How can my grandson, 18, manage phantom smell and migraines?

Hello,

Welcome to icliniq.com.

I understand your concern.

Those symptoms and blood test results in your 18-year-old grandson deserve careful evaluation because they point to several possible overlapping issues. Phantom smells (phantosmia) are sometimes part of a migraine aura, where the brain’s sensory system misfires before or during a headache.

Other possible causes include:

• Sinus or nasal issues (polyps, chronic sinusitis).

• Seizure activity in the temporal lobe (less common but should be ruled out).

• Certain viral infections or head injuries.

Concerning the elevated liver enzymes, such as ALT (alanine aminotransferase) and AST (aspartate aminotransferase), these levels rise when liver cells are stressed or injured. Possible causes in teenagers include:

• Viral hepatitis (A, B, C, EBV, CMV).

• Fatty liver disease (linked to weight gain or high sugar intake).

• Autoimmune hepatitis.

• Medication or supplement toxicity (even common painkillers like Paracetamol or Acetaminophen).

• Muscle injury (can also raise AST).

Regarding low SHBG (sex hormone-binding globulin): This protein carries sex hormones in the blood, and low levels can be due to:

• Obesity.

• Insulin resistance or early metabolic syndrome.

• Liver issues.

• Hypothyroidism.

In summary: The combination of liver enzyme changes, low SHBG, and high total protein could point toward liver stress or inflammation (possibly fatty liver disease or viral hepatitis).

Recommendation:

• Consider giving syrup Livolin (Levosalbutamol) 20 ml orally once daily for one month (only under medical supervision). It is essential to consult the doctor once.

• Follow up with additional testing as advised by his doctor.

I hope this has helped you.

Please feel free to reach out to me again if you have further queries.