High LIver Enzymes and Ferritin 8-7 months post op, help?

[Laura M 10]

Hello All,

I'm pretty scared, so bear with me on this. I am now 7 months post op RYGB and at my 3 month post op, my liver enzymes were mildly elevated but my ferritin was around 600, at 6 months now, my enzymes are AST 96, ALT 105, Ferritin 1022. I am with a doctor now and watching them every 2 weeks, I'm also getting a liver biopsy on Monday, and to say the least, what I read on the internet is scary as heck, about liver failure. I had a rough first 6 months with a lot of nausea and was not able to get as much Protein as I wanted and I lost on the high end of the weight loss curve. I know I had fatty liver before the surgery for some time, but again, liver enzymes were upper end of normal. Can you all let me know if any of you have had this experience? I heard they can be elvevated for some time due to the rapid weight loss, but mine are not coming down as of yet.

Thanks. Laura

[catwoman7 10,981]

yes - all of the above. It's pretty common to have high liver enzymes the first year or so after surgery. Rapid weight loss is pretty hard on livers. They'll usually stabilize when your weight loss slows way down - usually during the 2nd or sometimes the 3rd year (mine stabilized the third year). We hear about that every couple of months on here, it seems. When my PCP noticed my liver enzymes, she freaked - but the bariatric clinic knew what was going on. And they were right - they did stabilize and have been normal ever since.

My ferritin level is usually in the 200s, which is definitely higher than normal, but it's always been met with a shrug. I don't know about levels like 600 or 1022. If there's nothing else going on with you, they may just assume it's the supplements and have you cut way down on them for awhile. I wouldn't freak out yet, though. It may or may not turn out to be anything serious.

[Arabesque 6,683]

As @catwoman7 said it is pretty common. My GP arranged for an ultrasound to make sure there was nothing else going on with my liver but it was fine. (The scan did pick up a gall stone which was handy to know.) My bilirubin levels are still high 4 years out but they probably always were as I found out Gilbert’s is in the family - high bilirubin is a symptom & I have other symptoms too.

I’d probably reduce any Iron supplements too for a while & see what happens. Out of curiosity is hemochromatosis in your family?

[Jeanniebug 473]

Yep. Same. My liver enzymes have been high. My initial ferritin was high, but 6-months post op, it came down to normal. The liver is still elevated. This is very, VERY common for the first couple of years after bariatric surgery.

[Tomo 1,157]

Yes, seems common. A month or so ago, I posted on a reply post about how I was concerned about my AST and ALT were on the high side, and some on this thread and others responded that they had experienced something similar. It eased my mind a lot and later, my levels came down some.

[Laura M 10]

On 6/11/2023 at 1:27 AM, Jeanniebug said:

Yep. Same. My liver enzymes have been high. My initial ferritin was high, but 6-months post op, it came down to normal. The liver is still elevated. This is very, VERY common for the first couple of years after bariatric surgery.

Hi Jenny-bug-

Thanks for your reply on this. My biopsy showed I have Nash but since starting a different diet to help stabilize weight and exercise more, my enzymes have started to come down, now in the 50"s and ferritin is now around 500. If you don't mind sharing, how high did your ferritin get before it came down to normal and how high did your enzymes get and now?

Thanks so much, this last month has been extremely stressful,

Laura

[Jeanniebug 473]

3 months post op: Jan 9th - Ferritin - 162 (normal range 13-150), AST - 35 (normal 5-32), ALT - 51 (normal 5-33)

7 months post op: May 12 - Ferritin - 90.5, AST - 43, ALT - 77 - Ferritin has come down to normal and liver still going up.

I saw my surgeon the day before yesterday. She said that high ferritin and high liver enzymes is fairly normal, after bariatric surgery.