Alternatives and lab test results

[countrygirl]

I'll be going in for my 6 month lab work in October. I'm looking forward to seeing if my regimen is having any effect on my earlier numbers. But I'm confused...if the numbers (ALT, AST, Viral loads, etc.) fluctuate from time to time, how does one interpret those numbers? They must be important because many Drs. suggest retesting every 3-6 months, especially for those on alts. Do they look at those fluctuations, as long as they are slight and generally tend in the downward direction, as a good thing? I would think they'd take your overall health into consideration. I guess I'm confused because, on one hand you hear that it's so important to monitor liver panels, but then you hear, well, they tend to fluctuate anyway. Is it because they don't really know what to do with us? Sometimes I feel like I'm blazing my own path to wellness, like they're watching us for the answers. Just curious.

[zero]

Yes Pam, it is confusing. i would say as long as the numbers
tend to move in a downward direction who cares what the doc thinks? my doc said that a change of +/- 50 in the alt(for heppers) is normal! That would mean an average taken from all types of hep c patients including drinkers, users and junk food junkies.
among others.

I think you hit the nail right on the thumb.... we are all blazing our own path to wellness and i HOPE that some of the docs are watching us.  Lets show em something!!!    ~*~
Om Shanti,  
Scott

[OZ]

Scott,
Believe it or not, there are some docs that are interested in alternatives.  I was shocked when my PCP told me he was.  He is like the LAST person I would have expected.  So there is hope.  The conversation came up when I told him I was going to consult with a naturopath.  

"As to diseases, make a habit of two things—to help, or at least to do no harm."
---Hippocrates---

I would think in liver functions you would want to monitor trends over time, a couple of lab values could be prematurely discouraging.  Another important test of liver funtion:  albumin.  My original hepatitis doctor said it "is the single most indication of liver function.  Less than 3 is cause for concern".  Of the other liver function tests "ALT is the most sensitive to Hepatitis C"  -- also quote from same Doctor -- heard both at a lecture in a support group.
Donna

 

[Natasha2004]

So, I have wondered this too! My nutrition doctor said I need to monitor every three months as well.
Now my big question is, my ALT was only 42.  The lab said 30 was normal, but I see anything under 50 as acceptable.
My AST was normal, everything else was normal except Total Protein (I have no idea how to interpret that, but it was only one tenth a point over normal.)
I also want to know why two of the four catgegories on the RIBA test were non-reactive?
Just curious on any of the above.

[willy]

Pam:  You are correct that folks on alternatives are traveling..... blazing..... relatively uncharted terrain.  The likelihood is that it may stay that way.  There is no giant economic incentive to do studies on say... for instance, milk thistle.  People do make money selling it..... but it would be way more lucrative if one company OWNED it and could prevent others from making generic forms of it.  We are stuck then, with few studies.  The same dynamic exists for nutrition....... who gets to patent and make money off of eating right?  No doubt there are both good supplements for us.  No doubt there are better diets that exist for us.  It being refined further in small ways everyday.  Hep may be a bit more tricky to "fix" with diet or nutrition because it hides from us while it is doing damage.  It also manifests itself differently in many people making diagnosis more diffcult, and has an array of side effects and treatment for those extrahepatic symptoms and sicknesses.

        When we talk seeing what's going on with the liver a biopsy is considered the gold standard.  However, when one gets one, you also get a series of other tests; there were blood tests, ultrasounds, and for some of us, multiple biopsy sites.  I think that there still exists the notion of interpreting of results.  I think that same dynamic results in the interpretation of some liver panel scores.  This is why I have not seen one specific cut off score for ALT or AST.  That "cut off" is a range..... One gets that same notion for what constituutes a high score.  The fact is that sometimes this disease just doesn't make sense always.  Why do some people drink alcohol and suffer little damge?  Why do some that are not abusers suffer higher amounts of damage... or in shorter periods of time?

