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What Does The Following Liver Function Test Report Indicate?

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Posted on Fri, 7 Nov 2014
Question: I am 31 years old and have been drinking hard since I was 18. I have tapered off over the last 3-5 years a bit from my worst but still drink heavily and have concerns regarding damage to my liver. I routinely get blood work done and the doctors have always said everything looks good. I am specifically worried about my metabolic panel's findings. Specifically my AST and ALT values and the ratio between them. I have read there is a linake between the AST/ALT ratio and alcohol damage, specifically if the ratio is greater than 1, which mine is.



http://www.clevelandclinicmeded.com/medicalpubs/diseasemanagement/hepatology/guide-to-common-liver-tests/



In short I would like a second opinion about my blood work, specifically looking for alcohol related liver damage. Also, based on my blood work, should I still have concerns? (I understand blood work wont reveal everything in every case but in most cases if something is wrong would my blood work alert me?)







Below are my revelevent lab results from 10/2/14



Creatinine 0.90



AST 25



ALT 18



Alkaline Phosphatse 108



Bilirub 0.6



Albumin 5.3



Globulin 2.1



A/G Ratio 2.5



Protein 7.4



carbon dioxide 26



calcium 9.5



Chloriode 98



Potassium 4.0



BUN 13









Below are my OLDER metabloic results from July 2013



Sodium 140 135 - 146 mmol/L



Potassium 4.1 3.5 - 5.3 mmol/L



Chloride 101 98 - 110 mmol/L



CO2 25 19 - 30 mmol/L



Glucose 84 65 - 99 MG/DL



BUN 14 7 - 25 MG/DL



Creatinine 0.81 0.60 - 1.35 mg/dL



BUN/Creatinine Ratio N/A 6 - 22



Bun/Creatinine ratio is not reported when the BUN



and creatinine values are within normal limits.



CALCIUM 10.1 8.6 - 10.3 MG/DL



Protein, Total 7.7 6.1 - 8.1 G/DL



Albumin 5.3 3.6 - 5.1 G/DL



Globulin 2.4 1.9 - 3.7 G/DL



Albumin/Globulin Ratio 2.2 1.0 - 2.5



Bilirubin, Total 0.5 0.2 - 1.2 MG/DL



AST (SGOT) 28 10 - 40 U/L



ALT 24 9 - 46 U/L



Alkaline Phosphatase 101 40 - 115 U/L



EGFR 120 > OR = 60 mL/min/1.73m2


XXXXXXX XXXXXXX EGFR 139 > OR = 60 mL/min/1.73m2
doctor
Answered by Dr. Panagiotis Zografakis (1 hour later)
Brief Answer:
The tests are OK

Detailed Answer:
Hello,

you haven't defined what 'heavy drinking' means to you but since you recognize it as a problem it's probably really heavy. Drinking more than 30-50 grams per day is too much and may induce cirrhosis in susceptible individuals. Not everybody develops cirrhosis which means that other factors come into play as well.
A fairly sensitive indicator of alcohol abuse is the gamma glutamyl transferase (gamma-GT). You haven't done this test or you haven't provided the results.
The rest of your results are not indicative of liver damage. The slightly higher values of AST (in comparison to ALT) are not conclusive. Usually alcoholic liver disease is accompanied by an AST twice as high as the ALT. Such small differences in their values like in your tests, are probably normal.
Besides the small difference, the values themselves are normal (they are not increased). Other indicators of chronic liver damage like the albumin or the bilirubin are normal too.
Cirrhosis and alcoholic hepatitis are two possible outcomes after prolonged excessive alcohol abuse. Both may present with abnormal laboratory findings but particularly with cirrhosis, the damage will not be reversible. The liver has some regenerative potential but after cirrhosis gets diagnosed, your liver will never be the same.
Cutting down on alcohol is definitely good for a healthy way of living in many aspects including personal relationships, professional life and law-problems. Your liver would greatly appreciate it!
If you are alcohol dependent though and you absolutely need alcohol to open your eyes, stop trembling etc then you should seek medical help. You can't just stop drinking, or you'll probably experience hallucinations, seizures, etc. Alcoholics who cut down on alcohol abruptly without medical support may die. So, if you have that kind of alcohol dependency you're going to need medical support.
If you're not dependent though, then you just have to make that decision!
I hope you've a more clear view of the situation now!
If you have more questions on this subject, please let me know. I'll be glad to clarify things for you.

Kind Regards!
Note: For further follow up on related General & Family Physician Click here.

Above answer was peer-reviewed by : Dr. Yogesh D
doctor
Answered by
Dr.
Dr. Panagiotis Zografakis

Internal Medicine Specialist

Practicing since :1999

Answered : 3810 Questions

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What Does The Following Liver Function Test Report Indicate?

Brief Answer: The tests are OK Detailed Answer: Hello, you haven't defined what 'heavy drinking' means to you but since you recognize it as a problem it's probably really heavy. Drinking more than 30-50 grams per day is too much and may induce cirrhosis in susceptible individuals. Not everybody develops cirrhosis which means that other factors come into play as well. A fairly sensitive indicator of alcohol abuse is the gamma glutamyl transferase (gamma-GT). You haven't done this test or you haven't provided the results. The rest of your results are not indicative of liver damage. The slightly higher values of AST (in comparison to ALT) are not conclusive. Usually alcoholic liver disease is accompanied by an AST twice as high as the ALT. Such small differences in their values like in your tests, are probably normal. Besides the small difference, the values themselves are normal (they are not increased). Other indicators of chronic liver damage like the albumin or the bilirubin are normal too. Cirrhosis and alcoholic hepatitis are two possible outcomes after prolonged excessive alcohol abuse. Both may present with abnormal laboratory findings but particularly with cirrhosis, the damage will not be reversible. The liver has some regenerative potential but after cirrhosis gets diagnosed, your liver will never be the same. Cutting down on alcohol is definitely good for a healthy way of living in many aspects including personal relationships, professional life and law-problems. Your liver would greatly appreciate it! If you are alcohol dependent though and you absolutely need alcohol to open your eyes, stop trembling etc then you should seek medical help. You can't just stop drinking, or you'll probably experience hallucinations, seizures, etc. Alcoholics who cut down on alcohol abruptly without medical support may die. So, if you have that kind of alcohol dependency you're going to need medical support. If you're not dependent though, then you just have to make that decision! I hope you've a more clear view of the situation now! If you have more questions on this subject, please let me know. I'll be glad to clarify things for you. Kind Regards!