Digestive Disorders / Gastroenterology Expert Forum
Elevated ALT/GGT Levels
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Elevated ALT/GGT Levels

Dear Kevin:
I am a 44 year old black female who do not drink or smoke.  I recently received the reults of lab work wherein I had a total work-up of CMP12+LP+TP+TSH+6AC+CBC/D/PLt. All levels were within range except for my liver enzymes.  The results are listed below.
The week before the lab work was done, I had started a prescription of Augmentin 1000mg twice a day and Bextra 20 mg.
Before, starting the Augmentin and Bextra, I was taking Advil Liqui-Gels 200 mg as needed for muscle aches from exercising (treadmill).
Since 10/03, I have lost 30 pounds on a low carb diet.  However, the plan to me was very healthy, increasing fruits & vegetables and low fat protein--six small meals per day.  Walking/running 3-5 miles per day.  

My question is:  Do you think the medications and/or diet could have caused the elevation of the liver enzymes or could this be signs of something more serious?  Since starting the diet plan, I have noticed muscle pain in my lower back and left lower thigh-joint area after exercising.  I have also noticed pain in my third left finger.  Orthopedic doctor believes this be crooked-finger and bursitis.
Complete Hysterectomy 04/03.
Thanks for your reply.

Lab results:
Glucose, Serum 72
Uric acid, serum 4.9
BUN 12
Creatinine, Serum 0.7
BUN/Creatinine Ratio 17
Sodium, serum 143
Potassium, serum 4.6
Chloride, serum 103
Phosphorus, serum 3.7
Protein, Total 7.5 (Limits 6.0 - 8.5)
Albumin, Serum 4.1 (Limits 3.5 - 5.5)
Globulin, Total 3.4 (Limits 1.5 - 4.5)
A/G Ration, 1.2 (Limits 1.1. - 2.5)
Bilirubin, Total 0.4 (Limits 0.1 -1.2)
Alkaline Phosphatase, Serum 125 (Limits 25-150)
LDH 206 (Limits 100-250)
AST (SGOT) 40 (Limits 0-40)
ALT (SGPT) 57H (Limits 0-40)
GGT 154 H (Limits 0-60)
Iron, Serum 69 (Limits 35-155)

Lipids
Cholesterol, Total 149
Triglycerides 41
HDL Cholesterol 62 H (Limits 40-59)
LDL Cholesterol Cacl 79 (Limits 0-99)
T. Chol/HDL Ratio 2.4



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Your liver enzymes are mildly elevated.  Yes, the Bextra and Advil can elevated liver enzymes.  Alcohol can also be the culprit if you drink.  I would consider discussing with your physician about abstaining from alcohol as well as the medications and repeating the liver tests to see if they decrease.  

You can also consider a screen for viral hepatitis as well as a liver ultrasound.  The ultrasound can evaluate for anatomical liver and gallbladder disorders which may raise the liver function tests.  

You may want to discuss these tests with your personal physician.

Followup with your personal physician is essential.

This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.

Thanks,
Kevin, M.D.
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