Blood Drug Testing

Are Blood Tests Conclusive for indicating Liver & Kidney Health ?

I have 6 monthly checks .... My most recent ALT is 16 IU/L (normal < 56) And my Creatinine is 87 umol/L (normal 62 - 133) Should this re-assure me that my abuse of alcohol has caused no long term damage .... (and no I'm not looking for a "green light" to go on swigging the Chardonnay !) ... ?

Public Comments

1. Yes, ur levels are fine, but note as you grow older your liver and kidney function (with the rest of your body) will decline. Don't get scared it's just a way of life and that's how our body's are. Now if you drink you will accelerate those "aging" processes. But science has shown that drinking "some" alcohol is good for you, just as long as you don't over do it. For example: drinking 1 glass of 6-8oz of wine with dinner has cardiovascular benefits.....drinking 2-3 bottels of wine per night doesn't.....conclusion: all with moderation. Hope this helps
2. Laura, any medical test will show only what it is designed to show and no more. Briefly therefore, the ALT and Creatinine will only reflect hepatocellular and renal function respectively, they do not necessarily show any other physiological consequence of alcohol excess. It really depends on how much you drank and for how long, as well as a little bit of luck with how your own genetic predisposition metabolises alcohol, as to whether you have any lasting effects of ethanol abuse. For instance, it says nothing about the neurological, pancreatic or myopathic consequences of alcohol abuse, nor its nutritional effects. So, sorry, no green light per se. However, if you are otherwise well and stick to less than 14 units per week you should be okay, unless you have previously had problems directly as a consequence of alcohol excess. The evidence for a beneficial effect of alcohol is largely from red wine and again, only when used in moderation. Certainly the social benefits of relaxation in reducing blood pressure would have beneficial health consequence in the longer term. As for the ALT - the liver performs over 500 biochemical functions so the concept of a "liver function test" or LFT is sort of misleading. Crudely in medicine, we use LFTs as a summary of the liver's capacity to function and this usually involves measurement of hepatocellular enzymes (ALT or AST), bile cannalicular cell enzymes (ALP), bilirubin, total serum protein and albumin amongst others. This makes no account for other measures such as the INR (i.e. blood clotting), lactate recycling or glucose metabolism amongst many others. So ALT alone simply means you have an appropriate level of hepatocellular enzumes (not isoenzymes also exist, hence ALT elevation also occurs in MI as well as with liver disease). If it were elevated yes you would begin to investigate possible liver abnormalities but used as a simple monitor of your liver function it is fine. This is important for girls like us on HRT as this can affect liver function (oestrogens as well as particular anti-androgens such as ciproterone acetate). Creatinine is a waste product of muscle protein and is used again as a simple reflection of renal function. It can be elevated after eating a large meal of red meat simply due to ingestion rather than any problem in renal function per se, or in mesomorphic body builders. In fact, glomerular filtration has to fall by about a third or more before you see any elevation of serum creatinine so normal creatinine does not rule out the early stages of renal failure. However, significant impairment of renal function will reflect in elevation of creatinine so you can relax there - you don't have that. Not sure why you are being screened for that though, there is no reason HRT per se puts your renal function at risk unless you are on mineralocorticoid analogues (e.g. spirinolcatone). So, generally, you can be pretty confident you do not have any major derrangements of hepatocellular function or glomerular filtration. Other than that, one should not read beyond what each of these tests is designed to measure (i.e. it rules out nothing else). Furthermore, remember the definition of NORMAL for these tests is statistically definied according to a "normal distribution". That is, the upper and lower limits of normal here are defined by the range of normal results lying above or below the mean by two standard deviations. However, by such definition, at least FIVE PERCENT of all normal results will lie outside this range along with the majority of abnormal results. In other words, if one or other result is "abnormal", further consideration is needed to decide if this is a "normal" outlier or if there is clinical concern to investigate further. Hope this answers the question.