Elevated liver function tests

[speedbird011]

I recently underwent a series of blood tests and during the course of these it was discovered that my ALT was twice normal and the Gamma GT was slightly elevated.

MY GP suggested this was indicative that I was drinking a little too much however I am concerned that I may have caused some permanent damage which may prevent me becoming a pilot (I am currently studying for ATPL). I know that the airlines now run a range of tests to check for alcohol etc and am very worried that even if I lay off the pop I may not pass.

The GP indicated my readings were not uncommon in someone who is drinking more than the recommended limits and said that he'd seen much worse from alcoholics etc so didn't seem overly concerned.

For the record like many thritysomethings I drink a few glasses of wine most nights of the week ie 1/2 to 2/3 of a bottle isn't uncommon and I manage a whole bottle at the weekends when dinner parties etc happen. I do stay dry a night or two a week.

I never touch spirits and I hardly drink any beer.

I'd like views on whether if I cut down my levels should return to normal? I'd rather not blow £40 000 more training if I'm not going to pass an airline medical.

Thanks,

Speedbird011

[grouse]

Raised alt and ggt also weight related- could you lose some?

In isolation abnormal liver tests not too worrying (depends on levels) and often takes years to truly pickle your liver.

But- you are drinking more than recommended so may be worth reducing for 2 months and rechecking.

What's your MCV? if raised (size of red blood cells) and ggt also raised then 95% due to alcohol- and not sure the medics will be too happy

[777AV8R]

I have talked about alcohol and alcoholism on this forum before. Your post has some familiar earmarks to it and it might prompt you to reconsider your social situation. I am not going to placate your post and give you a soft approach to the situation, it appears at first glance that there is a serious problem here. Also, this post is NOT an attempt to make a diagnosis one way or another of your situation, but I hope that maybe there can be some illumination of the subject at hand.

Before I begin, let me tell you that I have worked with and worked for several different agencies with regards to peer support and rehabilitation of dependant flight crew members, and also have worked in developing rehabilitation programs for those in the industry. In short, I have some background in the business.

You have said:

For the record like many thritysomethings I drink a few glasses of wine most nights of the week ie 1/2 to 2/3 of a bottle isn't uncommon and I manage a whole bottle at the weekends when dinner parties etc happen. I do stay dry a night or two a week.

It is unfair to categorize 'many thirtysomethings' as drinking a few glasses of wine most nights of the week. In fact, most non-dependant thirtysomethings, especially professionals within the airline industry, drink nothing all week and rarely drink a bottle at a dinner party. Non-dependant people can put the cork in the bottle and go for many days without having a drink. It's not if you can do without for a night or two a week, but can YOU put it away for months at a time and not have to think about the next drink at all?

You have said:

I never touch spirits and I hardly drink any beer

The fact of the matter is: No matter what you drink or what you prefer to drink, alcohol is all the same. It isn't the redness or clarity of the wine that you drink for the buzz, it isn't the amber of the scotch nor is it the bubbles in the beer that cause the problem. It is the alcohol and the alcohol alone that gives concern. It is also a myth that 'light beer', 'light wine', fortified or unfortified is better. It all boils down to the one main ingredient....alcohol, and alcohol causes problems.

I am not a medical doctor and will never front myself as being one. It is the medical doctor who gives diagnosis of alcoholism and it appears that your examiner has already given you a warning flag about your situation. That said however; as a counsellor and my knowledge of the disease of alcoholism, I would say that there are certain common characteristics to what you have alluded to here in your comments, that I have found in others with whom I have worked and work with.

Should you spend the money on further training? That is certainly up to you, however; let you be aware of certain things.

With the increased insurance premiums that air carriers (large and small) are having to face in light of world situations, pre-employment testing and screening has been increased. Blood and urine tests have become the baseline for most acceptance or denials of employment. Do you have to take these medicals? No, not unless you want the job. No one will force you to take any medical, but under the regulations, one must present themselves for a medical under the same conditions as one would be appearing for work. Pilots have had a medical with-held for having a head cold on the day of their medical.

After one has been accepted for employment, however; the rules do change. Regulatory and corporate rules come to play and are enforceable. Refusal of a breath test or markers in a urine test can give rise to a whole range of issues, the least being the loss of the best job in the world. Simply denying or trying to justify by other means, a disease or dependancy just won't stand up to the test. The issue here is, are you honest enough to see that there might be a problem and are you willing to seek help.

If you or any other fellow colleagues out there would like some further clarity, you can always send me a private message. I would only be too happy to help out.

[slim_slag]

The liver is a pretty tough organ, you can destroy 90% of it and be OK, and it is good at bouncing back after being beaten up by booze. Not so things like hearts and brains, possibility of permanent damage to those organs should worry you more.

It's not easy to get your gamma gt raised in a healthy liver. In the days when nobody cared about who would pay for these things, we would get our ggt levels tested after a week of a heavy drinking rubgy tour, and none of us could get above "normal". Irresponsible youth :)

So I would say you are drinking more than you admit to. That's common, in fact 99% of patients lie about their drinking and smoking habits. As a rule, we would double what was admitted, and still be short.

Give up the booze for a couple of months. This will let you know what your LFTs are when your liver has had a chance to rest. It will also let you know if you can do it :)

[speedbird011]

Grouse,

Thanks for your post I don't know that MCV was tested but will check if that came out OK. It sounds as though I'd better cut back a bit and go easy for a while. I definately could do with losing some weight (BMI 30-31) so I'm interested that may be the cause. I don't think I drink any more than many friends do and indeed I don't binge drink at the weekends as many of them do which is why the results came as something of a suprise.

777 - your post is alarming in that you clearly work with a lot of alcoholics etc and are an expert in the area. If you feel there is a serious problem here then that is contrary to my GP's view (which is that I'm not a problem drinker - I just need to cool it a bit) but I would be a fool to ignore your opinion.

I don't really feel that I'm in need of counciling or support groups yet as I will see if I can reduce my intake on my own (I have gone through phases of hardly drinking at all). I do know however that I drink more when I feel the need to escape from worries about money, jobs etc and I don't like using it as that kind of crutch. Right now the worries are fairly pressing.

I appreciate your advice and I'd be interested in understanding if weight could be the issue or alcohol.

Best regards,

011

[QDMQDMQDM]

It certainly could be alcohol and I'd say with your level of consumption that's most likely. The other things worth checking, particularly given your high BMI, are your cholesterol and triglyceride levels. There is a condition called 'non-alcoholic steatohepatitis' which occurs more often in fat people and obviously in those with high fat levels in the blood. For whatever reason the fat induces an inflammatory reaction in the liver. Worth checking, but like I and others say it's probably all just down to the booze.

Clearly, too, your physician should be checking hepatitis serology and all the other blood tests you do when someone has raised LFTs.

QDM