What Causes Elevated Liver Enzymes After Having UDCA?

Posted on Wed, 4 Mar 2015

Medically reviewed by Ask A Doctor - 24x7 Medical Review Team

Wed, 4 Mar 2015 Answered on

Fri, 27 Mar 2015 Last reviewed on

Question : Hi,

I have been in regular check up for cholesterol control for last two years. This time when checking it is seen that total cholesterol=213, triglyceride=165, SGPT=130. So, I started using UDCA and after 10 days when testing, SGPT raised to 170 and SGOT was 130. I am 38, not a drinker, nor smoker, working from home and mostly taking homely food. So, what is your observation in my case?

Thanks,
XXXXXXX

Answered by Dr. Praveen (11 hours later)

Brief Answer:
Why was UDCA prescribed

Detailed Answer:
Hi dear.Thanks for your query on HCM.

I am really impressed by your healthy lifestyle habits and advice you to continue the same.

As per your description, your triglyceride(TG) is just above normal (150) level.I would not start on drug therapy and prefer suggesting exercise, walking etc which brings back your TG to normal.

UDCA is know to cause persistent elevation of liver enzmes (SGOT, SGPT) and normally not recommended.Hence I would like to know if UDCA was prescribed by your physician?If yes what was the reason for prescribing it?

I would always start a statin which is the current standard of care(with established evidence) for treating elevated lipid levels.

I would like to know the values of ldl cholesterol?

Could you please upload the scanned copy of the report with the help of report tab on your screen?

Await your reply soon.

Above answer was peer-reviewed by : Dr. Shanthi.E

Follow up: Dr. Praveen (1 hour later)

Hi,, Thanks for the quick response.

Last time the blood test was for T.Chol / Tgl / SGPT only. In it, the SGPT level seen 130, so doctor suggested Golbi (150mg) (Ursodeoxycholic Acid) for 10 days and asked to test SGPT/SGOT once again. By the time I was consuming 'Fibator 5' for 8-9 months to get teh cholesterol controlled.
After 10 days, when I retested SGPT/SGOT, the count shoot up to 170/130. Now doctor recommended Hep. tests/blood iron test/ and a ultrasound scanning after 3 days. For these three days he gave 'Sorbidiol 300' two per day, and asked me to stop using 'Fibator 5' for these days.

What do you think?

Answered by Dr. Praveen (11 hours later)

Brief Answer:
I would stop Sorbidol and evaluate the underlying condition

Detailed Answer:
Hi dear.Thanks for sharing the information.

I would first evaluate the underlying liver condition such as fatty liver which also presents with a similar elevation of liver enzymes.This is why your doctor has advised for ultrasound scan and other blood tests.

According to me your physician has stopped Fibator(Atorvastatin+Fenofibrate) since your SGPT is more than 3 times the high normal level(Normal SGPT is upto 40).

As as substitute for Fibator, UDCA was prescribed.Since it also cause a further elevation of SGPT/SGOT I would prefer to stop UDCA too.

Now if my liver/scan reports are normal then I would to choose plain fenofibrate instead of combination with statins(atorvastatin or rosuvastatin).Fenofibrate reduces both your LDL as well as your TG.However it causes a greater reduction in your TG levels than LDL.

Hope this answers your query.

Above answer was peer-reviewed by : Dr. Vinay Bhardwaj

Follow up: Dr. Praveen (22 hours later)

Hi Doctor,

Today I had the ultrasound scanning and also received the blood test results. Hepatitis B/C are negative, and syrum iron is normal. SGPT done today shows small decrease, 140 from the 173 shown few days back.

Doctor suggests to stop using Fibator 5 for next 2 weeks, and prescribed Sorbidol 300 and Evion 40 for next two weeks and then to retest the blood.

Uploaded the image of the scan report, please check.
Waiting for your opinion.

Thanks in advance, XXXXXXX XXXXXXX

Answered by Dr. Praveen (13 hours later)

Brief Answer:
Balanced diet, Exercise and follow physician's advice

Detailed Answer:
Hi dear.Thanks for writing me back and sharing the information.

I am glad that your reports are normal.Scan shows mild or initial stages of a condition called as fatty liver which is due to the accumulation of small quantities of fat in the liver tissue.This is the reason why you see elevation of SGPT which became even more evident when Fibrator was taken.This is definitely reversible and there is absolutely no need to panic.

Since the SGPT has come down continue Sorbidol and Evion 400(which is a good multivitamin supplement) as per your physician's advice.Followup regularly.

Add to this I would suggest balanced diet, increased physical activity and exercise to reverse the fatty change.Medication is not needed at this juncture.

All the best.

Above answer was peer-reviewed by : Dr. Shanthi.E