         The answer I think, is not in the exceptions..... but in the general truths.  We shouldn't drink alcohol because, in general, it is very damaging to most of us.  In general, lower AST and ALT scores do not guarentee no damage (either that is occurring or has occurred) but in general they are better than having a high score.  And so it goes for viral load.  I'd rather have a low score than a high one.  Doctors that treat patients for TX will tell us that a low starting viral load offers a greater chance for clearing.

         They all go up and down.  If I get a hep A and B vaccine...... my scores will go up.  If I get divorced ot lose my job, or get DX'd with hep...... they will probably rise too.  We can't always hang our hat on our scores, but in general, they can be clues that our regimen is working.  I believe that if we can get our liver panel scores down...... and keep them down..... that our viral load will drop too.  If we are able to do that...... thus probably reducing our liver damage and other hepatic side effects, even if our viral load does not drop, the alternatives may be helping minimize damage.  Since 5% of us may die from this, those that do not treat and simply minimize damage may be able to wait for an easier or shorter remedy.

         That is my opinion.

best,
Willy

[Natasha2004]

Willy: Wait a minute, since I am in the beginning of A and B vaccine, does that mean the ALT is going to go up?
Need to know because nutrition doctor wants me to get the liver enzymes tested every three months.........

[OZ]

I'd personally like to see sources to articles on what A & B immunizations do to liver function tests and viral loads and how it does it.  They are really important immunizations and I would hate to see comeone not have them because of fear.  Besides I am a black and white kind of  person that relies on facts.
When it comes to lab tests or any other test, one result is completely meaningless in the scheme of things.  Even different labs have different scales of normal.  And having an elevated test score maybe 1 or 2 points higher than the norm doesn't mean alot on its own.  The big picture includes other medications, other diagnoses, how the person feels.    A test result is just one part of the picture.  That is why it concerns me when people over-rely on one little thing such as an ALT.
Liver biopsies:  alot of subjective information in the report.  Other than the stain for iron stores, we rely on a pathologist's visual interpretation.  Statements like "there does not appear to be . . . " are rather vague.  I wondered about the accuracy when only a small slice is removed for biopsy.  One doctor told me that it is possible to have a "sampling" error, aother one told me that the same blood flows through the entire liver so it would affect the structure evenly so they are completely reliable.  With medicine -- that is why they call it the "practice of medicine" -- they are only practicing.
Now that is my OPINION.  
Donna

[Natasha2004]

Donna: Re-the sampling--Celiac runs in my family and The Gold Standard for Celiac testing is small intesting biopsy.  That is so hit and miss that many are now choosing either blood tests, or the newer stool tests or just going off on the diet on their own.
Good thing about that one though, the damage heals once you get on, and stick to, the diet.

[zero]

Donna you're rite on with monitoring trends over time. it took many of us 10-20-30 yrs. to get where we are so its going to take time to get our #s down going the alt rte. and i think most of us know that we can't realistically compare our #'s w/ each other..... they're more like our own personal graph of where we start out and a chart of our journey. the more of us that can keep posting over time the better the data base for the whole community.

  Willy, you're right, there are few studies, and the ones that exist are weak, but we are on the crest of the wave of our own study. It may not be scientific but if you take all the hep c forums out there there's the POTENTIAL for putting together
our own body of knowledge. Im not thinking of anything close to immediate reslts or even in our lifetime but in the big scheme of things. The computer and the internet are in their infancy. Sorry, mabey I'm going to far over the top but sometimes my imagination is my best friend(next to Lucy, my cat)   Nuff Said   ~*~
Om Shanti, Scott

[willy]

Donna...... I believe that I have heard the term medical opinion once or twice too.  It is important to understand that information is dynamic and therefore medical opinion can change.  That is simply saying that it can change it's collective "mind" when presented with new evidence.  In the United States the AMA or FDA seems to confer what is conssidered medical fact.  In other countries or cultures they have other governing bodies that may not agree with all the AMA or FDA lay out as fact; in medicine there is not always black and white "fact".

