Advice: can I drink moderately now? GGT/AST

Ok. My GGT was off the radar. Over 600. I was drinking very heavily earlier this year, due tolife issues and lack of responsibility. I have abstained for 4 weeks.

GGT is now 140. [should be <50. Was >600]

AST is now 42. [should be 40, was 72]

1. I plan to take another month off. It's not that hard really. I want to get the GGT down

2. I want to be able to drink moderately. I mean - 2 glasses of wine with a meal. Not every day. Weekends. Staying within limits

This is not a question of "Can you do that"? I know if I drink heavily again my liver probably will not be able to manage to process the alcohol and I will be in serious trouble.

I understand that I am lucky to have had my liver heal.

But - IF (and I know it is a big IF) I drink within recommend limits, and take days off, and maintain diet - am I putting myself at risk? For socialising and business a glass of wine is missed.

I will repeat my tests every 6-8 weeks. So I guess I will know if just drinking very moderately has caused my liver to react?

What do you think?

40 Replies

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  • I think there are enough non alcoholic drinks available for you to be able to socialise etc without having to drink wine. What is the real reason behind you feeling you have to go back to drinking?

  • Hi -

    The question isn't really about the psychology. I just want the scientific angle.

    As I said - I understand the psychological angle.

    I don't want to go back to drinking excessively.

    I want to be able to drink a glass or two of wine with a meal.

    And I want to know if that puts me in any significant danger.

    Thanks.

  • GGT at 600 is pretty alarming. your ALT and AST are'nt too bad, but still some damage has been done to your liver cells. I would think an ultrasound might be an idea?

    It takes 6 months for the liver to heal properly. Your GGT is telling you that you drink too much and too often. You really should re-think your life really, you have to change, most people slip back into their old drinking routines once they feel "safe" with tests that have come down. Don't fall into this trap, from what you have said your intending on drinking again. I were you I would stop fore-ever.

  • I had an ultrasound. It showed slight fatty infiltration of the liver.

    I fully understand what your are saying. Thanks. I appreciate what you are saying, and there is an element of truth to it. But, this is not specifically my question.

    That is - if a liver has *normalised* GGT/AST & ALT, and the patient has these checked every 2 months, can He/She *safely* drink within the recommended limit - ?

    Thanks

    Pauly

  • I would say NO, fatty liver is still liver disease, dont take it lightly! it can turn to cirrhosis if left to get worse.

  • Hi ralph - I'm not leaving it to get worse. I have changed lifestyle. I am asking if I can drink moderately now my levels are stablising, and if not now, how long to wait etc.... Thanks. One thing is how long for a fatty liver to repair itself? It seems like this is 6 months?

  • The fatty liver means your vulnerable to alcohol i should think, about 16% of the population have this, its genetic and nothing you can do about it. But you didnt say how long and how much you have been drinking for. Fatty liver to repair depends, but i will stick to the 6months I have suggested firstly, also when your tests go down it still takes longer to repair than them just going down. You will another ultrasound after you have stopped for probably 3-6months to see if it is getting better. Are you over weight, that can cause it too.

  • 6 months.... Ok. I think I should get the ultrasound repeated in 2 more months. Yes, am overweight

  • blood tests dont give any true indication of the livers condition you need a fibroscan

  • I did - I had slight fatty liver.

  • what was the score

  • what score?

    ALT is 42. GGT is 140.

    ALT was >70, GGT was >600.

    This is after a month of tumeric tea and all the other 'liver' fixing stuff

    (Pinterest has some great stuff on liver cleansing)

    Thanks

  • fibroscan score from 1 to 75

  • Hi

    I understand exactly what you are going through re. Alcohol. Obviously the best advice is to abstain, but the decision is yours. I abstained for just over a year and then decided to have the odd glass of wine when out socialising (just the one), and on birthdays etc. That was six months ago and I have kept to my plan. Blood tests last week all normal, and I have a US scan booked for next week, so fingers crossed. I don't think you'll find anyone who says "OK you can have a drink". Anyway good luck. Anne

  • What were your blood levels before? And what did you get them down to? And do you check up regularly? And did you have an ultrasound etc.?

    Questions questions!

  • My dr. told me that my liver problem is not from alcohol. not sure about yours I have pbc..but just because your liver tests are reasonable does not mean your liver has no damage. did you have biopsy? I would ask your dr. for advice they would know better.

  • I had an Ultrasound and it showed infiltration of fatty liver. My doctor thinks I cannot drink moderately - at least he doesn't want to advise drinking. Which leaves me in this kind of vague uncertainty about it all - if levels are down Can I etc...? I think I need to spend another month or two and then re-assess. Maybe I am rushing it. It's not that I want to drink excessively, I just am moving to a new city and want to know if I can have a glass of wine with new people etc..

