High GGT but ultrasound clear? - British Liver Trust

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High GGT but ultrasound clear?

briccolone profile image
48 Replies

Hi all, new to this but am greatly encouraged by the various posts here.

Thought I'd add my 3 penneth worth for others new to the murky world of the liver...

I had a random blood test last september in Italy which showed high GGT(188) all other liver functions were normal. OK I'd been drinking the vino all week prior so it could have slewed the test but 188? Took the decision to stop drinking and see what happened. About one week later met a friend and had one sip of cava and felt a bit strange-not drunk but decidely unwell. Stopped drinking for a month but during this time felt terrible-realised later this was PAWS symptoms-I'd never heard of it! All kinds of liver pain and pale stools etc. Took about 6 weeks to clear up and by all accounts I got off lightly. Had some blood tests done in UK all normal but no GGT...Just before xmas had a couple of glasses of wine with water and no major issues. Had some wine over xmas-a couple of glasses-again no issue. Then in January after celebrating wifes birthday-had a few glasses of wine-next day quite a bit of liver pain. Decided to lay off the wine for a few months-at this time still had issue with pale stools and then beginnings of itchy skin-mainly on lower legs-calves/ankles-not too serious though. Arranged a visit to the doc who then did another blood test-this time with GGT. Test came back at 215 despite not drinking for a month.. At this point doc ordered an ultrasound-just had results this week-completely clear! not even fatty liver or gall stones! New GGT test now at 182 after 6 weeks abstinence.

So, my doc's not too concerned-test again in 3 months but I don't get the clear ultrasound?-I have itchy skin still, stools a bit clay-ish and very occasional liver pain-all consistent with high GGT. A bit weird that all other liver tests fine. I guess it could be another kind of biliary issue but my gut instict says liver-57 years old and years of overdoing the vino-probably miraculous I haven't had issues before...! Just hope I haven't damaged the liver beyond repair. Any comments welcome on test results as I'm slightly concerned I'm missing something but am convinced I have some kind of liver damage-it's the intolerance to alcohol now which worries me-even a becks blue watered down with lemonade is no go.

Funnily enough I don't miss the alcohol-day to day no problem although hate not being able to have wine in restaurants...still-not the end of the world.

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48 Replies
Bigplanet67 profile image
Bigplanet67

Hi and welcome.

I too reasonably a newbie on here and still learning from he oldies. Like you said this is a good resource to bouncy issues, problems or a general bitching session or frustrations.

I will not fully comment on the details as others on here have the more experience in the bloods than , Bolly notably. But it does sound like some element of liver related condition, but the good elements are that scan clear and no sign of fatty liver, no Ascities (liquid build up on stomach) but the other symptoms are very commonly reported, itchy skin in lower limbs, intolerance to alcohol, liver area pain. Your GGT is not within range but not extremely high, I had up to 700 for sometime and now down to 300-400 range, GGT it is not commonly part of standard LFT now and has to be asked for. So I think that anything that has been damaged is repairable, Bolly would want to know all the LFT breakdown as each part points or discounts each condition. do you feel tried, sleepy and/or general yuck feeling is your weight stable as well, appetite? did the Dr take a full blood test or Urea test, semi standard tests along side LFT test. Ask for a print out from the Dr and keep on file.

PAWs not heard of it, but on reading is a withdrawal condition from certain drugs and or alcohol. correct? The symptoms seem general and similar to generalised liver condition.

Well hope all is okay and a lot of support and advice on here.

Happy Easter too

Andy aka bigplanet

briccolone profile image
briccolone in reply toBigplanet67

many thanks Bigplanet and a happy Easter to you, re the general wellness question-well to be honest I had no specific symptoms before I stopped drinking-all the symptoms started about 2 weeks after I stopped. However, now I'm through the post alcoholic withdrawal symptom (PAWS) phase I have no symptoms other than occasional liver pain which is diminishing and the abnormal stoo l colour (brownish- clay colour) although during PAWS was all over the place loose yellowish etc.No signs of abdominal swelling or jaundice at any time although eyes are wee bit bloodshot even now. Only abnormal liver test was and is GGT but I'll take your good advice and get the actual figures for future reference. In actual fact I feel pretty good apart from the itching which may be caused by something else-I've been doing an intermittent fasting diet which although efficacious may be also raising the ggt levels slightly-didn't have the itching until started the diet. Cholesterol levels are improving though so somethings working. I might do a post on PAWS because it may help others-there's not much out there on the web...cheers and all the best

briccolone profile image
briccolone in reply toBigplanet67

Hi Andy-a query on raised GGT-glad to see yours are coming down but what symptoms do you get at those levels 300-400? I know these will vary from individual to individual and how long did it take to see any kind of significant drop?

