liver function test
 

i have just received a letter from casa requiring further information in relation to alcohol consumption. I have been asked to take a blood test for carbohydrate-deficient transferrin, full blood count and liver function tests. no doubt someone out there has been asked to do the same. Any advice or information would be greatly appricated as i dont want to loose the class one for obvious resons. look forward to hearing from you

I know of a couple of folk that have had it due to folk reporting some concerns.

Basically they take a blood sample and have a look at various chemicals and they can tell if you are kicking the arse out of the bottle.

If you are a heavy drinker and then think bollocks I will stop drinking because I have a test coming up it actually makes it worse. This is because the liver once you stop abusing it starts to heal and it dumps all its toxins stored in it to deal with processing the booze. Its these toxins that they are picking up.

It takes something like 9 months to a year tea total for things to start sorting themselves out if you have passed the point of damage being done.

O and the out come was that one saw the writting on the wall went to AA and took their sponsor person (I think thats what you call them) with them to the AME. They all had a bit of a heart to heart, medical was suspended for a month for fatigue and the last time I saw him it was 2 years off the booze.

The other had thier medical pulled as apparently they could tell he had been drinking 2 bootles of red a day for years. And he could never convince them that he had sorted things out.

What utter, unmitigated, inaccurate and unscientific twaddle that entire post is. Toxins my arse! What the hell are "toxins"? Where do people get these daft ideas from? Books on homeopathy and crystals? Why would the liver store toxins? It is there to get rid of them! You don't have a clue pal. Not a firkin clue.

The internet will fill you in on the details of this test which is looking at Transferrin, a plasma protien associated with Iron transfer in blood and bone that responds to steady and substantial alcohol consumption. A few/several weeks of abstinence will reduce it markedly (Jock's 9 months is total bolleaux too) but it is a good indicator of recent activity.If you can't stay off the sauce it just won't come down much. It is quoted as having a half life of 14-17days which must make consumption even a month or few ago apparent, and also contradicts the little gem of misinformation in the post above about it getting worse for a while after stopping. If it does, medical sites on the net seem unaware of it...

It cannot diagnose alcoholism which is a clinical diagnosis that takes much more than a blood test and the analysys of many different liver-function parameters even within that.

But don't take my word for it, I'm not a doctor. The medical description of this process is available on the net - and this is not the right place to go believeing the tabloid tattle of the uninformed on such a potentially serious matter. It is so easy to find out the facts.

Oh, fcuk! Now Jock's going to be really mad.:p

Nah I am not, its what I had been told by the bloke that is still flying.

He got tested every 3 months and his levels apparently took a year to get into normal band. I might have the wrong term with toxins, enzymes would be proberly better. 300 rings a bell with his liver function test and he had a fatty liver what ever that is.

I am sure ginger will be along soon to give us the real data.

I am more interested in why casa sent the letter!

I didnt know they had spies around, so why pick on an individual? why should they suspect someone?

Sorry folk's, make a rule about posting medical stuff after the third glass of Pinot :)

I just dont understand. Just turned 40, BMI is well with in limits, lung capacity etc etc all well with in the range for my age. Eat well etc etc enjoy a beer like most and get this letter. And they want reply to my request for someone from CASA to dicuss it with me.
They have extended my medical until the new results so I will wait and see.

Someone will have been **** stirring.

I had a similar warning on my last medical.
I took a week off any alcohol consumption, and
took milk thistle pills. They are herbal and
assist in rejuvenating ones liver. A week later was
well in limits.

I . . . erm, hesitate to ask, but . . . erm, is there a similar natural product for alcohol damaged brains?

Blood tests can sometimes identify an underlying alcohol problem, but there are problems with sensitivity (the ability of the test to pick up a problem and not miss any cases) and specificity (the ability to get it right without falsely identifying those who haven't got the problem).

The ideal test would have high sensitivity (doesn't miss any cases) and high specificity (doesn't falsely pick up cases.) Most tests don't have either so we have to use them with caution.

Doctors (and nurses) love performing tests, it makes them look scientific, but in the real world it can often confuse the issues, rather than add to the picture.