  • I had an Ultrasound and it showed infiltration of fatty liver. My doctor thinks I cannot drink moderately - at least he doesn't want to advise drinking. Which leaves me in this kind of vague uncertainty about it all - if levels are down Can I etc...? I think I need to spend another month or two and then re-assess. Maybe I am rushing it. It's not that I want to drink excessively, I just am moving to a new city and want to know if I can have a glass of wine with new people etc..

  • I would say you've been lucky to get the levels down so quickly.. my advice as as on my previous response to you post is to abstain until xmas. If your luck continues your GGT levels may normalise.

    As others have opined-if you can get away without drinking then do so-I wouldnt use the 21 units as a guideline though-make it a couple of drinks a week. As Dr Michael Mosely says-there is no safe level of alcohol! Others have said that old habits tend to die hard and certainly true in my case.. I'm drinking nothing like I used to but I'm coming to the conclusion that I need to knock it on the head which as a wine drinker I will find very hard.

  • Thanks. Useful advice. Am moving to a new city & it's going to be very hard to socialise without being able to have a drink - yes, I know that sounds stupid. But I would just like to be able to share in a glass of wine or two. I think though that I do need another month or two as you say and then review.

  • yep do that and I think you'll be fine

  • I think the straight answer to your question is if you've stayed clear from alcohol for a substantial amount of time so that your liver has fully recovered, then yes i'm sure the odd glass of wine would do you no harm. If you have a healthy liver then the odd drink is okay. But your the one who knows your drinking habits and wether you can stick to this and wether its a wise idea to drink again. All the best.

  • Thanks. I agree. I am just wondering how to ascertain if the liver is healthy again. Seems like there is not a definite answer....

  • I think the thing to remember is that people will give you plenty of answers with all good intentions, but nobody on here is a doctor or specialist and are in no way qualified to give you a diagnosis or prognosis or anything (although it may seem like it sometimes lol). The best advice I can give you is go and see your doc or specialist and ask them, their the only ones who tell you if your livers fully recovered. And stay off google! ☺

  • the problem is that no doctor can tell for sure what state your liver is in without a biopsy or a fibroscan. Getting the scores down on an LFT doesnt mean the liver is healed. People are mistakenly thinking that going to the doctor and getting a good LFT is the green light to drink, its not! LFTs are a good way to find a problem once it is there. So if you get your fatty liver resolved, you will drink and get it fatty again in a couple of weeks? You surely need to start thinking alcohol isnt for you, like I have said fatty liver is liver diease, your susceptible through genetics.

  • At a presentation recently given by a Consultant hepatologist at a leading liver transplant centre he explained to us that once we start on a treatment plan for liver disease (be that medication, abstaining from alcohol, changing diet or whatever) first; we feel better; second; the liver enzymes drop; third; the histology of the liver improves. He estimated the first was quite quick, the second took about 6 months, and the 3rd took about a year. So far you 'feel' better, and your bloods are improving but are still not within normal range. So I would say stay off the alcohol until your bloods are within normal range, stay off for another 6 months after they normalise and check that at the end of the 6 months they are still within normal, and then another 6 months to ensure the liver histology has time to normalise - so about 1 year to 18 months with no drinking or perhaps after 6 months no more than one large or two (125ml) glasses of wine a week. You may find after abstaining for that long that the urge to drink has reduced and that you can be happy drinking less per week than the recommended units. You've been able to see scientific proof of what alcohol has done to your liver, hopefully that will be a reminder in the future of how to best give it lots of TLC. I still dont buy the argument that you HAVE to drink in order to be considered part of whatever social group you are in. Why not become the 'designated driver' when you go out, that might make you a very popular member of the group, save you ££££ and your liver will say thank you in a big way. :)

  • Thanks very much for your response. Yes, I have seen what damage has been done and appreciate your point. It's not a question of HAVE to but moreso how do I measure if the liver has repaired.

    "then another 6 months to ensure the liver histology has time to normalise"

    How do I check this? With an ultrasound?

    My ALT was mid 70s. My GGT was >600.

    After 1 month my ALT is 42 (should be <40) and GGT is 140.

    The doc was suprised how quickly they have gone down.

    If they are heading this way then in another month I hope they are both within range. GGT should be <50.

    The only things I need to know is:

    What tests do I need to do to establish if it has Fully Recovered.

    I may not drink again. I might have the odd glass of wine. I won't drink heavily.

    But this is not really what I am asking. It's more *how do I test to see if it has fully recovered*

    Thanks again.

  • Fibroscan or biopsy are the only ways, even a biopsy can be inaccurate if they place the needle in a healthy part of the liver. Autopsy is the only 100% way. Once you start researching alcohol and liver, you will soon realise technology isnt as good as we think. ultrasound should pick up on moderate to major damage, but again no guarantees. if you get your lfts down and get second clear ultrasound, that should mean you arent about to drop dead, but to carry on drinking would playing roulette with your health.

