Elevated liver enzymes (ALT/AST)

I’ve been dealing with some nagging pain in my upper right abdomen—right under the ribcage area—so I decided to go ahead and get a GI consult and an abdominal ultrasound. Here is what the report showed: My liver measures 16 cm at the midclavicular line, and there are these hyperechoic structures throughout the parenchyma, appearing as diffuse lesions, though no specific focal lesions were spotted. The pancreas looks totally normal in size and echostructure, and there's no dilation of the common bile duct. Everything else seemed fine! Following this, my doctor put me on a low-fat diet—with a strict "no alcohol" rule—and ordered follow-up labs. Well, the results just came back, and they aren't great: my GGT is elevated at 105 (normal is 11-55), my MCV is 105 (range 83.0-97.2), and my MCH is 34.4 (range 27.4-33.9). To top it all off, the tumor marker CA 19-9 came back high at 66.7 compared to the usual 33. Because of that marker, they're recommending an abdominal CT scan—to double-check the pancreas—along with a full blood count. Honestly, I’m not feeling any actual pain right now, but I am incredibly anxious about all of this. If anyone has dealt with something similar or knows what this might mean, please let me know.

How old are you?

Forty

Forty.

Terry Ramos7 said:Forty.

Any kind of malignancy in the pancreas tends to be incredibly painful because those types of carcinomas usually grow perineurally—basically wrapping around the nerves. If you aren't dealing with systemic symptoms like significant weight loss, loss of appetite, chronic pain, or digestive issues like diarrhea and vomiting, I’d lean toward ruling out a malignant process for now. That said, CA 19-9 is a specific tumor marker for the digestive system (intestines, pancreas, etc.), but keep in mind that an elevated marker doesn't always mean cancer.

Just get an abdominal CT scan and try not to worry too much; I really don't think this is anything serious.

Thanks for getting back to me! I actually don't have any of those symptoms you mentioned—I’m pretty careful about what I put in my body. For instance, I steer clear of greasy, fried foods, and I don't drink alcohol or smoke at all. My weight has stayed pretty much the same, too. Sorry, I have one more quick question for you—would it be okay if I had a non-alcoholic beer?

The good news is that my GGT, AST, and ALT levels have finally stabilized—plus, the tumor markers look solid! My abdominal CT scan came back clear, too, and there’s no sign of hepatitis. However—and this is the part that’s really weighing on me—my ceruloplasmin and copper levels are quite low.
I’ve been doing some deep dives online, but honestly, I’m finding so many conflicting interpretations that it’s getting a bit overwhelming. I’m just sitting here wondering what the doctor is actually going to make of all this at my next check-up.