Alcohol - High Cholesterol and Enzymes

[svermill]

Most earlier posts indicate a low level of alcohol consumption or none at all.  I am 35 yr/male and a life-long drinker (variable - in excess of 3/day on average).  I have not smoked cigarettes for six years but continue to smoke cigars.  My overall health is good, weight being very normal for height (180 lbs and 5' 11").  I have recenly (post-test) initiated a pretty intensive exercise program (3 to 6 miles/day - walk, hike, jog, cycle, or eliptical and also resistance training), after several years of inactivity.  My diet is probably much better than most in the US.

My wife and I were recently tested for a life insurance policy.  Interestingly, the policy was issued, but at a higher than expected rate.  Here are the results:

Chol: 264 (ABNORMAL - Lab Range: 140-199)

AST: 51 (ABNORMAL - Lab Range: 0 -33)
ALT: 102 (ABNORMAL - Lab Range: 0 - 45)
GGT: 126 (ABNORMAL - Lab Rnage: 0 - 65)

AP: 86 (Lab Range: 30 - 125)
Bilirubin: 0.9 (Lab Range: 0.2 - 1.5)
Albumin: 4.6 (Lab Range: 3.6 -5.5)
Triglycerides: 130 (Lab Range: 0 - 150)

Protein: 8 (Lab Range: 6.1 -8.2)

CDT: NEGATIVE

HepB/C: NEGATIVE

All others: NORMAL/NON-REACTIVE

We were instructed not to fast, except a few hours prior to the test, which was late in the afternoon.  Since I answered that I consumed alcohol during the interview, I saw no problem w/ consumption the night prior.  Could this have affected the results?

Of course you will recommend further study.  But my primary question is whether or not these high levels are simply a result of regular alcohol consumption leading up to and less than 24 hours prior to the test?  Some material on the Internet would suggest that my results are cause for great concern, yet a major insurance carrier issued a policy of $500k on my life??  Naturally I am concerned and have curtailed alcohol consumption, but on the other hand my concern is tempered by the issuance of this policy. Certainly they have a medical staff that is very capable of identifying serious health concerns and clearly they were thorough in their testing.

[Kevin Pho, MD]

Although possible, it would be less likely that a single episode of alcohol consumption would lead to the elevated liver enzyme levels.

I would consider an abdominal ultrasound to further evaluate the liver.  If the enzymes continue to rise, a liver biopsy can be considered for a more definitive diagnosis.  

With the elevated cholesterol levels, I would obtain a fasting lipid panel so the LDL and HDL can be evaluated.

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_

[svermill]

I should also add that I drink much in the way of coffee and strong coffee drinks (drinks w/ 3 or 4x espresso shots).  I read this evening that this can contribute to elevated liver enzymes but it was not clear to me to what extent.  I did drink coffee as normal up until the "few hour" cutoff prior to the test...

[svermill]

And do you recommend any vitamin, herb, or medicine as a buffer to the liver?

[Al_144]

I'll bet it's related to Alcohol intake. Just to be sure and for peace of mind, you may repeat the test after abstainig from the booze for at least one week.
Good luck,

[svermill]

Thanks AL144.  I am staying w/ intense exercise program (really enjoying that after several years) and no more than one or two glasses of w/ dinner.  Will re-test in a month or so and post back.  Thanks for your thoughts...

[hbp702]

Intense exercise can temporarily raise ALT/SGOT and AST/SGOT (the latter especially), and also CPK (if that is high too, points to exercise as a cause) and possibly other ones (LDH) (I am not sure about this one).

Having blood done while sore could raise the risk of a false positive.

Waiting a sufficient time after the last exercise before the test could help.

[svermill]

Thanks hbp702.  I have read that strenuous exercise can elevate some of these enzymes.  My exercise program is designed to lower overall cholesterol (obviously targeting the LDL) and to generally "detoxify" the body.  I do think that I'll rest for a day or two prior to the next drawing of blood, though, as you indicate might be wise...