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Medical Forum / General / Laboratory / September 2003Please help with high cholesterol, liver enzymes, AST and ALT levels
I'm trying to apply for a job over seas, and as a pre-employment requisite I had to go through some lab work - which involved taking blood and fasting. I was told not to eat anything after 12 Midnight, and my blood was drawn 10 hours later. I am now on medical hold due to some abnormal results, and I would like to ask some advise on the best method of correcting the possible health risks indicated by the following results: I smoke cigarettes, drink socially, and I am 32 years old male Suggested tasks for me to follow up on from the clinic: 1) Repeat LFTs and supply results 2) Check for Hepatitis 3) Gallbladder / Liver Ultrasound or Scan 4) Evaluate for Cirrhosis, Clotting, Platelets, INR In Range Out of Range Reference Range LIPID PANEL Triglycerides 163 H Less than 150 MG/DL Cholesterol TOTAL 282 H Less than 200 MG/DL HDL Cholesterol 41 40 MG/DL OR MORE LDL-Cholesterol 208 H Less than 130 MG/DL (CALC) CHOL/HDLC RATIO 6.9 H Less than 5.0 (CALC) Bilirubin, Direct 0.1 0 to 0.3 MG/DL GGT 203 H 2-80 U/L IRON, TOTAL 107 40 to 190 MCG/DL LD 239 100 - 250 U/L Phosphate (as phosphorus) 3.1 2.5 to 4.5 MG/DL Uric Acid 5.8 2.7 to 8.2 MG/DL Glucose 102 65 to 109 MG/DL FASTING REFERENCE INTERVAL UREA NITROGEN 15 7 to 25 MG/DL CREATININE 1.2 0.5 to 1.4 MG/DL BUN/Creatinine Ratio 13 6 to 25 (CALC) Sodium 141 135 to 146 MMOL/L Potasium 4.1 3.5 to 5.3 MMOL/L Chloride 104 98 to 110 MMOL/L Carbon Dioxide 26 21 to 33 MMOL/L Calcium 9.6 8.5 to 10.4 MG/DL Protein TOTAL 7.3 6 to 8.3 G/DL Albumin 4.5 3.7 to 5.1 G/DL Globulin 2.8 2.2 to 4.2 G/DL (CALC) Albumin/Globulin Ratio 1.6 0.8 to 2.0 (CALC) Bilirubin 0.8 0.2 to 1.5 MG/DL Alkaline Phosphatase 87 20 to 125 U/L AST 162 H 2-50 U/L ALT 175 H 2-60 U/L HEMATOCRIT 51 H 38.5 to 50 % Hepatitis A IGM ANTIBODY (PENDING) After the lab samples were obtained, I was given HEPATITIS A, HEPATITIS B, TYPHO, and POLIO vaccines... Please give your best opinion as to what these "out of range" results mean, how serious of a problem I have to deal with, and how I could move my out of range results within the reference range listed above.... What time frame am I realistically looking at, what methods and diets should I observe... > I'm trying to apply for a job over seas, and as a pre-employment > requisite I had to go through some lab work - which involved taking [quoted text clipped - 62 lines] > above.... What time frame am I realistically looking at, what methods > and diets should I observe... The lipid panel results are not that important right now as lipid panel results are impacted by clinical situations and become problematic in interpretation. The liver function tests are of more concern. Are you on any daily medications? These are the usual things you look at first. It can take 4-6 weeks off the offending meds for the liver enzymes to become normal once more after removal of the drug. You should be having a hepatitis panel performed and not only Hep A testing. If these are normal then an ultrasound looking for gallstones might be of help although you mention no pain. They might also see a small liver or fluid in the abdomen associated with cirrhosis. If the viral hepatitis screen is negative then autoimmune hepatitis testing might be in order or a liver biopsy. All these things are usually taken one step at a time. As far as things you can do or not do is you do not want to drink alcohol and avoid Tylenol as much as possible. Let your liver heal > The liver function tests are of more concern. Are you on any daily > medications? These are the usual things you look at first. It can take 4-6 > weeks off the offending meds for the liver enzymes to become normal once > more after removal of the drug. I did take some type of penicillin after having a root canal, about Aug 15th (1 month prior to my tests). Could this be a contributing factor to the results? I have been eating salads, and fruits ONLY - and LOTS of water + excersize to lower my levels... I began to take a natural cholestrol reducer that doesn't filter through the liver, only the stomach... Will this help me? How expensive could these tests cost, since I don't have insurance? Thanks in advance for the replies... > > The liver function tests are of more concern. Are you on any daily > > medications? These are the usual things you look at first. It can take 4-6 [quoted text clipped - 9 lines] > cost, since I don't have insurance? Thanks in advance for the > replies... You can never say never involving any medication or even food additive natural cholesterol reducer causing problems. If you don't have money to do testing then you have a problem. Kuhnfucius is right in