Persistent Elevated Liver Enzymes: Seeking Answers After 6 Months
For over six months, my liver enzymes, specifically ALT and AST, have remained elevated. Typically, these levels hover around 200, but at times, they have surged into the 400 or 500 range, with my ALT consistently exceeding my AST. I witnessed a notable decrease of 200 points within a week, only for the levels to spike once again shortly thereafter. At 33 years old, I maintain a healthy lifestyle, which is why I'm bewildered by this situation. My hepatologist has indicated that at this severity, I am likely ingesting a chemical substance; however, I have adhered to her recommendations and eliminated all potential triggers. Here are some relevant details about my situation: - I am diagnosed with ITP, - My alcohol consumption has been minimal to nonexistent over the last six months since my enzyme levels began to rise, - I have completely ceased using melatonin, despite having taken it infrequently, - I have experimented with different formulations of my ADD medication, which I have used for over 12 years, - After undergoing a transjugular liver biopsy, the pathologists reported that the tissue samples were particularly difficult to analyze, - For the past month, I have only consumed bottled water, suspecting that the plumbing in my aging building might contribute to the issue, - Additionally, I have kept my windows open during the winter months in case there were environmental factors affecting my health within my apartment. I'm reaching out to see if anyone might have insights or ideas about what could be contributing to this dilemma. My list of possibilities is dwindling, and I find myself growing increasingly discouraged...
Answers (1)
12/16/2025, 6:10:39 PM
OpenHealth AI
Elevated liver enzymes, especially when persistent and fluctuating, can be concerning and confusing. It sounds like you've done a lot to investigate the possible causes and care for your health, which is commendable. Let’s break down your situation and consider the steps you can take moving forward, keeping in mind you're seeking clarity and solutions.
Explanation
Elevated levels of liver enzymes (ALT and AST) indicate that there may be an underlying issue affecting your liver, even if you maintain a healthy lifestyle. Common causes of elevated liver enzymes include liver diseases (like hepatitis, fatty liver disease, or autoimmune conditions), reactions to medications, exposure to toxins, and other metabolic or systemic issues.
Your hepatologist’s concern regarding chemical ingestion points towards potential environmental or medication-related factors. Since you've already cut out alcohol, melatonin, and monitored your water intake, it's essential to critically assess everything else that could impact your liver function, including any new medications you've started recently.
Prioritized Next Steps
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Maintain Detailed Records: Continue to keep a detailed log of your diet, water intake, medications, environmental changes, and any symptoms. This information can help identify patterns related to your elevated liver enzymes.
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Review Medications: Discuss your ADD medications with your doctor again. Sometimes, formulations or dosages can affect liver function, especially if there have been recent changes.
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Assess All Environmental Exposures: Since you've suspected environmental factors, consider performing a basic home assessment for potential toxins (like mold or other chemicals). Taking a break from your environment (staying elsewhere for a short period) might help identify if this plays a role.
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Follow-Up Tests: Discuss with your doctor about repeating liver function tests along with additional tests like viral hepatitis panels, autoimmune panels, or even imaging studies to further assess the liver.
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Nutritional Considerations: Maintain a balanced diet rich in fruits, vegetables, and lean proteins. Since you've previously avoided certain substances, continue focusing on clean eating with minimal processed foods.
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Support & Mental Health: Given the emotional toll this situation can take, it might be helpful to reach out for support, whether through family, friends, or counseling. Stress can also impact your overall health.
It's completely understandable to feel discouraged, but focusing on actionable steps can help regain a sense of control. You're taking the right approach by seeking support and actively addressing this issue. If your symptoms persist or worsen, don't hesitate to communicate this with your healthcare team for timely adjustments in your management plan.
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