The title pretty much states what I want to know:
In cases where a person might be taking strong pain medication like Lortab, or, after a person has had a few beers (hopefully not along with the Lortab!), how long do liver enzymes remain elevated?
How do physicians decide if the elevated levels are “normal” for a person, or if they are truly elevated?
I think they guess. Well, probably not, but every doctor seems to have their own tolerance level.
I am a HepB carrier - every year since diagnosis (I was 17 at the time) I have had a liver function test. All of them within the normal range. I drink very little, because carriers like me are at risk of liver cancer.
In late 2005 I left permanent employment and started contracting, so I took out some additional life insurance. My doctor had to provide a medical report, and called me a few days later. Seems my previous liver function test six months earlier had produced an elevated result, and because she was away, no-one had told me. I was a bit pissed at the time. It wasn’t hugely high, but it was out of the range of results I had been getting. She wanted to refer me to a specialist - I could have ended up on antiviral treatment. However, because I was living out of town during the week, I had to find a new local (to my work) doctor. So I did. And he wanted to do a new test. Which came back elevated. And I got more concerned.
And the doctor did nothing. He told me lots of people live with elevated liver function results, and I should not worry. I was telling him I wanted to know what could be doing it, aside from viral activity. I never did win (so I probably avoided a painful liver biopsy). And (because of the way the NHS works) there was not a lot I could do about it. I pushed it for a few months, then ended up working somewhere else for six months, not having a doctor at all. When I got back, I had another test - back in the normal range after over a year.
Shortly, I will be living at home again, transferring back to my old doctor, and hoping for consistently normal results. But I know that if they do elevate, my home doctor will probably respond quicker to the change.
Wikipedia - Liver Function Tests gives normal ranges. I don’t believe you would see elevated levels of enzymes after a few beers or painkillers. It is when cells are being killed by serious abuse that enzyme levels elevate.
Si
Certain liver enzymes can remain elevated for several weeks after a period of “heavy drinking”. So, it depends on what enzyme is being used for the test. Likewise, there are non-liver enzyme tests that can suggest excesive alcohol intake (e.g. MCV = mean corpuscular volume of red blood cells) that can remain high for months.
Of course, if a person has a chronic liver disease such as hepatitis C, then the liver enzyme level may always be high, whether or not they’ve used alcohol to excess.
In terms of what’s normal, I suppose there are two ways to look at it. By far the most common is to define abnormal as being beyond the 95th percentile. Indeed, this is how so-called normal ranges are determined for all, or nearly all, blood tests. A second way might be possible if the treating doctor had access to a series over time of liver enzyme levels. In that way, it might be possible to infer that an ostensibly abnormal level of say, 60, is actually pretty typical for the patient at hand (e.g. monthly values of 58, 66, 53, 57, 68, 63, and now 60).