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Liver Enzymes - Elevated GGT, Alk. Phos. and Bili. Tot.
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Liver Enzymes - Elevated GGT, Alk. Phos. and Bili. Tot.

I recently had a physical/blood work done for life insurance application which came back denied with 3 abnormal results for liver enzymes:

GGT 268
Alk Phos 163
Bili. Tot. 1.4

AST and ALT normal (21 and 28 respectively).  Total and LDL Cholesterol also slightly elevated, though ratios, HDL and triglicerides (triglycerides) all normal.

I am 38 years old. My alcohol consumption is very limited - perhaps 6 drinks in the entire month before lab test - most likely 0-1 in the week prior to test.  I take only 2 meidcations and very few OTC meds.  Prescritions are birth control pills and synthroid.  Synthroid is taken for Hashimoto's thyroiditis (autoimmune thyroiditis).  Have 2 children - just 3 and almost 2.  In past have also had several ovarian cysts, kidney stones (both about 10 yrs ago) and have a known gall bladder polyp (small) and kidney ultrasounds (to monitor for polycystic kidneys which run in family) do show some scar tissue they said may have been from small stones as well which may have been more recent and passed by themselves.

Called my primary care doc - didn't want me to send him lab results - just said to go 1 month without any alcohol and then go to their lab for tests and then schedule appointment.

Some research I've done has indicated that these 3 lab tests can be indicative of primary biliary cirrhosis.  I've also read that PBC can be more common in woman who have other autoimmune diseases (such as thyroid) and can also first exhibit after pregnancy.  

Should I just wait a month as my doctor suggested or should I try to see him before then to talk about how to rule out (hopefullY) PBC and/or other conditions?  Given my labs/other information above what questions should I be asking and what follow up tests should I expect?  Do my labs/ med history indicate to you that PBC could be a ptoential concern?

Thanks

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233190_tn?1278553401
I would repeat the bloodwork to ensure there isn't a case of lab error.

Many reasons can cause elevated liver enzymes - including hepatitis, anatomical abnormalities, gallstones, in addition to PBC.

A reasonable initial workup would start with a liver ultrasound as well as blood tests looking for hepatitis.  

If there is concern about PBC, anti-mitochondrial antibodies can be obtained.  A history of autoimmune diseases should also warrant an ANA level to look for possible autoimmune hepatitis.

These options should 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_b
1 Comment
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Avatar_n_tn
My 8 year old daughter had a blood test come back last week with these liver function results:
GGT                 52
AST                269
ALT                376
ALK PHOSPHATEASE   264
LDH                328

The following day we had more blood work done and the AST was roughly 100 less and so was the ALT.
But her blood clotting level was high.
We are having an ultrasound on her liver on Friday and I am hoping to have a little insight as to what kinds of things I should be preparing myself for.
Thanks
Gail
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Avatar_n_tn
I am a 44 yro female and have just recently had blood tests done, alarming results.
GGT - 504
AST - 645
ALT - 565
Bili - 30
what does all this mean is it serious, should i get second opinion, my doctor has indicated type of hepetitis (hepatitis),
shirley
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A related discussion, enzymes was started.
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