Liver Function Tests and Bariatric Surgery

[MrsFitz 441]

Eugh…I have to have 3-monthly blood tests as I have Methotrexate injections for Rheumatoid Arthritis. I’ve been on Methotrexate for 12 years now. Occasionally there’s a blip in my liver function test but this is generally when I’ve been unwell as the slightest thing can change my results.

Anyway, I made a cock-up on my test 2 weeks ago. It was Bank Holiday Weekend and I had a couple of drinks on the Saturday and then more on the Sunday. I can count on one hand how many times we’ve been out this year and I don’t drink at home unless it’s a glass of champagne before we go out to dinner for example. Anyway, I wasn’t thinking and did my jab as normal on the Monday and then my bloods on the Tuesday. This resulted in a phone-call from a Rheumatology Nurse on Wednesday saying my liver function test levels were way, way up, what had I been doing? I was honest and said I’d been out at the weekend and had my jab when I should have left it a week and then had my bloods after. So, I had to miss the next two weeks jabs and have my bloods again which was yesterday. Phone-call today - levels have dropped some but still high. It was then a mass of questions - had I been drinking? No. Any infections? Not that I know of. Any ‘herbal’ ingestion (er…what???) No. Any NSAIDS? No. The list was endless and she sounded completely disbelieving of me, which has pissed me off no end. Could I miss my jab this week and have my bloods again on Monday? No. We’re out for our anniversary dinner on Sunday and there will be alcohol so it would be pointless. I did offer to have them on Friday but she said it wouldn’t be enough time for things to reduce. Now I have to have my bloods again in 2 weeks. It turns out that my levels have been creeping up for the past few months but no one had told me. She did tell me that the other things I’m tested for are all good (4 things in total so only be of them is bolloxed)

I’m not happy, especially as I’ve been managing my condition and medication for 12 years. I drank more often earlier in my treatment and never had any issues. My worry is that this could affect my WLS journey. I know I may be worrying over nothing but the worry is still there. It may be that my liver has just had enough of the Methotrexate (as it’s a poison - lovely) and it’s time to stop it.

Anyway, I’m not asking for advice, more a rant ☹️ I will now do some research on how to deal with toxins in the liver and how to reduce them.

Sigh…

[catwoman7 11,284]

high liver enzyme levels aren't uncommon the first year or so after weight loss surgery. Rapid weight loss is really hard on livers. Mine were high for about the first year, and I've heard this several times from others as well (including people from here on Bariatric Pal). My regular doctor was really alarmed by it, but the people at my bariatric clinic knew what was going on. They went back down to normal and have been normal ever since.

[Arabesque 7,608]

I was thinking the same thing as @catwoman7: the rising levels could be a result of your weight loss so far. It’s very common to have rising liver function levels while you’re losing.

Also worried me a bit because I had a glass of Prosecco at lunch on Sunday and then had a liver function test Monday in preparation of a surgery I’m having next week. Hope the glass didn’t throw my results out at all. Considering I was asked lots of questions at the pathologists, they didn’t ask when was my last alcoholic drink and how much and often I drink. Hmmmm.

[BlondePatriotInCDA 594]

20 hours ago, catwoman7 said:

high liver enzyme levels aren't uncommon the first year or so after weight loss surgery. Rapid weight loss is really hard on livers. Mine were high for about the first year, and I've heard this several times from others as well (including people from here on Bariatric Pal). My regular doctor was really alarmed by it, but the people at my bariatric clinic knew what was going on. They went back down to normal and have been normal ever since.

Wow, first time I'm "hearing" about this. Which enzymes show up as off? Is there a reason? My liver thus far is ok, but my kidneys have been a little off - up a few points that the doctor attributes to "lab errors" or "lab differences" since its just a few points above normal.

Thanks for sharing!

[catwoman7 11,284]

On 9/11/2024 at 12:18 PM, BlondePatriotInCDA said:

Wow, first time I'm "hearing" about this. Which enzymes show up as off? Is there a reason? My liver thus far is ok, but my kidneys have been a little off - up a few points that the doctor attributes to "lab errors" or "lab differences" since its just a few points above normal.

Thanks for sharing!

the two they usually measure for are ALT and AST. But not all clinics test for those, so not everyone knows their values (actually, my bariatric clinic doesn't test for them, either - I'd gone to my primary care provider for some reason or another (it's been eight or nine years, so I don't remember why) and she did some panel that included liver values. She freaked about it, but my bariatric clinic knew what was going on - and again, they were back down to normal once I was about a year out).. They go up because rapid weight loss is really hard on the liver.

[BlondePatriotInCDA 594]

11 hours ago, catwoman7 said:

the two they usually measure for are ALT and AST. But not all clinics test for those, so not everyone knows their values (actually, my bariatric clinic doesn't test for them, either - I'd gone to my primary care provider for some reason or another (it's been eight or nine years, so I don't remember why) and she did some panel that included liver values. She freaked about it, but my bariatric clinic knew what was going on - and again, they were back down to normal once I was about a year out).. They go up because rapid weight loss is really hard on the liver.

I've recently had those tests, they were a few points above "normal" but doctor said "in the margin of error" for lab values and wasn't worried. Thanks! Great info!