  • Hi Paul

    I have just read your other post and you were on 7/8beers a day for 10 years. Thats more than enough to be at End Stage. I think you also need to reconsider your outlook on the tests you have had, an ultrasound isn't very good at determining damage and LFTs are good for measuring an inflammed liver whilst its inflammed. Your reading of GGT 600 is the highest I have seen apart from alcoholic hepatitis. It means your liver has been swelling up all the way from the normal ranges, that could be years, swelling causes Fibrosis and Fibrosis can go to cirrhosis if the cause isnt stopped. What all this means is that even if you get all your bloods to normal ranges and get the fat out the Fibrosis will still be there, some can be reversed some wont. So even if you stopped for 10 years and then went back to drinking you will be on a fast track to cirrhosis because of previous scarring. I have seen a fair few people on other forums now regretting falling off the wagon after years of sobriety and now find themselves in cirrhosis. What you will need is a Fibroscan or perhaps a Fibromax blood test which can measure the Fibrosis, LFTS and ultrasound WONT measure Fibrosis. People with cirrhosis can have normal LFTS once they stop drinking, you need to realise at the moment your trying to dodge a bullet! You shouldnt even consider drinking again with your history . Sorry to lecture you ,but its the gravity of the situation, getting your bloods down is the first part to stop further damage, you then need to survey the damage done, your GP probably wont have a clue. You may have to take this into your own hands and get extra tests.

  • This is really a question for your medical team, not for a bunch of random though often well-informed lay people on the internet.

  • disagree, he has had liver disease end of story. a bit like someone asking if they can still smoke after a heart attack, you dont need need a PHD to give this man some advice. Pitty you didnt actually add anything useful to the discussion

  • GGT of 140 is still over the normal range (normal range = 0 to 50 as i understand0

  • Definately NO!

  • Definately NO!

  • " It's not a question of HAVE to but more so how do I measure if the liver has repaired."

    You can't. As Ralph says the most accurate way would be a biopsy, but even that would only give you an answer if you had already had a baseline a biopsy while the damage was bad, which you didn't.

    Your baseline results for comparison in the future are what you have already: GGT, liver enzymes etc.

    I think what you are actually asking is, is it ok for me to go back to drinking. The answer is in your hands really. If you are relaxed about risking damaging your liver again by either drinking again too soon or drinking more than your liver is comfortable with, then go ahead and start again whenever.

    If you are anxious at all about further damage, then don't drink at all, or don't drink for at least another 6 months and then start again slowly.

    You ask how to check your liver health. That's dependant on what you can persuade your doctor to do within the NHS, which would most likely be some blood tests a few months down the line - if you ask them. I doubt your case warrants an ultrasound and it certainly doesn't warrant a CT, MRI or biopsy. There is no magic cure the doctor can give you for alcohol damage, the cure is in your hands and yours alone. Future liver monitoring is pretty much only given to people with liver damage that can be clinically measured, or people with chronic liver disease.

  • So did u find out what your fibroscan score from 1to 75 is?

  • Is your liver damaged in any way? Because if it is then the short answer would be No.

    My husband, however, had high GGT and it is now completely normal (he stopped drinking when cirrhosis almost killed me, but now consumes perhaps five cans of beer a week with no ill effects.

    With that said, I can't help but wonder why you appear so keen to return to alcohol? It's the "emotional crutch" that nearly got me killed and I would personally never drink again even if I thought a couple on occasion wouldn't hurt.

  • Personally I Would not drink. I was never a drinker ( 2-3 pints a month ) having now had a liver transplant I would never dream of putting my health back in danger. It's a decision you need to think long and hard about..

  • My AST is 62, ALT is 63. I got denied for life insurance. I freaked out saw a doctor who wants to retest and come back in 2 weeks for a new blood test and a scan. I can't drink during the week period

    I was drinking 25-30 vodka sodas about 5 days a week. I am 49 and live alone. My wife left me years ago and my drinking got worse. Going to bars and hanging with other alcoholics.

    I do work out but not everyday. I am disgusted bc I don't know if I can not drink for even just 2 weeks. I usually drank after my workout.

    Any advice. I know I sound pathetic.

  • I went to the doctor last week and i already knew my liver was damaged due to heavy drinking but not that bad i only drank heavy for 3 years just heavy beer i always stayed away from the vodka and heavy drinks like that well i went to the doctor they said my liver enzymes were sky high over 600 my spleen was enlarged but the doctor said my liver isnt damaged due to drinking but i would drink for 2 days straight non stop and take a little break then go back did your doctor say if the high liver enzymes were due to drinking cause i need answers man i went to the hospital lastnight and my liver enzymes were around the 300 range i plan on eating better getting my body in shape

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