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Anthony Bray, MD
Anthony Bray, MD, Doctor
Category: Health
Satisfied Customers: 10341
Experience:  14 years as clinician in the field of Family Practice
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I recently had blood work done and my GGT came back at 181,

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I recently had blood work done and my GGT came back at 181, about three times the normal range. I have been a moderate to heavy drinker for 20+ years, the last 78 really watching my AST and ALT's. These were in the normal range but high end of the range. Alk Ohos. is well in the normal range as, but Creatine kinase was evelated at 200. For years I have been experiencing what feels like a muscle strain right where my liver is but every ultrasound and MRI of the liver has come back fatty but normal. I quit drink for 8 weeks a couple years back and it had no effect on the side pain - Dr's seem puzzled as am I...???

Anthony Bray, MD :


Anthony Bray, MD :

The isolated GGT is probably due to your drinking...

Anthony Bray, MD :

The GGT is the most senstive to change due to drinking alcohol...

Anthony Bray, MD :

The fact that your AST and ALT were not elevated at this time then that would be reassuring...

Anthony Bray, MD :

The side pain may be of other origin than your liver>> I would expect this to likely be the case.. Usually when we see this isolated GGT elevation, the patient does not have any pain complaints at all...

Anthony Bray, MD :

Fatty liver changes could be related to problem. A fatty liver does not indicate NORMAL but rather excess storage of fat within the liver. This can cause enlargement and pain to the right upper quadrant...THis could potentially fit with your side pain...

Anthony Bray, MD :

Fatty liver changes may also occur with no symptoms but the mild enlargement of the liver may cause some discomfort such as fullness sensation at times...

Anthony Bray, MD :

Low fat diet and avoiding alcohol would be expected to improve fatty liver changes. It is hard to say if these changes may help you to feel better as the source of your pain remains in question, it seems to me...

Anthony Bray, MD and 2 other Health Specialists are ready to help you
Customer: replied 3 years ago.

I started to cut back on the drinking and now am experiencing edema in my feet and other symptoms


Well edema may be caused by many factors!
I can't see cutting back on alcohol as being a cause though ! I suspect that it is coincidence with some other cause! Tell me more of your age and health conditions. It could be due to venous insufficiency of the legs as a common cause... If this were the cause then it would tend to be worse with standing and better with lying down and resting over night... Venous insufficiency as a cause may also worsen with string with your legs dependant-- it is better to elevate legs up to couch or ottoman for example ...

Kidney insufficiency is a possible cause. If your kidneys operate at much lower than 100% ( more like 50% or less..) then you might have tendency to have swelling and perhaps high blood pressure as signs ... This type would center on probable need to treat with diuretics, other high blood pressure meds and working to protect kidney function.

Heart disease can be a cause of swelling. Congestive heart failure can be a cause if the edema as a symptom. Alcohol is toxic to both heart and liver ( and brain by the way ) heart failure would be more likely in a person with known history of heart disease such as past heart attack. Sometimes it is not known until it presents problems. Fatigue with exertion, shortness of breath and tightness of the chest are more likely to be symptoms with this cause. Treatment would be centered in taking care if the heart in this cause of course.

Obstructive sleep apnea is also capable of leading to edema. Excess sleepiness during the day and snoring history may be clues.

Liver disease can lead to lower extremity edema. There are a couple if different ways this may be a factor . If there is resistance to blood flowing up through the liver then this may be a factor. If the protein albumin which is made by the liver is too low then the capillaries throughout the body may leak fluid...

These would represent the main causes of edema. I would advise that you work with your doctor to determine the cause and best treatment for this!!

I hope that this is helpful for you! Let me know if you have further questions! Best regards!

Anthony Bray MD
Customer: replied 3 years ago.

I just realized that after 18 years my new doctor took me off of hydrocholorthiazide a couple weeks ago. A water pill. Could this be the cause? I loved my prior PCP but the Affordable Care Act forced me to a more "clinical" care insurance program.


Thank you for your professional opinion, they're valued.

Hello again,

Yes that is probably the cause here in your case. You are right that HCTZ is a diuretic and going off of this has probably made a difference.

At least I think the cure here will be very straight forward!

Best Regards,

Anthony Bray MD
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