In your case, I suspect that the docs will be looking at a constellation of tests to try and focus on the underlying problem. Traditionally the Gamma GT (GGT) test was seen as a marker of alcohol use, but problems with specificity limits it's use (gamma GT (GGT) and alcohol - General Practice Notebook) so I think they'll be looking at things including liver enzymes and the size of your red blood cells (MCV) which is part of your full blood count (FBC).

Technically you could argue the toss. You could argue that the biggest p*sshead in Manchester are within normal parameters, whilst the guy who has the odd glass too many have results outside what's classed as "normal." (I see this every day :-) )

It does sound like a warning shot has been fired across the bow.

It'd be interesting to explore the journey that has brought you to this point.....you'll find some understanding ears here:)

Now, forgive me if I fail to reply tonight, a rather cold glass of Pinot awaits.

I agree Gingernut - why are people getting these letters unless of course they are admitting to excessive alcohol intake? I am unaware of other examples of the medical department responding to tittle tattle from other pilots, and AMEs on the whole dont make wild assumptions that people are on the binge unless they turn up to medicals half cut

Can we have some more information from anyone?

I sometimes wonder about the practical validity of some of these scientific tests. I seem to recall an Australian policeman who finished in the top ten of the Hawaiin Ironman in recent times yet failed the BMI test in his annual medical for employment. Scientific tests ain't everything yet we are governed by them; doesn't make a lot of sense to me.

We recently had a new hire do a pre-employment medical, he was initially told that his readings were high, then a week later he was told that because his liver had responded so rapidly to his not drinking, that this indicated he was an excessive drinker. His employment offer was rescinded.

Mutt

When they take blood for your medical they look for a GCT count (enzyme). Normal is considered less than 50. Mine has been as high as 180 over the years but all else was fine. First reaction from the Dr was that I drank too much. Didn't touch a drop for a 3 month period with weekly blood tests but GCT stayed high (150-180). Went to gastroenterologist, did ultrasound and said I had "Fatty Liver". In short, diet was way too high in saturated fats and very little exercise. Went on low fat diet and had to get lazy arse moving again, as well as little or no alchol and within 6 months back under 50 again. Been managing it like that for last 15 yrs. Gets hard at Christmas time. :ok:



Fatty liver, also known as fatty liver disease (FLD), is a reversible condition where large vacuoles of triglyceride fat accumulate in liver cells via the process of steatosis (i.e. abnormal retention of lipids within a cell). Despite having multiple causes, fatty liver can be considered a single disease that occurs worldwide in those with excessive alcohol intake and those who are obese (with or without effects of insulin resistance). The condition is also associated with other diseases that influence fat metabolism.[1] Morphologically it is difficult to distinguish alcoholic FLD from non alcoholic FLD and both show micro-vesicular and macrovesicular fatty changes at different stages.

Steelcraft.

Yes I had a very similar thing happen to me.. However mine was much worse
In addition to the blood tests, CDT cost money I had to provide a psychiatric report.

They request it if you score too highly on their AUDIT and FAST tests..

No real advice I can give people out there, but just to stop drinking in the interim.. Advice given to me by my dame aswell... I was a binge drinker at the time and didn't drink for two weeks and my results came came reasonably normal besides my GGT which was a little elevated. Possibly due to fats

what do you think the motivation behind liver function tests is anyway ?

Is it possible for liver damage to cause sudden incapacitation or are they using this as a proxy for heavy drinking inferring you may take the controls while inebriated or hungover or both ?

No they can't.

First of all they need to appreciate the difference between being a heavy drinker and being an alcoholic. Both are problems, but for different reasons and in different ways.

As mentioned, one of the so-called identifiers for heavy drinking is Gamma GT. The 'norms' for an adult male are anywhere between 8 and 70 IU/L (International units/litre) depending on whom you ask and in what country. Mine is consistently around 100, has been as high as 200, and I have always been a very light drinker, in fact my doctor says that by some standards I am almost teetotal, probably consuming about 5 units a week. I know people who drink that at lunchtime and then double it in an evening, consistently and one of my friends who drinks more every lunchtime than I do in a week, has a Gamma GT of 24.

Brilliant!

Reminds me of a girl I once knew who used to claim she was "almost a virgin..."