a hot mess! GGT, IgA, SHBG, and elevated liver enzymes

[frenchmoxie]

Hey kids!

Background: Hashimoto's, hypothyroidism, Sjogren's Syndrome, chronic Lyme?

Ok, I've got what appears to be a mess of problems right now. was just diagnosed with mono a week ago. Extremely elevated Epstein-Barr virus antibodies. I've got elevated liver enzymes for the first time in my life. Elevated homocysteine (doing methylation protocol past 6 months with Yasko multi), before starting protocol I had borderline low homocysteine.
LOW: glutathione, active folates, SAM-e...
HIGH: SAH, high levels of oxidized glutathione (bad). Very elevated IgA. Has been borderline high in past, but is now very high. Isn't this mucosal immunity? Or like a food allergy type response?
IgA range: 85 - 385 mg/dL result: 535

Thyroid peroxidase antibodies are the highest they've ever been, and my TSH is now super low at 0.14 (normal for me is around 1.3). However, free T3 and T4 are still borderline low. Always have been.

FT4 range: 0.8 - 1.8 ng/dL result: 1.0
(Highest ever T4)
Free FT3 range: 2.3 - 4.2 pg/mL result: 3.2

High levels of sex hormone binding globulin, SHBG as well. I've heard this is not good and binds to hormones in blood, including testosterone, which I am low in as well.

What I'm also curious about is an elevation in something called Gamma-Glutamyl Transpeptidase (GGT). FYI - I do NOT drink alcohol. I read that GGT is sometimes elevated when drinking.

Any thoughts, ideas, or advice on what to do with all this new info would be appreciated! I'm a bit of a mess and have been for awhile, things just seem to be going downhill fast lately.
Looks like perhaps a stint of hyperthyroidism, and liver disease/damage?
Any way to decrease SHBG?

 

[Lynn_M]

You don't have hyperthyroidism. More likely hypothyroidism due to high TPO antibodies. You would need a high T3 to actually be hyperthyroid. Your FT4 result is much lower in range than optimal, and your FT3 is middling. TSH is not a thyroid hormone, it's made by the pituitary and just a feedback indicator. The levels of the hormones that the thyroid actually produces (T3, T4) are what you look at to know your thyroid status. But with high TPO antibodies, any of the these results will be misleading, especially the TSH.

SHBG also binds to thyroid hormone. The T4 test level includes what is bound to SHBG, and the FT4 test includes is the amount of T4 not bound to SHBG.

 

[andre79]

I am sorry i can't give you answers, but i just wanted to comment that i have raised Liver enzymes and very HIGH GGT.

GGT 113 (5-36)

I don't have a final diagnosis yet, but my parents have fatty liver, even though it doesn't produce any symptoms in them. So, maybe we have genetic fatty liver. My doctor suspects autoinmune hepatitis in me because i have lots of symptoms. We don't drink alcohol either.

Is your cholesterol normal or elevated? If is elevated maybe it could be that little cholesterol nodes are blocking your billis conducts.

Maybe your liver enzymes are raised because a medicament?

 

[Sea]

I can't comment on your overall picture at all, but I do know that elevated liver enzymes are fairly common in acute mono

 

[frenchmoxie]

@Lynn_M . In regards to the hyperthyroidism I was just pointing out that my doc said that's what I had because at first she only tested my TSH, which we all know is a pretty useless indicator. But, it's just so ridiculous that there are doctors out there that 'll tell you that you need to reduce your thyroid med simply because your TSH is low. Though I do appreciate your input, thanks!

 

[frenchmoxie]

@andre79 . My cholesterol levels were normal when tested about a month ago, but then again, that was all pre-mono diagnosis. I've also had low cholesterol in the past. It fluctuates, I guess? I do not eat dairy or dietary cholesterol, FYI.
What kind of symptoms are you having that would indicate autoimmune hepatitis?

