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Dr. Thomas, MD
Dr. Thomas, MD, Board Certified Physician
Category: Medical
Satisfied Customers: 56407
Experience:  Internal Medicine--practice all of internal medicine, all ages, family, also Integrative, CAM, etc
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I have had elevated liver enzymes for years. In 2003, my levels

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I have had elevated liver enzymes for years. In 2003, my levels were ALP = 191, AST = 42, ALT = 74, and GGT = 277. I saw four doctors, none of which were alarmed and just told me to watch it. They've patterned in the same ranges for ten years. Last November, my gastro doctor said he was concerned. Levels at that time were ALP = 255, AST = 41, ALT = 51, and GGT = 239. He tested for Wilson's, every auto-immune possible, and every other general test (again). So we did an endo and colonoscopy. The results of the endo showed signs of Celiac. I have been gluten free ever since and I've never felt so healthy in my digestive system. I was tested again about a month ago. ALP = 211, AST = 28, ALT = 47, and GGT = 282. I have an easy-to-pinpoint pain under my right rib that is sharp at times and comes and goes, mainly first thing in the morning. I have a 3mm polyp in my gallbladder and a severely low vitamin D deficiency. My gastro insists on a biopsy. The 2
Submitted: 11 months ago.
Category: Medical
Expert:  Dr. David replied 11 months ago.
Hello, this is Dr. David. I have read your question and I'm ready to help.

yes, I agree with your gastroenterologist to get a biopsy of yoru liver to see why your enzyme leves have been elevated for so long. this is really the needed next step to find out what is going on.

I'm sure you have been tested for hepatitis already and this was negative.

hopefully you don't drink alcohol as well.

I doubt the celiac spruce disorder is causing your elevated liver enzyme levels.

are you willing to get a liver tissue biopsy to sample cells from the liver to find out what is going on in the liver?
Customer: replied 11 months ago.


Why would it not be my gallbladder though? I've had three doctors in the last year tell me my levels aren't high enough to warrant the risk of a biopsy. I'm not sure what the smartest thing is to do. And if it's liver disease, wouldn't they be progressively worse over 10+ years?

Expert:  Dr. Thomas, MD replied 11 months ago.
Hello
Biopsy is probably the only way to get to the bottom of this and is necessary.

yes if it were a progressive disease you would probably have problems, but not always.

The biopsy is to see the degree of damage, as you can not tell otherwise...you need to see if there is fibrosis and scarring
make sense?
Customer: replied 11 months ago.

I think so. Just two more questions: is it as risky as I've heard, and what would be possible treatment? medicine?

Expert:  Dr. Thomas, MD replied 11 months ago.
It depends on if a cause is identified.
Yes, for example, if it is autoimmune, prednisone.

Treatment would depend on the cause.

Diet is very important.
The more protein from vegetable foods, the better, easier on the liver.

Please let me know if you have further questions.
Use reply as needed.
Please do not forget a positive rating.
Dr. Thomas, MD, Board Certified Physician
Category: Medical
Satisfied Customers: 56407
Experience: Internal Medicine--practice all of internal medicine, all ages, family, also Integrative, CAM, etc
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