Liver Test Results- An Update

[RickThai]

Liver tests have been brought up in a related post (Liver Checkup), and I had mistakenly mentioned SGOT as a separate test. As a kindly poster pointed out, the SGOT is actually another name for the AST test. That got me to thinking, and I thought I share some of my experiences concerning liver tests and drinking.

As I have repeatedly posted (probably to the bordom of other readers), I was diagnosed with Hep C in 1997. I was a life-long, moderate-to-heavy drinker (read heavy!) and as a result a liver biopsy showed that I had Stage II liver disease. This bascially means that both my liver and the portal veins which carry blood through the liver, had quite a bit of scar tissue (fibrosis).

At the time I was still drinking, and I begin a series of treatment to clear the virus (which failed). During the process I was constantly getting liver function tests. These consisted of a blood draw and included the following tests: ALT, AST, and GGT (among others, which I won't go into in this post).

I went back this morning and did a quick refresher of some information I had acquired about these three tests, and I would like to share that information with you.

I am not going to spell out the entire names of these tests, since I don't think it is important to this audience (and they're a pain to spell and/or pronounce), nor am I going to go into a lot of detail about them, including their units.

For the purposes of this post, I submitt the following information:

AST - This is also known as the SGOT, for a normal, adult male, this value should be less than 50. For a female, slightly less. Increased values indiicate problems with your liver, your kidneys, or other organs. It is commonly used with the ALT to indicate liver function.

ALT - This is also known as the SGPT, and again normal values for an adult male should be less than 50, and for a female, slightly less. It is considered the most sensitive marker for liver damage. The ratio of ALT to AST is often considered proof of liver damage from alcohol abuse.

GGT - This is also known as the GGTP. Increased values of this is often used an indicator of on-going, or current use of alcohol.

When I first started getting liver tests regularly, my values for AST and ALT were consistently in the 180s to 300s. That was when I was drinking.

The first time I stopped drinking ((I was undergoing a medical investigational study on the use of Ribavirin and Interferon as a treatment for Hep C), my AST dropped to a47, and my ALT dropped to around 51, and my GGT dropped to 45. This was after 24 weeks of treatment without drinking any alcohol.

I then drank a 6-pack of 3.2% alcohol beer over a one week period. Two weeks later I did another blood draw and liver test.

My AST jumped from 47 to 61, my ALT 51 to 74, and my GGT from 45 to 50. My doctor immediately knew that I had started drinking again, and I was kicked out of the study.

So you can see that drinking even a small amount of alcohol, impacts a damaged liver, for a long amount of time.

Once I got too sick to continue to drink, a year after stopping, my ASTs were still in the mid-50s, and my ALTs were in the 30s, with my GGTs in the 20s. Now these numbers could be considered 'normal' for a healthy person.

The only problem was that I was already in End-stage-liver disease! Basically, my liver already had so much scar tissue, that there wasn't a lot of healthy liver cells to die and increase the markers! By that time, my liver was just about at the end of its (and my) days.

Now I think that is an important concept for heavy drinkers and people with Hep C to understand. As I stated before, the problem with scar tissue is that it doesn't have any of the original functionality of the tissue it replaces. It doesn't die anymore from abuse, thus alcohol and the Hep C virus doesn't effect it anymore. Therefore the low or normal values being read during the lab tests are misleading.

There are other blood tests that are still valid indicators of advanced liver disease (such as INR, etc). but for people with dieseased livers, the three tests mentioned above are of limited value.

Since I had my liver transplant, my AST has climbed to 469, and my ALT has climbed to 834! Now these are considered really high values, and a person can not live long with those kinds of numbers. These numbers were the results reduced blood flow to my new liver, due to a stent that wasn't removed properly. Fortunately, an endoscopic procedure corrected the problem, and my liver started functioning normally.

I have had 76 blood draws (outside of the hospital), since I had my transplant. My ASTs and ALTs have been continually in the teens (11-19) for over two years. This was after I cleared the Hep C virus. Needless to say, I have not drank any alcolholic beverages for over 3 1/2 years.

I hope this info is useful to those of you who have (or suspect) on-going or past liver damage.

Rick

[ding]

Congrats on getting a transplant, and on your new life especially!

[Newsh]

Hi Guys

Would anybody be able to kindly inform me as to where it would be possible for me to conduct a GGT test in Thailand? I have been in touch with the Bangkok hospital who said they can not do the test. Has anyone previously taken the test in Thailand? if so I would be very grateful if you could let me know where it was you did the test.

Thanks in advance for any help with this.

Newsh

[ding]

Hi Guys

Would anybody be able to kindly inform me as to where it would be possible for me to conduct a GGT test in Thailand? I have been in touch with the Bangkok hospital who said they can not do the test. Has anyone previously taken the test in Thailand? if so I would be very grateful if you could let me know where it was you did the test.

Thanks in advance for any help with this.

Newsh

You can likely get a specific test at Bumrungrad, but I see it included in this package;

http://www.bumrungrad.com/check-up-package/package-recommendation?age=57&gender=0&id=8816

Search a Dr on this site and email or make an appointment online. It works well.

[Newsh]

Thank you, much appreciated Ding

[cheynewalk]

hi rick,

when you say you were a moderate to heavy drinker, how much were you drinking at the time? ..... i guess we all have different standards as to what constitutes a heavy drinker

[mogandave]

Did you get the transplant in Thailand?