Abnormal Liver test

In my liver test, my SGPT level is 78 and my SGOT level is 52. Are these normal, or is there a serious problem?

  • You have to provide the normal lab values for these tests. But considering the normal value of 40 IU/L in most Indian labs, these are abnormal.
  • Is this the full picture? No. I would advise a complete LFT including bilirubin ,alkaline phosphatase, albumin and prothrombin time to know the full story.
  • If only these are 2 abnormal values, then these are definitely abnormal but not alarming. Considering these, possible causes include viral illness, viral hepatitis, steatohepatitis or related to medications.
  • The first step would be to repeat these tests again after 2 weeks to confirm that they are indeed elevated. If so, you need to consult a gastroenterologist.
  • Again, doctors treat the patient and not the report. Full interpretation of reports is always done in context to the clinical setting and cannot be made on isolated lab values.

My SGPT levels are 1571 and SGOT levels are 1257. What should I do?

  • SGPT and SGOT are liver injury markers. These become elevated when liver cells-hepatocytes are getting destroyed.
  • Your SGOT and SGPT levels are nearly 50–100 times the normal level.
  • This is commonly seen in viral infections. Like viral hepatitis A and E.
  • Fortunately, viral hepatitis is self resolving. The level of elevation does not necessarily correlate with the outcome or prognosis. I suggest doing PT/INR for that.
  • You will require workup to diagnose which type of virus is present and whether it is non-viral. Sometimes this could be autoimmune, Wilson's or a medicine induced reaction.
  • The treatment depends on which causative factor is identified.

What causes high SGPT?

  • There is an entire list of causes that can cause elevation of SGPT. Some of these are transient and come back to normal e.g. viral illness. Some other them are more sinister e.g. cirrhosis. Other causes could be hepatitis B and hepatitis C, Autoimmune liver disease, steato-hepatitis (fatty liver) or some genetic diseases.
  • The first step would be to repeat these tests again after 2 weeks to confirm that they are indeed elevated. If so, you need to consult a gastroenterologist.
  • Again, doctors treat the patient and not the report. Full interpretation of reports is always done in context to the clinical setting and cannot be made on isolated lab values

What is the normal size of the liver, and is it dangerous if the liver is 19.5 cm in size?

  • The normal size of liver based on ultrasound is 13–14 cm
  • 19.5 cm is an enlarged liver.
  • However, this is only an ultrasound assessment. The severity cannot be decided merely on size but we have to study the level of liver enzymes and the cause. Sometimes it is only fatty liver, which can be revered on stopping alcohol or with lifestyle measures.

What is the best way to lower SGOT/SGPT levels?

There is no specific exercise or food that targets the liver. Fortunately to keep your liver healthy, you need to eat a balanced diet, high in antioxidants and exercise regularly. Keep your weight in check and stay away from alcohol.

Do’s:

  • Exercise regularly: This will add more years to your liver. Fatty liver disease is reaching epidemic proportions. Maintain a healthy lifestyle to prevent it.
  • Consume more green leafy vegetables: These contain numerous micronutrients, fiber and antioxidants
  • Eat probiotics: Curd is a natural probiotic and contains good bacteria. It improves gut immunity and general health.

Dont’s:

  • Avoid Alcohol: It is the no.1 enemy of your liver. Keep it at a minimum.
  • Avoid fatty foods: Highly processed foods and items with high fructose corn syrup are to be avoided. These lead to fat and in turn toxin accumulation within the liver.
  • Avoid sugary foods
  • This was the preventive aspect.
  • If your SGOT/SGPT is already high, you need to be investigated to detect the cause of the abnormality and then treat it. No matter what you hear there is no single medicine or natural remedy that is useful across all liver diseases that has been proven effective.

Which test shall be done to check the condition of liver?

  • There are a number of tests for the liver.
  • The liver is a very important organ of the body and serves > 100 metabolic functions. So when liver gets damaged, it affects a large number of test results.
  • Testing for infections like hepatitis B and C can be done. These are highly prevalent in our country.
  • The most basic blood report is LFT which consists of bilirubin, AST, ALT, ALP, Albumin and prothrombin time. Other tests can be done as required.
  • The size and structure can be studies by ultrasound, CT scan or MRI.

Is it true that some people with chronic liver disease have absolutely normal liver function tests?

  • Yes, it is possible.
  • The interpretation of liver function tests is very tricky. It does not represent liver function per se, but shows ongoing liver damage. A “normal” level is a wide range and it depends on many variables. LFT within acceptable range can be seen in normal individuals, those with chronic viral hepatitis (because abnormalities can be intermittent) and also in those with cirrhosis.
  • That is why doctors don't treat reports but treat patients. The final interpretation is done on a combination of clinical examination, ultrasound and LFT and sometimes special tests like Fibroscan, liver biopsy etc.