Elevated GGT/ALT

[Gough]

I have had an elevated GGT in my last 4 or so annual health checks. Results (against U/L of <35) have been 39 (1998), 113 (2000), 91 (2002) and 111 (2003). I have also had slightly elevated ALT results - 30 (1998), 49 (2000), 32 (2002) and 41 (2003). My ALP was elevated once (113 - in 2000). My LDL's have been good. My HDL has been low (0.8-1.0) and my Triglycerides have been high (3.1, 4.1, 3.5, ??) - against mmol/L <2.0.

Each time the doctor has said that normally these results would be consistent with high alcohol intake, but this is not the case. They have therefore dismissed the results as being probably due to hereditary factors or fatty liver. There have been no follow-up tests done and I have not worried.

I have been slightly overweight at 80-85 Kilos' against "ideal" of 75. They indicated I was borderline "obese" at one of the exams.

Questions
1. Should I be concerned and are further tests warranted?
2. The doctors say that the ALT elevation is mild and only cause for concern when x2. Is this correct?
3. Are the results consistent with fatty liver?
4. I was diagnosed with Sarcoidosis (lymph nodes in chest)last October. Subsequent chext x-ray this March indicated it had done away. Could this be a cause of abnormal liver tests? I had not had a chest x-ray done for several years prior to that, so the sarcoidosis may have been present for a while.
Thanks  

[Kevin Pho, MD]

To answer your questions:
1) I would consider a hepatitis screen and liver ultrasound.  The ultrasound can evaluate for things like fatty liver.  At least with this test there is a chance for a diagnosis rather than presumptions.

2) I would agree that the ALT elevation is mild.  In some labs, ALT results of less than 50 are considered normal.  

3) Fatty liver may be a possibility.  An ultrasound would be the most reasonable next test.

4) The stomach is the most commonly involved portion of the GI tract, but sarcoidosis of the esophagus, appendix, colon, rectum, and pancreas have also been described.  I am not aware of sarcoidosis specifically targeting the liver.  

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.

Thanks,
Kevin, M.D.

[Inventor]

I noted a previous post by Gough 16 Dec. where his symptoms were very similar to mine. I just had a blood test (last complete one probably 3 years ago) where for the first time I had low iron, elevated GGT and ALT. My doctor asked if I had a colonoscopy recently which I had within 8 mths so he ruled out bowel cancer for the low iron. He also asked if I had excessive alcohol intake which I do not - maybe a binge of 4 glasses of wine once a month and a glass or two every third day. I have had a recent cold after returning from USA in late Feb 04 and I had the flu on Dec 22 03. These were the worst health problems and first real colds or flu for eight years. To prepare for USA visit I had Hepatitis "Twinrix" A+B shots. July 7th 03, August 4th 03 and Dec 8th 03. Could my smptoms be related to my immunisation shots?

[Inventor]

I noted a previous post by Gough 16 Dec. where his symptoms were very similar to mine. I just had a blood test (last complete one probably 3 years ago) where for the first time I had low iron, elevated GGT and ALT. My doctor asked if I had a colonoscopy recently which I had within 8 mths so he ruled out bowel cancer for the low iron. He also asked if I had excessive alcohol intake which I do not - maybe a binge of 4 glasses of wine once a month and a glass or two every third day. I have had a recent cold after returning from USA in late Feb 04 and I had the flu on Dec 22 03. These were the worst health problems and first real colds or flu for eight years. To prepare for USA visit I had Hepatitis "Twinrix" A+B shots. July 7th 03, August 4th 03 and Dec 8th 03. Could my smptoms be related to my immunisation shots?