I'm still a bit wary on my recent drop as although scan is clear am still seeing some symptoms-itching/irritation on legs, slightly pale/clayish stools although these getting more variable and tending to normalize and very occasional liver pain but noticeably less. All other liver function bloods completely normal. Bolly suggests that even if you get a clear scan there may be still damage which makes me wonder about the scans usefulness in some respects....

Bolly profile image
Bolly in reply tobriccolone

Hi briccolone. The ultrasound scan you mentioned in your first post is the most basic of the 'scans' done on the abdomen/liver. It works in a different way to a CT or an MRI scan and diagnoses/shows different things. Ultrasound works by echo - it sort of bounces back images which will show if the liver is shiny and smooth (healthy) or rough/scarred (fibrosis/cirrhosis). It can see blood flow through the portal vein, and whether the liver is enlarged or not. It can see if there is fluid in the abdominal cavity. It can pick up fat deposits, and things that might be cysts or lesions or tumours, but in the latter its not used to make a definitive diagnosis of cysts/lesions or tumours - these usually get diagnosed by CT or MRI.

So its a good starting point in picking up any problems, as its quick, cheap and non-invasive.

What an ultrasound doesn't diagnose is the 'symptoms' that people often experience when their liver is starting to struggle but is not yet enlarged or scarred or significantly less shiny than normal. Symptoms such as bowel or digestive changes, nausea, itchiness, slower recovery from hangovers, beginnings of intolerance to alcohol, fuzzy thinking, muscle tremor, fatigue. You can have these symptoms - some of which you do - and a high GGT (which 80% of people who drink over the recommended amount will probably have) but not have anything sinister on the ultrasound. What that gives you is a warning to change things before you do start to get fibrosis or scarring etc.

briccolone profile image
briccolone in reply toBolly

Thanks Bolly-a very interesting and helpful post-this pretty much answers my original question. I couldn't get my head around the fact that the ultrasound was clear yet I still had some symptoms-. Since that ultrasound the symptoms have diminished further to more or less minimal impact. I'll continue with alcohol abstinence until the GGT's are normalised or lowered considerably-have been abstinent for 3 months now. Best regards K

Bolly profile image
Bolly in reply tobriccolone

"57 years old and years of overdoing the vino-probably miraculous I haven't had issues before...! Just hope I haven't damaged the liver beyond repair."

-I've copied this extract from your first post on this thread, having read (above) what sounds like a decision that you will, at some stage, start drinking again.

Bear in mind that your liver is now 57 years old, not the teenage liver it probably was when it first had to process alcohol toxins. Assuming your GGT levels normalise, I don't think your liver will be starting from baseline health again.

Nothing wrong in the odd drink or two within limits once your liver function is back to normal, but personally, having had this wake-up call as to what can happen, and in particular reading stories on here of people who let the drinking go on just that bit too long, might you rethink?

briccolone profile image
briccolone in reply toBolly

dead right Bolly-one or 2 drinks within limits is what i was thinking about....having got rid of the partial dependancy I hope-no longer have a social life that revolves around it or home life, keen cook wine slurper etc. Wakeup call is spot on. I suspect that when I get the bloods down in 3 months the GGT's will not be at normal levels although I might be lucky. One thing though-having been completely ignorant on the liver-this forum has certainly been an education. Trust you're doing Ok...!

