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Treated for hypertension. LFT test done. What does the report suggest?

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have gone for routine LFT test while taking treatment for Hypertension where i found my SGOT/SGPT reading too high(139/199),my ultrasound report is ok and i have no problem with my liver but i consult a doctor(gastroentrologist) who advice me some tests(HCV Test-negative and HbsAg Test-negative) and then prescribed me URSODEOXYCHOLIC ACID alongwith Essentiale(contains PHOSPHOLIPIDS) for 15 days then my test(OT/PT) shows 108/143,i continue same medicines for 15 days more after that my test shows 184/163 my doctor Prescribes me medicine(URDOHEP) which contains URSODEOXYCHOLIC ACID & SILYMARIN alongwith Essentiale tablets and Baclofen tablets bust still test shows elevated levels of SGOT/SGPT ,SINCE THEN I am taking URDOHEP for 2 months,one time test(ot/pt) shows 89/126 and then i left medicines for 1 month and i underwent another test(15 days back) and it shows now SGOT-97/SGPT-150.i consult my doctor again and he prescribed me URDOHEP again. I want to know about the causes of elevated LFT so i went for renal profile tests the results are Creatinine-1.0 mg/dL,Uric Acid-5.1 mg/dL,Blood Urea-28,SODIUM-140 mg/dL,Potassium-4.5 Mg/Dl but My Blood Serum Copper shows elevated 194 ug/dL.I consult my gastroentrologist again he tells me nothing to worry about elevated levels of sodium but also advise me for Auto Immune Hepatitis,i am attaching herewith my Auto Immune Hapatitis report,my doctor says my report suggest half postive and half negative results so he tells that liver biopsy may be required and advise me to consult another doctor in Escorts Hospital for second opinion for the same.
PLs check my report and give ur opinion, i don't want to go for liver biopsy as i am not experiencing any liver problem,my ultrasound report is ok,I feels no pain in my liver.I just went for routine checking of my liver and then only my report shows elevated LFT.Also my gastroentrologist tells me to refrain form drinking alochol when i met him first time but i am drinking alochol regularly however i have reduced my daily intake to 2 pegs only,i am drinking regularly for lst 4 years .Please give ur valuable assessment of my case and report.Also one thing more i have joined a dietician 2 months back and lose about 7 kg of my weight except i continues to drink regularly.

Posted Fri, 27 Jul 2012 in Digestion and Bowels
Answered by Dr. Dinesh Kumar Singal 18 hours later

Common causes of raised SGOT / SGPT are

1. Alcohol: you definitely should stop taking alcohol and repeat your SGOT / SGPT on monthly basis. If these continue to stay high then further investigations to look for other causes are needed. Based on your present results probably a liver biopsy may also be needed in future for further evaluation. Even if it is found that alcohol is not the cause of your raised SGOT / SGPT, I will suggest that you completely quit alcohol. because it will add to the damage of your liver.

2. Viral infections: Hepatitis B and Hepatitis C infections have already been ruled out by your doctor.

3. Non-alcoholic fatty liver disease(NAFLD): this is a common cause of raised enzymes and usually occurs in people who are obese / overweight, are suffering from or have family history of diabetes, hypertension, hyperlipidemias. Here an ultrasound examination may show fatty liver. To confirm this diagnosis a liver biopsy is must. You should tell me your weight and height so that your BMI can be calculated. This should ideally be less then 25.

4. Autoimmune hepatitis: Here the auto-antibodies will be positive. In your case these are borderline. To establish this diagnosis we also need to do protein electrophoresis and IgG levels. Finally a liver biopsy is diagnostic of this condition.

5. Wilson's disease: Here serum ceruloplasmin levels are low and is also confirmed by a liver biopsy.

6. Drugs: certain drugs can also cause raised enzymes. Your BP medicine probably is not the cause of raised enzymes.

My advice will be to completely stop alcohol. Reduce your weight if you are obese or overweight. Reduce fat and sugar intake. Also exercise. If your enzymes stay high then please follow your gastroenterologist advice for further tests, and in last probably a liver biospy may also be needed.

You dont have any symptoms right now due to liver, but problem is that unless liver gets damaged to about 80%, there may be no symptoms. That is why it is important to find out the cause of liver abnormality now and take corrective actions at the earliest.

Hope my advice helps you.

Best wishes.

