Elevated Enzymes Concern - pls help

[ksilv]

Hello -

I had a physical a couple of years ago and my liver enzymes were elevated. The Dr. did not seem concerned at all and said I should completely abstain from any type of alcohol for 30 days and re-test.(I am not a heavy drinker, but do enjoy on average a drink a day (beer or wine) with dinner...and sometimes 2 on a weekend night). I did not have a drop for 30 days and my enzymes returned to very close to normal and the Dr. let the matter drop......I have still always been a bit concerned.

Monday, I had another physical and everything turned out very well except for my enzyme levels; again!! I have not been drinking heavily and have not drank heavily since my college years about 8 years ago - like most college students!!

Anyway, here are my statistics:

ALT........100
GGT............95
Biliruben..........1.9

All other ezymes and parts of blood test were completely normal. Of course, I've been doing extensive research on the web and am scared to death....the problem is my physician does not seem concerned at all.........it was me that was more concerned and asked to see a specialist. He thinks that would be a good idea just to put my fears to rest, but I'm truly scared that there could be something wrong -

I am 29 years old
5'9"
185 lbs

I feel great and excercise, etc........no symptoms whatsoever except for the elevated count. I'm seeing a specialist this month but would love to hear anyone's thoughts.

Thanks so much!!

Ksilv

[ksilv]

Thank you for the comments!! Hudson if you don't mind me asking, what were your levels and how was the outcome.....I hope everything worked out alright for you and that you are doing well. From the research I've done (albeit only on the web, which paints quite a picture of doom!!) - I can see where he would make those comments. Obviously, I'm hoping that the fact that I am young and in good health otherwise, my only vice being moderate alcohol use, that this will not be a very serious issue.

This board is so helpful to hear from others that have had similar occurances, so again I can't tell you how much I appreciate the comments!!

Kenny

[Hudson]

As one who has just gone thru a major liver panel work-up  and ultrasound, you can't diagnose this person as having chronic liver problems based on the info he provided. JMO.

Hudson

[Yezinki]

To me it looks as Chronic liver damage due to some hepatotoxic agent, along with bilary obstruction.

U/S, CCK test would be very helpful.

Regards!

[ksilv]

Thank everyone for all of your comments. I'm interested to hear if anyone has had similar results or heard of the ALT>AST, elevated GGT, ALP normal, and biliruben at 1.9 (Elevated ALT, GGT, and Biliruben). I've seen a ton of posts that say AST>ALT suggests alcohol but what about specifically ALT>AST, elevated GGT, and elevated biliruben - everything else normal. I know that it is not possible to get an answer or even hope for a sure answer until I see the specialist in June - is this more suggestive of fatty liver or possible something gastro problems? Thanks.

[Kevin Pho, MD]

There can be many reasons for an elevated enzyme count - this can include fatty liver, Gilbert's disease (a benign condition of bilirubin metabolism), gallbladder disease, hepatitis etc.

An ALT of 100 deserves further workup.  I would start with an ultrasound and blood tests for hepatitis.  

If these tests are negative, repeating the enzymes periodically is recommended.  If they continue to rise, a liver biopsy can be considered.

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_b

[ksilv]

Thank you all for the comments and thoughts....I really appreciate all the responses. I have an appointment set with a liver specialist on June 14 (that's the soonest they could get me in and they say I do not have an "emergency"??? oh well....)

Is there any other symptoms I should watch for until then? I feel perfectly normal and am exercising, etc.....and I do have a good diet. I guess I'll just wait and see; and stop drinking alcohol for now - I'm going to Vegas with friends next week so that will be very tough!!! Club soda with a lime please!!