Bolly profile image
Bolly in reply tobriccolone

Middling ok at the mo. Immune system has taken a nosedive as it doesn't like the new immunosuppressant drug I'm on, so GP and hepatologist checking my blood test results closely (as am I!!). AFP tumour marker has been a teeny tiny bit higher this year so far than it has been for the last 2 1/2 years, so that needs watching too but nothing too worrysome at the moment. Brother came to visit and brought bottle of vino, lol! Had to gently remind him I cant drink and offered it back again, ha ha.

briccolone profile image
briccolone in reply toBolly

I admire your fortitude I really do. I'm sure though your attitude is the correct one-get informed and get on with it-a sense of humour helps as you're demostrating admirably! All the best

Maxi_me profile image
Maxi_me in reply toBolly

Hi I have had a hard time tryif. To get my doctors tondonanfibronscan I suffer from fatty liver for over two years and they keep monitoring from blood rest until things get worse . I feel quite angry why wait for it to get worse then treat it. I want to have private treatment now following dr fung methods and they need MRI and Fibroscan and bloods. I got all bloods done privately but the others are expensive . Any ideas ? Anyone offer free funding or tests roadshow etc ? I need stomach rest and Fibroscan to have private treatment . Am thinking to change my dicots very soon been with them thirty years and they wait for disease to develop before treating rather then sorting out the root!

briccolone profile image
briccolone in reply toMaxi_me

saw a comment recently from Bolly about a research charity that funds fibroscans-this should be your fisrt port of call. dont' where you live but the london clinic does fibroscans for about £300. If you're that concerned may be worth investing. Btw my GP had never heard of fibroscans...fibroscan would be a good indicator and if a borderline result should spark a further investigation. My fibro done at the road show was 7.2 which was above normal but not disastrous but then had a scan which showed fatty liver-British Liver trust should be able to provide more info.

all the best

Nibby profile image
Nibby in reply toMaxi_me

I’m from the US and have had NASH/cirrhosis for 10 yrs. Prior to that my liver numbers were never particularly good and I had fatty liver. So, no one ever really told me what to do. So, I investigated on my own and realized. 1. You must be optimum weight for me a woman 5’5” it was 140 lbs. ok I was not that. So, I lost a lot of weight while learning how and what to eat. Took me a year. 2. You have to exercise. Not to lose weight but it helps no it is an integral part of the staying healthy. 3. Sleep. Regular and decent amount. 4. Research all those things. My results: of course started way to late cause I already had cirrhosis. I was a diabetic 2. Now I’m not. My cholesterol was sky high now it’s normal. My liver numbers are all within range and you’d never know by them I even had a problem. I sent from you’ll probably need a transplant soon to your numbers are better then mine.

I am not a doctor at all but something doesn't seem right there. I have been drinking Becks Blue since November and have no issues with it, it shouldn't be because its alcohol free (and not too bad in my opinion if its really cold)

Has the docs mentioned or considered pancreas issues?

briccolone profile image
briccolone in reply to

thansk Kleam for your interest-yes I think its strange maybe I've developed a reverse tolerance for alcohol which worried me because this could be cirrhosis? no other signs though apart from what I've posted'I did think about the pancreas but I don't have a lot of pain and cholesterol would be through the roof-on the contrary the cholesterol levels are coming down due to diet.

Bolly profile image
Bolly

Hi briccolone.

I think you have worked out cause and effect for yourself. Your liver doesnt like alcohol any more. Its not damaged enough yet for anything significant or sinister to show on an ultrasound, but your body is telling you - via the itching and the feeling unwell - that it would prefer you to stop drinking. Your body is giving you much more accurate feedback than the blood results, so listen to it and act on what it's saying.

Try it, not just for a day or a week or a month, - but for as long as it takes for you to feel fully fit again and for all your blood levels to return to normal. If you've been a longterm drinker then your GGT has probably been elevated for years and may take some time to return to normal. It can take 2-3 weeks to return to normal after a binge, but 6-8 weeks with it still high could suggest something else as well. Do you take any medication such as nonsteroidal anti-inflammatories painkillers (NSAIDs), antibiotics, stomach acid meds, antidepressants etc.

