Elevated Liver Enzymes and functional dyspepsia and alcohol tolerance

In June 2003, I had a slightly elevated AST level (43), normal ALT (38) and slightly high GGTP (84) discovered during a life insurance blood test.  My primary doctor adivsed me to not drink alcohol for 4 weeks and redo the test (I was having 1-2 glasses of wine nearly every day).  We did and the AST and GGTP went down to normal but then ALT was slightly higher.  To aid me in my fight for a reduced life insurance rate, my doctor did the hepatitus (hepatitis) tests and a liver ultrasound.  All were negative.

Recently, I had more blood work done to qualify me as healthy for a new FDA trial for a functional dydpepsia medicine (Itopride).  I have been diagnised with functional dyspepsia for about 4 years.  In that test, hepatitus (hepatitis) was still negative.  AST was 42, ALT was 44, and GGT 54 (all within ok ranges for the FDA trail qualification but AST is higher than some "normal" ranges I see listed).

For more background, I am a long distance runner and do 1-2 marathons a year (I run about 35 miles a week).  I mention that since I have heard that such activity can elevate AST levels.  Additionally, I now only drink about 1 glass of wine, only 4-5 days a week.  I have found that my tolernece for alcohol is definitely much less in the last two years, both in terms of feeling while drinking and morning after.

While my enzyme levels are not above, or at least much above normal, and I am very healthy overall (blood pressure, cholestoral, etc), should I be concerned that my levels have stayed a little high for 2 years and that I also have the stomach issues (bloating/discomfort) after meals and the reduced alcohol tolerance?  I just want to be sure I don't have some progressive liver issue - or would that have shown up in the ultrasound two years ago?

Thank you.

[Kevin Pho, MD]

You have had a pretty good evaluation for elevated liver enzymes, including hepatits test and a liver ultrasound.  With those tests being negative, serial monitoring and observing can be considered.  

The enzymes are not high enough to warrant a liver biopsy - typically, this can be considered if the enzymes are 3 times to upper limit of normal.  

Abstaining from alcohol, as well as stopping medications that may raise the liver enzymes (i.e. Tylenol) can all be considered.  If this has already been done, repeating the enzymes on a periodic basis 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.
Medical Weblog:
kevinmd_b

[butsy]

I am 50 i drink too much and I have this feeling or ache right at the bottome of the rib cage is this a fatty liver or agall bladder or enzymes.it si not a pain just a feeling