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SGOT and SGPT are always high. Hepatitis B is always negative on blood test. Suggest?

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Posted on Sat, 27 Jul 2013
Question: In Lever function test , My sgot and sgpt levels are always high( varies from 50 ~150). for the last 10 years I have been Imonitoring my critical health parameters ( LFT/RENAL/LIPID/Hepatitis b/glucose et)every six months. All parameters are perfect except sgot and sgpt.GGT level is also ok.whenever i undergo a medical test i am always referred to check hepatitis b and its always negetive. what could be the reasons for elevated levels? what tests can help in further probing? probing required or not required
doctor
Answered by Dr. Robert Galamaga (9 hours later)
Hello and thanks for the query.

You ask a very good question and I will work on providing you with some information and recommendations.

First, congratulations on paying close attention to your general health - this will pay off in a longer more enjoyable life.

Regarding the elevation of the liver enzyme levels - there can be a number of possible causes. One which your doctors have ruled out is hepatitis - this is a virus which causes damage to liver cells and in your case - this is certainly not a cause.

Next - we consider medications - including Tylenol or acetaminophen. Regular use of Tylenol for example can affect the liver. If you are not taking any medications or supplements then this again is not likely a cause.

Next - a very common cause of elevated liver enzymes is obesity. Depending on your height and weight, if a patient is even 10-15 pounds overweight this may cause fatty changes in the liver and subsequently - elevation of liver enzymes. This is usually reversible with gradual weight loss.

As far as additional tests at this time - I would possibly consider an ultrasound of the liver. This will tell us what the liver looks like and if there are any changes in the appearance of the liver tissue. If it appears normal then no additional testing would be recommended. If there are changes - you should discuss this with a hepatologist who is a physician specializing in liver issues.

Otherwise - I would continue to monitor periodically with a repeat liver fuction test in 3 to 6 months. You might also ask your doctors to check an INR - this is a measurement of how well your liver is producing proteins which are used in maintaining normal coagulation activity in the body.

Lastly, continue to focus on maintaining excellent health with good diet and exercise.

Thanks again for the query. Please let me know if you have any additional specific concerns,

Sincerely,

Dr. Galamaga
Above answer was peer-reviewed by : Dr. Vasanth
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Follow up: Dr. Robert Galamaga (2 hours later)
Thank you for a prompt reply ! I am indeed impressed by the services offered through your website .you and your team is doing a great work.
Just wanted to know if taking Tefrolive forte or Liv52 syrup or omega 3 fatty acids would be of anyhelp.do they have any adverse health effects ?
I think you are spot on .the most likely reason would be obesity or fatty liver. I have been gaining weight for the last 10 years and my current BMI is 33.I have already done some correction in lifestyle like using olive oil , no alchoal , yoga , more fiberous diet etc. Will share progress after a month or so .
doctor
Answered by Dr. Robert Galamaga (1 hour later)
Hello again! Thanks for the feedback and additional information.

Regarding the Liv52 and Tefrolive forte - i have not seen good data on these supplements. Therefore I cannot recommend taking them and I would honestly avoid taking them for now until you have a followup liver check. Omega3 is fine to take - one cap 2 - 3 times per day - this is good for heart health as well although I am not sure it will affect the liver in any respect.

Keep working on the lifestyle modification - slow steady progress will pay many returns for you in the future. I look forward to your followup in the future!

Regards,


Dr. Galamaga
Above answer was peer-reviewed by : Dr. Prasad
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Follow up: Dr. Robert Galamaga (9 days later)
Hi Doctor

Today I got my reports of Executive healthcheck up ,from Asian Heart Institute Mumbai. tmt,2d echo,ecg,PFT ,renal function ,lipid profile ,Ultrasound whole abdo,blood glucose fasting ,pp & HB1AC etc is ok. Follwing are the abnormalities
moderate fat on liver ,liver enlarged by 17.5mm.
sgot-115 sgpt-150 , total bilurbin is 1, gamma gt -160 , isr 30 ,INR-1 ,ALAKLINE PHOSPHATE-110
hav total -positive , HAV IMG- Non reactive,HAVigg- reactive ,hepatitis b- negetive,hepatitis c- negetive.
I dont recall if i were ever detected with hepatitis A and given its vaccine. I use to take alchoal but have completely stopped since last one month. My height is 174cm and weight is 126 kg. It was 133 one month back and by stopping alchoal and with some lifestyle changes reduced by 6 kg in a month.targeting to bring in <100 in next one month.
considering all above whats your reccemendation for HAV? SHOULD I TAKE ITS VACCINE? What appears to be the overall issue?does hav and sgot/sgpt levels have any relationship?
Regards
XXXXX
doctor
Answered by Dr. Robert Galamaga (11 hours later)
Hello again.

Thank you for the additional information. At this time I really think the most likely cause of your laboratory abnormalities is fatty changes of the liver related to your weight. I believe this will improve if you continue to focus on slow and steady weight loss and improving your diet and exercise lifestyle.
Discontinuing alcohol consumption will also likely have a positive impact on your test result.

Regarding the Hep A result. IgG means you were exposed to the virus in the past and now have antibodies. This does not affect your liver test results at all. You do not need any vaccination for this virus.

Thanks again for the additional information. I am very confident that you will continue to do better and feel better every day. Please keep me posted regarding your progress. Dr Galamaga

Above answer was peer-reviewed by : Dr. Prasad
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SGOT and SGPT are always high. Hepatitis B is always negative on blood test. Suggest?

Hello and thanks for the query.

You ask a very good question and I will work on providing you with some information and recommendations.

First, congratulations on paying close attention to your general health - this will pay off in a longer more enjoyable life.

Regarding the elevation of the liver enzyme levels - there can be a number of possible causes. One which your doctors have ruled out is hepatitis - this is a virus which causes damage to liver cells and in your case - this is certainly not a cause.

Next - we consider medications - including Tylenol or acetaminophen. Regular use of Tylenol for example can affect the liver. If you are not taking any medications or supplements then this again is not likely a cause.

Next - a very common cause of elevated liver enzymes is obesity. Depending on your height and weight, if a patient is even 10-15 pounds overweight this may cause fatty changes in the liver and subsequently - elevation of liver enzymes. This is usually reversible with gradual weight loss.

As far as additional tests at this time - I would possibly consider an ultrasound of the liver. This will tell us what the liver looks like and if there are any changes in the appearance of the liver tissue. If it appears normal then no additional testing would be recommended. If there are changes - you should discuss this with a hepatologist who is a physician specializing in liver issues.

Otherwise - I would continue to monitor periodically with a repeat liver fuction test in 3 to 6 months. You might also ask your doctors to check an INR - this is a measurement of how well your liver is producing proteins which are used in maintaining normal coagulation activity in the body.

Lastly, continue to focus on maintaining excellent health with good diet and exercise.

Thanks again for the query. Please let me know if you have any additional specific concerns,

Sincerely,

Dr. Galamaga