briccolone profile image
briccolone in reply toBolly

HI Bolly, many thanks for your post. Yes you're totally right-I'm convinced it's alcohol related. Now I 'm a little less befuddelled as no longer drinking fine chianti every night some of the more non-specific symptoms were probably all drink related but I didn't recognize them or chose not to! I won't be drinking anything until everything's normallised if indeed it does normalise but I do feel a hell of lot better than I did and it looks like I only had a mild dose of alcoholic liver disease although god knows what a severe dose is like...! In retrospect my liver was probably borderline for years as you say before it decided enough was enough... I'll keep you posted but once again thanks for your input. cheers

kizzy40 profile image
kizzy40

Hi I am very interested to hear more of PAWS, I am an ex alcoholic who stopped drinking christmas eve and been abstinent since, I have a large gall stone but a consultant suggested my pain not consistant with stones.

My liver at scan was fine although like you I have raised levels, at 40 could my pain just be my organs cranking back into full working order? hope so haha.

briccolone profile image
briccolone

Hi Kizzy,

Firstly well done on giving up the hooch on xmas eve-toughie!

Right-PAWS-there's not a lot of info out there or if there is I'm looking in the wrong places-I did find one very useful post which I'll dig out-very informative. Basically-PAWS are the physiological symptoms after you give up Alcohol. Don't know about you but i didn't get the normal alcohol withdrawal stuff-shakes-craving for a drink etc. Probably due to the way I used to drink which was wine with food but on a daily basis over many years. I had periodic breaks from alcohol every 5 weeks or so which was why I was surprised that 2 weeks after stopping all hell broke loose. A lot of liver pain -sometimes at night-pale loose stools-anyway-after about 6 weeks symptoms started to subside although a lot of bad sleepless nights. Relapsed over xmas which was a mistake-a few glasses of wine xmas day and a a bit of a binge boxing day-cue instant liver pain and a few worse symptoms- including pruritus. So-my advice is now that you're abstained for 3 months is to stay that way and the PAWS symptoms will reduce-it may take another 3 months though depending on your history. Don't know much about gall stones but that will probably raise the GGT levels anyway-my ultrasound showed clear for gall stones but i suspect i had at least one mild attack. The alcohol was depressing a lot of body issues which you will now become aware of so I I'm currently hyper-sensitive to body changes but this also improving as is my general health. I'm doing a 5:2 intermittent fasting diet which is taking my mind off things-look, feel and damn sight better. Good luck in your recovery

kizzy40 profile image
kizzy40

Thankyou so much for your reply. funnily I too followed Dr Moselys fast diet when I quit it was excellent and I should really keep it up.

I drank evenings only every day for the best part of 16yrs, wine and occasionally spirits too.

Googled PAWS and it took me to the sober recovery forum, have been using this as my only means of support lately so that was quite eerie too haha.

Like you say it does become easier to read what your body requires and I feel we may have had a lucky escape from any serious long term damage (fingers crossed) I understand what you mean about the occasional clayishness as had this too as well as insomnia and panic attacks.

The pain was very worrying but has now lessened considerably, I feel you are right about PAWS and what you said makes perfect sense, I just wish my doc had let me know that this may be the case instead of scaring me half to death.

Good luck to you too, and I raise my cup of green tea to you in thanks Briccolone.

briccolone profile image
briccolone

hi Kizzy-yes that diet's great-I've lost 9kgs and cholesterol significantly down-I aim to stay on it. here's that link on PAWS which I found very helpful..... Why We Don't Get Better Immediately: Post-acute Withdrawal ...

whatmesober.com/personal...about...recovery/...recovery/paws...

sunflower1 profile image
sunflower1

Why am I not getting emails regarding thse posts, anyone know? And the comments are not in order?? I.e posts from an hour ago are in the middle of the page yet posts from 3 days ago at the bottom, Am I stupid?

briccolone profile image
briccolone in reply tosunflower1

maybe emails are going into spam check sunflower? anywayI'm seeing your posts but not necessarily in the right order....:-)

sunflower1 profile image
sunflower1

I have just logged on and got loads of notification emails, not in junk????? Thanks for your response Briccolone, they are not in order though!

