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I have a problem with the liver and I do not know what disease is that.
Let me explain how all started.
In the winter of 2017-2018 (1 year and half ago) I had a lot of problems respiratory tract infections (pneumonia, bronchitis and colds) and I took several rounds of antibiotics (2nd generation cephalosporins and levofloxacin) and several other medicines (like ibuprofen - not too much - maybe 1 pill of 200mg at 3 days) and many herbs.
Then in March 2018 I’ve had bacterial prostatitis and I had to take 1 month of levofloxacin. Also, my GP gave me indomethacin (for several days) so that I can urinate better. Needless to say, indomethacin din not improved the condition...
All have passed, and I did not had any respiratory problems nor prostatitis in the past 11 months.
In April 2018 I have discovered a good salmon in our neighbourhood store and I have started to eat a lot of it (about 2-300 grams) every day. Unfortunately, I cooked it by frying in oil. After 1 month I develop gastritis (probably my stomach was weakened from Ibuprofen and too much fried oil has raised the acid too much …).
I started to take Pantoprazole for 3 weeks and Sucralfate. The stomach pain has reduced significantly, but not entirely. I took a break from PPI … and after 2 weeks the stomach started to hurt again. I tried some herbal medicine, with no significant effect.
In August 2018 I started to take Ranitidine (150mg in the evening), because I read that PPI have too many side effects. After 5 weeks of ranitidine, I started to have a very strong pain in the right side of the abdomen where the liver is located. No other symptoms, just the pain. I stopped Ranitidine, and the pain has disappeared. After 1 week, I resume Pantoprazole (because the gastritis was still there). After 1 month of Pantoprazole, I again had strong pain in the liver area. I stopped the Pantoprazole and the pain has disappeared. Also, the stomach condition has improved significantly.
In November 2018, I was ok. I followed a simple diet: potatoes, carrot, chicken breast, banana.
I December I said that I’m cured and I can eat anything what I want. Bad mistake, after 3 days the stomach pain was again present.
During this time, I have lost weight (about 9 kg in the last year) so I started to eat white chocolate to gain weight again. After 3 days of white chocolate [200g per day] the strong liver pain was again there. The pain was more severe if I bend forward. It felt like I had a wound there.
At the end of December I went to a lab of to do some blood test for liver. The values have been:
Gamma GT = 93 (normal interval [0-55])
ALT = 70 (normal interval [0-45])
AST = 35 (normal interval [0-35]).
My GP was on vacation, so I had to research more by myself.
I took silymarin (150mg/ day - not very constant) since August 2018, but with not too much effect.
After the first blood test I started to take Quercetin. The pain has disappeared very fast. After 1 week of 3x 500 mg of Quercetin, the pain in the liver area was almost nonexistent.
I repeated the blood test after 1 week, this time with more parameters:
Gamma GT = 124 (normal interval [0-55])
ALT = 82 (normal interval [0-45])
AST = 32 (normal interval [0-35]).
Direct Bilirubin = 0.17 (normal interval [0-0.2])
Total Bilirubin = 0.48 (normal interval [0.1-1.2])
B and C hepatitis = negative.
So, the Quercetin has improved my symptoms significantly, but [some] of my blood tests became worse. I stopped Quercetin.
At that moment I was novice in that field and I have not realized that I need more blood tests.
I started to take Silymarin [300 mg/day], Essentiale Forte [6 pills per day], Liv52.
After 2 weeks (to another blood test lab):
Gamma GT = 67 (normal interval [0-50])
ALT = 39 (normal interval [10-60])
AST = 30 (normal interval [10-50])
ALP = 274 (max value 270)
Albumin = 4.9 (normal interval [3.5-5])
Eosinophils = 6% (max normal value is 5%); but I had this value 6 years ago too.
So, my blood tests have been improved, but some are still outside the normal range.
My GP ignored me telling that the values are not pathological.
I also did a stool test for H Pylori and was negative.
Also, I went for a upper gastroscopy and I was diagnosed with mild antral gastritis and no H. Pylori. They gave me Nexium, but I refused to take knowing the liver pain from Ranitidine and Pantoprazole.
In the meantime, I have started to read more and I did tried all kind of medicine.
SAMe, L-methionine, NAC = all good, reduce the liver pain and improve blood tests, but I get pain in the stomach from them and I cannot take them for too long (several days).
ALT and AST are usually inside normal range, but Gamma GT and ALP never decreased below maximum value.
I suspected that I have intrahepatic cholestasis from drugs, but I did not had other symptoms [no itching, urine has normal color].
Also I did a test for Bile acid in serum and the score was 1.4 (max value 10) … so, maybe is not cholestasis.
I went to an ultrasound and the liver is enlarged [16 cm in diameter - I understand that normal size is 14 cm], but no other problems there.
I tried TUDCA for 2 days before getting stomach pain from it … and even if the liver pain has disappeared, the blood test have jumped out of range (ALT jumped to 80, Gamma GT jumped to 90, Direct bilirubin jumped to 0.4).
I also tried Medrol (Metilprednisolon) … only 1 pill of 16 mg because I got a serious stomach pain from it.
The ALP has decrease with 30% from the previous value! Now is at 80% from upper range.
Now I’m on phospholipids (3x 600 mg /day) and silymarin (3x 150mg / day) and much better than in December 2018. But I still have some small pain in the liver area.
Also, I cannot tolerate Ranitidine (I get liver pain after 1 pill). I got liver pain even after 2 pills of Sucralfate (this drug goes to liver too?! ). I do not know from which other drugs I get liver pain because I did not tried !
Stomach is better since I started to drink water with Ph 8.8.
Also eat a lot of oatmeal.
Last blood test looks like this:
Gamma GT = 87(normal interval [0-50])
ALT = 43 (normal interval [10-60])
AST = 21 (normal interval [10-50])
ALP = 221 (max normal value 270)
Direct bilirubin = 0.18 (max normal value 0.25)
Prothrombin time = 25 seconds (normal range [13 - 17]). I recall that whenever I had an open wood it took more time to stop the bleeding.
What disease is that?
What other tests should I make to understand the problem?
Cholestasis? If so, why Bile acids in serum are so low? Why it does not respond to TUDCA?
Autoimmune hepatitis? My ALT and AST are in normal range.
Or what else can be there? My GP says that blood test values are not pathological … but why the liver hurts?
Fatty liver? In the past I have ate a lot of chocolate trying to get some weight (now I have 65 kg at 177cm, BMI = 20.7). One year ago I had BMI = 23.6. I recall that I had some very mild liver pain after eating chocolate in the past … but the pain would have disappeared after stopping chocolate.
I cannot eat sugar anymore. I cannot eat white bread or pasta because I get liver pain.
I also had Hepatitis A, like 30 years ago.
I did consume alcohol only occasionally (that is 4-5 drinks per year).
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