 

[andre79]

My symptoms:

During Onset:

Night sweats / tremors / pain all over my body / numbness and tingling in arms and hands / fasciculations / nauseas and vomiting / fatigue (extenuating) / headaches / very weird movement inside my left eye/ dilated pupils /general swollen lymph nodes / tachycardia / dizziness / anxiety / memory loss / dry skin / diarrhea / lose my ability to speak coherently / insomnia / IBS / exacerbation of allergies / candida overgrowth / hair loss / and so on...

Two years after the symptoms than linger are:

Stiff neck / tingling and numbness in my legs / fatigue (not so bad like during onset) / fasciculations / tachycardia / swollen lymph node in my neck / night sweats (a little bit, not so bad) / IBS / allergy to gluten and dairy / dilated pupils (not so bad) / difficult to sleep.

None of my symptoms are exclusive of autoinmune hepatitis. It could be many other things but as my doctor was going trough my tests she said: "the only thing that is altered is the liver, everything else seems normal, so i am going to dig a little bit further to see if maybe is an autoinmune hepatitis".

So i did the specific tests for that, and i don't have the results yet. Waiting...

 

[andre79]

I can't comment on your overall picture at all, but I do know that elevated liver enzymes are fairly common in acute mono

This is right. Both EBV and CMV can cause elevated liver enzimes during acute stage. Maybe you should wait a few weeks and test again to see if the enzymes lower.

 

[frenchmoxie]

@andre79 . I was also wondering if maybe something was going on with my liver when in the past, a bout two yrs ago, I tested as LOW for cholesterol levels. Now, I know that yes, you can get cholesterol from diet, but I do not. I know that the liver manufactures something like 70-80% of the cholesterol in our bodies, so if my cholesterol levels were LOW, then wouldn't that perhaps point to some faulty mechanism ?

 

[Lynn_M]

Frenchmoxie,

I'm glad you know better than to let the crap TSH test guide any health decisions.

I thought I'd share what my Textbook of Biochemistry for Medical Students says about GGT (gamma glutamyl transferase):
GGT can transfer gamma glutamyl residues to substrate. In the body it is used in the synthesis of glutathione. GGT has 11 iso-enzymes. It is seen in liver, kidney, pancreas, intestinal cells and prostate gland.

Normal serum value of GGT is 10-30 U/L [this is an Indian textbook]. It is moderately increased in infective hepatitis and prostate cancers. GGT is very sensitive of biliary tract disease.

GGT is clinically important because of its sensitivity to detect alcohol abuse. GGT is increased in alcoholics even when other liver function tests are within normal limits. GGT level is rapidly decreased within a few days when the person stops to take alcohol. Increase in GGT level is directly proportional to the amount of alcohol intake.

GGT is increased in obstructive and alcoholic liver, chronic alcoholism, non-alcoholic steatohepatitis (NASH), pancreatic disease, myocardial infarction, renal failure, chronic obstructive pulmonary disease, and in diabetes mellitus.

 

[Violeta]

Have you been checked for iron storage in the liver?

Do you eat a lot of brassica vegetables or other foods high in sulforphane? I have seen TSH go down when overdoing it with those vegetables and it makes liver enzymes go up.

 

[frenchmoxie]

Ok, @Lynn_M , thank you for that info. I have read all that already, however. I do not drink alcohol and haven't for years now. Doc tested for pancreatic issues and I am in the clear as far as pancreas problems go. My sister has Type 1 diabetes, however, so it does run in family.
I am negative for hepatitis as well. What's interesting with the GGT levels being high, in relation to glutathione levels, is that i am LOW in Glutathione!

@Violeta - someone else has mentioned this to me, and I'm honestly not sure what my iron looks like. I would assume low because i do not eat red meat. I do eat pretty decent amount of lentils though. I will get this checked. THanks for the input.

I do not eat a TON of brassica veggies, broccoli maybe once a week or every two weeks. I eat more asparagus than any other veggie.