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Dr. Frank
Dr. Frank, Board Certified Physician
Category: Medical
Satisfied Customers: 8999
Experience:  Neurologist/Internist with academic and clinical experience.
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My husbands lab work came back and is showing high levels of

Customer Question

My husbands lab work came back and is showing high levels of Ast (106) and Alt (224). His Throglobulin Antibodies are 136. What could this be?
JA: Thanks. Can you give me any more details about your issue?
Customer: He is an occasional drinker. Doesn't take medicine other than an occasional pain reliever, and eats right and does sports every day.
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Submitted: 6 months ago.
Category: Medical
Expert:  Dr. Frank replied 6 months ago.
Hello. Welcome to JA. What other findings does he have on exam. Anti-thyroid antibodies should be negative, and are seen in a variety of thyroid conditions and autoimmune diseases. So if he has thyroid disease, then Hashimoto's thyroiditis, either hyper or hypothyroid disease can be seen. Also graves disease. These antibodies are non specific too and can be seen in Lupus or Diabetes if he has high anti-GAD antibodies. Has he had a liver ultrasound or HIDA scan for the increase in enzymes? Does his doctors think that the elevation is alcoholic hepatitis? Has he been checked for other types of hepatitis? Get back to me to discuss this further if I can help Dr Frank
Customer: replied 6 months ago.
He has no known diseases these findings were found accidently on an allergy test. He has been tested for diabetes it was negative, and the doctors do not believe alcohol is a factor. He hasn't been checked for any other hepatitis, and has had no further testing other than lab results. Attached are a copy.
Expert:  Dr. Frank replied 6 months ago.
HI. From what I can see here on the lab sheet (It is stretched so I am not sure), his thyroglobulin antibodies are normal, but is thyroid peroxidase antibodies (TPO) are elevated. Is that correct? That would again be a more non specific finding for autoimmune diseases, so if he does not show any signs of thyroid disease (Hashimoto's thyroiditis) with either increased or decreased energy, pain in the throat, or increased bowel movements, dry skin, dry hair, tremor, etc., then you have to wonder if he has sarcoid, lupus, rheumatoid arthritis, Sjogren's disease with dry eyes, crohn's disease with intestinal problems, etc. He needs an ultrasound of the liver or CT of the liver if your docs feel the increased LFT's are not related to alcohol. What about his GGT, alkaline phosphatase?
Expert:  Dr. Frank replied 6 months ago.
I see his alk phos is normal, and his bilirubin values are normal, what is he taking for allergy pills? Is he on steroids? The TPO may be a mistake as well, and might want to be repeated to make sure it is valid. Dr frank
Customer: replied 6 months ago.
Alkaline phosphatase 88, bilirubin indirect .3, direct .1, total .40. I do not see GGT labs, however his immunoglobulin E was 462. And he has had issues with dermographism.
Expert:  Dr. Frank replied 6 months ago.
I see. these issues might be related to his histamine response, there is no signs of obstructive liver damage, cholecystitis, but there is cellular injury, consistent with toxic damage as from alcohol, although the numbers are not that high, or from medication effects, or viral injury as in hepatitis. He needs a hepatitis viral panel. Dr Frank
Expert:  Dr. Frank replied 6 months ago.
I will put out the phone option if you wish me to call you. Dr Frank