Elevated levels of GGT

[Alan]

6 months back my BIL in England had an infection causing swelling in many of his glands which took a fair amount of anti-biotics to cure. Part of the tests included Liver Function Tests (LVT) which showed an elevated level of Gamma-glutamyl transpeptidase (GGT). It was 167 instead of the normal range 2-60. He drinks a lot of beer ( ~30 imperial pints a week - 20oz pints) so the Doc told him to quit and come back in 3 months.

No beer and 3 months later, in December, he goes back, 20lbs lighter and confident. He had been overweight but cutting out all the calories with the beer meant he lost weight and is now in a "normal" range. His GGT reading is now 65 - all other LVT's normal but the Doc says he wants to get it down to 50 - so stay off the alcohol and come back in 6 weeks.

That was last week and this time his GGT was 300 the Doc does not know what is going on so he has referred him to a specialist, which will take a few weeks at least. Meanwhile they are now really worried.

Talking to my sister yesterday she says that the only thing she can think of is that he has replaced his beer drinking with large quantities of diet soda - about 4 - 6 liters a day - that is 140 - 210 oz /day.

All other LVT's are normal? I've done a bit Googling but don't see what potential health issues there may be with high GGT and no alcohol consumption and all other LVT's in normal range.

Any ideas?

PS He is not taking any medications including Tylenol - he is age 40 and has never smoked

 

[kaneohe]

Do you know the GGT history prior to the 6 mos. ago gland swelling incident?
Perhaps he just has a weird baseline . I don't recall my baseline either but some (perhaps many) yrs ago , my family doc got concerned because my GGT was elevated (I'm guessing at about 150 or so). Sent me to internist for some tests.....ultrasound of liver, some blood tests for hepatitis, something for heavy metals?, etc. All negative, never had any symptoms, never drank.
Since any further tests would have been invasive (biopsy),
in recent yrs, just a watch and monitor mode......GGT has jumped around but if you control charted it, you would have to say it is in statistical control tho still higher than the limits from the lab so almost always flagged High.
Long trend lower and the most recent one was actually not flagged because it was lower than the high normal limit.

Originally I was going to post about medications but upon second reading, I see you noted no medications. Just for the sake of education........my doc originally said he wanted to put me on medication for high blood pressure but was reluctant to do so because of the elevated GGT. A few yrs later, perhaps because of changing medical history, he changed his mind and decided to issue the prescription. In those days, my memory was still good and so I challenged him that I would only take the medication if he would monitor lab results for a yr. 2 wks after I started taking the lowest dose of lotensin, I got a frantic call from him to stop taking the medication because GGT had gone sky high 300-400, I think. Changed to a different type of medication and GGT came down to my "normal". My lesson was to always monitor lab results when taking a new medication which is what I preach to anyone who will listen.......since us humans are all unique and reactions to medication can differ from the norm.

 

[Alan]

Kaneohe,

Thanks for the feedback. Up to now he has been disgustingly fit and has never even had a physical before with blood work of any sort so has no idea of his GGT history. Nice to know your experience of a high baseline and GGT levels jumping around. Hopefully it will turn out to be something similar. He has no external symptoms except feeling a little tired, but he says he feels like that most winters.

 

[Rich_by_the_Bay]

6 months back my BIL in England had an infection causing swelling in many of his glands which took a fair amount of anti-biotics to cure. Part of the tests included Liver Function Tests (LVT) which showed an elevated level of Gamma-glutamyl transpeptidase (GGT). It was 167 instead of the normal range 2-60. He drinks a lot of beer ( ~30 imperial pints a week - 20oz pints) so the Doc told him to quit and come back in 3 months.

It’s good that the GGT is the only LFT (not “LVT”) that’s high. It’s a very sensitive test. The causes are numerous and his beer intake is certainly of concern.

Some possible causes: alcohol, fatty liver (fat infiltrates the liver itself, common in diabetes), hepatitis AB or C; iron overload disease (hemochromatosis); mono (causes swollen lymph nodes by the way); gallstones; certain medications; infrequently cancer. Doctors know that many patients who say they have stopped alcohol have not actually done so.

Hope his remains stable or improves with time.

 

[Alan]

It’s good that the GGT is the only LFT (not “LVT”) that’s high. It’s a very sensitive test. The causes are numerous and his beer intake is certainly of concern.

Some possible causes: alcohol, fatty liver (fat infiltrates the liver itself, common in diabetes), hepatitis AB or C; iron overload disease (hemochromatosis); mono (causes swollen lymph nodes by the way); gallstones; certain medications; infrequently cancer. Doctors know that many patients who say they have stopped alcohol have not actually done so.

Hope his remains stable or improves with time.

Thanks Rich. My sister is pretty sure he has given up drinking, plus he is terrified of ending up like his step father who pickled his liver, nearly died and was saved by a liver transplant a few years back. There is no family history of liver problems but his step father and mother live 2 blocks away so he has a constant reminder of the seriousness of liver damage.

What is worrying my sister most is the possibility of cancer, as he has never been obese, takes no medication, and only symptoms are a little tiredness. (the swollen nodes have long since gone following the course of anti-biotics).

We'll have to wait and see how this progresses, and what the specialist has to say.