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Dr. D. Love
Dr. D. Love, Doctor
Category: Medical
Satisfied Customers: 17672
Experience:  Family Physician for 10 years; Hospital Medical Director for 10 years.
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I have been through an extremely

Resolved Question:

I have been through an extremely difficult four years involving depression, back problems and excessive behaviour with my 15 yr old daughter who has stolen a great deal of money from me - around £4,000. I have always had a few glasses of wine a night but however are now drinking more. My daughter was taken into care approximately 10 months ago which I found extremely distressing. I was unaware that my alcohol consumption had increased. My Doctor took my bloods approximately a week ago and the enzyme readings had jumped from 80 last June to 120 this May. He stated that this was serious and that I could have cirrhosis. I was then told that he had requested an appoint and they had refused as I was drinking alcohol. However I have had two scans in the past and neither had shown any damage. Please could I have your advice on this matter. MANY THANKS Caroline XXXXXX

Submitted: 2 years ago.
Category: Medical
Expert:  Dr. D. Love replied 2 years ago.
It will help if you could provide some further information:
Could you provide the results of all of the liver tests?
Are you currently taking any chronic medicines?

Customer: replied 2 years ago.

I will have to call my surgery to confirm which I have just done. My serum phosphate is 1.91, alkaline phosphate 313 and gamma GT 1208. I am also suffering with severe depression which I am taking two doses of efexor 75 twice daily. This is because I am unable to work due to a extremely painful back. I am taking codeine, ibuprofen, solpadol. zydol and Neurontin 100g for the pain

Expert:  Dr. D. Love replied 2 years ago.
There also should be both an AST and an ALT, both of which are enzymes (you do not say which is the 120 that you mentioned in your original question). There should be a bilirubin, total protein, and albumin level. There may have been a prothrombin time (PT). Do you also have these values?

Customer: replied 2 years ago.

I will have to call my surgery once again. The gamma gt is 1208. There is no result for the AST. ALT is 38, bilirubin11, total protein 68 and albumin level 36

Expert:  Dr. D. Love replied 2 years ago.
What test were you referencing in the original question that was 120?

Customer: replied 2 years ago.

The original test results of 120 was a mistake. This is actually the gamma separate gamma gt 1208?

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

If the only abnormality is the GGT of 128, then it is unlikely that there is cirrhosis. It is difficult to be specific based solely on blood work, and the information is incomplete since the AST is not available. However, when the only abnormality is an elevation of the GGT, it is usually not a serious level of liver disease. It is more likely to be inflammation of the liver related to the drinking, but unlikely to be cirrhosis.

The GGT is very sensitive, so can become very elevated from relatively minor levels of liver disease. The AST and ALT are better measures of significant liver disease. And with cirrhosis, there is also usually some level of liver dysfunction, which would typically cause an elevation in bilirubin or other abnormality, and these values are OK.

Since the GGT is increasing, it is appropriate to quit alcohol. Limiting alcohol may help, but it is a better test to completely quit alcohol to see if the liver enzymes return to normal. I ask about the medicines that you are taking because one of the other possible causes of liver enzyme elevation is a reaction to medicines. Certainly, the alcohol is what is seen as the most common cause of this pattern, but the paracetamol in the pain medicines can also irritate the liver fairly often, particularly if taken frequently. Several other of these medicines also can cause liver enzyme elevation less often, including the Effexor, ibuprofen, and Neurontin. If you only limit the amount of alcohol and the liver enzyme does not return to normal, then it does not clarify if the alcohol is the cause. But if you completely stop the alcohol, then it will better clarify the role of the alcohol.

So, it is most likely that this is inflammation of the liver related to alcohol intake and not cirrhosis, but the only way to know with certainty is by further evaluation or by resolution of the liver enzymes with quitting the alcohol. If you think that you cannot completely quit the alcohol, then it would be appropriate to pursue further evaluation. If unable to achieve that evaluation in the NHS, it would be appropriate to be seen by a private consultant.

If I can provide any further information, please let me know.

Customer: replied 2 years ago.

The gamma get is not 128 it is 1208 which is significantly higher. That was what my Dr was so concerned.

Expert:  Dr. D. Love replied 2 years ago.
I'm sorry; that was a typo. I understand that it is 1208, but if the AST and ALT are both normal (and you did not have the AST), it is still much more likely that it is from inflammation of the liver from the alcohol, regardless of the level of the GGT.

Customer: replied 2 years ago.

Thank you. I feel that I understand matters more now. But I do think I need to cut down my alcohol intake drastically.

Expert:  Dr. D. Love replied 2 years ago.
I agree with that. As I noted above, it would be better if you could completely eliminate the alcohol intake.

Dr. D. Love, Doctor
Category: Medical
Satisfied Customers: 17672
Experience: Family Physician for 10 years; Hospital Medical Director for 10 years.
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