# Liver enzymes



## Odiern

Was diagnosed with hashi, goiter. Just found out that my liver enzymes are also elevated. Is there a relation between hashi and liver?


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## bigfoot

Just how elevated are we talking -- can you list your pertinent labs (and ranges, too)? However, you probably know that Hashi's is autoimmune / inflammatory in nature, and that can have an effect on other parts of the body, and put you at risk for developing other autoimmune diseases. And the liver also happens to be a *huge* converter of thyroid hormones, so potentially if your liver is wonky, that would cascade down.


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## Andros

Odiern said:


> Was diagnosed with hashi, goiter. Just found out that my liver enzymes are also elevated. Is there a relation between hashi and liver?


There could be for when the thyroid is not feeling well, the impact is like dominoes. All systems are affected.

Are you on any med that would be hard on the liver?


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## CA-Lynn

The liver is the spokesperson for the entire body.

Will help if you post your lab results.


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## Odiern

TSH 5.88
Globulin 287
Thyroid microsomal 6500
AST 55
ALT 54
Total bilirubin 0.5
BUN is also elevated 27
Glucose 101

Seems as though everything is elevated.

I am on zocor and have been for probably five years. Have never had an issue with elevated liver enzymes.


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## Andros

Odiern said:


> TSH 5.88
> Globulin 287
> Thyroid microsomal 6500
> AST 55
> ALT 54
> Total bilirubin 0.5
> BUN is also elevated 27
> Glucose 101
> 
> Seems as though everything is elevated.
> 
> I am on zocor and have been for probably five years. Have never had an issue with elevated liver enzymes.


OMG!! TPO is really really high. Are you scheduled for an ultra-sound? If not, you should be!

TPO Ab
Mild to moderately elevated levels of thyroid antibodies may be found in a variety of thyroid and autoimmune disorders, such as thyroid cancer, Type 1 diabetes, rheumatoid arthritis, pernicious anemia, and autoimmune collagen vascular diseases. Significantly increased concentrations most frequently indicate thyroid autoimmune diseases such as Hashimoto thyroiditis and Graves disease.
http://labtestsonline.org/understanding/analytes/thyroid-antibodies/tab/test

And this..................

Liver damage
Occasionally, statin use could cause your liver to increase its production of enzymes that help you digest food, drinks and medications. If the increase is only mild, you can continue to take the drug. Rarely, if the increase is severe, you may need to stop taking the drug. Your doctor might suggest a different statin. Certain other cholesterol-lowering drugs, such as gemfibrozil (Lopid) and niacin (Niacor, Niaspan), slightly increase the risk of liver problems in people who take statins.

Finish reading here:
http://www.mayoclinic.com/health/statin-side-effects/MY00205


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## Odiern

Yes, I had an ultrasound of my thyroid. There are no nodules. I do have a goiter. Doctor says thyroid and 1 1/2 times normal size. I see my family physician this Thursday regarding the elevated liver enzymes and glucose. I did have a positive ANA test a couple of years ago, but negative lupus test. However, I did test positive for Epstein Barr. I have also had breast cancer. Just had a ct scan due to a tumor on my adrenal gland. The tumor has not changed in size since a year ago. I do not what else was on the ct scan at this point.


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## Odiern

Also, the endocrinologist did say I do have hashimotos.


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## Keba

Hashimoto's can contribute to Auto-immune liver disease.
Saying this, there are many things that can cause elevated Liver enzymes including taking OTC meds.
They'll probably want to do an ultrasound of your Liver to check for enlargement. Even then if your numbers stay elevated they may want to do a Liver biopsy.

I may be wrong but I thought Hashimoto's will cause the presence of ANA's.
I believe if you have Liver problems you will also have SMA's.

I had a scare with this last fall and am still be monitored if you have any questions let me know.


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## bigfoot

I don't believe Hashi's will show as a positive ANA. However, autoimmune hepatitis (liver disease) would, as would *many* other autoimmune diseases. They like to run in packs. And the SMA would be important to check, too, as mentioned above in relation to liver disease, along with checking for Hep. A/B/C. Autoimmune hepatitis, if it turns out to be that, is put into remission with drugs like prednisone and immune-suppressors (Imuran, etc.).

From your brief history, your immune system has had to deal with a *LOT* in the last few years, and still is currently. I don't know what kind of treatment you underwent for the cancer, but if it involved chemo of any sort, I can tell you from experience that it is very nasty stuff. Your body's immune system can be left in attack mode of sorts, which can cause problems itself.

I would tackle that EBV as soon as possible, too.


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## CA-Lynn

Yes, deal with the liver issue. Forget about a relationship to thyroid disease.


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## Odiern

My understanding is that there is nothing they can do for the EBV.


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## CA-Lynn

It may or may not be the EBV that's elevating the LFT's.

Epstein-Barr virus is a causative agent of infectious mononucleosis syndrome, which is commonly seen in young adults and characterized by fever, sore throat and lymphadenopathy. In adults, Epstein-Barr virus infection can cause liver function test abnormalities without pharyngitis or lymphadenopathy. Liver involvement usually causes mild elevation of transaminases and this abnormality resolves spontaneously. Jaundice might develop rarely during the clinical course of Epstein-Barr virus infection. It reflects either more severe hepatitis or Epstein-Barr virus infection-associated hemolytic anemia. Acute hepatitis with icterus is a rare clinical manifestation in primary Epstein-Barr virus infection. Especially in older patients, Epstein-Barr virus infection can cause cholestasis; the diagnosis can be established by elimination of extrahepatic biliary obstruction.


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## Keba

Hey I just wanted to add this link on postivie ANA. It states both Hashimoto's and Graves can give a positive ANA reading.
http://http://suite101.com/article/theanatesttoday-a222


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## CA-Lynn

THE SIGNIFICANCE OF ANTINUCLEAR ANTIBODIES

Patients with the following systemic autoimmune diseases may have a positive test for ANA:

◾Systemic lupus erythematosus (see "Patient information: Systemic lupus erythematosus (SLE) (Beyond the Basics)")
◾Scleroderma
◾Sjögren's syndrome (see "Patient information: Sjögren's syndrome (Beyond the Basics)")
◾Mixed connective tissue disease
◾Drug-induced lupus
◾Polymyositis/dermatomyositis (see "Patient information: Polymyositis, dermatomyositis, and other forms of idiopathic inflammatory myopathy (Beyond the Basics)")
◾Rheumatoid arthritis (see "Patient information: Rheumatoid arthritis symptoms and diagnosis (Beyond the Basics)")
◾Pauciarticular juvenile chronic arthritis
◾Polyarteritis nodosum

Patients with organ-specific autoimmune diseases may also have a positive test for ANA. These diseases include:

◾Thyroid diseases (Hashimoto's thyroiditis, Grave's disease)
◾Gastrointestinal diseases (autoimmune hepatitis, primary biliary cirrhosis, inflammatory bowel disease)
◾Pulmonary diseases (Idiopathic pulmonary fibrosis)

Patients with infectious diseases may also test positive for ANA. These diseases include:

◾Viral infections (Hepatitis C, Parvovirus)
◾Bacterial infections (Tuberculosis)
◾Parasitic infections (Schistosomiasis)

Other associations with positive ANA tests have been noted, including:

◾Various forms of cancer (rarely)
◾As a harbinger of the future development of autoimmune disease
◾Various medications, without causing an autoimmune disease
◾Having one or more relatives with an autoimmune disease

Some individuals, even those without a relative with autoimmune disease, may have a positive test for ANA and yet never develop any autoimmune disease.


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