Hi,

Long story...attempting to make it short. I was admitted to the hospital after falling down the stairs and hitting my head on February 8th of 2014. Had a concussion/traumatic brain injury that we have dealt with and are still dealing with. All of my blood tests came back normal, with the exception of my AST and ALT. I'm just going to write this down chronologically, because I think you'll be able to follow this easier. Prior to this, I have never had any enzymes that were high.

January 24th Was put on a drug called perphenazine for anxiety
February 8th AST 58 ALT 72
February 27th AST 63 ALT 108
March 5th Immediately stopped taking the perphenazine after doc tells me it can be toxic to liver
March 5th Liver Ultrasound Moderate to severe fatty infiltration of liver, all other findings unremarkable
March 5th Doctor told me I had NASH, based on high liver enzymes and fat found upon ultrasound NO BIOPSY EVER DONE
March 6th Freaked out for most of the day.... :o) (Generalized Anxiety Disorder will do that to ya!)
March 7th Got off my fat fanny (was weighing 190 at 5 feet 5 inches) and started exercising/eating right
April 21st AST 37 ALT 59 (According to my lab, AST now normal, ALT 3 points over limit)
July 21st AST 33 ALT 33 (Now both within range according to lab my doc uses)
November 6th AST 21 ALT 24
January 15th, 2015 AST 27 ALT 55 (top of range is 56)

My doctor is not concerned at all about this 30 point increase since it was still in range, although barely.....however, I am concerned that my ALT went from 24 to 55 in 2 months. I confess that over the holidays, I exercised much less than usual and ate a LOT of things I shouldn't have. The weekend before the test, I ate so much chocolate, it was pathetic. Over the holidays, I gained about 7 pounds back, after losing 60 pounds during 2014. I have now lost the weight again. Also, I took 400 mg. of ibuprofen about 3 times, 11 days prior to test.

My question is this....my doctor had actually thought that because my liver enzymes normalized so quickly, that she might have jumped the gun on diagnosing me with NASH. I did have moderate to severe fat in my liver and she has said that despite all of my weight loss, there is no need to do another scan, as my enzymes have been normal for since mid-last year.

Should I be concerned about this jump? Could it be the lack of exercise? The 7 pound weight gain? The poor eating? The Ibuprofen? I'm so scared that this is the start of my liver enzymes going back up out of range, which is significant of a major liver problem and that I'm not going to be around for my children.

I have totally gotten back on a good diet and am exercising (fast walking) at least an hour each day. Sorry to sound so dramatic.....my generalized anxiety disorder is really getting to me today.

One other question. My rbc count has been rising since this whole issue started as well. It is currently at 5.14. THe top of the range is 5.1 according to my lab. I will tell you that I take fish oil and flax oil three times a day, take a daily vitamin each day, 2000 mg of vitamin d each day and eat a TON of fish, nuts, dark green vegies, fruit, yogurt. And when I say fish....I eat salmon/trout pretty much every single day......tons of broccoli and asparagus, squash, etc.... My doctor told me that she wasn't the least bit concerned, as MANY healthy women have this level of rbc. My hemocrit is 43.2 and my hemoglobin is 14.4. I was NOT dehydrated when I went in. Could it be that I am just eating a lot of rbc friendly foods along with the supplements that I use for cholesterol?

Also, just thought of one more thing.....the day of my appt. and during the week before, I took a fair amt. of Xanax and Vistaril for anxiety as I was so nervous about the appt.

What could be going on here? I've read that high rbc counts can be caused by a condition called pv. I am terrified that I might have that. Can you please help me understand these results?

My doctor wrote at the bottom of the report that she was pleased with everything and that I didn't need to follow up on any of it unless I wanted to. By the way, everything else was TOTALLY normal....and all of my liver tests except for my ALT and AST have never been anything but normal.

THanks so much for your help. I am really scared.

Sincerely,

Robin