Dumbfounded by results of blood tests. New to this.

[Tearsofaclown]

When I received shocking news about my blood test results, I found it hard to take in the information. I don't drink alcohol, so cannot understand what can be wrong with my liver. Does anyone know if prescribed medications can trigger the problem, and what does an ALT, GGT & LDH level that has tripled indicate? All information will be gratefully received, Thank you.

[papataal]

sorry to hear this.. Prescribed drugs can and do efffect the liver, especially if taken over a long time, certain meds are worse then others, also other issues like weight/diet etc. Did your consultant not give you an indication of what is causing this? And how bad is it, the Liver is remarkable in its healing, ask your GP or Consultant for more answers, the better informed you are the better action you can take.

Hope you get better.

[Koinonia]

Sorry you've got problems. There is a liver disease called "Autoimmune hepatitis" which has nothing at all to do with alcohol. I have it and have never touched alcohol in my life. It is to do with your immune system attacking your liver. There is a dedicated Forum for those with it which is extremely helpful--you may like to go there to read through some of the posts. If it turns out that you do have AIH it's not the end of the world---there are many treatment options once diagnosed.

I suggest you go back to your Doctor for more info. as there are other possibilities too.

[Bolly]

Sorry to hear you have been given this shock. Can I ask what symptoms took you to the GP and what tests they ran.

ALT is commonly elevated if there is liver inflammation, but can be raised in other conditions too. GGT also can indicate a number of conditions not just liver, but diabetes, weight issues, heart problems, kidney function. Elevated LDH can indicate a few things; liver, heart, anaemia, muscle trauma.

As koinoinia pointed out, its not just alcohol that the liver doesnt like, but long term use of some medications, diet, viruses, autoimmune conditions, iron overload, etc etc can cause stress on the liver.

Can you give us a bit more background to your overall health and medical history?

What has the GP suggested as a next step to you, now you have the test results.

[Hidden]

Dear Tearsofaclown,

I hope that you’ll find the following information about the Liver Function Test (LFT) helpful.

The LFT usually consists of up to 6 specific elements, therefore there will be 6 different names with the corresponding reference range in brackets, along with the actual individual test result.

The results of these tests are not ‘gold standard’, and therefore further tests; physical examination; looking at the patients medical history and listening to the patients symptoms, should all be part of the evaluation for a diagnosis. NB - the reference ranges will differ from lab to lab, depending on the analyser that is used.

I don’t know whether you’ve come across this publication ‘Liver disease tests explained’, on our website yet, but please click on the following weblink: 79.170.44.126/britishlivert...

If you click on ‘download’, may I then direct you to page 13, where we illustrate the 6 elements of the LFT. One of these elements is the alanine aminotransferase (ALT) enzyme, which is found in the cardiac and skeletal muscle, but primarily in the liver. When there is any e.g. trauma/injury/infection* to the liver (or the body), this enzyme will leak into the bloodstream.

*Even if for instance, you had suffered from a recent cold virus the ALT may well elevate, and the result fall outside the reference range.

Another element that you’ve mentioned in your ‘post’ is the Gammaglutamyl transferase (GGT or GammaGT), and this is often elevated due to, e.g. certain medications, smoking, fatty infiltrations, alcohol consumption. If the ALKP (alkaline phosphatase) is elevated with the GGT, this can sometimes point to bile duct obstruction (cholestasis).

The GGT enzyme is also found in the kidneys, pancreas and prostate gland. Please click on the following for further information: labtestsonline.org.uk/under...

These elements within the LFT can fluctuate very quickly, and they’re not necessarily suggesting that the liver is damaged, but indicating that the liver is ‘irritated’ by something.

I like to use the word ‘irritated’, because when the word ‘damage’ is used, there can be a huge misunderstanding. I also explain that there can be ‘temporary’ damage to the liver, as well as ‘permanent’. Therefore, when the liver is inflamed (hepatitis) due to an acute infection, e.g. Hepatitis A, the liver can be referred to as being temporarily damaged. The inflammation (hepatitis) will subside as the body rids the virus.

I also mention ‘activity’ within the liver, and I usually use this word when there isn’t a diagnosis, and all we know is that there is some activity in the liver which we have to determine the cause of.

Even when there are some abnormal results in a LFT, it doesn’t necessarily mean that there is a problem with the liver, but can indicate that there is something going on in another part of the body.

As you probably know, the liver has the capability of renewing (regenerating) itself, but this is only under certain circumstances – obviously, if the liver cells have died, and the liver has become cirrhotic, the liver will not be able to repair this permanent damage.

May I please direct you to this website which I refer to, as I find the information invaluable, (I have copied and pasted a section below): labtestsonline.org/understa...

OTHER FACTORS AFFECTING TEST RESULTS

"Laboratories will generally report your test results accompanied by a reference range keyed to your age and sex, if appropriate. Your physician then will still need to interpret the results based on personal knowledge of your health status, including any medications or herbal remedies you may be taking. A plethora of additional factors can affect your test results: your intake of caffeine, tobacco, alcohol, and vitamin C; your diet (vegetarian vs. carnivorous); stress or anxiety; or a pregnancy. Even your posture when the sample is taken can affect some results, as can recent heavy exertion. For example, albumin and calcium levels may increase when shifting from lying down to an upright position."

I just wanted to advise you, that there are over 100 liver conditions, and they are not always easy to diagnose, and sometimes a barrage of tests have to be undertaken, as a process of elimination, to determine a definitive diagnosis.

The other test that you mentioned was the LDH (Lactate dehydrogenase), but this is NOT part of the LFT. Therefore, please click on the following for further information: labtestsonline.org.uk/under...