Dr Dinesh Singal
Above answer was peer-reviewed by
Follow-up: Treated for hypertension. LFT test done. What does the report suggest? 20 hours later
1My Height is 71 inches and my weight now is 85.2 kg(reduced from 92.5 kg to 85.2 kg in 2months through dietician),so my BMI is 26.1 ,I am still undergoing weight loss from dietician so i am already having high fibre diets ,no sugar,high fruit intake/detox etc and my BMI will definitely drops to 24-25.My ultrasound shows no fatty liver.
2.About Alcohol i will definitely reduce the consumption right now and will try of leaving it gradually.
So i can skip liver bopsy now and reduce alochol consumption and take URDOHEP and will repeat SGOT/SGPT test again and wish it will get down.
3.About Auto Immune Hepatitis what do you think after reveiwing my report?what do you think report will also improve after some time of reducing alcohol?what are chances of this disease in me?Is this disease dangerous?Is dieting or reducing weight has something to do with antibodies?what are the further tests to check for this disease so that i can avoid liver biopsy?
4. I have also told you about my copper content in my blood which is 194,Is it normal?any further lab test required for copper toxicity?
Finally i want to know about liver biopsy,Is one has to admit to hospital for the test?what are the risks involved in liver biopsy and cost involved?what are the after affects of liver biopsy as part has to be taken from the liver?i think it is done if any harm is suspected in the liver but my ultarsound shows no liver demage or hepatatais etc?do you think liver biopsy can be done only to check the elavated SGOT/SGPT?
I have asked you a lot of questions coz i don't want to go for liver biopsy,one thing more i have underwent surgery in my left elbow 4 years back where small needle like metal pieces is inserted in the bones of my elbow.
Answered by Dr. Dinesh Kumar Singal 12 hours later

Thanks for contacting again.

1. It is nice to know that you are reducing your weight. This will help you a lot. Continue doing that.

2. Also nice to know that you have decided to quit alcohol.

3. Regarding auto-immune hepatits (AIH). Your XXXXXXX is borderline positive, so there are chances of you having AIH. But before reaching to any conclusions we must do IgG levels and protein electrophoresis. These are blood tests. And finally if these suggest possibility of AIH and your enzymes stay high inspite of weight loss and alcohol stoppage, then a liver biospy will be conclusive.

4. Copper levels do not help. For Wilson's disease you need to do Serum ceruloplasmin levels. These levels are reduced in Wilson's disease.

5. If your liver enzymes continue to be high and there is still doubt about the cause then liver biopsy should certainly be done. In most cases it is a safe procedure, though rarely there may be a complication like bleeding from liver. This is the most dreaded complication, but is uncommon. This can usually be tackled just by blood transfusions, though sometimes surgery may also be needed. There are no long term effects of liver biopsy on liver or body. You will have to find out the cost of liver biopsy in your city as it may vary in different hospitals and city. Liver biopsy will be important because constantly high liver enzymes may suggest that your liver is getting damaged, and in early stages this can not be picked on ultrasound examination.

Hope my explanation helps you.

Best wishes,

Dr Dinesh Singal
Above answer was peer-reviewed by
Follow-up: Treated for hypertension. LFT test done. What does the report suggest? 18 hours later
Thanks for your valuable replies!I have gone to doctor in Escorts referred by my gastroentrologist.he advise me to stop alcohol completely and then go for LFT test again after 2 months.HE REVIEWS my auto immune hepatatis report and give opinion AS:
1 XXXXXXX +VE (1:40) -non-specific +insignificant
3.LKM-1 Abs & ASMA bOTH -VE
HE says no need to go for liver biopsy at this stage as he thinks auto imune profile can be non-specifically positive and says this is required only after 6 months of leaving alochol and still LFT valves remains high
He also advise Immunoglobulins(IgG) test,Western blot M2 and ceruloplasmin+24 hour urine copper test (to rule out XXXXXXX Disease)
Pls give ur advise .Do you also think that alochol is the only cause for elevated SGOT/SGPT?which medicines you suggest for reducing SGOT/SGPT?which test you suggest to further know the cause of elevated LFT except liver biopsy?WHAT ARE your views on my auto immune profile(report attached-2 pages in my first post)?what AMA suggest,should i go for thyroid test?
Answered by Dr. Dinesh Kumar Singal 10 minutes later

Thanks for contacting again. Your gastroenterologist has given right advise to you. You should follow his advice.

I have already described what more tests you need to do. Please read it properly. There is no definite medicine to reduce liver enzymes. UDCA and sylimarin can be used which you are already taking.

Yes you should do thyroid tests.

Best wishes.

Dr Dinesh Singal
Above answer was peer-reviewed by
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