i will wait for them both to give me their advise and if they want to order any additional test then great That way my insurance pays for it. When i buy my own labs online i have to pay which is not bad at all but still lol