Abnormally High Liver Function
Discussion
Hi All,
Mrs geeks has been unwell of late, a few symptoms here and there, pain when swallowing (which lead to an endoscopy and the diagnosis of a possible Hiatus Hernia, she has a barium meal test to confirm that coming up) however they were far more interested in her other symptoms (some of them girly and personal in nature) along with fatigue, headaches etc you know the drill. So they ordered blood tests, today she gets a call from the quack advising her that her liver function is abnormally high, this isn't the first time we have heard this (she had sepsis a couple of years back and was admitted to hospital, they were concerned about it then however they also said as she was on pain medication, antibiotics and fighting off a severe infection it was most likely related so they let her go with a follow up test which showed it coming down so they left it) the Dr was pressing her about her alcohol consumption, this is virtually zero, and I do mean that, she has maybe three or four drinks a year, generally with christmas dinner and something fizzy for new year, Dr clearly doesn't believe her but we are scheduled in for follow up tests.
So question time;
How do we show the Dr that she really doesn't drink?
Her symptoms don't really at this stage really point to a specific thing, Dr suggested that if she was being truthful about the drinking (and she emphasised the if
) then it could be a number of things from infection to celiacs disease. Does anyone have similar experience running down this road, what sort of tests is she likely to be subject to over the coming couple weeks? (celiacs or otherwise?)
A bit worried about her truth be told, she has a tendency to disappear into her own head on these things and make herself worse, so for now its a case of keeping her talking and staying positive, anyone have any advice here?
We are going away this weekend to Brands Hatch (first round of a championship I run) and she loves being track side and in the paddock so this will help her a mood for now but once the weekend is done I need to keep on top of her (fnarr fnarr)
Thanks in advance, one concerned husband!
Mrs geeks has been unwell of late, a few symptoms here and there, pain when swallowing (which lead to an endoscopy and the diagnosis of a possible Hiatus Hernia, she has a barium meal test to confirm that coming up) however they were far more interested in her other symptoms (some of them girly and personal in nature) along with fatigue, headaches etc you know the drill. So they ordered blood tests, today she gets a call from the quack advising her that her liver function is abnormally high, this isn't the first time we have heard this (she had sepsis a couple of years back and was admitted to hospital, they were concerned about it then however they also said as she was on pain medication, antibiotics and fighting off a severe infection it was most likely related so they let her go with a follow up test which showed it coming down so they left it) the Dr was pressing her about her alcohol consumption, this is virtually zero, and I do mean that, she has maybe three or four drinks a year, generally with christmas dinner and something fizzy for new year, Dr clearly doesn't believe her but we are scheduled in for follow up tests.
So question time;
How do we show the Dr that she really doesn't drink?
Her symptoms don't really at this stage really point to a specific thing, Dr suggested that if she was being truthful about the drinking (and she emphasised the if
) then it could be a number of things from infection to celiacs disease. Does anyone have similar experience running down this road, what sort of tests is she likely to be subject to over the coming couple weeks? (celiacs or otherwise?)A bit worried about her truth be told, she has a tendency to disappear into her own head on these things and make herself worse, so for now its a case of keeping her talking and staying positive, anyone have any advice here?
We are going away this weekend to Brands Hatch (first round of a championship I run) and she loves being track side and in the paddock so this will help her a mood for now but once the weekend is done I need to keep on top of her (fnarr fnarr)
Thanks in advance, one concerned husband!
I'm sure someone more knowledgeable will be along to offer more advice, But....
Celiacs disease can be diagnosed by a blood test, but it's never 100%, you said she had a Gastroscopy? During the gastroscopy it could/shoud have been noted weather celiacs disease was present.
Flattening of the stomach duodenum mucosa can often be seen during procedure, and biopsies should be taken to confirm diagnosis. A negative celiac blood test and positvie bipsies would mean celiac.
Infection is often but not always easily to notice on a full blood count,
High Liver function
I suppose it depends what was high? ALT? Bilirubin?
Again, my last 3 LFTs have all come back high, not really concerned as it only Bilirubin.
If your not happy with the Dr Tell them. If they don't believe your wife doesn't drink and are to lazy to do the job, find one who will.
Celiacs disease can be diagnosed by a blood test, but it's never 100%, you said she had a Gastroscopy? During the gastroscopy it could/shoud have been noted weather celiacs disease was present.
Flattening of the stomach duodenum mucosa can often be seen during procedure, and biopsies should be taken to confirm diagnosis. A negative celiac blood test and positvie bipsies would mean celiac.
Infection is often but not always easily to notice on a full blood count,
High Liver function
I suppose it depends what was high? ALT? Bilirubin?
Again, my last 3 LFTs have all come back high, not really concerned as it only Bilirubin.
If your not happy with the Dr Tell them. If they don't believe your wife doesn't drink and are to lazy to do the job, find one who will.
Friend had what sounds like something similar, she too had trouble convincing the Dr she didn't drink heavily. As I recall it turned out to be some sort of reaction to an antihistamine she had been taking on a regular basis. Once she stopped that it returned to normal.
