31-year-old woman, high enzyme count

[Caitlin70433]

Ok. I am terrified. I happened to check my blood pressure and it was high so I went to the doctor for the first time in five years. After several days on a light diet w/o caffiene my BP was down but still borderline. They did bloodwork and my liver enzymes were high. My GGTP was by far the most high with 533. My LDH was 263 (only 20 over normal range). The SGPT was 60.

They did more bloodwork to test for hepatitis but the Dr. agrees I probably don't have that. When that comes back negative, they will refer me to a liver specialist at Earl Long hospital (which should be free due to my income, the previous was at a student health center-I am in grad school).

I should say that I am 30 lbs or more overweight and that is a lot as I am only 4'11'' and I ate at Wendy's a lot and drank a lot of diet coke (behaviors I have since ceased). Anyway, the cholesterol was only slightly elevated (LDL 160, HDL 56)and I was also slightly hyperthyrodic (TSH Ultrasensitive 4.915). The doctor wants me to track my BP for several weeks and wait to see what the specialist says about my liver before putting me on any meds.

I am not on medication and I hardly every drink. I did have an irritated gallbladder once, though. So, I go back on Wed. to find out about the hepatitis and be referred to the specialist. The worst part is the waiting.

1. Could this be a function of diet?

2. I had a mild case of food poisoning on May 1. The test was May 13. Would that have affected the test. Also, I got a sinus infection right after. The food poisoning on lasted 24 hrs and the Sinus infection only 3 days. I didn't take any OTC medications for at least 2 days before the test.

3. I am off of caffine, avoiding artifical sweetners, eating salads, and exercising every day ever since May 8 (when I found my BP high). Is this the right path?

[Kevin Pho, MD]

To answer your questions:
1) It is possible that a high-fat diet would lead to non-alcoholic steatohepatitis (NASH) which can subsequently raise liver enzymes.

2) Yes, food poisoning can possibly elevate liver enzymes.

3) Without knowing the cause, it is difficult to say what the correct course of treatment is.  The next reasonable step would be a liver ultrasound.  This can evaluate for any masses as well as determine if there is fatty liver present.  If the enzymes continue to be elevated, then consideration of a liver biopsy should be considered with enzymes that high.  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.
Medical Weblog:
kevinmd_b

[brenda713]

A related discussion, elevated AST/ALT and Alk Phos was started.