Elevated Liver Enzymes

[johnjohn83]

I'm a 23-year-old male with no history of anything...

Recently I've been feeling some flu-like symptoms, and getting some headaches, for some weeks. Feeling a little fatigued as well.

Blood tests revealed abnormal liver enzymes:

ALT/SGPT is elevated to 123 IU/L (range says <37)
Gamma GT is elevated to 189 IU/L (range says 2-30)
AST serum is elevated to 43 IU/L (range says <37)
Albumin is elevated to 49 g/L (range says 33-47)

Obviously I'm quite concerned because based on what I've read, these seem very high. This is the second test I've done and the Doc said they have reduced slightly, which is good, I suppose, but I still need to get them down.

Bilirubin, Alkaline phosphate, total protein, globulin, free T4 level, TSH level, C-reactive protein, creatine kinase, other blood counts are all normal, urea & electrolytes, thyroid, CRP, ESR right on the money.

Any ideas what might be wrong?

I'm negative for infectious mono and cytomegalovirus, waiting on results for Hep A/B/C, but my symptoms certainly don't seem to match up with anything hep-like.

So I'm a bit concerned about what might be going on here.

In terms of the inevitable alcohol question, I do drink weekly, but even on a heavy night, we're talking no more than 3-4 beers, no more than twice a week, which would be way more than average, which is 2-3 beers once a week.

I've completely stopped after these results.

[hbp702]

If your liver wasn't doing its job well, albumin would tend to go DOWN (it is opposite of the other LFTs). It being high often points to DEHYDRATION. Drink more water, and see if you feel better, also get checked for diabetes.

Hep A without jaundice can also make you feel off.

[johncash11]

I have had similar symptoms...dizzy and elevated enzymes.  That was the first couple weeks.  Then I started getting really bad stomach pain and twitching in my hands.  I moved out of my apartment and it has almost gone away after 2 weeks.  In apartment, ALT was 101, out of apartment ALT was 70.  I think I have been exposed to a poison, such as a pesticide.  I also began having severe anxiety and headaches.  

[Netty27]

I too have elevated liver enzymes. 5 blood test in a row with ALT and AST levels in the triple digits. My doc believed it was because I had a 4 week bout with bronchitis and that the numbers would subside. They have gone down a little. Last test last week ALT=142 AST=124. Liver ultrasound came out normal, Hepatitis A, B, C, all negative. Doc ran an entire blood panel, red and white blood counts, bilirubin..etc...all normal.

The only physical things that I have been feeling is slight fatigue and dizziness at least once a day.  I take Celexa (20mg) once a day and Xanax (.25mg) twice a day for anxiety. And Protonix (40mg) twice a day for GERD.

I do also have the chronic disease Sarcoidosis. Maybe that is the culprit. I am seeing a liver specialist for a consult next week. But am really worried about these high liver enzyme results.

Anyone have any ideas??

[CYNDI1]

I have elevated Liver enzymes as well....however I had a terrible bout with gall stones and just recently had it removed...
My enzymes are still not within normal limits...ALT/SGPT = 102
AST/SGOT =240 and so on...with an Alk Phosphate of 240
they have gone down but that was after an ERCP to dislodge gallstones...maybe the Dr is correct and you have a gall bladder problem that is silent now?
Cyndi 1

[jep65]

like i have mentioned to other people in this forum look into milk thistle to help support your liver and cut back a little on the meat and add more fruits and veggies for the antioxidants.like the above has mentioned check out your meds and see if any alter liver enzymes.

[bridgefreak]

I too,have elevated liver enzymes,but do not drink.after much research it was found that the medicine,ultram is to blame for these results!! Some medicines can really throw lab results out of order,so be sure to mention any you are taking.Even over the counter ones like aspirin or ibuprophen

[johnjohn83]

Many thanks for your reply.

Had my ultrasound today - Liver, Pancreas and Spleen show normal results and normal blood flow through the organs. No sign of disease or structural problems. My physician is pleased with this, as am I!

Additionally, my LFTs today (only 3 days after the first round) now show ALT of 117, AST of 38. I know things can go up and down, but my Doctor finds this result encouraging.

I suggested tests for the possible conditions you list above, however the Doctor suggests that my lack of symptoms normally associated with these make them extremely unlikely.

Instead he has suggested abstaining from alcohol, careful diet and moderate exercise for the next 2-3 months, and will repeat the LFTs monthly to monitor whether they decrease.

What are your thoughts on this workup so far?

[Kevin Pho, MD]

I agree with the workup thus far.  

Alcohol use is certainly a possibility, and I agree with abstaining.  An ultrasound of the liver should be done to exclude alcoholic liver disease.  

Other possibilities can include hepatitis, hemochromatosis, autoimmune disease, as well as gallbladder disease.

The ultrasound can help with the diagnosis.  I would also obtain blood tests to rule out some of the aforementioned diseases.  

If the enzymes continue to rise without a clear diagnosis, a liver biopsy can be considered.

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 patients education only. Please see your personal physician for further evaluation of your individual case.

Kevin, M.D.
www.kevinmd.com