Starting diagnosis

Hello everyone,
I have some disturbing syndroms that might strongly suggest PSC. I’m 29 now and 9 months ago I’ve been diagnosed with UC - proctosimoid. My UC has a quite mild run, but my body temperature is constantly elevated to 37,2 Celsius. I also feel back and front pain in area where liver is located but i cannot tell if it’s liver itself because similar pain i also on the left side. I’m fatigued but this may be related do the fact that I’m depressed. I’ve made lots of liver enzyme test and these arw result i got (from last 3 months):
Bilurbin - range from 0,96 to 1,23 binded 0,34-0,40
ASPAT - below 20 (lab limit 35)
ALAT - below 20 (lab limit 40)
ALP - 67-70 (lab limit 30-120)
GGTP - 19-25 (lab limit 55)
Albumin - 48 (lab limit 50)

What really upsets me is high normal/mild elevated bilirubin level. Did someone of You have only bilirubin elevated? My gastro doc told me that my results are ok and not think about PSC for now. What do You think? Of course I will proceed with more accurate test, but i also keep wondering “do I wanna know?” Do You regret knowing?

Not sure what “binded 0,34-0,40” means, but if you mean that you have only bilirubin (mildly) elevated while other LFTs are in normal range, then I have the same situation. No other symptoms. PSC and UC diagnosed few years ago.

Binded is the conjugated bilurbin. Depending on lab the limit it’s usually between 0,3-0,4 so it’s upper limit or mild elevation. Only in the last two test made within last two weeks my bilurbin spiked from 0,96-1,00 level up to 1,09-1,23. 9 months ago my total bilirubin was 0,3 and also no LFT was elevated. What really changed is my lifestyle - I have 0 physical activity now, but a few months ago I exercised often.

By the way, I was curious why there was such a difference between my current bilirubin levels and very low lvl 9 months ago and yesterday at 4 pm afternoon i checked my bilirubin level and total was 0,56, conjugated 0.23, unconjugated 0,33. I know there might bez some diiference but it dropped more than twice. Anyone know if normal?

Raven, our lft’s can vary day to day, and a total bilirubin of 1.23 is not bad at all. The outer limit of acceptable is 1.0. Don’t sweat that now. When it gets upwards of 2, I begin to worry.

Are you getting care from a liver specialist? They are more specialized than your normal Gastro doc, and have more in-depth knowledge.

Of the other enzymes you listed, I keep an eye on the albumin and the ALP. A low albumin is not good, and a high ALP is a good indicator that the liver is not working well. Mine have been in the 400’s to 500’s for a while. Not sure how that coincides with your labs.

And yes, you do want to know, since knowledge is power and you do not want to bury your head in the ground and just hope for the best.

Thanks Jeff for Your reply, I guess You’re right.The worst thing is that there not much You can do about PSC even if it’s diagnosed on an early stage. When I got UC diagnosis i told myslef I would never have children before I would rule out concomitant PSC so making a serious decison would still force me to get an yes or no diagnosis.

About my bilirubin level I’m pretty sure it depends od the time of the day, I see strong connection here. When i got my result 9 months ago blood sample was taken about 6 p.m. and result was 0,3, now at 4 pm i got - 0,56 which is still low. The hisghest result i got was from sample taken early in the morning, the higher results 1,00 and 0,96 were taken also in the morning but not so early - 1-2 hrs later.

About my liver doc it’s hard to find someone who is really into autoimmune diseases. My gastroenterologist is highly specialised in IBD and all related conditions so I’m not convinced that hepatologist would provide me with a greater knowlegde, especially in Poland i see that liver docs are much more concentrated on viral liver diseases instead of rare autoimmune ones (not a surprise)