dinoiii
January 3rd, 2005, 11:26 AM
It seems as though there has been a lot of talk on this board about liver and potential toxic side effects of methylated PH's - as well as signs & symptoms (S&S) and I feel this is a good time to comment.
As many have suggested it is good to monitor Liver enzymes, but sometimes many find it hard to come forth with rationale as to why they want their liver enzymes checked to their doctors. There are alternative ways to know (I know of a few tests where you can send in for results that are reliable if there is interest - they have been pretty reliable thus far).
Liver Function Tests (LFTs)
-what to ask for:
(1) the transaminases (AST/ALT)
(2) alkaline phosphatase
- these actually are more a measure of liver inflammation (hepatitis) than function, however.
Better Liver Function Tests or what I call the real Liver Function Tests (rLFTs)
-what to ask for in assessing function:
(1) albumin
(2) bilirubin
(3) PT
- while being better predictors of functionality, abnormalities are not SPECIFIC for liver disease
- there are specific times to avoid testing all of these (i.e. - when you are taking antibiotics, it is ideal to not check PT time which could be elevated...it is additionally elevated during anticoagulation - guys this includes any analgesics like aspirin and/or ibuprofen which should be avoided while using methylated PHs anyway).
How to interpret distinctive patterns in LFTs:
(1) AST:ALT > 2 = alcoholic injury
(2) ALT>AST = viral hepatitis or non-alcoholic steatohepatitis
(3) The tricky part is that with methylated PH's, both tend to be elevated in almost a 1:1 ratio (IF YOU ARE SUSCEPTIBLE), you are also likely to see transaminases in the 1000's <this is toxic, ischemic or viral levels> not often seen with alcohol
(4) ALT:LDH ratio of <1.5 is suggestive of ischemic hepatitis rather than viral ditinction
Symptoms you are likely to experience if your liver has been affected by methylated PH's:
NONSPECIFIC (though may help tell you about onset of problems):
-malaise
-jaundice (check the color of the whites of your eyes)
-nausea
-vomiting
-weight loss
ALSO- DO NOT USE methylated PH's if your family history includes ANY of the following disease/illnesses:
-Wilson's disease
-alpha-1 antitrypsin deficiency
-hemochromatosis
(granted it may be too late for you to consider this if you have not prior to use)
Signs your physcian or other people may find:
- jaundice
- spider telangiectasia (pathogenesis would actually be result of high Estrogen conversion, so be VERY WORRIED HERE!!!)
- palmar erythema (red hands)
- testicular atrophy / gyno (again, E related)
- Dupuytren's Contracture (believe me, you would not be able to lift weights and would know if you had this, your palm is continually in a flexed position)
- Ascites (water retention in lower body trunk cavities)
Personally, I have ordered right upper abdominal quadrant ultra sounds for confirmation of steatosis (which is for lack of better words - your liver being replaced by fat). I also on occasion verify the diagnosis with creatine kinase (CK) or aldolase, but I very well would check these up front if you told me about your history of methylated PH use.
Before your doctor considers biopsy or veryifying it is not obstructive in nature, make certain you buckle down and tell him of your use of methylated PH. I may actually have you bring the bottle with you, in fact - it is a good idea anyway. Have your wife hold it in her bag until your doctor gives you some results.
I hope this helps. If you have further questions about evaluation, please contact me via email.
As many have suggested it is good to monitor Liver enzymes, but sometimes many find it hard to come forth with rationale as to why they want their liver enzymes checked to their doctors. There are alternative ways to know (I know of a few tests where you can send in for results that are reliable if there is interest - they have been pretty reliable thus far).
Liver Function Tests (LFTs)
-what to ask for:
(1) the transaminases (AST/ALT)
(2) alkaline phosphatase
- these actually are more a measure of liver inflammation (hepatitis) than function, however.
Better Liver Function Tests or what I call the real Liver Function Tests (rLFTs)
-what to ask for in assessing function:
(1) albumin
(2) bilirubin
(3) PT
- while being better predictors of functionality, abnormalities are not SPECIFIC for liver disease
- there are specific times to avoid testing all of these (i.e. - when you are taking antibiotics, it is ideal to not check PT time which could be elevated...it is additionally elevated during anticoagulation - guys this includes any analgesics like aspirin and/or ibuprofen which should be avoided while using methylated PHs anyway).
How to interpret distinctive patterns in LFTs:
(1) AST:ALT > 2 = alcoholic injury
(2) ALT>AST = viral hepatitis or non-alcoholic steatohepatitis
(3) The tricky part is that with methylated PH's, both tend to be elevated in almost a 1:1 ratio (IF YOU ARE SUSCEPTIBLE), you are also likely to see transaminases in the 1000's <this is toxic, ischemic or viral levels> not often seen with alcohol
(4) ALT:LDH ratio of <1.5 is suggestive of ischemic hepatitis rather than viral ditinction
Symptoms you are likely to experience if your liver has been affected by methylated PH's:
NONSPECIFIC (though may help tell you about onset of problems):
-malaise
-jaundice (check the color of the whites of your eyes)
-nausea
-vomiting
-weight loss
ALSO- DO NOT USE methylated PH's if your family history includes ANY of the following disease/illnesses:
-Wilson's disease
-alpha-1 antitrypsin deficiency
-hemochromatosis
(granted it may be too late for you to consider this if you have not prior to use)
Signs your physcian or other people may find:
- jaundice
- spider telangiectasia (pathogenesis would actually be result of high Estrogen conversion, so be VERY WORRIED HERE!!!)
- palmar erythema (red hands)
- testicular atrophy / gyno (again, E related)
- Dupuytren's Contracture (believe me, you would not be able to lift weights and would know if you had this, your palm is continually in a flexed position)
- Ascites (water retention in lower body trunk cavities)
Personally, I have ordered right upper abdominal quadrant ultra sounds for confirmation of steatosis (which is for lack of better words - your liver being replaced by fat). I also on occasion verify the diagnosis with creatine kinase (CK) or aldolase, but I very well would check these up front if you told me about your history of methylated PH use.
Before your doctor considers biopsy or veryifying it is not obstructive in nature, make certain you buckle down and tell him of your use of methylated PH. I may actually have you bring the bottle with you, in fact - it is a good idea anyway. Have your wife hold it in her bag until your doctor gives you some results.
I hope this helps. If you have further questions about evaluation, please contact me via email.