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Gamma-glutamyl transpeptidase (GGT) is a blood test that measures the level of the enzyme GGT to screen for diseases of the liver or bile ducts.
- The normal range of GGT for adults is 5 to 40 U/L.
- GGT may be measured along with other tests (such as the ALT, AST, ALP, and bilirubin tests) to differentiate between liver or bile duct disorders and bone disease.
- GGT may also be used to screen for, or monitor, alcohol use.
High GGT levels are caused by:
- Scarring of the liver (cirrhosis)
- Blocked flow of bile from the liver (cholestasis)
- Inflammation of the liver (hepatitis)
- Lack of blood flow to the liver
- Liver tissue death
- Liver cancer or tumor
- Use of drugs that are toxic to the liver
- Alcohol use/abuse
- Diabetes
- Heart failure
- Lung disease
- Pancreas disease
- Use of certain medications
Stress does not directly cause high GGT levels, but stress can have a negative impact on the liver, and liver disease can cause high GGT levels. There are studies that have shown links between stress and liver disease:
- The release of cortisol, a stress hormone, can worsen liver injury
- During stress, natural killer cells (NKT) are expanded in the liver and, may contribute to liver cell death and worsening of
- liver disease
- In the part of the brain that controls the liver, stress was found to impact blood flow that can lead to or trigger liver damage
- Stress can contribute to the inflammatory process that takes
- place in the liver
What Are Symptoms of High GGT Levels?
High GGT levels are usually a sign of liver problems. Symptoms of liver problems may include:
- Yellowing skin and eyes (jaundice)
- Abdominal distension from fluid accumulation (ascites)
- Pain or tenderness in the upper right side of the abdomen
- Enlarged liver (hepatomegaly)
- Fatigue/tiredness
- Feeling unwell (malaise)
- Lethargy
- Loss of appetite
- Nausea
- Vomiting
- Itching
- Difficulty sleeping
- Weight loss
- Fever
- High blood pressure in the liver (portal hypertension)
- Bleeding from veins in the esophagus (esophageal varices)
- Behavior changes
- Enlarged spleen
- Malnutrition
- Confusion
- Coma
What Is the Treatment for High GGT Levels?
Treatment of high GGT levels involves treating the underlying cause of the liver problems. Treatments may include:
- Acetaminophen toxicity
- Hepatitis B infection
- Antiviral therapy with a nucleos(t)ide analogue
- Mushroom poisoning
- Early administration of activated charcoal
- Administration of silibinin and penicillin G
- Budd-Chiari syndrome
- Transjugular intrahepatic portosystemic shunt placement
- Surgical decompression
- Thrombolysis
- Herpes simplex virus infection
- Wilson disease
- Liver transplantation
- Plasma exchange to remove copper may act as a temporizing measure
- Autoimmune hepatitis
- Glucocorticoids
- Liver transplantation for patients who develop encephalopathy
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Reviewed on 3/9/2022
References
Image Source: iStock Images
https://www.uptodate.com/contents/enzymatic-measures-of-cholestasis-eg-alkaline-phosphatase-5-nucleotidase-gamma-glutamyl-transpeptidase?sectionName=GAMMA-GLUTAMYL%20TRANSPEPTIDASE&search=ggt%20test&topicRef=3576&anchor=H13&source=see_link#H13
https://www.ucsfhealth.org/medical-tests/gamma-glutamyl-transferase-%28ggt%29-blood-test
https://hepfree.nyc/wp-content/uploads/2017/11/stress_liver.pdf
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https://www.uptodate.com/contents/acute-liver-failure-in-adults-management-and-prognosis?search=liver%20failure&source=search_result&selectedTitle=5~150&usage_type=default&display_rank=5
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3838908/
https://www.uptodate.com/contents/enzymatic-measures-of-cholestasis-eg-alkaline-phosphatase-5-nucleotidase-gamma-glutamyl-transpeptidase?sectionName=GAMMA-GLUTAMYL%20TRANSPEPTIDASE&search=ggt%20test&topicRef=3576&anchor=H13&source=see_link#H13
https://www.ucsfhealth.org/medical-tests/gamma-glutamyl-transferase-%28ggt%29-blood-test
https://hepfree.nyc/wp-content/uploads/2017/11/stress_liver.pdf
https://www.uptodate.com/contents/acute-liver-failure-in-adults-etiology-clinical-manifestations-and-diagnosis?search=liver%20failure&source=search_result&selectedTitle=4~150&usage_type=default&display_rank=4
https://www.uptodate.com/contents/acute-liver-failure-in-adults-management-and-prognosis?search=liver%20failure&source=search_result&selectedTitle=5~150&usage_type=default&display_rank=5
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3838908/