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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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What Is The Cause Of Worsening Exhaustion With Elevations Of Liver Enzymes?

Hello, I have had slowly increasing mild elevations of liver enzymes over the last 9 months when they were initially discovered.I had taken venlafaxine 300mg and mirtazapine for 20 years for severe OCD. The previous 5 years I have had chronic fatigue syndrome which has been incapacitating for the last two years in particular with symptoms of ibs symptoms, extreme fatigue, mental fog and back pain.Depression and OCD has worsened also.Since the elevation of the liver enzymes I have changed medication to fluoxetine as venlafaxine was believed to be the cause of this but mental health is worse and no improvement in liver tests I am a 40 year old woman with pcos.My current alt levels are around 70, ggt 180,alp 134 and have had slow steady increases. Ultrasound showed only slight fatty changes.Do you think my worsening exhaustion could be partly related to liver?Should I have any further investigations for this before change in meds? Thank you.
posted on Fri, 14 Mar 2014
Twitter Sun, 8 Jan 2017 Answered on
Twitter Mon, 9 Jan 2017 Last reviewed on
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Gastroenterologist,  's  Response
Hi,

His light fatty liver changes are a normal finding after an age of 40 years. So don't worry a lot about them. Though liver function tests are deranged, yet they are not that deranged that they cause fatigue. Fatigue and feeling of exhaustion are because of Fluoxetine which you are having for your ocd.

Abnormal liver function tests were most likely because of Mirtazapine. Dont go for any further medication just ask your pychiatrist for few latest ssri's like Paroxetine which are much safer and have significantly less toxic effects. Liver rejuvenator like Sylimarin can be taken for 3 months to improve liver functions.

Hope I have answered your query. Let me know if I can assist you further.

Regards,
Dr. Ramesh Kumar
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What Is The Cause Of Worsening Exhaustion With Elevations Of Liver Enzymes?

Hi, His light fatty liver changes are a normal finding after an age of 40 years. So don t worry a lot about them. Though liver function tests are deranged, yet they are not that deranged that they cause fatigue. Fatigue and feeling of exhaustion are because of Fluoxetine which you are having for your ocd. Abnormal liver function tests were most likely because of Mirtazapine. Dont go for any further medication just ask your pychiatrist for few latest ssri s like Paroxetine which are much safer and have significantly less toxic effects. Liver rejuvenator like Sylimarin can be taken for 3 months to improve liver functions. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Ramesh Kumar