Elevared GGT

[vlad]

I have elevated liver enzyme GammaGT.
Thank you for this opportunity to ask questions.
I am 53 years old male and was 1995 diagnosed with elevated GGT ( 142 U/L)
and positive Antibody Hepatitis A and B. All other blood tests were about normal.
What is fanny about that I can not remember any hepatitis in the my past. had blood tests many times within 1995-1999.  But the value GGT was the same or more.
There are the results of blood tests and other Investigation within 1995-1999:
1. Liver function tests:
1995: GGT-142U/L, AST-14U/L, ALT-24U/L, ALP-136U/L,
Protein total- 7,5g/dl, Iron- 94ug/dl, Bilirubin otal-0,46mg/dl.
1996: GGT-142-173, AST-13-20, ALT-24-43, ALP-128-140, GLDH-11,7U/L,Coueroplasmin-29mg/dl, Alpha-1-Antitrypsin-169mg/dl, Iron-100-141 ug/dl, Protein total- 7,2-7,3g/dl, Bilirubin total-0,59-0,66 mg/dl.
1998: GGT-135-154, AST-12-16, ALT-21-27, ALP-135-152, GLDH-9,1,
          Ferritin E1A- 84ng/ml, Transferrin- 3,03g/l, Protein total-7,8g/dl, Albumin- 67,7%, Iron-115-153ug/dl, Bilirubin total-0,4-0,69mg/dl.
1999: GGT-146-214, AST-14-21, ALT-27-37, ALP-162-168, GLDH-13,36,
          Protein total-7,5g/dl, Albumin-55,2-67,7%,Iron-91ug/dl,
          Bilirubin total-0,36-0,69mg/dl.
2. Other blood tests 1995-1999 are about normal:
LDH-115-137U/L, LAP-36,35U/l, PTT-28 sek., Uric Acid Serum-7,2-6,1mg/dl,Blood Urea Nitrogen-19-47mg/dl, Creatinine 0,94-1,3mg/dl,  Glucose- 78-93,HDL-Cholesterol- 34-52mg/dl, LDL-Cholesterol- 132-165mg/dl,LDL/HDL-2,7-3,2,Triglycerides-220-164mg/dl, Bilirubin direkt-0,15-0,19mg/dl,
Bilirubin indirect-0,5-0,52mg/dl, CHE- 7536-7980U/L, Hemoglobin-14,8-15,6g/dl,
Erytrocytes-4,82-5,1Mio/ul, Hematokrit- 46-42%, Leukocytes-7,2-5,8 tsd/ul,MCV- 91,5-88fl, MCH- 29,2-31,2pg, MCHC- 32,2-36g/dl,Potassium-3,8-4,6mmol/l,Trombocytes-185-235tsd/ul,
Sodium-137,8-142mmol/l,Calcium-2,45-2,32mmol/l, TSH-E1A basal- 2,33-3,71uU/ml,T4 E1A- 7,1-7,5, Free T4 E1A- 1,33, T3- E1A- 1,39-1,9,Neutrophils-56,7%, Lymphozytes-36,3%, Monozytes-5,3%, Eosinophils-1,5%,Basophils- 0,2%, Alpha1-Globulin- 3,2-3,7%, Alpha2-Globulin- 3,7-8,8%, Beta-Globulin- 10,8-14,2%, Gamma-Globulin- 14,6-18,1%,Immunoglobulin A-1,12g/l, Immunoglobulin G-10,6g/l, Immunoglobulin M-1,13g/l.

