GGT increased

GGT (gamma-glutamyl transferase) is an enzyme that is mainly found on the surface of liver cells. GGT can also be elevated in liver diseases. Because of its superficial location on the liver cell, an increase in GGT usually indicates that the liver is only slightly damaged.

Often the GGT is the first of the three liver values to increase with increased alcohol consumption. For this reason, the GGT is also frequently used for the abstinence control of alcoholics undergoing withdrawal therapy. If the GGT is greatly increased, biliary diseases such as inflammation of the gall bladder (cholecystitis) or the bile ducts (cholangitis) may be the cause.

Causes of elevated liver values

Many different diagnoses can be considered as causes for increased liver values. Very often an increase in liver values is caused by increased alcohol consumption. The alcohol is broken down by the liver and converted into fat.

This produces a toxic intermediate product which damages the liver cells and thus leads to an increase in liver values in the blood. The resulting fat leads to the development of a fatty liver. Patients with a fatty liver are usually free of symptoms.

However, the liver value GGT is usually already elevated. The alcohol can also cause inflammation of the liver. In this alcoholic fatty liver hepatitis (ASH), the other two liver values, GPT and GOT, are also elevated.

Increased liver values can also be caused by other metabolic factors. People who suffer from obesity or diabetes mellitus have a disturbed fat metabolism. In these diseases, too, fats are stored in the liver and non-alcohol-induced fatty liver hepatitis (NASH) can occur.

Furthermore, drugs that are broken down in the liver and form toxic intermediates can also lead to an increase in liver values. Other common causes of increased liver values are viral diseases. Here, diseases with hepatitis A, hepatitis B and hepatitis C viruses are in the foreground.

Autoimmune diseases, such as autoimmune hepatitis, can also cause increased liver values. Here, autoantibodies, i.e. antibodies directed against the body’s own structures, attack and destroy the liver cells.Elevated liver values can also occur in the context of diseases of the bile ducts. The presence of gallstones in the bile ducts (choledocholithiasis) can cause the bile to back up into the liver, leading to the destruction of liver cells.

Cancer can also lead to increased liver values. The liver’s own cancer, the hepatocellular carcinoma, should be mentioned here. However, metastases in the liver from tumors outside the liver can also lead to increased liver values.

There are numerous possible reasons why liver values can be elevated. The most common cause is excessive consumption of alcohol. Alcoholics practically all have an increase in at least one of the three liver values, if not all three.

As a rule, excessive consumption of alcohol increases the gamma GT value. It indicates that the liver has to detoxify a lot. In the case of single consumption of alcohol or regular and low consumption of alcohol, the capacity of the liver is usually sufficient to render the alcohol in the liver harmless.

However, when high amounts of alcohol are consumed, the liver soon reaches its limits, which is shown by an initial increase in gamma GT. Here it can happen that gamma GT values of several hundred (e.g. 500 or 600) occur. If the doctor finds elevated liver values in the blood, it is essential to ask whether the patient is drinking alcohol and if so, how much.

Afterwards an ultrasound of the liver should always be performed. This shows already occurred liver damage, which often leads to liver cirrhosis in a strong and long-standing alcoholic person. Patients with cirrhosis usually have chronically elevated liver values.

These usually do not decrease as much as in a healthy liver. The reason is that although liver cells are able to regenerate, if there has been such a great deal of damage to liver cells in the past, the liver is no longer able to renew the cells, which means that liver values are chronically elevated. With prolonged alcohol consumption, the liver begins to reach its complete load limits, especially since it must be remembered that even without alcohol intake, it must render toxins from food and the environment as well as e.g. medication harmless.

There is an increase in the transaminases GOT and GPT. These values are initially only slightly increased. However, if the consumption of alcohol is not consistently and permanently restricted or stopped, these values often rise above 100.

The classic blood count of an alcoholic person is GOT, GPT and gamma GT moderately to strongly elevated, whereby the gamma GT value provides the greatest indication of chronic alcohol consumption. As a rule, the liver values decrease when the alcohol consumption is stopped. If not a drop of alcohol has been consumed for several weeks, the values are usually back to normal.

An exception is long-term alcohol consumption with accompanying liver damage. If the liver has already been damaged to such an extent, it cannot regenerate so easily, which means that the liver values do not drop so quickly. If chronic alcohol consumption is not completely stopped in a person with liver disease, sooner or later liver failure occurs, which is inevitably accompanied by death.

Treatment of cirrhosis of the liver is only symptomatic, in that medication is given to ensure that the waste products that can no longer be detoxified by the liver are excreted more quickly so that they do not cause any major damage in the body. The only treatment that is sustainable is liver transplantation. Here, some values other than the liver values play a role, e.g. blood clotting values, albumin values, etc.

