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What do these high liver enzymes indicate?

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Posted on Fri, 9 May 2014
Question: Dear Dr XXXXXXX Thank you very much for inquiring about my health. As I told you earlier I was given Actimarin Forte by the physician (twice a day), as my SGPT and SGOT were slightly increased in one report. The enzymes are now within the normal range. The physician advised for Abdominal USG, the report is given below. The medicines which I am taking are given below: Coversyl AM - once in day Concor 5- once in day Xtor F - once in day (Atorvastatin and Fenofibrate) Ecospirin 75 - once in day Cremalax - once in day Cetapin XR (Metformin) 500 mg -once in day PAN-D - once in day Actimarin Forte -once in day I am hypertensive, take statins and fenofibrates and I am also suffering from IBS (constipation type). I dont take liquor regularly; I take generally on weekends. Blood glucose is under control. All lipids are under control. TSH is ok. Heart Angiograph is almost normal. I have given my history in brief. Kindly give your advice. Is my liver too bad. I think fatty liver condition is reversible. Please advise what to do. The report of abdominal USG is pasted below: Lab No. : KHA/09-04-2014/MR012289 Patient Name : Mr.A P XXXXXXX Patient Id : PIA/010033 Age : 59 YRS Sex : MALE Ref Dr. : Dr. SAIBAL ADHIKARI Date Of Collection : Report Date : 09/Apr/2014 04:02PM DEPARTMENT OF ULTRASONOGRAPHY REPORT ON EXAMINATION OF WHOLE ABDOMEN LIVER Liver is mildly enlarged in size(169.5 mm.) with grade I fatty changes. No focal parenchymal lesion is evident.Intrahepatic biliary radicles are not dilated.Branches of portal vein are normal. PORTA The appearance of porta is normal. Common Bile duct is normal (4.3 mm.) Lab No. : KHA/09-04-2014/MR012289 Patient Name : Mr.A P XXXXXXX Patient Id : PIA/010033 Age : 59 YRS Sex : MALE Ref Dr. : Dr. SAIBAL ADHIKARI Date Of Collection : Report Date : 09/Apr/2014 04:02PM with no intraluminal pathology (Calculi /mass) could be detected at its visualised part. Portal vein is normal (10.4 mm.) at porta. GALL BLADDER Gallbladder is physiologically distended. Wall thickness appears normal. No intraluminal pathology (Calculi/mass) could be detected. Sonographic Murphys sign is negative. PANCREAS Echogenecity appears within limits, without any focal lesion. Shape, size & position appears normal. No Calcular disease noted. Pancreatic duct is not dilated. No peri-pancreatic collection of fluid noted. SPLEEN Spleen is normal(81.2 mm.) in size. Homogenous and smooth echotexture without any focal lesion. Splenic vein at hilum appears normal. No definite collaterals could be detected. KIDNEYS Both kidneys are normal in shape, size (Rt. kidney 104.9 mm. x 47.5 mm. & Lt. kidney 106.3 mm. x 43.3 mm) axes & position. Cortical echogenecity appears normal maintaining corticomedullary differentiation. Margin is regular and cortical thickness is uniform. No calcular disease noted. No hydronephrotic changes detected. URETERS Visualised part of upper ureters are not dilated. URINARY BLADDER Urinary bladder is distended, wall (2.3 mm.) thickness appeared normal. No intraluminal pathology (calculi / mass) could be detected. Lab No. : KHA/09-04-2014/MR012289 Patient Name : Mr.A P XXXXXXX Patient Id : PIA/010033 Age : 59 YRS Sex : MALE Ref Dr. : Dr. SAIBAL ADHIKARI Date Of Collection : Report Date : 09/Apr/2014 04:02PM PROSTATE Prostate is normal in size.Echotexture appears within normal limits. No focal alteration of its echogenecity could bedetectable. It measures : 32.4 mm. x 38.7 mm. x 29.5 mm. Approximate weight could be around = 19.37 gms RETROPERITONEUM & PERITONEUM No ascites noted. No definite evidence of any mass lesion detected. No detectable evidence of enlarged lymph nodes noted.Visualised part of aorta & IVC are within normal limit IMPRESSION Mild hepatomegaly with grade I fatty liver. ***End of Report***
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Answered by Dr. Praveen (1 hour later)
Brief Answer: Grade 1 Fatty liver is reversible in every case Detailed Answer: Hi Sir.Hope you are doing well.I am glad that you have reverted with your detailed health workup. At the first place I would like to appreciate that you have been taking medication regularly to keep your sugars, blood pressure and lipids within normal limits.Sonology reports are normal except for Fatty liver. This borderline or high normal rise in enzymes with mild enlargement of liver is due to the deposition of fat droplets in the liver->early/inital stages due to consumption of alcohol which is called Fatty liver.Grade 1 fatty liver is often silent and remains undetectable since it does not present with any symptoms.Normally it does not interfere with functions of the liver.It is virtually reversible in every case. Avoiding of the causative factor(alcohol) will help liver to restore to normal over a period of time.Else it might progress further to irreversible conditions like cirrhosis which can rarely turn into cancer(very rare) complicating your existing health condition. I were to suggest to taper the consumption gradually and totally stop over a few weeks as far as possible.I definitely believe this is possible since you are an occasional drinker.This also eases control over hypertension and diabetes (alcohol being one of the risk factors). Therapeutic life style modification - Low salt intake, 20 to 30 minutes of moderate/brisk walking (without exerting yourself), increasing the proportions of vegetables/fruits , yoga/meditation/pranayama keep you mentally and physically healthy. Regular follow with these few suggestions will improve your health & I am sure shall feel the change.Long live sir.Thank you once again.
Above answer was peer-reviewed by : Dr. Vinay Bhardwaj
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Dr. Praveen

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Practicing since :2008

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What do these high liver enzymes indicate?

Brief Answer: Grade 1 Fatty liver is reversible in every case Detailed Answer: Hi Sir.Hope you are doing well.I am glad that you have reverted with your detailed health workup. At the first place I would like to appreciate that you have been taking medication regularly to keep your sugars, blood pressure and lipids within normal limits.Sonology reports are normal except for Fatty liver. This borderline or high normal rise in enzymes with mild enlargement of liver is due to the deposition of fat droplets in the liver->early/inital stages due to consumption of alcohol which is called Fatty liver.Grade 1 fatty liver is often silent and remains undetectable since it does not present with any symptoms.Normally it does not interfere with functions of the liver.It is virtually reversible in every case. Avoiding of the causative factor(alcohol) will help liver to restore to normal over a period of time.Else it might progress further to irreversible conditions like cirrhosis which can rarely turn into cancer(very rare) complicating your existing health condition. I were to suggest to taper the consumption gradually and totally stop over a few weeks as far as possible.I definitely believe this is possible since you are an occasional drinker.This also eases control over hypertension and diabetes (alcohol being one of the risk factors). Therapeutic life style modification - Low salt intake, 20 to 30 minutes of moderate/brisk walking (without exerting yourself), increasing the proportions of vegetables/fruits , yoga/meditation/pranayama keep you mentally and physically healthy. Regular follow with these few suggestions will improve your health & I am sure shall feel the change.Long live sir.Thank you once again.