I’ve had a slew of questions regarding elevated Liver enzymes, the Zone, Paleo, CrossFit etc. We have two clients, both pharmacists, who had stunningly high liver enzymes, particularly ALK (alkaline phosphatase). Frequently AST and ALT are also elevated, occasionally even bilirubin. Both clients have seen a dramatic reduction in liver enzyme levels with the adoption of a Paleo diet…for one individual he also had a con-founder of hyperinsulinism. The doctor of one client said: “It is preposterous… dietary manipulation cannot change liver enzyme status…the decrease must be due to another factor…” This person has had high liver enzymes for over 20 years…the only change was dietary, that mainly being the adoption of a gluten free Paleo diet. What a mis-informed IDIOT.
Here are a few links and abstracts to the topic….Sorry I can not get deeper now but this is a section I’ll flesh out in the book. Sorry also for the lack of comments processing on my part. We just moved the gym to a new 6,000sqft location and I’m pooped…only about 50% finished with that project. Here are those links:
J Clin Gastroenterol. 2005 Aug;39(7):630-3.
Cirrhosis in children with celiac disease.
Section of Pediatric Gastroenterology, Hepatology and Nutrition, Department of Pediatrics, Hacettepe University, Faculty of Medicine, Ankara, Turkey. [email protected]
BACKGROUND: Liver involvement represents an extra-intestinal feature of celiac disease (CD) and shows a clinical spectrum varying from nonspecific reactive hepatitis to cirrhosis. Here we report the association of cirrhosis with CD in 5 children. PATIENTS AND METHODS: The mean age of the patients was 9.4 +/- 2.8 years. Viral, metabolic, and autoimmune etiology of liver disease was ruled out. Intestinal and liver biopsies were performed to confirm the histologic diagnosis in all subjects. RESULTS: Three of the patients had chronic diarrhea and hepatosplenomegaly in whom diagnoses of CD and cirrhosis were established at presentation simultaneously. In the other 2 patients, CD was diagnosed following an initial diagnosis of cirrhosis. At diagnosis, alanine aminotransferase (range, 64-271 IU/L) and aspartate aminotransferase (range, 90-225 IU/L) values were elevated. After 1 to 5 years of a gluten-free diet (GFD), normalization of serum aminotransferase levels and clinical improvement were observed in 3 patients with strict GFD. The other 2 patients without improvement of the liver disease had poor dietary compliance. CONCLUSION: CD may be associated with severe hepatic damage in children and strict GFD may have beneficial effect on the course of liver disease. Serologic screening of CD should be included in differential diagnosis of chronic liver disease of unknown origin.
Am J Gastroenterol. 2000 Aug;95(8):2009-14.
Detection of autoantibodies against tissue transglutaminase in patients with celiac disease and dermatitis herpetiformis.
Department of Internal Medicine, Charité, Humboldt-University, Berlin.
OBJECTIVE: Endomysial autoantibodies (EmA) are specific for celiac disease. The target antigen has been identified as tissue tranglutaminase (tTG). Our aim was to study the accuracy of a newly developed enzyme-linked immunosorbent assay (ELISA) for easy detection of tTG autoantibodies. METHODS: Thirty-one sera from patients with histologically proven celiac disease and 23 healthy controls were examined for EmA using monkey esophagus and human umbilical cord as substrate. IgA-tTG autoantibodies were determined by newly developed ELISA. Additionally, sera from patients with dermatitis herpetiformis (n = 20), inflammatory bowel disease (IBD; n = 32), chronic liver disease (n = 36), and diabetes mellitus (n = 19) were tested. RESULTS: The sensitivity of the tTG autoantibody ELISA accounted for 90% detection in patients with untreated celiac disease. The specificity was 76% owing to positive values in the lower range in patients with IBD (15%), chronic liver disease (36%), and diabetes (22%), all of whom were negative for EmA. In dermatitis herpetiformis patients 90% were EmA-positive. Of these, only 47% showed elevated tTG autoantibodies. Preincubation of sera from dermatitis patients with tTG abolished immunofluorescent staining of endomysial structures. CONCLUSION: Detection of mid- to high-titer tTG autoantibodies is highly specific for celiac disease. However, in the low-titer range, overlap exists with liver disease, IBD, and diabetes. Tissue transglutaminase autoantibodies may evolve as a new screening and follow-up method for celiac disease. Although tTG seems to be a major autoantigen in dermatitis herpetiformis, the low sensitivity of both tTG ELISA and immunofluorescence using human umbilical cord suggests differential involvement of tTG in this disease.
These two abstracts had nice clinical data attached. A simple pubmed search with the terms “elevated liver enzymes celiac” produced over 30 citations. A google Search with the same terms produced enough reading to keep one out of trouble for a decade or two. Our general practitioners are so overwhelmed with paperwork and reticent to continue their education it’s really buyer beware with regards to health and medicine.