Guest guest Posted February 16, 2005 Report Share Posted February 16, 2005 Hello Drainers, I've been seeing a 44 year old male who presented to the clinic b/c of elevated liver enzymes, found on routine lab testing. GGT 92 (N = <49), ALT 58 (N = <50), AST 39 (N = <36). Symptoms include fatigue, some tingling of extremities, muscle cramps, deep leg pain (all of which are minor). Also, a left sided fluttering sensation/slight pain that comes and goes in the area of his spleen. He's been treated for parasites in the past, as he does travel overseas often. Currently no GI symptoms other than an intolerance of fatty foods. He's been tested for celiac (-ve), hepatitis (-ve), HIV (-ve), cholesterol 5.1 = borderline high, LDL - borderline high, Triglycerides - borderline high. Hx of dientamoeba in his stool (1.5 years ago). Ultrasound of spleen has shown enlargement. I've worked with 1, 20, 2243, 3, 6, 39, 43, Aroma 4, citrigen, black walnut caps, HLIP, and milk thistle, Meyers IV with hepar compositum ... a slight drop over the past 5 months, but no significant changes in the enzyme levels. Physical exam and history are otherwise unremarkable. So my questions are: 1. What else could be causing elevated liver enzymes? ie, is there anything else I need to rule out? 2. Any suggestions for bringing down his enzyme levels? Thanks in advance! Sheheen Mithani, ND Vancouver BC ______________________________________________________________________ Post your free ad now! http://personals..ca Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 16, 2005 Report Share Posted February 16, 2005 Sheheen, I can't speak to more drainage remedies, however I can speak to also using some supplements. the high GGT, I consider to be gall bladder indicator. Intolerance of fat is GB too. Try giving him a little bile with meals? I give more liver support and a product to thin the bile by Biotics called Beta TCP, I think standard process has something similar. I would give electrolytes also for the cramping. I think you are on the right track. I would definitely consider more parasite cleansing. Can you find his constitutional homeopathic? Whittaker Everett, WA Family Practice Abnormal liver enzymes > > Hello Drainers, > > I've been seeing a 44 year old male who presented to > the clinic b/c of elevated liver enzymes, found on > routine lab testing. GGT 92 (N = <49), ALT 58 (N = > <50), AST 39 (N = <36). Symptoms include fatigue, some > tingling of extremities, muscle cramps, deep leg pain > (all of which are minor). Also, a left sided > fluttering sensation/slight pain that comes and goes > in the area of his spleen. He's been treated for > parasites in the past, as he does travel overseas > often. Currently no GI symptoms other than an > intolerance of fatty foods. > > He's been tested for celiac (-ve), hepatitis (-ve), > HIV (-ve), cholesterol 5.1 = borderline high, LDL - > borderline high, Triglycerides - borderline high. Hx > of dientamoeba in his stool (1.5 years ago). > Ultrasound of spleen has shown enlargement. > > I've worked with 1, 20, 2243, 3, 6, 39, 43, Aroma 4, > citrigen, black walnut caps, HLIP, and milk thistle, > Meyers IV with hepar compositum ... a slight drop over > the past 5 months, but no significant changes in the > enzyme levels. > > Physical exam and history are otherwise unremarkable. > > So my questions are: > 1. What else could be causing elevated liver enzymes? > ie, is there anything else I need to rule out? > 2. Any suggestions for bringing down his enzyme > levels? > > Thanks in advance! > > Sheheen Mithani, ND > Vancouver BC > > ______________________________________________________________________ > Post your free ad now! http://personals..ca > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 17, 2005 Report Share Posted February 17, 2005 Sheheen, There are many things that could be causing the mild elevations of liver enzymes in your patient. I assume that the hepatitis panel that was run was complete including HepBcAb, HepBsAb, HepBsAg, HepCAb. Must of course rule out chronic alcohol or drug consumption including over the counter meds such as tylenol, maybe he's a kava kava addict! Most likely diagnosis once these things are ruled out is non-alcoholic steatohepatitis (NASH) ie. inflamed fatty liver. An extremely common condition that corresponds with his high cholesterol and TG numbers. Is he obese? diabetic? what are his blood glucose numbers?. Definitive dx is by liver biopsy, but you can treat as if for a little while and should see the numbers get better. More unlikely but possible dx include Primary billary cirrhosis, Primary sclerosing cholingitis, autoimmune hepatitis, early liver cancer,liver parasite, EBV and others. Again a liver biopsy would be the next step in confirming some of those less likely dx. As far as treatment I would assume NASH and treat, monitor his blood glucose, cholesterol,TGs, enzymes. Consider biopsy referal if not responding in a few months. Absolutely no alcohol (or tylenol) avoid simple carbs, AI diet, increase protein (consider a detox protein powder like mediclear(Thorne) or ultraclear(metagenics), buckets of water. DAILY EXERCISE. Castor oil packs daily. Unda 1,20,243. 2,20,258. 20,226,243. 3,34,20. Lecithin, ground flax seeds, Ichol plus 2caps tid. Cod liver oil. Magneleuvres. His liver will thank you! Keivan Jinnah,ND, LAc. Portland OR Quote Link to comment Share on other sites More sharing options...
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