Bolly profile image
Bolly

Hi sunflower - its possible to reply to a post within the sequence by clicking on the blue 'reply to this' under a particular comment. For example, if I replied to your last post (as I am) its clear its addressed toward you. If I wanted to reply to something kizzy said 4 posts up, I can click on the blue 'reply to this' further up and insert a reply directly under kizzys' post.

Emirates profile image
Emirates

Hi guys, just had a LFT and the results are off the charts. all being not good but my GGt is 4475 so you can imagine what I'm going through. my liver is enlarged but my ultrasound is not bad. off course I have fatty liver. I was a heavy drinker till very recently and I have resorted to vegetables and fruits. how bad should I be worried about my GGT right now. have had no pain. any suggestion will do for now. I'm very new to this. thanks.

briccolone profile image
briccolone

hi Emirates-not point worrying about what's happened in the past! My liver tests are all normal other than GGt which is currently about 250-I need to cease drinking or moderate which is what I'm doing over the next couple of months-conveniently-happens to be Lent. In your case-you need to cease drinking for 3 months and then full liver panel to evaluate-you may be surprised by the improvement. If you're not having any symptoms-that's a good sign? keep us posted

AlexandriaUK profile image
AlexandriaUK

Same here and just waiting for another test next, will keep you posted

RobStin profile image
RobStin

Hi briccolone et al,

I am very new to this so good to see this forum post. I have drunk too much over many years, and two months ago my GP found a "high liver value" in a blood test. The value was 125 and am not sure if that is GGT or ALT, but in either case it is far too high. He didn't carry out any ultrasound but said I should get my blood retested in 3 months (i.e. in one month's time from now). For 2 months I have been completely dry and have had no withdrawal symptoms at all. I realise that cirrhosis is a possibility. I have none of the symptoms commonly listed for cirrhosis but realise symptoms may not yet have occurred. I suppose I have to wait another month for the repeat tests and request an ultrasound in order to be sure, and as I've now waited two months, I suppose another month isn't that long. But it's still nerve-wracking. Good to read other people's experiences. Thanks.

briccolone profile image
briccolone in reply toRobStin

hi and welcome,

I did respond earlier but god knows where the reply went? hey ho.

Ok-loads of things to consider...

firstly-good news-no symptoms---big plus!

I wouldn't start thinking about cirrhosis at this stage-I would take this course of action. You havent been drinking for 8 weeks so go and have the bloods done again and make sure GGT is one of them. Despite my drinking over many years-my liver results were always normal other than when tested latterly for GGT. When you get the results-get a copy and anything that's out of range ask the doc about it.

GGT though can be high for other reasons than alcohol-dieting, gallstones etc.

If you're not getting pain or digestive issues you may well be lucky-all depends on age and how long you've been drinking and how much? everyone's different.

Keep us posted-good luck

angse profile image
angse

Hi Briccolone

I had the same thing happen to me in 2015, had scan which showed normal smooth sized liver, although high GGT, I had no other symptoms at that time, I was under gastroenterolgist because of high GGT, he was going to discharge me from his clinic, but decided to wait one month to see if GGT levels dropped, which they didn't so he ordered a biopsy which showed cirrohiss of liver which was also enlarged and contained lots of fat, so the person who did the scan I dont what they were seeing, but it defiantly not healthy and normal as I was told, so it would be worth pursuing that, hop all goes well. annette

angse profile image
angse

Briccolone sorry I meant to say 2013. Happy Easter. Annette

briccolone profile image
briccolone

thats' bad news Annette-sorry to hear that. Just shows how important this forum is..everyone's experience is different. May I ask how high the GGT was pre-diagnosis? You've got me worried now! How are you doing?

RobStin profile image
RobStin

Thanks for the reply, Briccolone. Annette, that is awful when you think the scan has cleared you. So is biopsy the only foolproof way of being as sure as possible?

