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Elevated ALT, Gamma GT. Fatty liver. High cholesterol levels, protein in urine. What would be the reason?

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Pediatrician, Infectious Diseases
Practicing since : 2005
Answered : 1528 Questions
I recently did a full medical and the results from my liver function test showed a high gamma gt number (186) and elevated ALT (51). The final report did not even refer to the high gamma gt but cited the ALT and said it was likly due to fatty liver. I have elevated cholesterol (243) but low blood triglycerides (44). All of my other test results were in the normal ranges however I am concerned that they are at the high end of the ranges. My fasting glucose was 99, my potassium was 5 and there was also mention of trace protein in the urine. I am 32 years old with no known health issues, I am 5' 8" and weigh 175 lbs. I am careful with my diet and exercise 4 -5 days a week using a combination of strength and cardio training and I use protein supplements. I wanted to know what these results mean and what should I do from here. I am awaiting an appointment with the doctor to discuss. Any advice would be helpful.
Posted Sun, 17 Jun 2012 in Liver and Gall Bladder
Answered by Dr. Hema Yadav 1 hour later
Thanks for posting your query.

Elevated GGT levels can indicate numerous serious health conditions, especially cholestastic, or blocked bile ducts, liver disease,fatty liver or , liver scarring or a tumor. GGT is particularly sensitive to alcohol, and it is elevated in alcoholism and the use of medications and drugs.
Any injury or inflammation in liver can cause elevated ALT.
Cholesterol level when high and associated with elevated liver enzymes can be suggestive of an underlying cardiovascular problem, metabolic syndrome or alcoholic or fatty liver.
So considering your reports ,It may most probably mean that you have an underlying fatty liver or hyperlipidemia causing such enzyme levels however further investigation is necessary to rule out risk of cardiovascular problems like atherosclerosis.
Rest of your reports though borderline are to be considered normal.
It's good that you have an appointment with your doctor who may after thorough evaluation order few more investigations like ultrasound abdomen, echocardiogram , stress test , hb1ac ( better test to rule out diabetes), etc to confirm the diagnosis and rule out any significant problem .
Meanwhile he may advise either lipid lowering agents or dietary modifications for controlling the hyperlipidemia ( cholesterol) .
It's good that you lead an active and healthy lifestyle which is best for you considering you have a family history of diabetes and hypertension.
Please do not worry as the present situation is not worrisome but just warrants further investigation and precautionary measures if any significant cardiovascular risk found.
Hope I have answered your query.
Wishing you good health .
Above answer was peer-reviewed by
Follow-up: Elevated ALT, Gamma GT. Fatty liver. High cholesterol levels, protein in urine. What would be the reason? 3 hours later
Hello thanks for the response, its consistent with what i have seen online. I did have an echocardiogram and stress test as part of the exam and those were fine. I aslo had some detailed heart exams for insurance purposes done in the last year or so since I had a heart murmur as a child. All results were normal so I would be surprised if heart problems exist especially given my intense exercise regime. I dont drink alcohol often but I did gain alot of weight in my mid twenties, I have managed to drop about 50 lbs and shed about 5 inches off my waistline over the past few years and kept if off. I guess why I'm a little worried is that I didnt have a starting set of numbers to know if I'm improving or getting worse. I did get diagnosed with small asypmtomatic gall stones some time ago but the doctor told me not to worry about it as it doesnt affect me. Since then I made a serious effort to eat right and exercise often. My last question is that if it is fatty liver, what can be done to improve it?
Answered by Dr. Hema Yadav 10 hours later
Thanks for the follow up.
Considering you have a history of gall stones , there is a possibility of a partial obstruction of bile ducts which can cause the elevation of liver enzymes.
So it's advisable you consult a gastroenterologist or your surgeon to reevaluate the present status of the fall stones by ultrasound etc .
If its fatty liver you can try the following ,
1. Cessation of alcohol consumption altogether.
It has been noted that many people who drink alcohol and have this condition have seen a reversal in the fatty liver once they stop consuming excessive alcohol.
2. Avoid these medications or consult doctor before starting any medication.
medications that are known to elevate liver enzymes and create a fatty liver include: amiodarone, methotrexate, high doses of vitamin A, tetracycline, cortisone, phosphorus, and prednisone .
3.Continue your exercise but remember weight loss should be achieved safely at 1-2 lbs per week for optimal results.By exercising regularly (at least 30 minutes daily, 3-5 days per week) and consuming a diet that is low in fat and properly nutritionally balanced, it is possible to reverse the condition and to return the liver to its normal functionality.

4.As such there is no specific treatment and medications are not effective on this condition; however, it is sometimes recommended that taking a L-carnitine dose of 340 mg twice a day, or lecithin and choline, to potentially decrease the severity of a fatty liver.Personally I do not think its necessary inyour case , however you may discuss out with your physician.

Hope this answers your query.
Kindly accept my answer if you have no further queries.
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