My liver GGT test came back 155

[ckbalog]

I recently had a physical and all my lab tests came back normal BILIRUBIN .03, SGOT 29, SGPT 24 Cholesterol 145 the ratio was 2.3 one of the lowest risk factors.
However, my Liver GGT level came back 155. I'm a 42-year-old male 6'1'' 195lbs. I don't drink, smoke or use drugs, no fatty diet, I

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[Frieda]

I just found this site and saw the comment about the use of tylenol. Tylenol on a daily basis is dangerous.  I took tylenol on a daily basis for two years never exceeding the recomended dosage.  I now have Primary Biliary Cirrohsis.  My husband works with a woman with the same history and same result PBS.  Neither of us a drinkers, drugs, etc.  The common thread is we both used tylenol.  I used it without fear because it was "safe".

[ckbalog]

To whom it may concern:
I had my abdominal ultrasound and all came back completely normal.  My physician said he would recheck the GGT in 1 year however, what is the long-term effect of having your GGT elevated?  I never drink alcohol, what else would raise my GGT? I take Stress B vitamins daily; I also use OTC Tylenol almost daily to fight migraines would this affect it? Is it ok to go a whole year with that enzyme elevated?
    Reminder all my other liver function tests were well in the low normal range as well as all my other blood tests came back in the normal range. I am in very good physical condition.

[ckbalog]

Dear Surgeon,

Thank you for the infomation however, as I said I don't drink and I never really have. Maybe 6 beers in 3 years at most.
  
   If it is gallstones what caused them and why will they most likely return? Since I have always followed a healthy diet and athletic life style, why is my GGT suddenly elevated?

My only two health problems are moderate high Blood Pressure (genetics) and I have suffered from migraines for almost 18 years. I use a lot of Tylenol, would Tylenol over long periods suddenly create an elevated GGT level with not an elevating any other enzymes?(Is Milk Thistle herb good for this problem)? I read it is good for your liver. This the first year I had any elevated levels.
  
    With my Doctors permission would just simply cutting back on my B/P & H/A Meds for a period of time help?
     I'm not sure I could stop the Tylenol, Fioricet or Imitrex because of my Migraine/Tension headaches frequency?

Just to reiterate there is no Alcohol in my diet at all.

Thank You

[kevinmd]

Bibliography:
Pratt et al. Alkaline phosphatase and other enzymatic measures of cholestasis.  UptoDate, 2004.

[Kevin Pho, MD]

Elevated serum activity of GGT is found in diseases of the liver, biliary tract, and pancreas, and reflects the same spectrum of hepatobiliary disease as alkaline phosphatase, 5'-nucleotidase, and leucine aminopeptidase.

You note in the comments below that there is no alcohol present.  The ultrasound is a reasonable next step to ensure there are no gallstones or anatomic abnormalities present.  You may want to ensure that the medications you are taking do not affect the liver.

I would also consider a hepatitis screen (for A, B, and C) which can also increase the liver enzymes.

If all the tests are negative, you may want to consider serially monitoring the enzymes to ensure they are not rising.  

Regarding how to get rid of gallstones, surgery and medications to dissolve the stones are considerations.  The modality used would depend on the symptoms, size and position of the stones.  

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.

[surgeon]

an isolated elevation very likely means nothing serious; the most common cause is alcohol. It can also occur with some medications, so it might be related to your various meds. Whereas gallstones are a possibility, unless you are having symptoms suggesting it (typically severe pains in the right upper abdomen) it's not all that likely. However, an ultrasound isn't a bad idea, since it'll likely provide more information that your liver is normal. In which case, probably nothing needs doing except repeating the blood test in a few months to assure stability. If there were gallstones, to answer your question, sometimes they're just left alone if there are no symptoms. If they are attended to, in most cases it means surgery to remove the gallbladder, which, as operations go, is pretty simple and free of side-effects for most people. The other option is pills to dissolve them; they can work (around 40% of the time), depending on the size and number of stones, but there's a pretty high chance of stones coming back later. I'd bet it's not gallstones; and if it were, if there are no symptoms (other than the blood test) there's not a rush to do anything about it.