Pregnancy-Related Itching & Bile Acid Levels: What's Normal?

Question
Hi! Could you please tell me what a normal level of bile acid is in a pregnant woman? I have been suffering with severe itching all over my body for nearly 8 weeks. I am currently 18 weeks pregnant. The doctors have ruled out just about everything. All blood tests appear normal, but my bile acid count was 20. The doctors said this was not a great concern unless it rises. They only give medication if it is 40 or over. On all of the websites I've been reading anything over 14 is diagnosed as high.  I had a blood test done one week ago and am supposed to go back in in 2 weeks for another. Is this an ok amount of time to wait? I am also being watched due to having a staph and strep infection in my leg. I have been given steroids for the itching, but it does not help at all. Thanks so much for your time and help!

Answer
The main symptom of Intrahepatic cholestasis of pregnancy is severe pruritus. A mild jaundice may develop in around 50% of patients. Anorexia, malaise, fatty feces,  and dark urine are also common complaints.  Usually it is accompanied by weight loss, malnutrution, and a deficiency of vitamin K.  The differential diagnosis includes hepatitis and gallbladder disease (which also is accompanied by itching). Lab results include elevated serum alkaline phosphatase (5-10 times normal), elevated bilirubin, and elevated bile acid levels (up to 10 times above normal).I do not know what your labs reference values are, however they should be noted on the lab report. If the value of 20 is much higher than their reference range, you should check the other values. Perhaps a sonogram of your gallbladder may help. Elevated liver enzymes (for  hepatitis) should also be checked. Itching,by itself, is not a problem and steroids and Benadryl may help alleviate the itching.