If I Should Be Concerned

[Isidore]

I changed primary physicans in January 2004.  The doctor completed blood work to create thresholds.  To give you a little history, my Mother died of heptatis C and primary liver cancer last year...the liver cancer told was dues to the hepatitis.  I had received Hep A shots about 4 years ago and last year got the Hep B.  The Health Clinic I should check if I got protection from the shots so when I went to my new physician he checked those levels as well. Blood tests results for Hep A IgM Antibody non reactive, Hep B Core IgM nonreactive and Hep C Antibody non reactive final lab 54 for all three.  The lab results did show out of range levels for the enzymes and bilibubin. (see below)  Because I am 5'1" and weigh 155 the doctor suggested I take off the excess weight. The doctor also did further blood work to elimate conditions of thyroid and diabetes. His test results are both Jan and March 2004 and were normal for thyroid and diabetes. So I went to a weight clinic.  The clinic did the blood work in April 2004.  He suggested I fax the results to my primary care physician, which I did.  The out of ranges are:

Jan 21, 2004
Alkaline Phosphatase    119      (35-104)
AST                      32      (12-36)
ALT                      75      (9-43)

March 2, 2004
Alkaline Phosphatase    111      (35-104)
AST                      27      (12-36)
ALT                      46      (9-43)

April 8, 2004
Alkaline Phosphatase    107      (35-104)
AST                      44      (12-36)
ALT                      62      (9-43)

The weight loss clinic said the tests results in April because the AST is higher than the ALT...he mentions possible causes gallstones, primary liver cancer, right heart condition (which he quickly thought no likely), a condition from alcoholism ( I seldom drink alcohol) and he also mentioned viral hepatitis.

What do you think?  Is there a blood test to eliminate you have cancer in your body?  Should I be concerned and what do you recommned?     Isidore (nickname)

[Kevin Pho, MD]

You note mildly elevated liver enzymes.  Your physician listed some causes of his - in addition to alcohol and gallstones, I would also like to add fatty liver.  

You may want to repeat the viral hepatitis screen if you are concerned about this, or if you have been exposed.  However, the next test I would suggest is an abdominal ultrasound.  This can evaluate for fatty liver, as well as anatomical liver or gallbladder disease.  Tests for autoimmune hepatitis (with an ANA  level) can be considered.  

If you drink alcohol, abstaining from this and repeating the test can be considered.  Medications that affect the liver should be evaluated to see whether this is causing the elevation.  

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.