Is a high a/g raio always a cause for concern?

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My most recent blood test revealed a high (2.4) A/G ratio (reference 1.2 - 2.2). The albumin (4.8) and globulin (2.0) are both in the normal range, although the globulin is near the low 1.5 level. Everything else in my blood work is normal except a slightly elevated LDL cholesterol.

These were flagged on my lab report, but my doctor said the test results are great except the slightly high LDL (124), but the doctor noted that the HDL:LDL ratio is OK (2.82).

I'm asking out of curiosity because I've had some severe health problems that have been improved greatly after having been diagnosed with late disseminated Lyme disease, Bartonella and mast cell activation disorder. The only medications I take now are H1 and H2 blockers to control the mast cell dysfunction, but I did take rifampin, and I know that it has been linked to liver damage (https://livertox.nih.gov/Rifampin.htm).

I wouldn't be asking about liver issues because my doctor didn't mention the high level, except that out of curiosity, I looked up signs and symptoms of liver disease, and I found this list:

1. Skin and eyes that appear yellowish (jaundice)
2. Abdominal pain and swelling
3. Swelling in the legs and ankles
4. Itchy skin
5. Dark urine color
6. Pale stool color, or bloody or tar-colored stool
7. Chronic fatigue
8. Nausea or vomiting
9. Loss of appetite
10. Tendency to bruise easily

A few of these apply to me--although those symptoms also can be related to my other health problems. I am 40 now and I noticed around 33 (when the mast cell disorder problems began to present) that socks always leave impressions in the skin of my legs for 20-30 minutes after I take them off (edema?), and chronic fatigue and itching have been problems for the same approximate length of time. (Probably worth noting that I am *far* less fatigued now at 40 on an everyday basis than I was before the Lyme and MCAS treatment, which was the majority of my 30s).

Sorry for the long post, but I thought context might help anyone who may have answers to interpret the question of whether an elevated A/G ratio may be a concern that warrants further investigation into a potential liver problem. Thanks in advance for any guidance anyone might be able to offer.

[klause01]

Nothing wrong with your A/G ratio, you would rather your Albumin to be high, then the other way around.  I wouldn't be worried about my liver unless I drink a lot, take a lot of meds. If you are concern about your liver have your doctor to do liver enzyme labs and include a GGT.

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Thank you! The only reason I have a slight concern are because, as mentioned above, I took rifampin and had a reaction to it (fever and tremors), and because my alcohol tolerance has diminished significantly in the past couple of years. I don't drink heavily at all--two drinks maximum maybe four times a year--but I used to be able to have at least one whole drink before I felt intoxicated and now two sips of wine makes me feel full-on drunk. Which I figure is good in a sense because it prevents me from *wanting* to drink more, but aside from age, I'm not sure why my body's reaction would change so significantly and I was concerned that perhaps my liver is not performing as well as it once did.

[klause01]

Well, I don't think your liver has anything to do with that, however high Albumin means your liver is working good, but you can't always rely on labs, most say you can have good labs and have liver disease. I really don't believe people that say that because if you really look at their labs, the platelets are hanging on the low side and if they are a long time drinker their GGT is high. However, drinkers usually do well after being diagnosed with ALD if they are able to stay sober.