Natasha:  I got my hep A and B shots a few months ago.  I had absolutely no reaction to them that was dicernable to me...... other than the bill, of course.  I have read that they may cause our viral load to raise for a period of time.  Following the flow of what I wrote earlier...... they may have more or less effect in some people.  For me, there was a time when I thought..... what if I played the odds..... and tried to sneak by without those shots..... I'd be saving money, keeping my viral load lower...... that could save me treatment time.... that could save me more money..... an on and on.  After several people died from eating tainted onions at a chain restaurant, or reading about grade school kids getting Hep A or B from eating frozen strawberries at the school lunch program....... I started realizing that the consequences for me contracting another form of HEP could be fatal.  In the end, playing the odds just wasn't what I wanted to do, nor was it fair to my family.  My family is all getting the A and B shots.  Which reminds me....time for their booster.... mine too.

best,
Willy
         

[OZ]

Willy
Hep A is impossible to avoid, if it is there, you will get it.  Especially if you eat out at all or buy food.
Hep B is bloodborne, I don't think I would put myself at risk.  But I had both anyway, the B series I had twice because I didn't develop immunity.  
I do object to the practice of giving newborns hep b vaccines when they are 2 or 3 days old.  I could understand it if the mother was positive, but they are quick  to start those immunizations.  And they are a requirement for school in New Hampshire. -- But that's a completely different subject.

Donna

[willy]

Scott:  I just now noticed your post.  You and I may have started typing about the same time last night.  You bring up the point that I started on and digressed away from.  In a very small way our posting here can help provide a sort of data base that someone else may read and write a study for....whatever.... milk thistle studies, ALA, thymic extracts, teas.....   The more information there is or people that can prove years of use, the more likely some result can be determined.  Who can say....... maybe what we hope for could be proven wrong...... it may also be proven correct.  Here is where I ask that people regularly get tested, record their test results here, and record what they use.  You will be helping yourself and all of us that are trying to better refine what we take for alternatives.  I agree with you about all the other HEPC sites providing information that can help medicine figure it out.  There's a lot of raw loose data out here and a means to tie it together.  This is a relatively new disease.  The science of treating viruses is also pretty new.  The notion of what is proper nutrition is possibly undervalued by modern medicine.  The notion of treating diseases with supplements is poo pooed (I may be understating that a bit).  
         For many of us, whether on TX or on alternatives..... the disease exists just beyond our threshold to defeat it.  By incorporating as many positive tools to fight (in this case HEP) it I feel that we can improve our chances......possibly curing...... but more likely minimising the damage, while improving our quality of life.

Best,
Willy

[Helen]

I go for my 6 month bloodwork on Wednesday, Sept. 1st. and I am wondering if the A & B series will affect my numbers, Im due for the last shot on Sept. 9th, I believe the one before that was sometime in May, I guess if my numbers go up, Ill try not to let it make me crazy, and look to my next test in February, but Im glad this subject came up because I have been thinking about it. I know that I have read SOMEWHERE   that it can possibly spike your numbers for up to a year.

Helen

[willy]

Helen:  When you say numbers..... you just mean your liver panel?  I have read that the vacinations can affect viral load...... I have no idea if they raise liver enzymes too.... I wouldn't be surprised though.  I assume you are getting a liver panel and not checking viral load.

         My sense is that everyone is different.  Perhaps some could be affected for a year.....perhaps some very little or for a shorter period of time.  Soon we will have some data here.  You will have your results posted very soon.  I got tested in May '04 and posted my results and am due to get my liver panel sometime soon(as well as my A & B boosters.  Then I will have my results posted.  We may not know about the viral load..... but we will have some AST and ALT scores that follow the vacinations.  I think it is a useful tool to post them numbers (in the alternative section)..... for those of us on alternatives.  I am becoming more interested in switching to the improved milk thistle and am looking forward to seeing your results.

Best,
Willy

[Helen]

Willy,
Yes, Im geting the liver panel, I thought that also included viral load. This is my first check since dx. so
guess Im a little confused about it, Im going to ask if I can get my viral load also if it isnt part of the package,
and I agree, we should all post out numbers and mine will be up here as soon as I get results.

 Helen