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Dr. Andrew Rynne

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What do high levels of GGT and ALP levels indicate?

Answered by
Dr.
Dr. Kaushal Bhavsar

Pulmonologist

Practicing since :2008

Answered : 14131 Questions

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Posted on Thu, 2 Aug 2018 in Digestion and Bowels
Question: My daughter 31 years had acute bronchitis in 1st week December and treated with cefpodoxime.antibiotic and another course of Zanocin antibiotics. She started having nausea , loss of appetite followed by vomiting , dysentry and fever
LFT and USG abdomen was done . USG liver , Gall bladder and bile duct was normal.
Gamma GT was marginally higher than normal ( 49 ). Alkaline phosphatase was little higher (170). (( Her alkaline phosphatase alone has been always raised from her childhood .))
Globulin was high ( 4.5 ). All others SGOT, SGPT , Bilirubin., Protein and albumen are normal.
Repeat LFT after 10 days showed little higher Gamma GT (60). ALP & globulin same.
Consulted GP who prescribed Udiliv 300 twice a day and Heptagon.
After 15 days ALP and Gamma GT further went up To 218 and 72 respectively. Globulin came down to 4.2.
All others SGOT SGPT Bilirubin proteins albumen normal. Prothrombin time normal. Protein electrophoresis pattern and break up normal ( marginally High Gamma globulin)
At doctor advise Udiliv has been stopped
And to repeat LFT after 3 . months.
Kindly advise action. Regards Rupak Choudhurie.


doctor
Answered by Dr. Kaushal Bhavsar 21 hours later
Brief Answer:
Get done CT Abdomen for biliary tract.

Detailed Answer:
Thanks for your question on Healthcare Magic.
I can understand your concern.
Raised GGT and ALP (alkaline phosphatase) are suggestive of obstructive pathology in biliary tract.
Sometimes ultrasound examination can be normal. So get done CT scan for biliary tract to rule out obstruction.
Another possibility is acute pancreatitis.
Inflammed pancreas can also cause similar symptoms with raised ALP and GGT with normal USG.
So get done amylase and lipase levels.
Please let me know
1. Is she having any addiction?
2. Is she taking any painkillers regularly?
3. What about her symptoms? Do nausea, vomiting worsen?
Please reply me answers of above asked questions, so that I can guide you better. I will be happy to help you further. Wishing good health to your daughter. Thanks.
Above answer was peer-reviewed by : Dr. Prasad
doctor
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Follow up: Dr. Kaushal Bhavsar 24 hours later
Answer to your questions
1. No addiction
2. No regular painkillers
3. No symptoms at all except one week nausea and loss of appetite during strong and double antibiotics consumption.
She has been recently seen by a top gastroenterologist of XXXXXXX who advised CPK, Amylase and Lipase. All are normal.
Her appetite is better than normal by the grace of God. She has gained over 15 kgs in past 3 years and recently after the acute chest infection and stomach infection there has been weight gain.
As per the gastroenterologist bile flow is sluggish due to excessive weight gain.
Please advise if any blood test is required and cause of Gamma GT increase.
ALP is likely to be connected to Vit D deficiency as per the GP and gastroenterologist.
Please advise


doctor
Answered by Dr. Kaushal Bhavsar 17 hours later
Brief Answer:
It's good that amylase and lipase are normal.

Detailed Answer:
Thanks for your follow up question on Healthcare Magic.
Sorry for late reply as I was busy.
It's good that amylase and lipase are normal.
No need to worry for major pathology.
Yes, you are right about vitamin D 3 deficiency and high ALP and GGT.
So give her vitamin D3 supplements.
No need to worry for higher ALP and GGT because she is asymptomatic and having all normal reports.
Hope I have solved your query. If you are not having further queries, then please close the conversation and rate my answer.
You can ask me directly on bit.ly/askdrkaushalbhavsar.
Wishing good health to your daughter. Thanks.
Above answer was peer-reviewed by : Dr. Kampana
doctor
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Follow up: Dr. Kaushal Bhavsar 2 days later
I have not received any response to my follow up questions of day before yesterday.
Apparently the doctor is not in a position to answer as it appears.
His assumptions and recommendations are not in line with the inputs provided.
It is ok on the part of a pulmonologist.
I would like a refund for addressing my questions to gastroenterologist

My questions were the reason of sudden increase in Gamma GT.
Can it be due to Vit D deficiency ?
Can it be due to blockage in bile duct whereas there is no nausea and no appetite loss?
Is this due to strong 2 antibiotics course.?
How long will it take to get to normal range
doctor
Answered by Dr. Kaushal Bhavsar 47 minutes later
Brief Answer:
No, antibiotic can not cause rise in GGT.

Detailed Answer:
Thanks for your follow up question on Healthcare Magic.
I can understand your concern.
I don't know why you didn't get my answer.
Coming back to your query, antibiotics don't cause rise in GGT.
I have already mentioned earlier about obstructive pathology and rise in GGT.
And this is the reason why I advised CT scan to rule out obstruction in biliary tract.
Reports have been noted about vitamin D3 deficiency and rise in GGT but exact mechanism is not known.
So if you really want to go in depth about obstruction in biliary tract then get done CT scan.
In some cases, idiopathic (reason not known) rise in GGT is there without any symptoms.
Hope I have solved your query. If you are not having further queries, then please close the conversation and rate my answer.
You can ask me directly on bit.ly/askdrkaushalbhavsar.
Wishing good health to your daughter. Thanks.
Above answer was peer-reviewed by : Dr. Kampana
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