3. Immunserology: ANA, SMA, AMA, LKM- negative.
4. Hepatitis-Serology 1996:
    a) negative : HBV-PCR, HDV-RNA, HCV-RNA.
    b) positive: Anti-Hav ; Anti-HBc , Hep.G - IgG-Ak.
    c) negative: Anti-Hav-Igm, HBsAg, Anti-Hbe , Anti-HBc- Igm, Anti-HBs-59,HCV-RNA-PCR, Anti- HCV E1A, AMA ( IgG IFT, M2 Blot,, M9 Blot),GMA IFT, LKM Ak IgG IFT, ANCA IgG IFT ( c, p, x).
5, Investigation:
a) 1996:- ERCR - bile duct - normal
b) 1996,1998: Ultrasound - Fatty liver, circa 17cm., spleen circa 12,5cm.,others - normal.
c) 1999 - MRI- Fatty liver, circa 16 cm. There was no sign of cancer. Gallbladder, bile duct, spleen, pancreas and kidneys all appear normal.On the right kidney is cyst circa 5 mm.
*****
The results of last blood test in Dez. 1999 were: GGT-214, AST- 21, ALT-37,ALP- 168. I like my physician, but he does not know now what to do further.He has proposed me liverbiopsy. But, at first, I am afraid, because my father had problems with Blood coagulation ( V111 Factor deficiency), and secondly, I can not believe that after all other investigation the biopsy of
accidental  part of liver will give the correct information in my case.
I am not fat, no-smoker. My weight is 102 kilograms ( steady within approximately 10 years), my height is 189 cm. I drink before alcohol only occasionally - not often as one time per month. Now I am no-drinker more then 1 year. I eat healthy
enough. I have not any especial pains, nausea or any other physical ailments.
I take regularly two medicaments:
a) against high blood pressure- "Teveten(Eprosartan)".
    (I had before blood pressure - 160/100, now - 145/90);
b) for support of Liver - "Legalon (Silymarin)"
***
Questions:
a) Must I be serious concerned?
b) What can be the possible reasons of pathological increase GGT? Is it possible that the reasons are not connected with liver or bile duct, but others?
c) What Tests would you request?
d) What further investigations would you request?
e) What for treatment and medicines could be offered?
f) Is liverbiopsy for my case so necessary and effective for diagnosis?
I am very concerned and can't ignore it, because it proceeds already about 5 years after first registration and till now without the correct diagnosis.
Please forward my message to anyone you deem appropriate.
Many thanks for your time. Excuse my English. I am not English-speaker.
Please write to me at my email address if you have any information for me:
***@****

[HFHSm.D.-Gastro-rf]

Dear Vlad,
Your physicians have performed a very complete evaluation of your problem.  There is a suggestion that your problem is fat in the liver 'nonalcoholic hepatic staetosis' [NASH].  A liver biopsy is often the last step to confirm diagnosis.  NASH, not considered a progressive disease [in most cases]. can cause asymptomatic elevations of liver tests.  If a liver biopsy confirms the diagnosis, then no additional tests or ttreatments are needed.

[John Joseph]

I, too, have elevated GGT.  My question: Is it correct to assume that if there is no obvious cause of this elevated GGT (my gastroenterolgist calls it a "benign" elevation in the absence of any hepatitis or fatty liver) the elevated GGT in and of itself is not harmful to me?  

I am about 40 pounds overweight, and while my physician seems to have no opinion on that one way or the other, I guess I can assume from postings on this thread that the weight gain is, indeed, a possible cause (the first elevated GGT was discovered  8 years ago, concurrent with a 20-30 pound weight gain that has persisted to the present day.)

Thank you for any answers you might provide on the danger, if any, of GGT in the blood stream in the absence of any underlying liver disease or condition.

[John]

I don't believe you can have such an elevated GGT level without a logical explanation.
At the present my GGT is sitiing around 200.  Does anyone know why it would be this high?  I am a non-smoker, non drinker, 36yrs old, 10 lbs over weight but otherwise in good condition.
I had liver and Kidney failure last summer and was in Intensive Care for 7 days not knowing if I was going to live or die.  I have had no follow up treatment through the hospital and my Family Dr. seems to be rather removed from leading me in any helpful direction.
Thank-you for any information you my have,

[Kirby Butler]

Through applying for life insurance I learned that I was rated at a much higher rate and reduced coverage because my blood test indicated that my GGT was 208 while AST was 33 and ALT was 27.  All other results were well within normal range other than CHOL was 241 with HDL at 85 and LDL at 131.  I contacted my physician who said he was puzzeled to see only one liver enzyme elevated and that we should repeat the test.  He said alcohol intake can increase the GGT.  I am a male age 56, 6'and 160 pounds and drink moderately.  Some evenings one or two oz. of Bourbon and many nights do not drink anything.  I was very ill around 1983 and the physician said he thought I had Hepatitis non A non B.  I had a recent blood test to check for previous Hepatitis and it was negative.  What are your thoughts?

[John Loeckle email [e-mail]]

I have a very high liver enzyme a GGT of 1100+ all other things ok have had all blood test you can take doctor seems not to be worried i am but do not know what to do.  e-mail at ***@****

[Matt Specht [e-mail]]

Over the past 3 years I have had a high GGTP  last test was 4/20/00 with a GGTP of 214.  My physican says it is time to "bite the bullet and get the liver biopsy.  Is this a wise choice? The only other elevation is ALT at 67.

Should I have the biopsy?