New member - Hello

[Babylon214]

I have a family history of liver disease. Father passed at 67 liver tumour. My GGT is 118u/l. I do not smoke and do not drink alcohol. I had cholecystectomy when I was 25 due to gall stones. Gestational diabetic with both pregnancies. Glucose intolerant but not diabetic. Ultrasound normal so I'm really unsure why the GGT level is high. I have a healthy diet and am not overweight yet my serum cholesterol and serum ferritin is also high. FIB - 4 normal 0.74, Hep c and b normal, AST 37. Wonder if anyone has had similar experience or can advise possible cause?

[AyrshireK]

Has any mention been made of investigating the possibility of genetic haemochromatosis? In light of Dad passing with a liver tumour and your high ferritin levels the two may be linked.

There is information on this condition at :- britishlivertrust.org.uk/in...

Katie

[QuietButBold]

I believe Katie's consideration about haemochromatosis is a strong one among a liver health history family.

However, without attempting to "diagnose" I am reflecting upon and sharing my (female) family's (slightly less commonplace) history and lived experience here - what I am about to suggest you potentially discuss with your GP; might not be uppermost in your thoughts (or that of your GP) - due to your family's understandable sensitivity around liver health matters.

In some women, each of: raised ferritin / raised ggt / raised cholesterol (not necessarily accompanied by excess weight or incorrect diet) / glucose intolerance (but not to the point of diabetes) / higher incidence of gestational diabetes / and gallstone disease ...may be the hallmarks of some women living with polycystic ovary syndrome (PCOS).

For some PCOS women there is also a higher tendancy towards fatty liver - as a possibility also worth monitoring.

PCOS is not a "medication" treatment condition - more; a nuanced ever-refining "management" situation (not unlike the situation with liver health).

There are some potential PCOS-related health outcomes a GP may wish to more vigilantly monitor (to ensure following lifestyle choices guidance alone is achieving the desired goals - pretty much the usual things reviewed at a 5 year health check).

Endocrinology research has suggested PCOS women have a normal life expectancy - so women should be told about that point of understanding!

The diagnostic "murk" can start to arise in that ferritin and ggt are known to potentially impact each other (you can think of it as; they can have the effect of mutually reinforcing each other - upward). This, traditionally, also could indicate "inflammation" often more readily associated by clinicians with initially considering / excluding e.g. rheumatoid arthritis, or an over-active thyroid, or perhaps a particularly strong response to e.g. a COVID-19 infection or hepatitis etc. ...the potential of PCOS may not have been nearly as high on a Clinician's radar.

PCOS is a life long condition (affecting circa 1 in 8 women) and your GP should be able to rule in / rule out (for you) the likelihood of PCOS.

There is good information available about PCOS on NHS websites (which might either help shape a suitable conversation to have with a GP, or the information might quickly help you to discount my suggestion - end of story).

If it were to be PCOS-related; your GP should be able to review management suggestions, with fresh insight, applied appropriate to age group health choices etc.

For instance, it would not be surprising if a GP also might want to double-check some other potentially attendant factors e.g. how well your body seems to manage its vitamin D levels (more recent research has highlighted low vitamin D may (for some PCOS women) exacerbate their symptoms of PCOS, including insulin resistance, among other things).

PCOS impact can be intertwined with endocrine maintenance and hence, the potential link to dysregulated liver metabolism / blood sugar / cholesterol etc. (All rather a tangled feedback loop).

If a GP does not seem that knowledgeable about PCOS, if you were already to have access to a Hepatology Dr - they would more likely be knowledgeable in this area.

[mickeymouse42]

I know someone with a similar history who had very high ferritin levels and subsequently had gall bladder removal.

She self diagnosed haemochromatosis with an online DNA test and then got access to venesection treatment (removing blood regularly until ferritin n levels were reduced).

Haemochromatosis appears to be linked with cholestasis (slow transport of bile acid) which leads either to bile acid blockages in the bile ducts or gallstones in the gallbladder. A common sign of cholestasis is pruritus (itchiness) where there's too much bile acid in the blood stream.

[Sunnyskies33]

I would ask to be tested for genetic Hemochromatosis to rule that out. There is treatment for that if you have it