Abnormal Liver Enzymes: Causes and Concerns - Gastroenterology and Hepatology

More Info

---

Understanding abnormal liver enzymes is crucial for diagnosing and managing liver health. Elevated liver enzymes, such as AST (GOT), ALT (GPT), and GGT, can indicate liver inflammation or damage. In your case, the significant elevations in these enzymes (GOT: 90, GPT: 210) suggest that your liver is under stress, and it's essential to investigate the underlying causes.

Several factors could contribute to your elevated liver enzymes. Given your history of high weight, the possibility of non-alcoholic fatty liver disease (NAFLD) is significant. NAFLD is often associated with obesity, insulin resistance, and metabolic syndrome. It can lead to inflammation and liver damage, manifesting as elevated liver enzymes.
Additionally, you mentioned a history of taking multiple medications, including antibiotics and pain relievers, which can also impact liver function. Certain medications, especially when taken in combination or in high doses, can lead to drug-induced liver injury. It's crucial to consider the cumulative effect of these medications on your liver, especially if they were taken concurrently with alcohol consumption. While you have reduced your alcohol intake, even moderate drinking can exacerbate liver issues, particularly when combined with other liver stressors.

Your family history of hepatitis B and liver fibrosis is also a critical factor. While you have tested negative for hepatitis B and C in the past, the genetic predisposition to liver disease can play a role in your liver health. Chronic conditions like hepatitis B can lead to liver fibrosis and cirrhosis, which may increase the risk of liver-related complications in family members. It's essential to monitor your liver health regularly, especially given your father's history.

The fact that your liver enzymes have continued to rise despite changes in medication and lifestyle suggests that further evaluation is necessary. A liver ultrasound or imaging study may help assess for fatty liver or other structural changes. Additionally, a liver biopsy or non-invasive tests like FibroScan could provide insight into the degree of liver damage or fibrosis.

In terms of management, it is vital to adopt a comprehensive approach. This includes:
1. Lifestyle Modifications: Focus on weight loss through a balanced diet and regular exercise. Reducing body weight can significantly improve liver health and enzyme levels.

2. Medication Review: Consult your healthcare provider about all medications you are taking. It may be necessary to adjust or discontinue certain medications that could be contributing to liver enzyme elevation.

3. Regular Monitoring: Schedule regular follow-ups with your healthcare provider to monitor liver function tests and assess any changes in your condition.

4. Avoid Alcohol: Given your liver enzyme levels, it is advisable to avoid alcohol entirely to prevent further liver damage.

5. Screening for Viral Hepatitis: Although you have tested negative in the past, consider periodic screening for hepatitis B and C, especially given your family history.

6. Consult a Specialist: If liver enzymes remain elevated, consider consulting a hepatologist for specialized care and management.

In summary, elevated liver enzymes can result from various factors, including obesity, medication use, and family history of liver disease. A thorough evaluation and proactive management plan are essential to address these concerns and protect your liver health. Regular monitoring and lifestyle changes can significantly improve your liver function and overall well-being.