Question: Hi. I'm concerned about a blood report I was given back in August. My GP says that it's all relatively normal barring moderately raised AST, ALT and LDH levels. My AST was 43 (upper level of normal as per the lab is 40), my ALT - the one I'm most concerned by was 68 (upper level of normal as per lab is 40) and my LDH was 259 (upper level of normal 250). Bilirubin 10, Gamma GT 23 and Alk Phos 79 if that helps.

My GP asked if I'd been drinking/or do and whilst I certainly over-indulged in the past (beer only and usually light to mid strength at that) recently I probably haven't had a drink since around April-May, and that was only a couple of beers. I am however overweight, due to 12 months of extremely poor diet - linked to depression but before that I was (ironically) ridiculously fit and very careful about diet and adhering to my ocd fitness regime.

My question is - given that my GP most likely assumed alcohol to be the cause, and that I've probably only had a dozen beers in the last 12 months, *could* I have damaged my liver with a shitty diet and absolutely NO exercise in the same period, never mind my having v-shaped abs only 1 year before? Are these levels indicative of something more sinister like cancer or cirrhosis? Or can they be reversed with diet and exercise.

Kind regards,

48 year old male.

Hi Dr. R K,

I haven't had an ultrasound on my liver. The blood test was requested by my GP for an unrelated matter - slightly enlarged lymph nodes either side of my neck. The test was clear in this respect and because the nodes are symmetrical (which I did have an ultrasound on) and the same size on each side it was deemed that it's just the way I am i.e. my nodes are slightly larger than most peoples.

What the test did show however was the "moderate ALT and/or AST Elevations". Again, my GP said that the levels were still very low and something I shouldn't concern myself with but suggested a follow up blood test to see if "the levels are 'normal' for me."

The bilirubin level is 10 'umol/L', the normal range as per the report is 4-20.


Kind regards,


48.

Thanks for your prompt reply much appreciated. I don't have Hep B or C, was tested for those just over a year ago at my own request during a general annual health check up and haven't done anything that would risk contracting them.

Is fatty liver disease something I can rectify? Or is it something I can only 'manage'?


Kind regards,


48

Thanks for the feedback Doc, will do.


Cheers,


48.

Just a query Doctor, my LDH level of 259 (lab range was 120-250), is that something I should be concerned about? Does it combined with my ALT of 68 indicate liver cancer?

I've been trying to ascertain online what a 'high LDH' level is and I'm getting conflicting information but it scares me because of it seemingly being primarily used as a tumor marker.


Kind Regards,


48

Thanks for your reply. I went for a follow up blood test on Friday, my GP had noted on the paper work so the lab knew what to test for "mildly deranged LFT."

I won't know the results until Tuesday when I see him next and I've been having kittens worrying about what it's going to show (increased levels etc).

Should I be concerned (liver excluded) about a LDH of 259, in your opinion?

Thanks Dr. R.K. I've uploaded a copy of my initial blood test. Would you please be able to tell me what the 'CA' directly below 'Comments on Lab Id' indicates? I'm concerned they're suggesting testing for tumour markers and my GP hasn't discussed it with me.

Good news Dr. R.K., my folow up results were AST 26 (down from 43), ALT 33 (down from 68) and LDH 211 (down from 259). My GP suggested that my initial results were probably the result of an infection.

Total Bilirubin was up from 10 to 17 but I suppose these things just fluctuate even if nothing is wrong.

Seems the only thing that was 'slightly deranged' was my unnecessary panicking.

Cheers,


48.