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12-07-2004, 06:25 PM
Hi Guys!

I'm just referring to blood tests I had in August 2003. My ALT was 24 then... and it's 10 now.

My GGT was 15 - the same it is now.

Which is better re: ALT scores? Is the 10 or 24 healthier? I KNOW someone on this board will know the answer. Once you have a disease/condition - you become an expert in these areas.

Thanks all.

I hope you are feeling well.



12-07-2004, 08:27 PM
Hi there....Your GGT and ALT scores are both within the normal range, and neither is more healthy than the other. AST and ALT are good enzymes to look at to see if there is anything going on in the liver. If there is some type of damage to the liver cells, then AST and ALT will be raised. However, when I mean raised, they'll be in the 100s, and in some cases, even in the 1000s! Obviously, you're nowhere close to that. GGT is less useful than its counterpart ALP which is a good indicator for problems in the liver which involve obstruction of bile flow (like gallstones).

In all liver disease, the above enzymes are raised; however, there are some characteristics.

#1. For obstructive problems and non-obstructive things involving primarily the bile ducts, GGT and ALP will be raised to a greater degree than AST and ALT.

#2. In diseases where the actual "meat" of the liver is attacked (e.g. viral hepatitis, toxic injury etc.) AST and ALT will be raised to a much greater degree than ALP and GGT.

#3. Finally, the only time when liver enzymes in the normal range are actually abnormal is when a patient has cirrhosis and the liver FUNCTION tests indicate the liver is failing. (Which is obviously not your case because you would be much more sick).

Finally, keep in mind that many people mistakenly called AST, ALT, ALP and GGT the liver function tests. This is incorrect. The above are just liver enzymes. Liver FUNCTION tests are four separate tests altogether.

12-07-2004, 08:31 PM
Could you tell me what exactly is a liver function test? Thanks!

12-07-2004, 08:40 PM
Hi Crisma!

There are four liver function tests. They are:

INR - (international normalized ratio) which is a measure of how fast the blood clots. around 1.0 is normal. If it is higher, it means the person has difficulty clotting, or the person is on medication that is helping to thin the blood. In liver disease, if the INR begins to raise, it means the liver is not able to synthesize clotting factors properly.

Bilirubin - this is a breakdown product of hemoglobin. It is normally conjugated by the liver and then cleared out both in to the stool and in to the urine. If the liver is dysfunctioning, it can't deal with the bilirubin, and it begins to rise in the blood.

Albumin - this is a simple protein that the liver synthesizes. Normally, you see a low albumin in people who are malnourished (they're just not getting enough protein in their diets), who are losing it somewhere (i.e. people who have a disease known as protein losing enteropathy...they lose too much protein in their diarrhea or nephrotic syndrome...the kidneys leak albumin) or people with liver dysfunction. If a person has liver disease, you see the INR going up and the bili going up, and then all of a sudden you see the albumin going down, you know the liver is failing.

Glucose - in end end stage liver failiure, the liver is no longer able to synthesize and store glucose (in the form of glycogen) or perform gluconeogenesis...the result is that you have a really low blood sugar.

12-07-2004, 08:41 PM
Thank you for your input and guidance. Gee, all this time I was thinking the blood tests I was getting were an indication of how my liver was functioning.

Why would my doctor test for enzymes only, and not function - considering the pain I've been in?

Now, I'm suffering with severe dry mouth and dry eyes. Has anyone had those conditions and did they relate to liver or gallbladder problems?

12-08-2004, 05:05 AM
Hi there wimzie, actually, if your doctor said "liver function" tests, the only mistake s/he made was with wording. If you were complaining of abdominal pain, then one test you could do would be to check liver enzymes. If you had hepatitis (i.e. inflammation of the liver) your liver enzymes, like I explained above, would be elevated. However, even with hepatitis, you don't necessarily have to have liver function abnormalities and the INR, bili, albumin and glucose would all be within normal limits.

12-08-2004, 05:23 AM
Thank you for your input and guidance. Gee, all this time I was thinking the blood tests I was getting were an indication of how my liver was functioning.

Why would my doctor test for enzymes only, and not function - considering the pain I've been in?

Now, I'm suffering with severe dry mouth and dry eyes. Has anyone had those conditions and did they relate to liver or gallbladder problems?
Severe dry mouth and eyes eh? That's strange. Question for you: the abdominal pain you were having, was it more like a heartburn feeling? A few more questions. Have you noticed any o' the following:

Tiny hard bumps under your skin you never felt before?
Have you noticed your fingertips going white in the cold?
Have you had any problems swallowing?
Have you noticed the skin on your fingers getting really tight and smooth?
Have you noticed any raised blood vessels anywhere in your body (especially your face?)

Additionally, the severe dry eyes and dry mouth could be indicative of something called "sicca syndrome" which is associated with a disease known as Sjogren's, which in turn can be associated with scleroderma. Is there anyone in your family that has any diseases such as lupus or rheumatoid arthritis or something like that?

12-08-2004, 07:37 AM
It's so funny you should ask that. I have been seen by a rheumatic doctor a few years ago, after being diagnosed with Raynaud's and GERD (globus sensation et al!)... He said he didn't see that I had that, but was more intent with finding that I had fibromialgia, and I think he missed the boat a bit. I hope NOT to have schleroderma...

What about Primary Biliary Cirrohsis? When I punch my symptoms into a search engine... this is what comes up - which is an autoimmune condition. My enzymes would be elevated though right???

Thanks for all of your expert advice!!

12-08-2004, 04:48 PM
Hey wimzie...yeah, it does seem like a bit of a stretch when I asked that eh? Well, the reason I was asking is because your symptoms could actually be related. As I mentioned above, this severe dry mouth can be something called Sjogren's disease which is associated with other rheumatologic diseases. It's interesting you mention you had a "globus sensation" in your swallowing tube. Do you still have that? Do you ever have problems with choking on food?

Could you please try to answer the other questions I wrote for you up there? (i.e. the skin on the fingers, the raised blood vessels etc. etc.).

Now, in terms of Primary Biliary Cirrhosis (PBC), the chances of you having it are slim. It usually attacks middle-aged females. Yes, your liver enzymes would be higher--especially your GGT and your ALP (if it was done). The problem with the internet for searching about symptoms is that symptoms aren't specific. There are certain symptoms which are very non-specific and they can indicate something as simple as the common cold all the way over to a malignant cancer. Signs (rather than symptoms) are things that the patient doesn't necessarily complain about, but the doctor sees them on physical exam. THESE are much more specific in pointing towards a diagnosis.

Is there any history of rheumatologic disease in your family? Do you have trouble with dryness anywhere else on your body?

12-08-2004, 05:29 PM
Okay, now you're getting personal. LOL (kidding)

You say it's unlikely for me to get it because it usually attacks middle-aged women? I'm a 40 year old woman, BUT I don't think I have it.

Regarding the other questions, No I don't have thickening skin or cholesterol bumps under my eyes. I don't have shiny fingers... I have shiny hair...??


All joking aside, you've been so helpful. I just feel like my pain has gone on long enough.. now I'm experiencing TMJ over and above my right side rib pain and 'dryness'... I see my doctor on Monday, so I'll ask for a function test and maybe get another referral to a rheumatic doctor. I do have so many symptoms that can link to auto-immune diseases as you mentioned. I'm otherwise feeling so healthy and I feel like I look like I'm in my mid-20's... My daughter is always saying... are you sure you're not a teenager?? LOL

Gotta love it.

I can't be THAT sick??

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