In addition, the patient must be dry and must be proven not to drink alcohol. If he can guarantee this, he will be put on the transplant list and must wait for a donor organ. Liver values should be checked at regular intervals in alcoholic patients.

It is recommended once to 2 times a year. Here it depends on how high the values are and how strongly they have developed. In all other patients who drink little alcohol, a liver value examination should also be carried out, although not as regularly.

The health examination, which is offered by the health insurance company every 2 years, is suitable for this. Cirrhosis of the liver is the result of liver damage that persists over a long period of time. The symptoms of liver cirrhosis, such as a feeling of pressure or fullness in the upper abdomen, fatigue, exhaustion or weight loss, are usually quite unspecific.

The main causes of liver cirrhosis are increased alcohol consumption or chronic type B or C viral hepatitis.Liver cirrhosis can also cause elevated liver values of GPT, GOT and GGT. However, this is caused by the liver cell damage in the context of the underlying disease and is not a specific sign of liver cirrhosis. To diagnose liver cirrhosis, the doctor can perform an ultrasound examination of the liver and determine other laboratory values such as albumin or the Quick value.

Hepatitis is an inflammation of the liver. In the course of the inflammatory reaction, liver cells are damaged and the liver values are increased. Hepatitis can have various causes.

One of the most common causes is a viral infection with the hepatitis virus of type B or C. An infection with these viruses usually occurs through contact with infectious blood or during sexual intercourse. There is a protective vaccination against hepatitis B, but not against hepatitis C. Hepatitis can also occur as a result of fatty liver. This has no infectious cause.

In rare cases, an autoimmune reaction can also lead to hepatitis. Certain drugs can also be the trigger for an increase in liver values. This can have various reasons.

For example, drugs that can be harmful to the liver when taken in high doses or over a long period of time can lead to an increase in liver values. In principle, this includes all drugs that are broken down by the liver, such as :

Paracetamol, which can lead to liver failure in case of overdose
Amiodarone is a drug against cardiac arrhythmia
Cytostatic agents used in the chemotherapy of cancer patients
Methotrexate for the treatment of rheumatism, psoriasis or Crohn’s disease
Numerous antibiotics
Clopidogrel
Allopurinol
Amitryptilin

A long intake of cortisone can also lead to an increase in liver values GOT and GPT. Cortisone is a hormone that is naturally produced in the body and is released, for example, under stress.

Normal cortisone, which is produced and released by the adrenal gland, does not increase liver values. However, cortisone taken as a medication can lead to an increase. The background to this is that cortisone causes blood sugar levels to rise on the one hand, and on the other hand that biochemical processes can also lead to deposits in the liver.

The result is the formation of a fatty liver, which can then be represented in the blood by an increase in the liver values GOT and GPT. However, it is decisive how much cortisone and how long the preparation was taken. To produce an increase in liver values, the cortisone must have been taken in high doses for at least a few months.

It is important that with a liver value increase the exact cause must be determined. This requires an ultrasound examination and, if necessary, further laboratory tests. Hepatitis must be ruled out as well as excessive alcohol consumption.

Liver values should be examined regularly while taking cortisone. Depending on the indication and the corresponding liver values, it may be necessary to reduce the amount of cortisone taken or to discontinue it gradually. There are also numerous medications that lead to an increase in liver values.

One drug is the contraceptive pill. There are numerous patients who tolerate the pill well and who do not experience an increase in liver value. However, in some of them an increased GOT and GPT value can be detected.

One of the main reasons for this is that the contraceptive pill, like many drugs, is broken down by the liver. Sometimes the liver is so overstrained that it reacts with an increase in liver values. It also plays a role in whether the liver already has a lot to work.

If, for example, it still has to metabolise alcohol, drugs and other toxins and the pill is also taken, liver values can rise as a result. It is also possible that liver values under a contraceptive pill can rise sharply if particularly high-dose preparations are taken. The contraceptive pill is a hormone preparation that is available on the market in different dosages.

The higher the dosage, the higher the risk of an increase in liver values. If there is an increase in liver values when taking the contraceptive pill, a lower dosage of hormone preparation should be chosen. Afterwards a regular laboratory check should be carried out over several months to see whether the liver values have decreased again.Also, in case of an elevation of the liver value below the intake of the contraceptive pill, an ultrasound of the liver should always be performed to show the condition of the liver, whether the tissue is normal or fatty.

