When a patient has elevated liver enzymes, naturally both patient and doctor want to find out what's causing them right away. And thanks to modern technology, it's easier than ever to run a whole battery of blood tests at once. All the doctor has to do is check a box ordering a panel of tests, the patient gives blood samples once, and they wait to find out the possible causes of the liver problem. Sounds simple, right?
It is. But researchers at the University of Michigan who have published papers on the topic in both the Journal of Hospital Medicine and the Journal of Hepatology are suggesting that simple isn't always better. That's because many of these panels screen for rare conditions that aren't causing the problem in most patients.
Initially, that might not sound like a big deal. After all, these conditions are rare, so what does testing for them hurt? There are actually a number of problems with this approach. The first is that many of these tests easily yield false positives. This can be very stressful for the patient, who now has to undergo a liver biopsy while facing fear about managing a difficult condition and the possibility of having passed it on to loved ones if it's genetic.
Next is the cost of these tests. While a panel might not cost much on an individual patient level, even small costs add up over time. In fact, the researchers point out that conducting these blood tests on every hospitalized patient would cost $40 million a year. And, of course, those costs skyrocket if waiting on the test results prolongs a hospital stay – or if they have to perform unnecessary biopsies.
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Finally, the researchers point out that most rare liver diseases don't cause acute liver damage. So waiting a couple weeks to rule out more common liver issues is unlikely to affect the course of the disease or the treatment options available or cause further harm to the patient.
The researchers recommend that doctors first focus on common causes of liver problems, such as lifestyle factors like alcohol consumption or drug use and viral infections, including hepatitis B and C. Doctors also should ask questions about prescription drugs or supplements that are known to cause liver damage. If there's an obvious culprit, doctors should focus on that as the most likely reason for elevated liver enzymes rather than testing for much more unlikely conditions. It might be inconvenient for a patient to have to have blood sampled more than once, but it's a lot better than having an unneeded biopsy.
Of course, the best way to avoid having unnecessary liver tests is to protect your liver. Maintaining a healthy weight, limiting your alcohol consumption, and eschewing drug use are obvious first steps. But you can also protect your liver by keeping toxins out of your body. Your liver performs over 500 essential functions for your body, including helping with detoxification. So lightening your toxin load can help you avoid overtaxing your liver. Choose organic foods as much as possible, avoid pesticides, and try a detox supplement like PectaSol to flush toxins out. Finally, Advanced Liver Support can provide additional help by lowering inflammation and protecting your liver from stress and depletion.
If you follow these strategies but still end up with high liver enzymes, talk to your doctor before you undergo an entire panel of tests. Try to find the obvious answer first. It's usually correct.
Yours for better health,
Frank Shallenberger, MD