Digestive Disorders / Gastroenterology Expert Forum
High Levels of Liver Enzymes
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High Levels of Liver Enzymes

About 4 years ago, I was being examined for an insurance application.  The blood test revealed that I had high liver enzymes.  Subsequent to the blood test, I followed up with a liver specialist, who confirmed the results and ruled out Hepatitis and other liver related diseases that can be test for using blood tests.  He decided to do a liver biopsy.  All results were negative.  He wrote me a letter stating: "The patient had no other abnormalities of liver biochemistry and he was extensively investigated with investigations showing the following findings: bilirubin 0.7, ALT 47, AST 33, alkaline phosphatase 84, albumin 4.1, white cell count 5800, platelets 236,000, hemoglobin 16.3, hematocrit 47.6, INR 1, electrolytes normal, BUN and creatanine normal, ferritin 320, alpha 1-antritrypsin levels normal, ceruloplasmin 32, and immunoglobulins G, A, and M 824, 218, and 145 mg, respectively.

Screening tests for hepatitis B serology were all negative.  Hepatitis C tests in the past have all been negative.  The patient has, in the past, had a bilirubin of 1.7 with a direct of 0.7 and an indirect of 1.0, suggesting mild Gilbert's syndrome.  He did have a repeated gamma glutamyl transpeptidase which was 184.  Based on this, he underwent a liver biopsy and this biopsy was entirely normal.

Based on the above, the patient has asymptomatic, isolated elevation of his gamma-glutamyl transpeptidase with no evidence whatsoever of any chronic or serious liver disease."

That was all 4 years ago.  Well, this year I wanted to increase my insurance and underwent another examination.  The blood tests revealed the following results:  my SGOT (AST) is 60 U/L, my SGPT (ALT) is 72 U/L, and my Glutamyltransferase is 171 U/L.  It also revealed an abnormal carbohydrate deficient transferrin (CDT) result.

The insurance company claims that these test results are indicative of regular alcohol intake at a level that may be significant to health or longevity.

To be honest, this test was completed during the holiday season in which I went to a number of Christmas parties that involved the consumption of alhohol.

During a normal week, I may consume 3-4 alcoholic beverages.  Some weeks, it's none.  Others it may be significantly more.  I would consider myself average or below average in the area of alcohol consumption.  However, there are time (at conventions, etc.) when it is elevated.

In your evaluation of this information, do you think it would be wise to get checked out again.  What do you think might be the cause of these results?
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You have undergone a significant liver workup, including biopsy and a variety of blood tests 4 years ago.  It may be possible that some sort of liver disease may have started in the interim.  However, it is more likely that it may be from the alcohol.  

An isolated elevation in serum GGT or a GGT elevation out of proportion to that of other enzymes (such as the alkaline phosphatase and alanine aminotransferase) can be an indicator of alcohol abuse or alcoholic liver disease. The reasons for this are not well understood.  There are varying degrees of sensitivity of the liver enzymes to alcohol depending on the person.  

Simple tests to reassess for liver disease would be an ultrasound and hepatitis screen.  If negative, I would suggest abstaining from alcohol and repeating the liver function tests.  

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.

Bibliography:
Pratt et al.  Alkaline phosphatase and other enzymatic measures of cholestasis.  UptoDate, 2004.
7 Comments
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This is not the official answer, which will arrive from Dr. Pho. Meanwhile, I'd say from what you describe, it's indeed from alcohol. Among other things, I'd take it as a wake-up call; some people are more sensitive to the damage done by alcohol than are others. I'd suggest kissing off alcohol; cirrhosis is not a nice thing to get. And if you agree and are able, then taking the tests after a period of time off alcohol would be a good thing to do.
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If the Dr. agrees with this and I quit drinking alcohol altogether (which I could and would do), what damage has already been done to my liver.  Will I have any long term effects or problems later in life (I'm 37 now).  Should I never have a drink again?  Has my life expectancy otherwise been changed?  Other than this issue, I exercise regularly, eat well, and am very healthy.
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the liver is very resilient: if you stop drinking, given the lab data you provided, it's pretty unlikely there'd be permanent damage of any significance.
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Three years ago my partner stopped drinking.  He liked a drink and would sometimes go over the top.  All his test results where good and no sign of any damage.  One month ago he died from liver failure.  Three weeks - tops from the time he felt unwell.  Everyone is different I realise this, but I guess the point is that he was just a normal guy who enjoyed the good life and would never have guessed this would have happened to him.  He was 52.  Predisposed is the word that keeps coming to my mind.  We don't get any choices as to when we leave this earth, but I tell everyone now think carefully about pushing the boundaries with drinking.  The next time you twist a top of a beer think ICU because the processes of dying from this disease are the most undignified and horrendous outcomes one could imagine.  Not the most pleasant experience I have witnessed.  If this message makes you shudder and stop and think - good, because I am not a wowser and I think that if anybody could have warned us about the consequenses of having a drink maybe I still would have the best person in the world still with me today.  All the best.
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I went for a blood test last week and they told me my enzymes were 119 which was high. They said I might have Hepatitis. I told them I drink a 1/2 gallon of liquor a week and they told me I need to stop. Strangley enough I keep telling myself I know people in their 60's who drink more than me (im 38)so I still keep drinking? I dont want to go through rehab and I cant see myself in AA-I stopped for 6 months and was so bored like I was very anxious all the time? I have an appt. with a doctor in 2 weeks to see if antidepressants would help me stop. I just wanted to hear anyones opinion about my experience-thanks!
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Avatar_n_tn
I went for a blood test last week and they told me my enzymes were 119 which was high. They said I might have Hepatitis. I told them I drink a 1/2 gallon of liquor a week and they told me I need to stop. Strangley enough I keep telling myself I know people in their 60's who drink more than me (im 38)so I still keep drinking? I dont want to go through rehab and I cant see myself in AA-I stopped for 6 months and was so bored like I was very anxious all the time? I have an appt. with a doctor in 2 weeks to see if antidepressants would help me stop. I just wanted to hear anyones opinion about my experience-thanks!
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Avatar_n_tn
I went for a blood test last week and they told me my enzymes were 119 which was high. They said I might have Hepatitis. I told them I drink a 1/2 gallon of liquor a week and they told me I need to stop. Strangley enough I keep telling myself I know people in their 60's who drink more than me (im 38)so I still keep drinking? I dont want to go through rehab and I cant see myself in AA-I stopped for 6 months and was so bored like I was very anxious all the time? I have an appt. with a doctor in 2 weeks to see if antidepressants would help me stop. I just wanted to hear anyones opinion about my experience-thanks!
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