All the very best

briccolone profile image
briccolone in reply toRobStin

think the answer to that is yes but there's a way to go before a biopsy is considered as its invasive-I would look at ultrasound and if you're really concerned why dont you opt for a private fibroscan-not very expensive but wait for the bloods first. I had my fibroscan at the liver trust road show -

RobStin profile image
RobStin

Hi briccolone. I waited 3 months before getting the blood tests done again, as that's what my doctor suggested. I now have a copy of the tests done now compared to three months ago. The Gamma GT done in February 2015 was 129, now down to 16 in May 2015. ALT down from 56 in Feb down to 22 now. Looking good I hope, and that's after absolutely zero alcohol for 3 months plus. Other wow! benefits: I used to suffer from psoriasis that was quite severe, now that has disappeared entirely. Also lost quite a lot of weight, now nearer 80kg.

briccolone profile image
briccolone in reply toRobStin

excellent news-keep up the good work-just shows what the liver can do with a bit of TLC!

RobStin profile image
RobStin

Thanks a lot for your supportive comments briccolone. I read on another recent thread that you think you may have some kind of liver damage. I hope things are OK?

briccolone profile image
briccolone in reply toRobStin

no worries Rob...re damage well yes almost certainly-how bad? will hope for the best doing bloods soon- . symptoms are fatigue and muscle aches plus pale stools-doesn't look great but we'll see in a few weeks. Will keep you posted.

RobStin profile image
RobStin

OK, all the best for you. Let us know how the bloods go. All fingers crossed for the results!

RobStin profile image
RobStin

Hi briccolone mate, how are you doing? I hope things are going well. Just wanted to let you know that I'm thinking about you. Rob

briccolone profile image
briccolone

very kind Rob-not too bad thnks. had some blood tests recently no GGT this time but ALT and bilirubin and pretty much everything else fine-only thing that's concerning is low organic phosphorous which I'm suspicious of ...vitamin D and B12 ok though-could be a lot worse. I suspect an inflamed liver-that's what it feels like...a lot of symptoms fading away though fatigue gone. I'm going to have some more tests in a couple of months.

yourself?

Reddevil2015 profile image
Reddevil2015

Hi , very new to this and would appreciate any advice. I would consider myself a social drinker, I had a work medical and had a high ggt. The score was 130, gap said that was due to 'alcohol misuse' and I needed to cut down straight away. My question is I am 47 very active sport wise and don't have any other issues apart from family induced higher than normal blood pressure, is 130 very high as there does not seem to be any I scale? Would appreciate any advice.

briccolone profile image
briccolone in reply toReddevil2015

hi welcome to the forum,

firstly GGT is in indicator of high alcoholic use but not the only reason-could be due to all kinds of things.

130 is not that high but you would do well to try and reduce. what do you mean by social drinking-how manu units per week and for how long?

45-60 would be normal for a man your age. Mine was 182 after years of drinking and actually went up after I stopped drinking but fell to 167 after 3 months abstinence. High GGt is also an idicator of obesity but sounds like your'e active. You could have fatty liver though which raises ggt. Why not go dry for a month and see what happens.? I wouldn't be overly concerned but try and take steps to reduce. Do you have any symptoms? I suspect you don' t at that level.

Reddevil2015 profile image
Reddevil2015

I have a couple of glasses of wine a night and would have a bigger night at weekends. But have been a steady drinker for 30 years, last year my ggt was 90 at the same time. The symptoms I had were linked to my blood pressure going up, tingly hands and tension headaches, these have reduced with beta blockers. Thanks for advice.

briccolone profile image
briccolone in reply toReddevil2015

ok there is s link between raised ggt with risk of heart attack/stroke so if you have high blood pressure-I would look at statins-I dont have high blood pressure but do have high cholesterol

briccolone profile image
briccolone in reply toReddevil2015

that doesn't sound too extreme to be honest-it helps though if you don't drink everynight-have 2 nights off per week and try and keep below 3 units-the issue like me is the amount of time drinking-I was 30 years too. I think you should be fine if you moderate a bit. Could be you have one of those rare doctors who cares about fatty liver and raised ggts-my gp couldn't care less. I'm 9 weeks into a 3 month pre-xmas dry(-ish) period and I'm feeling better than I've felt all year-digestive system coming back into sync. The fact you don't have symptoms is good news-take this as a wake up call. Dont do what I did and start bingeing again once your symptoms disappear-mine came back with a vengeance. cheers

dtreatment2017 profile image
dtreatment2017

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SageR

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