Question: I have elevated liver enzymes - alt, ast (initially 5-8x high normal, now at about 2x high normal), alk. phos. (initially 2x high normal and now just slightly above high normal) and ggt (significant elevations at about 10-15x high normal). I was made aware if this after blood work for life insurance, which was declined. Elevations have waxed and waned over the last 6 months, but are still above normal. My PCP has have done ultrasound, ct with contrast, and now my blood is at Mayo for possible PBC (ordered by liver specialist).

Only notable thoughts are that I had a root canal this past week and the endodontist told me it was likely the cause of some jaw pain that I have had for a few months. He said it was pretty bad, although an abscess wasn't noted. Could the tooth problem be the cause of elevated values if an infection were present for this period of time (no tooth pain until the last month)? And, over the course of the last 3 1/2 years I have lost 93 lbs. with diet and exercise. CT said I did not have fatty liver, but the liver specialist disagreed.

History of cancer on one side of my family (all kinds - throat, lung [small plueral spot in lung on ct, noted as insignificant with no f/u needed], stomach, liver, etc.) and heart disease on the other side. My full blood brother has had 4 heart attacks within the last 2 years and he is 52 (I am 51). My uncle had coronary bypass, as did my grandfather, who ultimately passed of CHF. I am not hypertensive since losing the weight, and only known health issues are Thyroid disease [Hashimoto's], migraine [weather/pressure induced], add, and allergies [allergic to dust mites, ragweed, and mold spores]. Drugs taken are Levoxyl, Furosemide, spironolactone, sulfamathoxole (sulfa antibiotic for cystic/nodular acne), gabapentin (small dose at night as a migraine preventative, but depressed my system too much for me to function, so only 300 mg. before bedtime), Prilosec for GERD, and previous Simvastatin for high cholesterol (also familial). PCP took me off the Simvastatin until further determination of cause for elevated liver enzymes [not sure I agree with him here because my last lab values were over 300 total cholesterol, and over 200 LDH, my HDL was (and always is) around 65.

Any thoughts on cause so that I can help move the research in the right direction? I am going broke with the medical expenses .... Celiac and Hepatitis have been ruled out. PCP initially thought it was a biliary anomaly, but ct and mri did not reveal anything out of the ordinary.

Thanks for your help.
KMorris XXXXXXX