Please advise!

[vacationhj]

Dear Dr.,

I need some advice. I am 46 female. I didn't drink alcohol and very concern about my health. On 9/23/2013, I did some blood tests and the results are all normal. However recently, I feel my feel slightly swollen and feel heavy, tingling sometimes. I went to see my doctor and request blood draw. On 4/21/2014 The Dr. request two times blood draw since some of tests are abnormal. The ALT 202, AST 105, GGT 105 and TSH 0.01 . I also did ultrasound for my abdominal and legs. The result of the ultrasound is all normal. Base on my test, the Dr. told me that I have hyperthyroid. He refers me to the endocrinologist. I will go to see her tomorrow.

I request the Dr. to order the CT scan or MRI since I told him that I want to find out why I have so high ALT, AST, and GGT results. I want to understand how can I have such a abnormal result only in 6 months. He said it is not necessary  since  my ultrasound is normal. I am not sure that the ultrasound would be always correct diagnosis tool. He also told that I only need to take hyperthyroid medication.

I am very worried with my ALT, AST, and GGT results like that should I take hyperthyroid medication? Since hyperthyroid medication could make my liver getting worse. I also asked my doctor to refer me to Hematologist so he/she can help me to find out what is wrong with my liver. However my Dr. said the hematologist only see you when you have abnormal blood test. I told him that my liver enzyme results are abnormal already. He said that whenever my ALT is 1000. I really don't understand about that.

I told him that I want to take a precaution and do a prevention and I want to make sure I don't have liver tumor, or scar liver, or inflamtion of pancreatics than it is too late like my dad. When his skin turns yellow and he got admitted to the hospital . He was diagnosis stage IV of pancreatic cancer.

Please help and give me some advice.

With gratitude,
Jennifer Huynh

[Thomas D Schiano, MD]

i think the treatment with the iodine is actually standard of care instead of being on life-long medication.i think you can still get a second opinion regarding your thyroid therapy.

[vacationhj]

Dear Dr.

Thank you very much for responding to my post. I saw my Thyroid Dr. today and he told me that I need to get a treatment with Radioactive Iodine.
I am kind of concern since the side effects that I might develop Hypothyroid and have to take medication for the rest of my life.

Back in 1999 , I also had hyperthyroid and my TSH  0.01. However my doctor at that time she did not order any medication for me. She only tell me that I should not stress myself out and try to  do yoga or relaxation class also eat healthy and when I come back to check my blood test after 6 months. My TSH result was normal.

I am more worried because of my family history with many relative have liver diseases. Should I refuse the treatment of iodine? Should I find out more about the problems of my liver. Please help!

Thank you!
Jennifer

[Thomas D Schiano, MD]

hyperthyroidism itself can cause abnormal liver tests.  I definitely think that you should see a GI doctor to assist in your management.  Some of the medications used to treat high thyroid can cause liver problems, ie PTU.  sometime women can develop autoimmune hepatitis that can present with thryroid dysfunction.  dont think you need an additional scan