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Dr. D. Love
Dr. D. Love, Doctor
Category: Medical
Satisfied Customers: 17679
Experience:  Family Physician for 10 years; Hospital Medical Director for 10 years.
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On 17th March the out of hours GP referred me to my local hospital

Resolved Question:

On 17th March the out of hours GP referred me to my local hospital as I was in acute pain, had blood in my urine and frequency and pain urinating. My pulse was also very fast. Seen at A&E, where I was given IV antibiotics, fluids and oral pain relief. It was suggested I should think about admission and mentioned a scan (I assumed to check that there wasn't a kidney stone) but due to circumstances at home this was not possible and the doctors discharged me without any stark warnings, except to tell me to follow up with my GP and return to them if symptons persisited. I completed the course of oral anti-biotics and followed up with my GP 1 week later. At this appointment she said my urine sample indicated there was no infection but my glucose levels (on the testing strip) were as high as could be indicated. Nurse took bloods but, when I phoned for the results I was told to come back in again as these had not been fasting bloods. New fasting blood results received yesterday and show serum gamma gt level 78U/L & alt/sgpt serum level 76U/L; serum c reactive protein level is 8,2mg/L fasting glucose 11.6mmol/L - GP stated my glucose levels have been significantly high for a long time. I'm now very concerned as I was sent off home from this rushed consultation with only the promise of an appt at the diabetic clinic in 4-6 weeeks time. No-one checked my BP. I've been taking 10mg of Lipitor for several years now and I have had gall bladder disease (lots of grit rather than large stones) for approx 18yrs and been hospitalised for a week due to a blockage in my bile duct, approx 7-8 yrs ago. I drink very little alcohol and (although I smoke when on holidays) I generally don't smoke. I am about to turn 50yrs old and have been really addressing my diet & (to a lesser extent) my exercise in the past 2 weeks since this all kicked off. Should my GP have changed my statin because of these liver emzynes results? Should I insist on seeing her or someone else urgently or wait for the diabetic clinic to assess me? I am supposed to be hosting a weekend celebration with 20 friend for my silver anninversay, this weekend. I ahve no issues with abstaining from certain foods and alcohol but I'm so upset and anxious I'm finding it hard to function.
Submitted: 2 years ago.
Category: Medical
Expert:  Dr. D. Love replied 2 years ago.
Did they check blood tests while you were at A&E?
If so, were the liver tests normal at that time?

Customer: replied 2 years ago.

Yes, they did take blood in A&E. It was fed back to me that there was no issue with glucose, at that point, either in my urine or bloods (although I had been in pain for some time and hadn't eaten for at least 12 hrs previously). No-one commented on liver function so I'm not sure if that was screened or not. Forwarding letter to GP didn't make any comment on liver tests.

Expert:  Dr. D. Love replied 2 years ago.
Thank you for the additional information.

It is likely that a general chemistry profile was checked while at A&E, and if so and the liver function was normal, then this single mild elevation of liver enzymes is less concerning.

It is important to note that the liver enzymes are very sensitive to conditions that may affect liver enzymes. WIth active inflammation of the liver, the AST and ALT can increase into the 100s or 1000s. An elevation in liver enzymes that is up to 5 times the upper limit of normal for the lab is considered a mild elevation.

Therefore, if the liver was normal three weeks ago and had this level of elevation in your GPs office, there is a good chance that this is a minor issue that will resolve spontaneously. Therefore, it may not be necessary to stop the Lipitor.

If the elevation in liver enzymes persist or worsens, then it may become appropriate to stop the Lipitor. But at this point, it cannot be said that your GP should have stopped the Lipitor. Some doctors may have done so, but this is an issue for which different doctors may have different opinions.

Regarding the blood sugar, it would be fine to wait until your appointment to be seen in the diabetes clinic. Until you are seen, it would be appropriate to avoid concentrated sugars and alcohol.

If you have any further questions or need additional information, please let me know.

Customer: replied 2 years ago.

Thank you for this. My GP had said she would normally expect to see these sort of liver test results in a chronic, heavy drinker which (as someone who drinks very little alcohol), alarmed me.


Would you comment on the elevated renal function result I mentioned (serum c reactive protein level HI 8.2 mg/L.) My GP said that my kidney infection was now clear and all the other renal function tests are normal, so what is the significance of this reading which I'm told is high?

Expert:  Dr. D. Love replied 2 years ago.
The C-reactive protein (CRP) is not a renal function test. It is a non-specific test of inflammation in the body. It is not surprising that a test of inflammation is elevated to this level in someone with a recent infection. It is only considered a mild elevation until a level of 10. If this level persists, then that may be of greater significance, but this may resolve with time.

Dr. D. Love, Doctor
Category: Medical
Satisfied Customers: 17679
Experience: Family Physician for 10 years; Hospital Medical Director for 10 years.
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