24 years post-op DS with questions and issues

[NancyNewYork 0]

Hello All, I'm 24 years post-op and I'm getting some out of range lab results and wanted to hear about other people's experience in these areas. Specifically....high ALT value. My liver panels have been all over the place for many years. I had an ultrasound last year which said "probable fatty liver" but it also said it was hard to be accurate because of so much gas in the way. My doctor told me to lose weight and that would clear it up. I lost 25 lbs (yes can you believe it) but my ALT is still high and this was drawn this morning. I was hoping to hear about other long timers' experiences with this. Years ago my old internist wanted me to get a liver biopsy but I saw a hepatologist who ordered an MRI-spectroscopy which did NOT show fatty liver. Maybe I should insist on that again...? Thanks.

Edited February 26 by NancyNewYork
added something

[ChunkCat 675]

9 minutes ago, NancyNewYork said:

Hello All, I'm 24 years post-op and I'm getting some out of range lab results and wanted to hear about other people's experience in these areas. Specifically....high ALT value. My liver panels have been all over the place for many years. I had an ultrasound last year which said "probable fatty liver" but it also said it was hard to be accurate because of so much gas in the way. My doctor told me to lose weight and that would clear it up. I lost 25 lbs (yes can you believe it) but my ALT is still high and this was drawn this morning. I was hoping to hear about other long timers' experiences with this. Years ago my old internist wanted me to get a liver biopsy but I saw a hepatologist who ordered an MRI-spectroscopy which did NOT show fatty liver. Maybe I should insist on that again...? Thanks.

Hi Nancy!

I've had a high ALT value since my 20s. They said it could be from fatty liver, but I also have arthritis and the bone/joint degeneration from it can cause levels like that too. How high is high? Are we talking a little bit out of range or quite a large amount out of range?

I highly recommend you go over to bariatricfacts.org I post over there regularly and there are a number of vets there who are 10+ years out from DS surgery who will probably be much more helpful about this than anyone here. There just aren't many DS people here who post or read the forum...

Also, there is a FB page with a ton of DSers, including a number of 10-15 year+ vets who could might have some experience with this. https://www.facebook.com/groups/1799552573392212

[NancyNewYork 0]

Hi and thanks. My ALT value is 53. 10 months ago it was 48. It's been up and down for many many years.

[ChunkCat 675]

36 minutes ago, NancyNewYork said:

Hi and thanks. My ALT value is 53. 10 months ago it was 48. It's been up and down for many many years.

Yeah mine generally stays close to 50 and everyone seems to ignore it. I think if yours continues to track upward they may want to do some imaging just to be sure nothing is wrong. Is your AST elevated at all? Or is it just the ALT?

[NancyNewYork 0]

Just ALT. AST is high end of normal. I had an ultrasound about 10 months ago because of the ALT. "Probably fatty liver" although it also said it was hard to read because of excess gas....I'm think of asking for an MRI-spectroscopy.

[ChunkCat 675]

13 minutes ago, NancyNewYork said:

Just ALT. AST is high end of normal. I had an ultrasound about 10 months ago because of the ALT. "Probably fatty liver" although it also said it was hard to read because of excess gas....I'm think of asking for an MRI-spectroscopy.

I think that is a reasonable ask given your history and your past MRI-spectroscopy... Hopefully they can get insurance to cooperate!

[NancyNewYork 0]

I'm not agreeing to a liver biopsy until I get that scan. It's just so funny - this exact situation happened to me like 18 years ago. My internist wanted a liver biopsy and I went over his head to a hepatologist at the same hospital who ordered the MRI-spectroscopy. My internist fired me!

[ChunkCat 675]

HAH! I would have gone over his head too. Liver biopsies are not pleasant, the liver hates them. Why do something invasive when you can do an MRI first!?

[Postop 405]

Almost 19 years out: have your liver numbers always been up and down? Mine have.

I had a liver ultrasound a few years ago to double-check. It was negative.

Edited March 11 by Postop

[NancyNewYork 0]

Yes, my liver enzymes have been up and down for years but this time it's just up up up and trending up. I will have an elastography scan to check for fibrosis. Better to be safe than sorry.

[Postop 405]

35 minutes ago, NancyNewYork said:

Yes, my liver enzymes have been up and down for years but this time it's just up up up and trending up. I will have an elastography scan to check for fibrosis. Better to be safe than sorry.

Good idea.

Edited March 11 by Postop