Re: Liver panel - Kathleen

[Guest guest]

Hi Kathleen,

Basically the short answer is that " it depends " .

Depending on which components of the panel are raised, as

well as how elevated the values are it can indicate either a biliary

blockage or damage to the liver cells themselves.

The AST, ALT for example can indicate that the liver is inflammed

for some reason. And depending on how high they are can

indicate what is responsible for the damage. Acute viral hepatiits

for example, can have elevation from 500 to 1,000 units / mL.

Acute poisoning can have levels in the thousands (tylenol OD or

exposure to toxic substances). Alcoholic hepatitis (hepatitis just

means inflammation of the liver) has lower elevations - up to 500

units. And anything that is up 1.5 or 2 times normal is

considered normal variation and nothing to be too concerned

about (sometimes medications can do this or if a person has

had recent alcohol or from a fatty liver) or after heavy physical

work (muscle injury).

The GGT, Alk phosphate, bilirubin, etc can indicate that the biliary

tree is obstructed for some reason...by a gall stone or SOD or

swelling or a mass......or again from alcohol injestion. Again, it

depends on how elevated they are...and if there is only one value

that is out of whack or more than one. The more that is out of

whack, the more likely that something is going on. One by itself

may not mean anything.....and of course it needs to be correlated

to the symptoms of the patient.

Most of the time, if they are slightly elevated and there are no

overt symptoms, the doctor will review your medication intake

and ask you to quit using something if he thinks it is something

that makes sense then repeat the tests in a couple of months or

so. If they are still high then he may investigate further by testing

for hepatiitis, HIV, auto-immunity, hereditary hep, to coagulation

and vitamin studies, etc iff it is the ALT or AST that are high.

He will look into a blockage of the biliary system (gallbladder or

common bile duct for example) if it is the other components that

are elevated and this is usually down right away....not after

waiting a few months to see if they go down...but again it

depends on the patient. If he has a strong suspicion that the

gallbladder is part of the problem, or if the patient is in extreme

pain or has a fever he will probably suggest surgery in the very

near future.

In my case, I had elevated AST, ALT, Alk Phosphatase, GGT and

CK whenever I tested my blood within 24 to 48 hours after a

biliary colic attack. They would elevate anywhere from 200 units

to near 1,000. But they returned to normal quite quickly (within 4

to 7 days). From what I read and been told, this is very typical of

SOD of the biliary type (pancreatic type will show amylase and

lipase elevations in addition to LFTs or instead of LFTs).

Because the spasm is quick and only stays obstructed for

minutes or hours the body is able to quickly return the values to

normal. Another theory is that a small stone was moving through

the common bile duct and got temorarily " stuck " in the SO then

works it way out. Both scenarios allows the body to quickly return

to normal. However a mass or big stone or other reasons for a

long term and growing blockage will have elevations that do not

always cycle - they usually remain high over time and may even

elevate further. So that is why repeat testing as well as paying

attention to symptoms and other eamination clues is necessary

to get to the bottom of weird :LFTs.

Laurie