Does high ggt mean liver disease

[Tuppence68]

My ggt is 169 all other bloodwork Bol but have upper right quadrant pain on and off

[Richard-Allen]

Good morning, I am sorry no one has got back to you, this is a rather quiet website.

I have been reading and looking at both of your posts on hear and I hope I can frow some light on your question.

Firstly our livers are brilliant machines, and they take an awful lot of punishment, but this is their job and they do it pretty well. Because of all the nasty toxic substances, it’s having to continually process, if the liver was to have pain receptors then we would all be in constant pain, as ammonia and the like are pretty dangerous chemicals. At times as the liver is cleaning out dead blood cells, and detoxifying the blood, it can become damaged for a while. This can give rise of a persons ggt levels. Like any form of injury, the damage may cause swelling. Because the liver doesn’t have any pain receptors, we don’t normally get to know when something is wrong. However, the liver is surrounded by a thin membrane, which is called, “The Gleison Sack”. This does have pain receptors. So, if the liver becomes swollen or enlarged, this membrane is stretched, and this can cause discomfort. As the damage is repaired by the liver, the ggt levels will return to normal.

(The basic liver function test just gives a "snapshot" of how the liver is performing at that moment in time. Having another one carried out just three days later, may see these levels return to normal).

I should point out here that I am not at all medically qualified to of specific advice from a medical viewpoint but can call upon personal experience.

I see you talk about you have had your gallbladder removed 10 years ago. What is becoming increasingly common is for leftover gallstones, to reform after the gallbladder is removed. These can then become stuck within the bile duct and impede the flow of bile from the liver. This then can cause bile to build up, and cause the liver to swell. As we are always mobile and walking about and changing our bodily position, these gallstones can them become dislodged and the bile can flow once more. A few weeks later, the same problem could occur.

This situation would cause the ggt levels to both raise and fall. If it is suspected that this could be the case, then a special procedure is carried out. This is called an “Endoscopic retrograde cholangiopancreatography” (ERCP). If you happen to like to understand more about this, here is a nice little video: youtu.be/O7adhUVAsl0(Not working as expected?)

I hope some of this is helpful. I may be way off target in your case but this is very much a case of identifying what it’s not and offering a possible cause.

Good luck and once again I’m sorry for the delay in responding to you.

Best wishes

Richard

[Tuppence68 in reply to Richard-Allen]

Richard thank you so much for your reply. I’m so sorry I have only just seen it! I have been off grid for a while with this whole corona thing, but recent visit to doctor and blood work us come back with weak positive for AIH. I’m so confused about what to do next as the GI doc said he couldn’t treat me as my enzyme reading were way below the level for medication and would actually make me feel very ill. He suggested healthy lifestyle diet etc which I follow anyway and to retest in six months.

[Richard-Allen in reply to Tuppence68]

I am sorry to hear that you have been diagnosed with Autoimmune Hepatitis. This raises a load of questions from me. Is this consultant a gastroenterologist or a hepatologist?

AIH is rather rare and is incurable. As you’ll most likely know by now, this is an autoimmune condition. It’s where the bodies immune system sees the liver cells as being a foreign invader and tries to destroy it.

What really surprises me is that this doctor hasn’t really done much to confirm that it is AIH. Normally a liver biopsy would be called for, or rule out other possible conditions. Primary Biliary Cholangitis (PBC) is another autoimmune condition that attacks the bile ducts. If I was your doctor I would certainly want to know exactly what it is I’m dealing with here.

Most people like myself who have had a liver transplant or any other form of transplant come to that. Have to be put on anti-rejection medication for life. This medication just tone downs the immune system, (Sort of makes it weaker) so it doesn’t go trying to kill the transplanted organ. I would have thought that if AIH has been diagnosed then this would be the treatment of choice.

Have a look at these websites for more information. This NHS site at the bottom of the page talks about AIH, it also has a link to the British Liver Trust website for more information: nhs.uk/conditions/hepatitis/

I would most certainly go back to this doctor and request more information. If need be, request to see another doctor or be referred to a Hepatologist. I would be blunt and be wanting answers. I’d be asking things like, “Why are you refusing me any treatment?”. Do you have someone who can go with you?

It is always a good idea to write down any questions you want to ask. It’s sod’s law that when you leave the doctors room, something will pop up you’d wished you had asked.

Don’t be afraid to ask questions. Firstly it’s your body, and you have a right to know. Secondly, a specialist doctor like a hepatologist, won’t mind you asking questions, they are often glad that you have shown an interest in their chosen medical subject.

This is not the end. There are options here. I have known some people with this condition to have more than one liver transplant in their lifetime, so don’t go thinking silly things.

Please keep me posted on how you get on. If I can help in any way, please feel free to ask.

Best Wishes

[Tuppence68 in reply to Richard-Allen]

Hi it’s a GI Doctor. He said he could do a liver biopsy but even if it confirms AIH my enzymes are way below the level for him to give me any treatment my ggt has come down to 169 at last test on July 7. my alt 49 and ast 33 and all other bloodwork normal except the anti smooth muscle titer. I have no symptoms of AIH no Jaundice, fatigue, weight loss, itching, I have normal bowel and urine movements. I stopped drinking eight weeks ago. I wasn’t alcoholic but enjoyed a couple glasses of red wine most evenings with dinner and had done for a long time. Like I said I have an excellent diet organic fresh foods and lots of fruit and vegetables daily even though I am heavy and I’ve been most of my life it is my genetics. (13.5 stone) I am also in menopause as I’m 52. I am convinced the pain in u.r.q is scar tissue especially as it’s more evident after exercise. The doctor I saw said I wouldn’t get pain with AIH. I have had this discomfort and pain for over five years now and two mris and three ultrasound have showed nothing. Not even sign of fsttt liver which the doctor said I mostly like Do have. I have had four pretty big surgeries from my neck down to my Pelvis in the last ten years and I think it’s more to do with this. I am seeking a second opinion though with another doctor

Thank you for the advice and input and sending continued prayers and well wishes for you.

Kate

[Tuppence68 in reply to Tuppence68]

Fatty liver *