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Julia Kizhner
Julia Kizhner, Physician Assistant
Category: Health
Satisfied Customers: 1126
Experience:  7 years experience working in Primary Care as well as Gastroenterology, Sleep Medicine & Weight Loss
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I visited my dr. last week with general flu like symptoms

Resolved Question:

Hello. I visited my dr. last week with general flu like symptoms and generally feeling bad. He called back for a follow up visit regarding strange liver enzymes,
AST= 178
The scheduling nurse mentioned they are running tests for hepatitis. Internet research has got me all confused, since I am not permiscious, no blood sticks and I drink less than 4 drinks a week.
What could cause this elevation?
Submitted: 7 years ago.
Category: Health
Expert:  Julia Kizhner replied 7 years ago.

Hello and thank you for your question.

Could you please tell me if you take any medications on regular basis, including vitamins?



Customer: replied 7 years ago.


Thanks for the quik response.

I dont take any meds/ vitimins. Only interesting background is I have historically (10 plus years) always had slightly elevated liver enzymes (know because follow up letters from life insurance, pre employment physicals).

I have been taking tylenol for the flu feelings and I have been on and off a no carb diet the last 6 and out of ketosis.


Expert:  Julia Kizhner replied 7 years ago.

Thank you for your reply, Matt.

Could you also tell me what kind of flu-like symptoms you had? Sore throat, fever? Were you checked for mono? Have you ever had an ultrasound of your liver since you have history of elevated liver enzymes? Since you mentioned "a no carb diet", are you overweight?


Customer: replied 7 years ago.


Thanks again.

Flu started with killer headache, upset stomach, mild fever and chills. No sore throat, no sinus or congestion issues....just aches. Slept a couple days straight. Felt better, but headache, aches continued. First onset was 4 weeks ago(1/8). Had a couple of times where "flu" felt like it was back heavy, with very fatigued, chills, cold extremities.

I am 39, 6'1, 280# ***** Was as heavy as 308(biggest ever) and and low as 260 in the last 6 months.

Had mono at 18, and I remember dr saying it cause a liver infection.

Expert:  Julia Kizhner replied 7 years ago.

Ok, I understand.

The most likely cause of your liver enzyme elevation is this virus which you battling with. It can cause inflammation in the liver. Also, taking Tylenol, that can do it as well. I would recommend being checked for mono since you've been battling this infection for almost a month.

It does not sound like you have hepatitis...usually AST and ALT numbers are raised about the same in Hepatitis plus you really don't have any risk factors for it, as you mentioned (no blood transfusions, IV drug use, unprotected intercourse with multiple partners).

If your Hepatitis panel comes back negative (and it most likely will), I would recommend repeating your liver enzymes in a couple of weeks after your flu-symptoms are over. If they are still elevated, I would recommend getting a liver ultrasound as well as being referred to a liver specialist for some additional tests of causes for elevated liver enzymes.

You are somewhat overeight, there is also a good chance that you may have what is known as "fatty liver disease". Basically its just some fat that surrounds liver cells causing inflammation. It is diagnosed with liver ultrasound. For this, weight loss would be crucial, however, no carb diet is not healthy. You need to have some carbs in your diet, maybe something like fruits instead of breads.

So the bot***** *****ne, the most likely cause of your elevated liver enzymes if your current virus. Since you've had it for almost a month, there is a possibility it is mono so I would recommend getting checked for it.

If additional blood work comes back negative for hepatitis, I would recommend getting an ultrasound of the liver done and also repeating liver enzymes after the virus is gone. If the enzymes are still elevated, then you will need additional blood work to look for other causes.

I know this is a lot of information. Please let me know if you have any additional questions or need any clarificatiton. I would be happy to assist.

If you are satisfied with the answer, please click the green "Accept" button. Otherwise your deposit stays with JustAnswer and I do not get credit for my work.

Best wishes,


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