Alcoholism: What else is wrong?

39 year old male with hx of alcoholism for over 20 years. Now reporting headaches ("migraines"), fatigue, sleeplessness at night but has to take naps during day. Hx of 1 episode of gastritis 5 years ago and intermittent gout.
Takes valerian to sleep and has occasionally taken indocin for gout symptoms. Occasionally takes ASA for HA. Difficult to get accurate hx due to alcoholism. No money for doctor bills; no job, just out of prison and returned to drinking.
Labs:  Albumin: 5.5; Protein, 8.4;Total bilirubin: 2.0; Direct Bili: .04; Iron, serum: 277; Iron binding: 363;  % sat: 76; GGPT: 442; LD:  359; AST: 340; ALT: 215; Cholesterol: 287; HDL: 147; LDL: 125; TSH (3rd gen): 5.58; HCT: 56.4; Platelets: 105.

[Kevin Pho, MD]

The liver enzymes are markedly elevated.  Alcohol certainly can play a role and should be eliminated.  

I would also test for hepatitis and image the liver with an ultrasound.  

A liver biopsy should be considered with enzymes that persistently elevated.  

I would be evaluated by a GI physician as soon as you can.

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