Liver Disorders Community
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Avatar universal

When to Consider Liver Biopsy???

Mild elevations of liver enzymes AST, ALT, and GGT started sometime late 2013 or early 2014 and still are elevated. By mild, AST and ALT around 60 and GGT about 100. Never have had that problem before and hadn't had any alcohol since 1/24/14.  Had full bloodwork and ultrasound from a hepatologist a month or so ago and everything was normal except the high enzymes. Note that high dose purified fish oil seems to lower the alt/ast about 10-15 pts but has little effect on GGT. Hepatologist said the only other testing to consider if enzymes stay elevated is a biopsy.

My questions are:

1. How long does it take for mild enzyme elevations to cause permanent damage?
2. Could this be a residual effect of a slo-niacin I took in late 12/13-early 1/14? Thought it might be the culprit but if it were the niacin, I'd think things would be back to normal by now.
3. What other type things can a biopsy show that the vast array of bloodtest and ultrasound wouldn't show? They did a bunch of blood tests I've never heard of before.
4. How accurate is biopsy? Couldn't the needle pick up tissue in an area not inflammed?

2 Responses
317787 tn?1473358451
Hi is the doctor advising you to have a biopsy?  Is he worried about the elevations?
The biopsy would show how much damage has been done to the liver.
It is about the best  test to show.
I am assuming he has tested you for Hepatitis.  I am not a doctor but I thought that elevated enzymes indicate inflamation/damage. Are all of your other numbers within the normal range?
Everything you eat or drink or put on  your body has to be filtered by the liver.  At one point mine were slightly elevated and my doctor said it must be a medication I was taking.  Unfortunately it wasn't I had Hepatitis C.

I hope you can find some answers, Dee
Avatar universal
Did full hepatitis and liver blood work up along with ultrasound....all negative. Elevated enzymes just started over a short period of time. Not sure why.
As a followup to anyone reading this, note that my mild liver enzyme elevations were related to severe tricuspid heart valve regurgitation. Had heart surgery in 11/2014 to repair valve and am doing well. If liver hadn't given me a warning, would have been in some stage of heart failure right now.
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