Worried about high gamma gt level

[jan-ran]

Hi, I'm new to this forum. I am 74 . I have diabetes (5 years) and recently (March 2016) started a low cal, low carb, high fat diet. Because of this, I've lost weight, reduced my BMI to normal, brought down blood glucose to near normal level (HbA1c 4.6), lowered cholesterol, lowered bp, have perfect kidney function, all blood tests are in the normal range except gamma gt. I have had a scan and non alcoholic fatty liver was confirmed a year ago. I do not drink much (alcohol). I get plenty of exercise (dancing, indoor cycling) and my diet is full of all the 'right' things for a diabetic. However, I am worried about the latest gamma gt level, which is 254 U/L. It has been up and down since 2014, but never this high. What concerns me is that I have been getting so much right, for three months, that I was confidently expecting to see my liver improving along with everything else. What am I doing wrong? My gp doesn't seem concerned, as all he wants to do is have a telephone conversation in ten days time. I also have a niggling worry because my ALP test, while still within the normal range (30-130 U/L) at 124, is also higher than it has ever been before. I can't help thinking that there is a link. Can anyone give me any advice or reassurance? Are there any supplements I could take? (BTW I already take atorvastatin, pantoprazole, metformin, flecainide for atrial fibrillation, and bisoprolol, plus fish oil and Co enzyme Q10)

Thank you to anyone who takes the time to respond. I know how good these forums are :- I am an active member of the diabetes, and atrial fibrillation forums. JanR

[jan-ran]

I forgot to mention I also take rivaroxaban because of AF.

[Bolly]

"atorvastatin, pantoprazole, metformin, flecainide for atrial fibrillation, and bisoprolol," - that could be your answer - your liver is having to de-toxify all these meds. At times we end up with a risk/benefit situation. What is the greater risk; the elevation in GGT possibly from the meds, or stopping the meds in the hope the GGT normalises. It sounds like you might be able to stop taking statins if your nutrition/lifestyle changes remove the need for statins. People can reverse diabetes with a total revamp of their nutrition (which would get you off the metformin) but you would need to remove all sugars (processed and natural) and all carbohydrates from your diet which is pretty radical. You cant stop meds for atrial fibrillation.

An elevated ALP plus elevated GGT can be a sign of bone disease, which is a possible for you, have you had a DEXA scan or any tests to see if you have osteopenia or osteoporosis?

[jan-ran in reply to Bolly]

Thanks for replying, Bolly. I did wonder if all my meds could be the problem. As for a bone issue, I do have osteoarthritis, but as far as I know, not o- penia or o- porosis. I will certainly mention this to my gp, though I think I may have to pay for a bone scan. Unless he too is thinking along those lines. Is o - arthritis implicated in raised gtt level? Jan

[Bolly]

Osteoporosis is a condition in which the BONES become less dense and more likely to fracture.

Osteoarthritis is a degenerative JOINT disease that often involves the hips, knees, neck, lower back, or small joints of the hands.

Alkaline Phosphatase (ALP) is produced in your liver, bones, intestines, and kidney. If you have elevated levels in your blood it needs other tests to find out where its 'leaking' from.

[Bolly]

DEXA bone scans are quick and easy and accurate at estimating your fracture risk. The downside is, that if the result says you have osteoporosis, at your age the chances ar the docs will want to put you on bisphosphonate drugs such as Alendronic acid, to prevent bone loss. These have potentially nasty side effects, including damage to your oesophagus and gut. I would only go down the bone scan route if you fully understand the implications of a diagnosis of osteoporosis.

Alternatively, you could do weight bearing exercise, which is supposed to improve bone density.

If you have been on meds for your cholesterol, diabetes, heart etc for some time, do you have blood tests to monitor your liver and kidney function. You should. If you dont, ask your GP why not and make sure you have them checked at least every 6 months.

[jan-ran]

Yes I do have blood tests every 6 months, Bolly. I consider my local health care practice to be the best there is, even tho' my gp only wants to have a phone conversation! I have a list of questions, relating to what you have been able to tell me. BTW my liver and kidney functions are fine, apart from raised ggt level. I take your point about wanting (or not) a bone scan. I will mention my thoughts about o-porosis, but I'm sure he will be able to reassure me. I do a little weight bearing exercise for my arms, and indoor cycling for my legs. Plus dancing 3 times a week. I'm feeling less anxious than I was, thanks to your knowledgeable input. Thanks for that.

Jan

[docwatch in reply to jan-ran]

Change your GP.

[sandra_dee]

Join the club! I have always had LFTs within the normal range until 6 months ago when they were slightly raised. Re-test 3 months later....even higher. One month later all back to normal but GGT still over 200. Just had an ultrasound which shows slightly fatty liver. Am not overweight, walk a lot, admittedly we overdid the booze on a caravan holiday over Xmas in Nice....it was freezing!! GGT can vary so much, dependant on many things I believe , even what you have eaten a couple of days before. Many labs. don't even test for it. Just wanted you to know you are not alone. btw. I have taken Lipitor (Tahor in France) for years due to familial history of high cholesterol. My ALPs and ASTs halved in one month but the GGT still high-ish.

[jan-ran]

hi sandra dee, thank you for replying. I'm still on the trail of the statins - I too take atorvastatin. I'm not sure what my gp will say when I ask to come off it for 6 months (until the next blood test). I'm trying not to worry about it, but it seems a long time till Friday! (phone call with gp). I feel I have a powerful argument (see my first post) with everything becoming so improved in 3 months of the right diet. I want to stop taking other things as well, like pantoprazole (hiatus hernia) and metformin (diabetes) As Bolly said, I can't stop the atrial fibrillation meds, but in fact, even that condition is better, along with everything else! Oh to be medication free! (Having said that, I do appreciate how lucky we are to have so many 'miracle ' drugs which are real life savers). Have a good day! Jan