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Dr. D. Love
Dr. D. Love, Doctor
Category: Medical
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Experience:  Family Physician for 10 years; Hospital Medical Director for 10 years.
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I have a family member who is alcoholic. His initial Gamma

Resolved Question:

I have a family member who is alcoholic. His initial Gamma GT reading was 3000! This has since come down to 65. After 2 weeks of bingeing he had a test and it read 46. We were perplexed as he had been drinking very heavily. His psychologist suggested this could be because his liver is not functioning properly now.

Can you help on this?
Submitted: 2 years ago.
Category: Medical
Expert:  Dr. D. Love replied 2 years ago.
It will help if you could provide some further information:
When was the reading of 3000 done?
Do you have the results of the rest of his liver tests?
AST? ALT? Bilirubin? Prothrombin time?

Customer: replied 2 years ago.

The 3000 reading was approx. 12 months ago.


 


I have access to these tests and can forward them. I cant get them until tomorrow morning. It is 2pm now.


 


Thanks


Greg Dartnall

Expert:  Dr. D. Love replied 2 years ago.
Well, let me address what information is available now, and then we can discuss this more tomorrow if it is still unclear when you review the lab tests.

It is true that the liver can be so damaged that the enzymes will return to normal. You can think of it that there has been so much damage to the liver, usually replaced with scar tissue, that there is so few liver cells remaining that there is not a detectable increase in the level of liver enzymes.

However, in this situation, there would usually be other evidence of liver dysfunction, either a poor clearance of substances that are removed from the blood or a poor production of substances that are manufactured in the liver for the blood. The bilirubin is a test of how well the liver is clearing substances; bilirubin is a substance created during normal turn over of red blood cells, and will increase in the blood with progressive liver dysfunction. This is the substance that makes a person with liver disease become jaundiced. The prothrombin time is a measure of how well the liver is making specific proteins that are used to form blood clots. An insufficient amount of these proteins will cause an increase in the prothrombin time, i.e., it will take longer for the blood to clot.

If the bilirubin or prothrombin time are increased, then there would be concern about liver dysfunction. If the remaining liver blood tests are completely normal, then it is unlikely that the enzyme levels are lower because of poor liver functioning.

As for why the liver enzyme is very elevated at times but not others, it is not always able to be explained. It may be related to the magnitude and duration of each drinking binge. It might be due to drinking different types of alcohol. It may be due to an intercurrent illness, such as a viral infection or gallbladder disease. Since it is 12 months after the time of significant elevation, it is difficult to perform tests to determine why it was elevated at that time.

If you have any additional questions now, please let me know now, and if you have any questions after reviewing the labs tomorrow, let me know at that time. I am on the computer every day, although obviously not 24 hours per day, and if I am away from the computer when you reply tomorrow, I will respond as soon as I am back online.

Dr. D. Love, Doctor
Category: Medical
Satisfied Customers: 17671
Experience: Family Physician for 10 years; Hospital Medical Director for 10 years.
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