Stress is unhealthy for the human body in many ways. The liver can also be affected. Particularly with permanent stress, there is an increased release of the stress hormone cortisol.

This can have a harmful effect on the liver in high concentrations. The side effects of permanent stress also have negative consequences for the liver. People under permanent stress often eat fast food or sugar-containing snacks to save time.

They also often drink more alcohol. Especially in combination with other factors, stress has a negative effect on the liver. In pregnancy it can come to the rather rare pregnancy fatty liver.

The cause is unclear. However, a connection with hormones is suspected. An acute so-called pregnancy scholestasis can also lead to an increase in liver values.

The exact cause is also not clear here. A connection with female hormones is also suspected here. The dreaded HELLP syndrome also leads to an increase in liver values.

It is suspected that the contraction of vessels leads to damage to the red blood cells, which in turn has negative repercussions on the liver. The symptoms of a HELLP syndrome range from unspecific flu-like symptoms to a full-blown picture with severe abdominal pain during pregnancy and severe deterioration in general condition. In addition to at least a threefold increase in liver values, HELLP syndrome is also characterized by a reduced number of blood platelets.

Treatment is not possible here except that the birth should be initiated as soon as possible. In most cases a caesarean section is decided upon. Liver cancer, also called hepatocellular carcinoma, is a malignant disease of the liver.

It often occurs as a result of cirrhosis of the liver. The viral diseases hepatitis B and C can also eventually lead to liver cancer. Since healthy liver cells are also destroyed in liver cancer, liver values are also increased in this case.

The symptoms of this form of cancer are often rather unspecific and are only noticed late. The patients often suffer from fatigue, weight loss and a feeling of fullness. As the disease progresses, pain in the right upper abdomen, water retention in the body and blood clotting disorders occur.

For a patient with elevated liver values, a complete physical examination to find the cause is on the program. If abnormalities occur in the area of the skin, this can always be related to the elevated liver values. On the one hand, it is possible that the patient had a skin rash and then took the appropriate medication to treat the rash.

In this context, there are many medications that raise liver values. Probably the best known drug in dermatology is isotrenioin, which is used mainly for acne. It can be taken in ointments or as a tablet.

Both dosage forms can increase liver values, whereby the tablet form has a stronger effect. If this is the case, the preparation should be discontinued urgently. Numerous liver diseases can also cause skin rashes.

The correlation between an increase in liver values and skin rash would therefore be the other way round. The primary sclerosing cholangitis and primary biliary cirrhosis should be mentioned here. In any case, an ultrasound of the liver should be performed and the liver values should be monitored as the course of the disease.

Although an increase in liver values due to alcohol is the most common cause, there are also patients who stand out due to high liver values and who state that they do not drink alcohol. In this case, it is also important to interview the patient to find out whether lifestyle can be responsible for the elevated liver values. Liver values always increase when the liver has to do a lot of detoxification work.

This can be caused by alcohol but also by medication. Patients who have to take medication regularly and who take a large number of different medications have an increased risk of liver value increases. There are also some drugs that can be specifically responsible for an increase in liver function.

These include some antidepressants, such as venlafaxine or mirtazapine, or drugs that are given for skin diseases (e.g. isotreninoin). In addition to the drug-induced elevation of liver values, liver inflammation can also lead to an increase in liver values.These include hepatitis A, hepatitis B and hepatitis C, which can be associated with an elevated liver function. If high liver values are found, but the patient denies excessive alcohol consumption or use of medication, one must always assume acute hepatitis, which can lead to such an increase in liver values.

Other symptoms of hepatitis B may also occur. There are some rarer liver diseases that can also be accompanied by a non-alcohol-induced liver value increase. These include PSC (primary sclerosing cholangitis) and PBC (primary biliary cirrhosis).

Furthermore, fatty liver can cause an increase in liver values. Here, too, an ultrasound examination will clarify whether this is the cause. In not so rare cases, an increase in liver values may occur, for example during a routine examination, and no cause can be found.

In any case, it is important to exclude diagnostically urgent and sometimes dangerous causes. Sometimes liver values are also physiologically elevated. Patients are usually unaware of this fact, as liver values have never been examined.

It is important in this context that the liver values are only slightly elevated. If, on the other hand, they are in the triple digits, doctors of the corresponding specialty should be consulted in order to further search for the cause. In this case, these would be gastroenterologists or hepatologists.

In the case of low to moderately elevated liver values, follow-up is crucial. This can also be carried out by a general practitioner and should be done twice a year depending on the values. If there is no further increase and the values remain in this range, further observation can be made. However, if the value continues to rise, further diagnostics must be performed.