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Pancreatitis, cholecystectomy, elevated ALT, fatty liver!
I was admitted on Christmas Eve for pancreatitis. CT scan and ultrasound showed gallbladder had to be removed. My lab numbers were through the roof. ALT was 1150. I had my gallbladder removed and have been doing well from that thankfully. I had blood work about 3 weeks out from the cholecystectomy with the GI and everything had returned to normal except for the ALT. It was 63 with the normal ranges from 7-52. I then had labs again at PCP office a few weeks later and it was 37 with normal ranges 7-35. I guess the GI and PCP use different labs which is why there is 2 different sets of normal ranges. My PCP sent me for an ultrasound that read as fatty liver. My PCP said it was slight fatty liver and that the ALT was from gallbladder surgery. Last week PCP checked labs again and the ALT jumped back up to 45 on the 7-35 range. Why will this number not return to normal. EVERY other lab has returned to normal and stayed normal except for the ALT. I have never had an elevated ALT level before the surgery. I have lost about 14 pounds, eat low fat, and do not drink. Now the PCP recommended me to see a liver doctor. I am so scared and confused. I only take OTC vitamins and no other medications like a statin. Any ideas?
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@jcsg Not a medical professional here, so I am only relaying my own experience - You are exactly 3 months out from your gall bladder surgery - your body is still adjusting to living without it. Your ALT is within the clinically acceptable range or 7-56 (not sure why the PCP or their lab is using 7-35 as their range.)
I am also going to guess that you, like most of us, never had a liver scan or any other tests on it before this one. So you may have had a "slightly fatty liver" for a very long time and the GI doc will probably conclude that it is clinically insignificant, and just something to watch. I can also tell you that after surgery (several times) I have had abnormal blood work indicating my liver was "working overtime" - apparently this is how the body recovers from anesthesia, though I'm not sure how/why is completely understood by the medical community.
I think you can breathe a sigh of relief and conclude that your PCP is just being cautious in ruling out anything else. Have you got an appointment with the specialist yet?
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2 Reactions@sueinmn Thanks for taking the time to respond to my post. You are right, I have never had a liver scan or any other tests and I probably had fatty liver before this. It seems very common. I am just frustrated. The gallbladder surgery and recovery was relatively easy for me (for which I am thankful). I guess I am thinking that the labs should be normal by now since everything else is pretty much normal. I am seeing the specialist tomorrow.
Technically, your lab is "normal" according to the tables used in both labs where my ALT has been tested recently. It just seems your PCP uses a different standard.
I did a quick Google search and it says labs have different reference ranges because of equipment, testing methods, etc. You would think they should all be the same and universal.
Me too, but ? Also, in my experience, some well-affiliated labs adhere closely to standards as they are updated. Others, possibly with older equipment or technology, do not move as quickly.
If I were in your shoes, I'd trust the GI doc over the PCP. And your liver doc may just be so the PCP can do the CYA thing. Hopefully that will give you some confort.