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Dr. Rick
Dr. Rick, Board Certified MD
Category: Eye
Satisfied Customers: 10786
Experience:  Ophthalmology since 1994 with Retina sub-specialty interest
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My ALT has risen from 1210 to 2385/ AST 500 to 1312 in 4 weeks

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My ALT has risen from 1210 to 2385/ AST 500 to 1312 in 4 weeks I have some jaundice ( corner of eyes are yellow). Current bilirubin is 3.6. I have had bouts of severe itchy red splotchy skin too ( comes and goes worse at night), since I was diagnosed with acute hepatitis B on September 3,2013 . This was diagnosed by my GP and now they want to send me to a liver specialist? Should I be worried here? I do not drink alcohol and I have changed my diet to include water, juice, soup, skim milk, nuts, low fat foods, lean protein, fruits, and veggies. Could you help me ?

Dr. Rick :

Hi. I'm Dr. Rick and I have two decades of ophthalmology experience. I'm online and happy to answer your question today.

Dr. Rick :

I do not think you should panic but I do agree with the plan to get you in to see a liver specialist ASAP.

Dr. Rick :

You liver is not doing very well right now......

Dr. Rick :

Are you happy with the liver specialist you are being referred to, or would you like to go to the "mecca" of liver treatment, which would require travel to Houston, Tx?

Customer:

This appears to be the normal course of acute hepatitis b. Once you have jaundice then the body clears the virus and ALT/AST go down?The high numbers are normal in this stage right?

Dr. Rick :

In many cases of HepB the body clears the virus and everything turns out ok. Given you rapid change in liver function tests, bilirubin, jaundice and itching you are having a much more complicated and serious course of it......

Dr. Rick :

The sooner you can get in to see a liver expert, the better.

Dr. Rick :

It is not unusual for your numbers to go up, as you said, but yours have gone up a lot in a short time and you are having other symptoms of liver problems. That is why your GP is sending you to someone who knows a lot more then he does.

Dr. Rick :

My very good friend and hunting buddy for the last 25 years just happens to be one of the worlds leading experts on liver diseases and medical management of liver transplantation so I know more about this then I really want to :)

Customer:

This is starting to scare me. I mean I have no pain in my liver(location). Do you think they will hospitalize me?

Dr. Rick :

It is impossible to say if they will put you in the hospital but, if the specialist is not near your home, I would pack as if you were going to stay.

Dr. Rick :

It is pretty scary as you really need your liver......when is your consultation with the liver doc?

Customer:

They haven't got back with me yet? The LS is located in my city though ( Roanoke, VA).

Dr. Rick :

Ok. it is good that the liver center is in your city. I am sure that you will be seen very soon. If you don't hear from them by Friday morning, call the liver doc and see when they are going to get you in.

Dr. Rick :

Is there anything else you would like to discuss with me this afternoon?

Customer:

I appreciate your help Dr Rick. Thanks -David

Dr. Rick and other Eye Specialists are ready to help you
David,

I was just thinking about you today and wondering if you have had a chance to talk to the liver specialist yet. If so, what did she say?

Let me know if you would like the name of my friend in Texas. I am sure he or one of his fellows would be happy to talk to you.

I hope you feel better soon.

Dr. Rick