high ggt

[ghettoyuppie]

Hi there my name is Rob and I am 40 years old last summer.  I weigh about 190 pounds and 5'10 inches tall.  I use to smoke about a half a pack a day about 10 years ago but haven't smoked since.  I use to drink socially but I have about 4 drinks a year now and has been this way for a long time.  I rarely go out anymore and a little bit of an intravert.
I have been battelling persistant elevated levels in my liver function tests.  I had gone to thailand about seven years ago and got sick on the way back.  When I got back to canada they said I had at one time hepatitis A.  They figure I had a small bout since I had been vacinatted.  Since then my doctor keeps brushing it off and states I have chronic persistant hepatitis A.  Everything I read though states that Hepatitis A does not go chronic.  Remember this has been going on six years.  My enzymes had been hovering around 270 ggt and alt of 102.  We thought it was getting lower every test so I didn't worry about it anymore.  
I just got retested last week and these are my results.
protein 81 g/l
bilirubin total 20 umol/l
ggt 421
alkaline phos 153
ast 44
alt 115
ld 340

This has me very concerned.  What should I do and in your opinion is their something to you that stands out on what this may be?
also I have been tired and very unmotivated lately.  i am forgeting things I shouldn't forget ie names just for a moment but I have to pause to think about it.  even every day tasks I have to think more than i use too.  I seem to zone a lot also.  I am aware of what I am doing but I cant concentrate.

I appreciate you advice.  I have a wife and a six month old son to think about.

[Kevin Pho, MD]

Further evaluation of the liver is necessary with the markedly elevated GGT.

Alcohol normally is the most common cause, but you mention that your use has been moderated.  

Imaging the liver with an ultrasound is recommended, as well as repeat tests for hepatitis a, b, and c.  

If the tests remain non-revealing, and the ast/alt hover at or above 3x the upper limits of normal, a liver biopsy is recommended for a more definitive diagnosis.  

These options can be discussed with your personal physician.

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 patients education only. Please see your personal physician for further evaluation of your individual case.

Kevin, M.D.
www.kevinmd.com

[ghettoyuppie]

I get out of breath when i climb one set of stairs.  After I climb I have a hard time having a conversation without gasping for air.  they did a stress test which came out remarkably good.  I do have asthma but it is under control with symbicort 200mg one puff twice per day.
other than that I do take one 75 mg zantac for heartburn which is quite constant lately.   Also I am quite gassy and as my lovely wife would say is I reak.
thanks