Should I push my GP for a referral?

[Loujchar]

I was found to have high ALT (340) high normal AST on a blood test at a hospital for another condition (testing for Sjogrens, so far negative).

Hospital called me and they asked me to re run the LFTs bloods with my local GP a few days later and said if still raised GP should refer to Hepatology. I did so and ALT was down to 260. AST up to 68.

Local GP said no need to refer or to do anything and just retest in 6 weeks.

These levels seem to be quite high, should I be pushing for a referral earlier?

[tgk62]

When I had a rise in my ALT & AST my GP sent me to see a Gastroenterologist. My GE did several panels of testing to find I have Alpha 1 Antitrypsin Deficiency (I'm liver affected).

[DibsFox]

Hi there

My Husband had an ALT before Xmas of 2825 and an AST of 900. Bilirubin went up into the 70s. He doesn't drink and the Hepatolgist he was referred to is monitoring him as these levels have dropped right down to below 300. Tomorrow we will find out if they have dropped to normal. The Consultant has run loads of tests and they have no idea what has caused it as he take no medication either and does not have Hepatitis viruses ( another possible cause).

I guess that is the reassurance you would want too so I would say keep getting the Liver Function Tests done until they go back to normal. If they don't ask for a referral to a Liver Specialist.

My advice would be to monitor yourself for any fatigue and don't drink alcohol at all. I guess if you were on any medication you may have been told to stop. Again if not happy get back to your GP and Good Luck.

[Loujchar]

Thank you.

I have ongoing fatigue issues (have likely CFS/ME diagnosis on its way) as have been really ill past 8 months and we can’t find anything concrete to explain my illness. This is the first test that has been ‘wrong’!

I don’t drink and don’t take meds that affect the liver that we are aware of.

Thank you for your reassurance.

[AyrshireK]

Has anyone mentioned possible auto immune hepatitis? Have antibody tests been run. It seems you are being tested for auto-immune conditions with the Sjogrens and mention of CFS/ME - when you have one auto-immune illness it is common to have others and AIH can often cause symptoms similar to CFS/ME plus a number of folks with AIH also get Sjogrens too.

AIH commonly causes raised ALT levels, fatigue and more. Might be worth asking about.

Katie

[Loujchar]

Hi Katie

I have negative ANA at present but haven’t had any other autoimmune markers tested since this happened. I don’t have Sjogrens blood markers but I am awaiting a lip biopsy to confirm as apparently it doesn’t always show in blood

My GP brushed off the possibility of anything being wrong really!

[AyrshireK in reply to Loujchar]

What about Smooth Muscle Antibody (SMA) has that been tested.

High ALT indicates possible liver inflammation so something isn't right.

[Loujchar in reply to AyrshireK]

Not to my knowledge. I believe the hospital first ran routine bloods (FBC, LFT, immunology, Virology) and found the raised LFT. MY GP then ran LFTs again and nothing further.