Guest guest Posted January 20, 2008 Report Share Posted January 20, 2008 Hi all, I hope everyone had a good holidays and a happy new year. With a new year comes more challanges and questions. I have been a part of this group for a couple of years now and try to read the posts as frequently as possible. I wanted to put a couple questions to the more " seasoned " members, or PSC sufferers. I see many posts about being asymptomatic. What exactly is the definition of asymptomatic? I consider myself very lucky at this point, besides some URQ discomfort, I seem to be doing fairly well. (knock on wood) I have been getting increasing URQ pain, well it actually feels more like a runner's stich. It concerns me. As is with most people, my New Years resolution is to get my body fat down to a respectable level. I am not obese, but I could stand to lose a few! I have found that exercize seems to make the URQ issues disappear. I am not sure if others have had similar experiences? Regarding the LFTs, I have been going to get blood work every 3 months and now I have enough data that I can start tracking my LFT results. I have spent many hours going through different doctor websites looking for standard numbers for LFTs. The one's that I do find seem to vary from site to site. Could someone give me the standard tolerances for the ALT, AST, AlkPhos, Bilirubin and GGT? Also, as a PSC sufferer, what magnitude of deviation for the NORM should I be worried about? which LFTs should I be most concerned with? Or which combination? Thanks very much. Take care. 37yo father of 3 great kids PSC `05 UC `05 Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 20, 2008 Report Share Posted January 20, 2008 Asymptomatic = no symptoms. Normal LFTs, no pain, no jaundice, no pruritis, no fatigue, no fever. I also found exercise to improve URQ, as long as I wasn't dehydrated. It also improves your recovery time when/if you need a transplant. Standard tolerances for any lab test depends on the lab. Mine are printed right on the test results page. Make sure you pay attention to the units, as some labs use an international standard, so you may see wildly different numbers on web sites. A good site for LFT descriptions is http://www.ariess.com/s-crina/tests-lft.htm. http://www.aafp.org/afp/990415ap/2223.html is another one, including normal distribution graphs. Arne 56 - UC 1977, PSC 2000 Alive and (mostly) well in Minnesota ________________________________ From: [mailto: ] On Behalf Of mclean_mcbain What exactly is the definition of asymptomatic I have found that exercize seems to make the URQ issues disappear. I am not sure if others have had similar experiences? Could someone give me the standard tolerances for the ALT, AST, AlkPhos, Bilirubin and GGT Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 20, 2008 Report Share Posted January 20, 2008 Arne gave you a great answer!! In medical terms the prefix a means without. We refer to a pt without fever as afebrile while someone who has a fever is febrile. > > Hi all, I hope everyone had a good holidays and a happy new year. > With a new year comes more challanges and questions. I have been a > part of this group for a couple of years now and try to read the > posts as frequently as possible. > > I wanted to put a couple questions to the more " seasoned " members, or > PSC sufferers. I see many posts about being asymptomatic. What > exactly is the definition of asymptomatic? I consider myself very > lucky at this point, besides some URQ discomfort, I seem to be doing > fairly well. (knock on wood) > > I have been getting increasing URQ pain, well it actually feels more > like a runner's stich. It concerns me. As is with most people, my > New Years resolution is to get my body fat down to a respectable > level. I am not obese, but I could stand to lose a few! I have > found that exercize seems to make the URQ issues disappear. I am not > sure if others have had similar experiences? > > Regarding the LFTs, I have been going to get blood work every 3 > months and now I have enough data that I can start tracking my LFT > results. > > I have spent many hours going through different doctor websites > looking for standard numbers for LFTs. The one's that I do find seem > to vary from site to site. Could someone give me the standard > tolerances for the ALT, AST, AlkPhos, Bilirubin and GGT? Also, as a > PSC sufferer, what magnitude of deviation for the NORM should I be > worried about? which LFTs should I be most concerned with? Or which > combination? > > Thanks very much. Take care. > > > > 37yo father of 3 great kids > PSC `05 > UC `05 > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 20, 2008 Report Share Posted January 20, 2008 Hi ; I've just added a couple of images into the " Photos/ " folder. One shows my son's LFTs and the medications that he has been taking over the years. You'll see that we have mostly tracked AST, ALT and Alk Phos, but we have also been monitoring albumin, and bilirubin (these have not changed much and are not shown). He was found to have PSC by accident ... he had acne and was treating this with topical retin-A without much success. In preparation for going on accutane, his dermatologist did a background liver panel, and found ALT, AST and Alk Phos elevated. Retin-A was discontinued. The dermatologist checked back through his blood tests and found elevated LFTs over 1 year earlier in his files, but these had never been reported to us. A single GGT test was done and found to be elevated, suggesting cholestatic liver disease. He then had a liver biopsy and ERCP and was found to have PSC [stage 2] (07/03), and was immediately placed on ursodiol. A colonoscopy one month later (08/03) showed that he had ulcerative colitis, and so he was put on asacol. Centrum Silver and extra folic acid were added at roughly the same time as the asacol. His ALT and AST declined almost immediately in response to the ursodiol (Actigall), but his Alk Phos remained high. He was placed on minocycline to see if this would resolve the acne, but it didn't have much effect. He began itching (pruritus), and we tried reducing the dose of ursodiol (Actigall), but all this seemed to do was elevate his ALT and AST. Atarax was tried briefly for the pruritus, but without any effect (not shown). His hepatologist then prescribed rifampin with excellent results .. his itching ceased. He stopped taking minocycline at the same time as the rifampin was started. Ursodiol (URSO 250) was added back again at a higher dose (25 - 28 mg/kg/day). We then added fish oils, and his acne cleared up (see photo of taken in May 2007). His dose of fish oils was increased from 1 capsule to eventually 3 capsules per day. His Alk Phos has slowly fallen, and is now just above the upper limit of normal. A good resource on liver function tests is this one: http://www.postgradmed.com/issues/2000/02_00/gopal.htm " Normal " ranges are shown in this article, but as others have mentioned, these ranges can vary a bit between labs, and certain of them (particularly Alk Phos) are dependent upon age. Best regards, Dave R. (father of (22); PSC 07/03; UC 08/03) Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 21, 2008 Report Share Posted January 21, 2008 What is the reasoning behind the Centrum Silver vs any other multi vitamin? Also, I can think of a few good reasons for us PSC and IBD people to take extra folic acid, but what is the reason for your son? Quote Link to comment Share on other sites More sharing options...
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