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Dr. Andrew Rynne
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Dr. Andrew Rynne

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Diagnosed with hypercholestrolemia. Liver test shows elevated ALT, alkaline phosphates. Due to fatty liver?

I have recently diagnosed with hypercholestrolemia with my cholesterol being 6 mmol/l. Trig 4.2. My liver enzymes are increased ALT 75 U/l. GGT 120. Alk phos 151. My age is 35 I m a smoker but don t take alcohol. Are these alterations in liver enzymes due to hypercholestrolemia or it suggest fatty liver or something else??
Fri, 7 Dec 2012
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Gastroenterologist 's  Response
Hello, zaraarshad,
The condition called "Metabolic Syndrome " is associated with overweight,
Type-2 diabetes, elevated lipid levels, and fatty liver in it's complete form.
If you have these it is possible that your liver enzyme elevation may be due
to mild fatty liver based on the levels of elevation. But you need to have a
good ultrasound of the liver to find out the degree of fatty liver (Grades).
In it's early stages, if appropriate measures are taken, your liver can
be perfectly normal. Losing weight, controlling blood sugar,proper excercise,
diet, and reducing the lipid levels.
Having said that, there are a lot of reasons for enzymes to be elevated.
Drugs, including over the counter ones, viruses such as Types-A, B,or C,
Autoimmune diseases, some metabolic disorders, some genetic enzyme
deficiency conditions, heavy metals, poison mushroom etc. etc.
Start taking a good super B-Complex Vit. daily along with 800 i.u. of Vit-E
and 1000mg. of Vit-C. along with a high protein diet.
I wish you the best.
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General Surgeon Dr. Iven Romic Rommstein's  Response
It definitely suggest fatty liver and hypercholesterolemia just approves this diagnose. The liver ultrasound would be also helpful and liver biopsy as well to find signs of liver fibrosis/cirrhosis.
Common causes of elevated LE are:

Infections such as viral hepatitis and mononucleosis
Alcohol abuse
Autoimmune disorders of the liver and bile ducts, such as autoimmune hepatitis
Diabetes
Elevated triglycerides (fat tissues)
Adrenal insufficiency
Hepatic steatosis and steatohepatitis, and non-alcoholic steatohepatitis (NASH)
Medications
Obesity

So if you are honest about alcohol drinking you should also check your viral DNA/RNA levels of Hepatitis A,B,C virus. These chol/trigl levels are not so high but consider some antilipemic drugs. Liver enzymes shows moderate elevation. This ALP finding suggest that there could be biliary ducts problem but you need to do US to check it out:) Till you find the exact cause you should care about nutrition and avoid medications and alcohol. If you feel fatigue, nausea, pain under the right subcostal arch or notice jaundice or stool/urine color changes, go to hospital as soon as possible.

Wish you good health, Dr. Ivan Romic (Rominho)
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Diagnosed with hypercholestrolemia. Liver test shows elevated ALT, alkaline phosphates. Due to fatty liver?

Hello, zaraarshad, The condition called Metabolic Syndrome is associated with overweight, Type-2 diabetes, elevated lipid levels, and fatty liver in it s complete form. If you have these it is possible that your liver enzyme elevation may be due to mild fatty liver based on the levels of elevation. But you need to have a good ultrasound of the liver to find out the degree of fatty liver (Grades). In it s early stages, if appropriate measures are taken, your liver can be perfectly normal. Losing weight, controlling blood sugar,proper excercise, diet, and reducing the lipid levels. Having said that, there are a lot of reasons for enzymes to be elevated. Drugs, including over the counter ones, viruses such as Types-A, B,or C, Autoimmune diseases, some metabolic disorders, some genetic enzyme deficiency conditions, heavy metals, poison mushroom etc. etc. Start taking a good super B-Complex Vit. daily along with 800 i.u. of Vit-E and 1000mg. of Vit-C. along with a high protein diet. I wish you the best.