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Elevated Liver Enzimes / Uric Acid
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Elevated Liver Enzimes / Uric Acid

Im a 24yr Male, 300 pounds, 6'2" tall.  I have had high blood pressure for the last 7-8 years(Average 160/100) and now just recently have it under control(125/80).  But when i went to the doctor 2 months ago they did a full blood work up and everything was ok, except my liver enzymes were high, as well as my bilirubin.  Kidney functions, electrolytes, cholestrol, and sodium were fine.  So they told me not to worry and to come back in 6 weeks for a re-test.  So a few weeks ago I went back in and they took more blood and tested my liver functions as well as my uric acid level.  They tested my uric acid level because they though i might have gout in my ankle, but it turned out to be a sprain.  I take Toprol Xl 50mg and Benicar HCT 20-12.5 for my blood pressure.  My blood test results are as follows:

GGT: 75 IU/L
Total Protien: 7.8 g/dL
Albumin: 4.8 g/dL
AST: 31 IU/L
ALT: 101 IU/L
ALK PHOS: 70 IU/L
BILIRUBIN, TOTAL: 1.7 mg/dL
BILIRUBIN, Direct: 0.4 mg/dL
URIC ACID: 7.6 mg/dL

That was the results from my second blood test, which he said everything was almost exactly the same as the first test they took 6 weeks before this one.  I do not drink much, just a few drinks a week at most.  I am scheduled for a ultrasound of the Liver, Pancreas, and Gallbladder next week.  Is that the only testing that i should be considering or should I undergo further testing?  How high of levels warrant a liver biopsy? Should I get a liver biopsy?  Both of my grandfathers had liver disease, but they were heavy drinkers.  When i was younger (18-21 i was a heavy drinker, but have majorly reduce my drinking over the last 3-4 years.  I am just worried that they will miss something on the ultrasound, as i have a large body mass, and i have heard that ultrasounds dont work as well on larger people.  My doc looked at blood test results from almost three years ago(during my drinking days) and the liver panal was fine then, so that why im conserned now.  If they were fine when i drank heavy and now that i rarely drink they are high, whats wrong?  I dont really have any pain in the area of the liver.  So what do you think is going on??  Thanks for the info.
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There can be many causes of elevated liver enzymes - including hepatitis, fatty liver, anatomical lesions etc.

Before a liver biopsy is considered, the ultrasound as well as blood tests looking for hepatitis should be considered.

A liver biopsy is normally considered if the ALT is above 3x the upper limit of normal.  Your levels are slightly below that.  Repeating the enzymes if the tests remain negative is a reasonable plan.  Reviewing alcohol use and medications that can affect the liver can also be done.  

These options can be discussed 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.

Kevin, M.D.
kevinmd_
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