As has been said, if you aren't happy with the Dr ask to see a different one, they can vary wildly. Mum kept getting sent away with, diet indiscretion, you're just constipated.. ended up in agony in A&E and they found a tumor the size of a football.
As has been said, if you aren't happy with the Dr ask to see a different one, they can vary wildly. Mum kept getting sent away with, diet indiscretion, you're just constipated.. ended up in agony in A&E and they found a tumor the size of a football.
The blood test should also have tested for Gamma GT as I believe it is included in a standard full blood count.
Gamma GT is usually high in people who drink a lot. The Dr should know this. I'm not sure if reasons other than alcohol can raise GGT though.
The Dr could also ask for an ultrasound on the liver as this can detect fatty liver disease. Although this can be caused by excessive long term alcohol as well as non alcohol related causes.
Essentially if GTG is low and the liver looks normal from ultrasound, it should be enough evidence to rule out drinking as a cause.
Gamma GT is usually high in people who drink a lot. The Dr should know this. I'm not sure if reasons other than alcohol can raise GGT though.
The Dr could also ask for an ultrasound on the liver as this can detect fatty liver disease. Although this can be caused by excessive long term alcohol as well as non alcohol related causes.
Essentially if GTG is low and the liver looks normal from ultrasound, it should be enough evidence to rule out drinking as a cause.
need to know exactly what was tested re: the liver. the standard "liver function test" isn't - it's measuring enzymes that are present in various body cells but tend to be packed into liver cells and they spill out when those cells suffer an insult. a more accurate test of liver function needs a bit more digging. the insult need not be seemingly significant - inflamation, infection, paracetamol, alcohol, disease etc.
one can have a perfectly functioning liver even though liver enzymes are raised; my own brother in law has a widespread metastasing cancer with significant liver involvement but his liver function is entirely normal. mildly abnormal results though are often an incidental finding and not usually of significance but, again, would need more info on exactly what was tested and what those numbers were..
is there a baseline ? - has she previous bloods to compare with and what other testing was undertaken at the consult ? could consider a non-invasive liver panel if there is raised ALT/ALP and raised bilirubin or raised yGT
Dr seems to be following the usual pathway though - first clear any known causative/contributory factors and go from there
paul
one can have a perfectly functioning liver even though liver enzymes are raised; my own brother in law has a widespread metastasing cancer with significant liver involvement but his liver function is entirely normal. mildly abnormal results though are often an incidental finding and not usually of significance but, again, would need more info on exactly what was tested and what those numbers were..
is there a baseline ? - has she previous bloods to compare with and what other testing was undertaken at the consult ? could consider a non-invasive liver panel if there is raised ALT/ALP and raised bilirubin or raised yGT
Dr seems to be following the usual pathway though - first clear any known causative/contributory factors and go from there
paul
Edited by paulmakin on Thursday 22 March 16:15
Thanks Paul, just a bit worried about her for obvious reasons, I have no real answers, I know when she was in hospital they took alot of blood and then did a couple of tests 4 weeks apart after too, that was around 2 years ago so hopefully that can serve as a baseline for her, I will have to remember to ask exactly what is high etc
Couple of years ago I had stitch like pains in my side and was prescribed 'Lansaprozole' sp? for acid reflux/indigestion. Blood test showed I had a high liver function test result and after an endoscopy and CT scan was found to be a cyst on my pancreas causing pancreatitis. Unlike your wife, I am a reasonably heavy drinker and had to avoid alcohol for 3 months. Which I did - the follow up CT scan showed that the cyst had disappeared. Whether alcohol consumption was the cause or not - your wife might have a problem with her pancreas, which a CT scan would likely find. Perhaps you could ask your GP to be referred for one.
montymoo said:
I'm sure someone more knowledgeable will be along to offer more advice, But....
Celiacs disease can be diagnosed by a blood test, but it's never 100%, you said she had a Gastroscopy? During the gastroscopy it could/shoud have been noted weather celiacs disease was present.
Celiac can be diagnosed from bloods yesCeliacs disease can be diagnosed by a blood test, but it's never 100%, you said she had a Gastroscopy? During the gastroscopy it could/shoud have been noted weather celiacs disease was present.
So the Barium Xray for the Hiatus Hernia happened this morning, good news is no cancer their but a very minor Hernia, Dr is fairly convinced that this is whats causing her discomfort while eating on occasion. Her Ultrasound for HLF is next week on Wednesday. Interesting one though and a follow up CT maybe ordered her stomach is on the incorrect side, apparently rare enough for the Dr to not have seen that before! Chances are apparently that her other organs are on the wrong side as well 
So Ultrasound done now we wait for the results, it would appear all of her other internal organs are on the correct side albeit a little jumbled (liver right side, wrong place relative to normal for example) was cool I got to watch the ultrasound, never seen one before, have now seen what the wife looks like from the inside 
I looked over the "screen" as my second child was born by C-section. I also got to see what my wife looked like inside - I had no idea they took so much of your bowels and intestines out and stacked them on your chest whilst trying to get to the little nipper. (It wasn't an entierly noremal C-section - previous birth had been emergency T-section and there were a lot of internal scars that were also being removed in this planned section.
Gassing Station | Health Matters | Top of Page | What's New | My Stuff