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Alcoholic. Have elevated sgot and sgpt level. Concerned for liver problem

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Internal Medicine Specialist
Practicing since : 2004
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i,am concerned that i have liver problems my levels are 51 and 52 and i drink beer everyday.
Posted Tue, 28 May 2013 in Liver and Gall Bladder
 
 
Answered by Dr. Enrique Molina 1 hour later
Hi XXXXXX,
I assume based on the numbers your are giving that those are your liver enzymes, specifically the AST and ALT (also known as SGOT and SGPT). They are indeed elevated, and this is definitely secondary to drinking alcohol everyday. However I am mostly concerned about your platelet count, which is 107. This is very concerning, as usually patients with a lot of damage to the liver (also known as cirrhosis), end up having an enlarged spleen which takes up the platelets, therefore patients with cirrhosis, have low platelets. The level of the platelets correlate fairly well with the degree of scarring and damage in the liver. The normal value for the platelets is over 150.
Regarding your liver enzymes, these fluctuate more often, and they can come down to normal even if your liver is destroyed, so it is not a good indicator of cirrhosis. It just reflects there is active inflammation in your liver, but if you stop drinking alcohol, these may come back down to normal fairly quickly.
It is also important to control your diabetes, as this can also worsen your liver disease if it is not controlled.
To have a better picture of how your liver is working, it would be nice to also know the rest of your liver enzymes (including your bilirrubin, total protein, albumin, alkaline phosphatase). Also your coagulation factors (that are produced by the liver) can reflect how well it is functioning (those are the PT and INR tests).
Hope that helps.
Let me know if you have any further questions or concerns.
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Follow-up: Alcoholic. Have elevated sgot and sgpt level. Concerned for liver problem 43 minutes later
does this mean that i have cirrhosis are spleen damage. and please tell me some of the most common syptoms.my bilrubin,total 0.5 total protie 7.5,albumin 3.7 and my alkaline phosphate 79
 
 
Answered by Dr. Enrique Molina 17 minutes later
I don't think you have cirrhosis, but you may have already some scarring in your liver, therefore you should get an ultrasound or imaging of your abdomen ordered by your physician to evaluate your liver and spleen and get a better sense of how these organs look and see if you have any risk factors.
The final diagnosis can be made with a liver biopsy, however oftentimes it is not necessary as we can tell most of the time based on imaging studies and labs.
The fact that your bilirrubin and albumin are normal is really good. Cirrhotics usually have a low albumin, and bilirrubin tends to go up.
Cirrhosis will not give you any symptoms until your liver is extremely damaged and terminal (you can become confused, throw up blood, develop "ascites" which is accumulation of free fluid in your abdomen, you can develop certain skin spots on your back typical of patients with cirrhosis).
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Follow-up: Alcoholic. Have elevated sgot and sgpt level. Concerned for liver problem 7 minutes later
thanks!! now i have one more question hepatitis? i'am really freaked out and working seriously on my beer addiction(cutting back but idon't think i can go cold turkey)
 
 
Answered by Dr. Enrique Molina 13 minutes later
Hepatitis can cause elevated liver enzymes as well. There are many other diseases that can increase liver enzymes as well, and a specialist can guide you with the labs you need. If you have not been tested you should definitely get tested for Hepatitis B and C.
Regarding the beer addiction, I understand if you can't quit cold XXXXXXX but you should decrease it substantially and seek help. There are "AA" (Alcoholic anonymous) meeting in all areas of USA. So there should be one close to you. The good thing about those meeting, is that you XXXXXXX people with the same addiction, you see which medical problems they ran into, and how they got better after quitting. It is very rewarding and helpful. I have sent many patients to them, and those who have the courage to go, are those who really quit and get better.
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Follow-up: Alcoholic. Have elevated sgot and sgpt level. Concerned for liver problem 8 minutes later
forgot to tell you something very important i have a history of low platelett counts. this is not new,my md prescribe folic acid, i also take ativan ,humolog levimere mavzide 75/50 metformin and asprin.
 
 
Answered by Dr. Enrique Molina 8 minutes later
Ok that is good. Just make sure they are not trending down, and that you get a liver imaging.
Again, alcohol abstinence is important.
Continue good diabetes control with your diet and medications.
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Follow-up: Alcoholic. Have elevated sgot and sgpt level. Concerned for liver problem 4 days later
looking at my labs do you think it's possble that i have hep c?
 
 
Answered by Dr. Enrique Molina 23 hours later
It is always possible, and mostly if you have ever received a blood transfusion in the past or used contaminated needles. The only way to really know is to get tested against Hepatitis C. It is a routine test, and can be easily done at any laboratory.
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Follow-up: Alcoholic. Have elevated sgot and sgpt level. Concerned for liver problem 41 hours later
i have and appt to get a abdormanal us,also to see a heptologist and a hemotologist. my primary examined my liver and my spleen and said that she didn't feel any enlargement.is this a good sign are should i mainly depend on the u/s.just still worried about everything that imight have . i it is cancer would my enzymes be higher or lower? o.k. until next time.
 
 
Answered by Dr. Enrique Molina 6 hours later
It is hard to feel the exact size of the spleen by physical exam, unless it is very enlarged. The size of the liver is more accurate. You should still see a hepatologist and hematologist, and take everything seriously. I don't think you have cancer based on the information provided. Liver enzymes are not good to identify cancer; in the case of liver cancer, the best method is via imaging studies (such as MRI, CT scan or liver ultrasound).
Hope that helped.
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Follow-up: Alcoholic. Have elevated sgot and sgpt level. Concerned for liver problem 3 days later
got my hep panel labs drawn today,what should i expect.u/s in the am
 
 
Answered by Dr. Enrique Molina 32 hours later
they will measure your liver, and see if there is anything else abnormal in your abdomen. It is a simple test.
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