Elevated ALT, GGT, ALP - cause unknown

Digestive health
1

Hi everyone

I'm currently living in South America and my doc doesn't seem to know what I have apart from some kind of Hepatitis. So I'm looking for opinions on my liver function test results.

I went to see the doctor (Gastroenterology) around 1.5 months ago due to stomach problems as I was worried that I have gastritis or ulcers. He gave me Omeprazol to reduce acid for 1 month. That made me feel better though it's kind of back, now that I finished all the pills.

Apart from that, I did a blood test as well as urine and stool test. All results seemed ok except three liver function markers (ALT, GGT, ALP). Based on that, my doc said that I have a liver inflamation (=hepatitis). Ultrasound of various organs and another blood test for a variety of viruses and parasites didn't show any results. So he just told me to do the liver function test once a month, eat normally but abstain alcohol.

Now I've gotten the results of the second test (1 month after the first) and results seem similar...one slightly worse, two better - but still much higer than normal.

The results (a month ago/today/normal values):

Alanine transaminase (ALT)   62.76, 77.19 (normal up to 50.0)​​

Gamma-glutamyl transpeptidase (gamma-GT)   158.80, 146.69 (normal up to 55)

Alkaline phosphatase (ALP)   553.14, 348.82 (normal below 258.0)

All other results are still in the normal range.

​​

Negative:

HIV, Parasiten (Toxoplasma), Rubeola, Herpes, Hepatitis A,B,C

Probably not the cause:

- Eppstein-Barr: I already had it a couple of years ago so it's not acute anymore. IgG positive but IgM negative

- Alcohol: until around 3 months ago, I used to drink an avg. of 0.3 liters of beer (1 small can), daily. At some point I didn't feel very well after drinking - maybe due to the liver or the gastritis/ulcers. I haven't had alcohol at all since the first test and never craved it...

- Fatty food: I'm not overweight nor do I eat/like much fatty food.

By the way, I'm male, 30y, BMI of 21.

Any ideas would be highly appreciated! Thanks for reading.

2

What are your Iron Studies?  These are a window to a lot of health issues.  Also test for Helicobacter Pylori for your stomach problems.

 

3

Hi Tom have you not had a liver biopsy. It sounds like you definitely need one.your numbers are very high and your having your blood taking once a month which is a lot.i hope you find out what is going on x

4

Thank you for both of your replies!

I would like to do a biopsy but am hesitant because I'm still waiting for my international insurance to confirm whether they will cover the expenses. I'm afraid it's probably quite expensive without insurance. Also, the doctor seems to be of the opinion that it can wait...

I'm not sure iron was tested for.

The blood test included the following (all in normal range):

White Blood Cell Count (WBC)

Hematocrit (HCT)

Hemoglobin (HGB)

Red Blood Cell Count (RBC)

Mean corpuscular volume (MCV)

Mean corpuscular hemoglobin (MCH)

Mean corpuscular hemoglobin concentration (MCHC)

RDW-CV

RDW-SD

Basal glucose

Urea

Creatinine

Uric acid

Total bilirubin

Direct bilirubin

Indirect bilirubin

TGO/AST

Amylase

Lipase

Total proteins

Albumin

Lactate dehydrogenase (LDH)

+ the 3 mentioned before andwhich were elevated

Ultrasound showed no abnormal morphology, size or echogenicity and with no dilitation of bile ducts nor focal lesion.

Gallbladder with fine walls and acalculous.

Spleen, pancreas and kidneys without alteration.

No internal or retroperitoneal adenopathies (?) and no free liquids.

5

When you had your scan did they mention fatty liver . because that would definitely come back elevated

6

sarah03222:

They didn't mention fatty liver. You mean, there is a specific test for it?

7

When you have a scan it's usally picked up.you have a lot of symptoms I have like bloating and acid.my numbers were raised and they said it's fatty liver.when did you last have a scan

8

Also you don't have to be overweight to have fatty liver it affects anyone

9

The good news is you don't have any lesions or no mass or fluids from any were which is good

10

Hi sarah

If it's usually picked up but they didn't mention it, I would assume they didn't find anything pointing to it. The first tests were 1 month ago, the second test for liver function was 2 days ago.

I understand that bloating and acid can be caused by a wide range of things. Does fatty liver have some other, more specific sympthoms?

I did also miss one more slightly "abnormal" value in the initial blood test:

Eosinophils (EOS) were at 4.8% (normal range 0.9-2.90).

At the same time the Eosinophil (EOS) # count was 479 which seems still to be normal (20-500).

11

The symptoms are so vague that's why there is 8 million Americans with it and don't even no they have it I live in uk London and my doctor says were not far behind that figure. I would love to know as I bet you too what they find with you .You seem to be in good health no hep c it's horrible not knowing but iam sure you want to know.are you under liver specialist

12

What you described is a Liver Function Test.  Iron Studies includes Serum Iron, Ferritin Iron, Transferrin Saturation %, and TIBC.  Drs are pretty stupid for not doing an Iron Studies test as a matter of course.  Only the good ones do it.

Too much ferritin iron causes fatty liver (as in haemochromatosis) and a fatty liver causes high ferritin iron.  Fatty liver is not necessarily caused by consuming fat - sugar and starches are the real culprit.

You are not in a country where a dr might think of this.  So you will have to be assertive and ask for it.

13

Thank you for the heads up, sheryl. I will definitely ask the doc about the possibility of hemochromatosis, next time!

14

Hi Tom

Can I ask what your outcome was? I have raised ALT levels that have increased in 3 blood tests over the last 6 weeks. Levels are at 73 atm. I've had a full medical check. Scans, full bloods etc for pretty much every condition and I am extremely healthy apart from the ALT levels. I have had an ultrasound to check my liver and everything looks healthy. Not fatty at all. Where are you with your diagnosis?

15

Going through same myself. Chronically elevated since January all tests clear apart from bloods and feeling very unwell