that when large chemistry profiles are performed on otherwise healthy people the chances of having some abnormalities show up is not uncommon. They are many reasons for this. The logical next step is to repeat any abnormality to see if it persists. It is also common to see those abnormalities not appear again in which case no further workup would be warranted. If the transaminases ALT and AST remain elevated then the whole point would be to try and treat something treatable before it gets out of control. If it is chronic hepatitis it will not go away on it's own and you will always have elevated transaminases so getting a job with those constant findings will be a problem. Some of these treatments can be very expensive such as treatment for hepatitis B or C. I would only repeat the ALT and AST to minimize expenses. County health services may be of help in diagnosis public health concerns which would be free. You can not control or influence hepatitis with what you eat unless you are eating toxic mushrooms that are destroying your liver. I got a family member with chronic hepatitis C that is not high enough yet in terms of viral load to treat with interferon. He is not receiving anything for it now and it has been a few years now but they need to keep an eye on it. He only has elevated transaminases now. I would told have told you not to eat after 6-8 PM. Yes the GGT is abnormal. Have the liver test repeated in one to two weeks. If still abnormal, then Roberts suggestions apply. Might have the hepatitis testing done when the liver enzymes are repeated. It is always surprising to see how much addition procedures can be avoided simply by repeat testing when abnormal results are presented.  SignatureAll the burning bridges that have fallen after me All the lonely feelings and the burning memories Everyone I left behind each time I closed the door Burning bridges lost forevermore For Big Joe, Crap Game, Odd Ball and Kelley > I'm trying to apply for a job over seas, and as a pre-employment > requisite I had to go through some lab work - which involved taking [quoted text clipped - 62 lines] > above.... What time frame am I realistically looking at, what methods > and diets should I observe... How do you define "drink socially?" If you are drinking a LOT of alcohol socially, you could be cooking your liver. Many people drink upwards of ten drinks a night on weekends and quite a bit during the week and define that as social drinking. I'm not being accusatory here - I'm just trying to define terms. I define social drinking as 1-2 drinks every now and then when I go out, which isn't often. My father was an alcoholic who died at age 50, so I know whereof I speak. He developed the beginnings of cirrhosis around age 47 or so, and died of an alcohol-induced cerebral hemorrhage. What had started to be a fifth of whiskey a week in his early 30's turned into a fifth a day by the time he passed away. Alcoholism's onset can be very insidious. If you are heavily into herbal stuff, some of it can be liver toxic, depending what it is. With liver results such as yours, you need to NOT DRINK ANY ALCOHOL PERIOD [for quite some time, i.e. months - to allow healing of your liver, regardless of the cause of the elevations]! Also, you need to probably quit self-medicating with whatever you're taking. Take some B vitamins - they can't hurt you. I had to take INH for 6 months as a follow-up to a positive TB skin test (lab exposure). INH can be somewhat liver toxic and the doctor prescribed Vitamin B6, I believe, to be taken daily along with the INH (anti-tubercular antibiotic). B-vitamins are water soluble; whatever your body doesn't use will be urinated out. You can buy B-complex vitamins over-the-counter. Don't overdue - follow label directions. The fact that your follow-up testing is suggesting a cirrhosis evaluation says to me you may not be being upfront about alcohol consumption. Your total cholesterol is pretty high, but again, your liver results are the first concern. Hepatitis testing is not cheap. Hepatitis B Surface Antigen testing would be a place to start. I haven't done this testing in many years - I know there's a test for Hep. C out there, but don't know the name of it. If you've ever been transfused or abused drugs (needle injected type) that testing would definitely be in order. Hep. A is usually the result of being exposed to infected seafood or contaminated water. Judy Dilworth, M.T. (ASCP) Microbiology (but used to do chemistry) "teleras" <teleras@hotmail.com> wrote in message : > I smoke cigarettes, drink socially, and I am 32 years old male > [quoted text clipped - 4 lines] > 3) Gallbladder / Liver Ultrasound or Scan > 4) Evaluate for Cirrhosis, Clotting, Platelets, INR |
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