Healthy Liver?

[pooter]

I am a 40 year old male. I have been a heavy drinker (12 beers per day) for 15 years.  I drank previous to this but not as much or as often. During the last 5 years I have had liver function tests done 4 times.  Twice for insurance and twice during routine checkup. All 4 times all tests came back normal including ggt,ast,alt,bilibrium,albium,etc. The test were all done about a year apart and while I was still drinking. I have no obvious signs or symptoms of liver desease. The concern I have is the information I have been reading on the internet. Specifically that a person can have liver damage and even cirrhosis regardless of having normal enzyme levels. My question is how likely is it that I have a serious liver condition despite the normal enzyme levels? Should I have a biopsy to check and how can I get a physician to order one? I hope you can ease my fears. Thanks

[Kevin Pho, MD]

Hello - thanks for asking your question.

First of all, I suggest that you see your personal physician for assistance in quitting alcohol.  As you know, the long-term effects of such heavy use can be serious.

There are several characteristic laboratory abnormalities in patients with alcoholic liver disease. The serum AST (SGOT), ALT (SGPT), gammaglutamyl transferase (GGT) are often abnormal in alcoholic liver disease. The most common pattern of liver biochemical test abnormalities is a disproportionate elevation of serum AST (SGOT) compared to ALT (SGPT). This ratio is usually greater than 2.0, a value that is rarely seen in other forms of liver disease.

You asked how likely is it that I have a serious liver condition despite the normal enzyme levels.

The answer is yes - you may have end-stage liver disease (cirrhosis) and still have normal liver function tests, however it is unlikely that all of them will be normal.  

Aspartate aminotransferase (AST) and alanine aminotransferase (ALT) are usually moderately elevated. AST is more often elevated than ALT. However, normal aminotransferases do not preclude a diagnosis of cirrhosis.

Alkaline phosphatase — Alkaline phosphatase is usually elevated but less than two to three times the upper normal limit.

Gamma-glutamyl transpeptidase — Gamma-glutamyl transpeptidase (GGT) levels correlate reasonably well with alkaline phosphatase in liver disease.

Bilirubin — Bilirubin levels may be normal in well compensated cirrhosis. However, they rise as the cirrhosis progresses.

Albumin — Albumin is synthesized exclusively in the liver. Albumin levels fall as the synthetic function of the liver declines with worsening cirrhosis. Thus, serum albumin levels can be used to help grade the severity of cirrhosis.

If you are concerned about your liver, I would suggest an ultrasound first, then you may want to discuss the option of the biopsy with your personal physician.  

I strongly suggest followup with your personal physician.

I stress that this answer is not intended as and does not substitute for medical advice - please see your personal physician for further evaluation of your individual case.

Thanks,
Kevin, M.D.

[Bubba1]

Well where should I begin. I started to have pain in center of chest worse when i lifted my arms. Heart test fine. Doc ordered ultra sound........the results came back abnormal. Doc said the surface of my liver in not smooth and liver emzemes where elevated. I go on tues to find out what he has to say. But in the last week or so pain on left side around hip area is killing me could this have something to do with the ultra sound results?

[Patrick J.]

I've got an idea, how about not drinking 12 beers a day ?? I have no sympathy for self induced problems.

[hilly]

Hey Patrick, If you don't have anything nice to say don't say anything at all. We're all here to help each other no matter what.

[Patrick J.]

There are alot of people here who have many illnesses who are trying to help themselves & each other get well. When you KNOW the answer to your problem, you really don't have a question. do you?

[lady20]

I'm a 23 year old female. I went to visit my doctor because of cronic fatigue. He ran some blood test and everything was normal except my ast and alt levels. ast was 201 and alt was 123. He refered me to a specialist, but the specialist wants me to pay any out of pocket cost up front and I can't afford it right now. I'm trying to save money in order to go. So until I can go I have no idea whats wrong with me. If anyone  has any idea what these levels mean I'd love to hear from you.

[mlabrego]

Hi Everyone. I'm sure glad I came on this board I just hope someonecan help me.

About three weeks ago I felt pain in my lower left rib cage it only occured when I slept and so I didn't sleep on my side anymore..then around the same time I felt a dull pain in my right abdoman. I thought it might be gas but it still continues. Every now and then I get a sharp pain even when I'm not moving or doing any strenuous labor. It doesn't hurt to press down in the area and I don't have a fever so I know it's not appendicitis. Also, about a week and half ago I developed a tightness in the center of my chest. It feels like something is trying to get out of my chest. I had a doctor perform an EKG and a chest X-ray and both came back fine but the pain is still there. After I eat anything (even a small lunch), I  have a feeling of extreme fullness in my stomach which seems to make the chest pain worse. Lying done only aggreviates the symptoms. I'm wondering if the pain in my right abdoman and the fullness in my stomach and the tightness in my chest are related. I'm supposed to see a GI soon and he said I will have a colonscopy done as well. Any ideas?
Thank you so much.
Miguel

[Lisamn26]

My brother was recently diagnosed with cirrhosis of the liver.  Well he was diagnosed last year I believe.  Anyway he was told by his MD yesterday that unless he stops drinking he has 2 years left to live.  He is 38 years old.  He has been drinking since he was 17 years old.  He has swelling in his abdomen and legs and even in his scrotum.  He has a rash all over his body.  I work in the heath care field and have an idea of what this disease can do to someone and it is a horrible way to die.  The sad thing is he doesn't want to quit drinking even after he has been told.  When does an alcoholic finally reach rock bottom?  Is he really still in denial, how could you be?   Anyone out there still drinking and wandering if you have liver disease and contemplating quitting should quit.  This is not something to play around with.  They told my brother if he would quit drinking he could live for many years.  But he refused.  I guess my question is what can I do, my family do, to get him to wake up.  Any ideas?  Thanks

[mrs Peke]

What kind of rash?  I have also been concerned about Liver diease, have had pain under the rib-cage and a full feeling.  I have some places on my legs that look a little like liver spots but they are rised and you can feel them.  I started drinking when I was 40 yrs old and divorced.  Now I am married and we have a couple of glasses of wine a day.  I am 55 year old.  My doctor says I am healthy but I hurt. My husband think I am a nut, he says your liver is painless, it does not hurt.  So it would be interesting to know what kind of rash?
mrs peke

[Lisamn26]

I don't believe you could feel his rash.  Honestly I don't think I really touched it.  The rash is mainly on his legs.  It is very dark red and did not cover the entire leg.  It appeared to be solid patches here and there.  I don't think he has had any pain under his rib cage.  I hope that helps.  If you are having  pain though I would try to check it out, it may not have anything to do with your liver.  If you are drinking more than you should and you know it then I wouldn't continue though.  Sounds like you've been drinking for awhile. But I don't think drinking a glass or two a day would hurt you.  Whenever your feeling pain that usually is an indicator that something is wrong.  May not be anything major though.  Sometimes you have to be a little pushy with your doctor or get a second opinion if you don't like what they tell you.  Good luck!

[mrs Peke]

Thanks for your reply!  I have had alot of test done and they tell me I have some liver cyst but they are something I probably was born with.  I also think a second opinion would be good and have made an appointment but I am having to wait 4 months for the appointment.  St. Louis is suppose to have great doctors but you have a long wait for appointments.  I also find the older you get the less they want to listen.    Good luck with you brother, sometime just showing a person how much you love them make a difference.

[mom244]

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