I don’t know how it’s been left with your GP, but in answer to your specific question, ‘yes’, medications can influence the blood results for both the ALT and the GGT. If both of these readings are three times more than what they should be, then your GP should be following this up with repeat bloods and an ultrasound scan; but in the meantime they should be discussing with you what the main cause of these elevated results could be related to.

Once all the test results are through, the GP will be able to assess as to whether or not you need to be referred to a specialist.

I do hope that this has been helpful to you, but please feel free to give me a call on the Helpline: 0800 652 7330, or email me direct at: [e-mail]

Best wishes,

Sarah Tattersall

Patient Enquiry Officer

British Liver Trust

[Cjh1968 in reply to Hidden]

How interesting Sarah. I've just received blood tests back for calcium and liver and both were abnormal. Could these be connected ???

[debi_p]

Could also be Primary Biliary cirrhosis

[Tearsofaclown]

THANK YOU EVERYONE, FOR ALL THE HELP YOU'VE PROVIDED ON HERE, FOR ME. IT IS TRULY WONDERFUL THAT EACH OF YOU HAS TAKEN THE TIME TO REPLY, AND OFFER ADVICE.

I DO FEEL REASSURED TO KNOW THAT SO MANY OF YOU HAVE THOUGHT TO REPLY, AND I WILL MOST DEFINITELY BE LOOKING INTO THINGS WITH A CLEARER VISION, FROM READING THESE REPLIES. ARMED WITH ALL OF THIS, I WILL NOW HAVE THE CONFIDENCE TO ASK QUESTIONS.

BEST WISHES TO YOU ALL, AND THANK YOU, AGAIN,

TEARSOFACLOWN.

[zZtopff]

Hi one of my family members had the same shock re liver tests. Paracetamol does affect liver function. He did take a lot of paracetamol for headaches, so stopped all paracetamol and the small amount of alcohol he drank (hardly any) and within a year his levels were back to normal. He was tested first for hepatitis and had a scan for fatty liver, but both were negative.

[Tearsofaclown]

Thank you. This sounds very reassuring, and I hope to have a similar outcome from my ultrasound scan. I guess that anything we take that is considered alien by the liver will cause it to react, so perhaps paracetamol is one of those alien substances, and I'll think twice before I take any more of those. Thanks again for responding, and for this supportive reply to my enquiry.

Kind Regards,

Tearsofaclown.

[Mandie4711 in reply to Tearsofaclown]

HiI just read your post. I used to be an Alcoholic but not drank for 12 years. My liver was getting better but I broke my hip in January and was taking Paracetamol for the pain. When I had blood tests done they said my liver functions were higher and to re test in 3 months. I used to take ibuprofen as I’m sure I remember dr saying it’s better for the liver so now I’m not sure what to take. Paracetamol or ibuprofen as I have a fatty liver but seems strange my liver functions were higher after taking Paracetamol. Any advise on which you consider to be the safest.

[Hidden in reply to Mandie4711]

Hi, this post is 8 years old so you may not get a reply. If you have a liver diagnosis please do speak to your own doctors about appropriate pain relief medication and what is safe for you to take. It is really important.

[Bolly]

I found an NHS guideline on the internet that described an ALT x3 normal level as a 'minor' elevation. Not sure about that! However the recommendation of monitoring this is for the patient to stop all alcohol and all non-prescribed meds (i.e painkillers) and then re-do the blood test in 4 weeks. Are you on any prescribed or over-the-counter medication?

If the patient also has a GGT result elevated x2-3 above normal, it may indicate 'fatty' liver (if you dont drink alcohol). But typically the AST will be normal - did you have an AST (aspartate aminotransferase) result? When I have LFTs done I never get an AST, only the ALT and ALP (confusing isnt it!)

I'm puzzled as to the LDH test - I've not heard of this being run if there is a suspicion of liver damage, as its not particularly useful on its own. As far as I know its a test done to asses general tissue/organ damage and is more commonly used if a patient is suspected of a heart attack. But then I'm not medically trained, just what I've picked up over years of tests for liver damage!

[Tearsofaclown in reply to Bolly]

Thanks for responding to my question, and for your helpful advice. I have my scan today, so am hoping that all will become much clearer, from that.

Although I never touch alcohol, I do take huge doses of pain killers for other conditions. I am guessing it could be those, which have created the problems. My doctor didn't seem to think so, when I asked and said there is a serious problem. She wasn't prepared to 'assume' what it was, but told me I'd need lots more appointments. Nevertheless, I won't know anything until later today, and my anxiety can then be put to bed.

I do hope that your condition will improve, and I do appreciate that you have many more problems than I do, so your kindness towards me is gratefully received.

Best Wishes,

Tearsofaclown.

[Deborahking in reply to Tearsofaclown]

Just joined , and looking to see how your test came back? I just got a high reading on a liver test and am waiting for other test to come back. I see this was 4 yrs ago but hoping you are still part of the group and able to replie. My test was a GDT I think the level was 144 2 yrs ago was 117. I am not very sure about any of this. But will talk with theDoc. In the morning. She left a message and I didn't get to talk to her so I know very little about what's going on with my liver... trying not to worry, I came a cross this site and found the info. Helpful. Feel a little scared. I had thyroid cancer over 20 yrs ago and take a high dose of synthroid , not sure if this would affect my liver??

Thanks

[barneythebulldog]

If anyone has lung or liver issues make sure they test for Alpha 1 trypsin. British doctors are not using this test sufficiently...you results will have two letters after them which indicates if there is a problem. The letter z indicates you have a bad gene and carry the condition. I'm MZ, brother and niece are SZ which is 2 bad genes. Zz is not good.