Blood test interpretation

[H1ghtower]

Hiya, guys. Not mentally at my best recently so my GP came and did a blood test to check for progression of my end stage cirrhosis. Does anyone know what i should be looking out for in the results? A link to a sitewhich explains in laymens terms would be great or maybe i could post the results on this site? Thanks in advance

[Hidden]

Lowering Albumin is not what you want, bilirubin going higher is not what you want. Please post. Your enzymes should be ok because you have stopped drinking.

[H1ghtower in reply to Hidden]

Thanks Ralph my man. Sup fella. I got my results back via a telephone call to surgery a min ago and my GP is off till Monday so the receptionist said she could give me the basics. something about folic acid deficiency which they,ve given me an extra prescription for and something about cholesterol although she prob didnt know what the results where for so i asked for her to email me them. She said i,d have to wait till Monday for the full results as its against data protection via email as its classed as insecure apparently.

[lola800]

I'm in same situation...ESLD. I know something about liver function tests, what they mean. Also ammonia levels and hepatoencephalopathy. I can tell you more, but don't want to alarm. Suggest going to americanliverfoundation.org and you can contact them personally and they will respond to you quickly and give you links. Another good resource is Cleveland Clinic website, liver section, has good info. And NIH nih.gov. Also, google "Lab Results" and there are many sites that'll tell you exactly what each component in a liver panel blood test means. High ammonia levels will definitely cause confusion, depression, alterations in levels of consciousness and can also result, as they did for me, in hepatoencephalitic coma (4x) which can be fatal. Go to emergency room if you feel, or others note, mental changes, extreme fatigue, etc. Good luck.

[Avux99 in reply to lola800]

Hi Lola

Don't know if you are in the UK or US (given the American website links) but in my experience (in the UK) they don't check Ammonia blood levels as part of a standard Complete Blood Count?

I know this as I myself am experiencing encephalopathy type symptoms on and off but all bloods thus far have been in range so I'm fine apparently (enlarged Liver on CT 3 years ago & other symptoms means I know what I'm suspecting...)

...according to some people on other forums Ammonia levels can be difficult to get a handle on.

I've never had mine checked and indeed when I asked the GP the reply was "I don't think they just check for Ammonia"

How/where did they check your Ammonia levels?

[lola800 in reply to Avux99]

Hi! I'm in the US, and I recently learned, after my liver transplant in Atlanta, that not all doctors/hospitals give the test for ammonia levels the same credibility. After living in Orlando, FL, I moved to Atlanta and within 1 year had a liver transplant here. In Florida, ammonia level tests were considered to be reliable and were done across the board. (I was in a hepatoencephalitic coma 4x in Fl). In Atlanta, it was an extremely elevated ammonia level that took me to transplant. However, after the transplant, when complications from the transplant arose, the doctors here said a) ammonia level blood tests were not always reliable and b) that the physical test (flapping of hands, etc.)for ammonia level would serve the same purpose...they didn't do ammonia level tests. I'm not so sure the blood test should be eliminated as the test, when it was taken in Florida and at one hospital here, showed highly elevated ammonia levels that are indicative of coma, and since coma mortality% is way high, I kinda think it should be done. Or why not both.

Do you know who could counsel me on a post transplant complication? Apparently, 24 mos. out from transplant, my liver function tests shot up to AST/ALT 400-600, high GGT 645 (now it's 1018), elevated alkaline phosphatase (216). They told me "somehow" I'd gotten de novo (after transp.) autoimmune hepatitis. My new liver was already cirrhotic. They said "it's nothing you did and it's nothing we did." They've been dubious about being real open about how this happened (this was in 8/20/2013). At this time I was rid of the virus (I was hep B virus seroconversion). I continued on entecavir for 10 mos post transpl. and HbIg monthly infusions. Now, they're telling me I have a recurrence of the Hep B virus (the reason for transplant) My medical records were changed this past month to show a diagnosis of Hep B on 8/20/2013 - wasn't there before, and no one told me until this past week of that finding. They are requesting specific blood tests for Hep B antibodies/antigens and DNA/quantitative for Hep B. I feel like they're covering their ass, but not sure.

[Avux99 in reply to lola800]

Hi Lola thanks for the input re: Ammonia levels, so it's as I expected, if I'm reliant on that test alone I may as well wait until I'm almost comatose through HE before bothering. May as well just take lactulose and/or reduce animal protein etc for what use the medics are being.

Re: your situ, from what you say it does sound like the medical fraternity could indeed be covering their ass or arse as we say over here

If you aren't already I'd be asking for copies of everything.

Don't know the situ in the USA but over here we have something called PALS, an independent patient liaison service. And I suppose if we really wanted to kick up a stink we always have the last ditch option to go public (writing to government, newspapers etc) if there is evidence of scandalous treatment and or neglect. It does happen.

Best of luck & good luck with the ongoing fight! Regards, Tim

[H1ghtower]

Hiya, Lola. Thankyou very much for that...i didn,t know you could detect the hepatic thing in blood so i will definately check the links you sent me. The Americans, or so i,ve read, are way ahead of the English when it comes ALD so it makes sense to check it out. Which scoring system do they use to diagnose how bad the cirrhosis is? We seem to have at least 3 in this country that the consultants use.

[lola800 in reply to H1ghtower]

Hi. It varies here in US. It varies between states even (see above comment) and doctors. The Transplant Team in Atlanta does not do ammonia level blood tests. Its hard to get info from drs here. They told me my new liver (2 yrs after transplant) was cirrhotic in 2013. The diagnosis of cirrhosis was made via liver biopsy, the gold bar here in states for the truest rendering of liver status. I don't know how bad the cirrhosis is...I don't even know for sure if they can tell. I do know they told me in 8/2013, that re-transplant was necessary, fairly quickly, and that never happened. Head Doctor on Transplant Team reneged on that with finality, much to the bewilderment of other drs. and nurses. No re-transplant, no further questions. I don't want to be re-transplanted now, at my age, anyway.

I've always trusted medicine in UK more than medicine in US. Here, profit can be a huge motivator due to our health care system.

[H1ghtower]

Sorry, its probably me being thick, but, whats ESLD?

[lola800 in reply to H1ghtower]

No, you're not being "thick". I've had liver disease for 20 yrs and only learned of ESLD in 2011. End Stage Liver Disease.

[H1ghtower]

Thanks for that, its the same in this country by the way. I was told i was child pugh c by the specialist at the hospital and apparently we have 2 scoring systems in this country and neither are the pugh scale...suppose it could of been a sneaky way of getting the patient to look up what it means as i wasnt exactly taking my mortality seriously at the time. I did learn quite a lot about my condition in the process of finding out though.