Q: I am a 40 years old man having slightly abnormal liver function tests (LFT) for the last 5 years. My total bilirubin is 2.3 of which 1.9 is indirect. ALT is 52 and GGT is 150. I have mildly high cholesterol for which I am taking Storvas 5 mg. For abnormal LFTs pre-date I use statins. Sonography taken 2 years back indicated fatty liver but is normal now. No symptoms, NAD on physical examination. I am an extremely moderate drinker and my BMI is 26. I do exercises regularly. A complete abstinence for 6 months has no effect on bilirubin, as I took Udiliv 300 mg/ Viboliv. However ALT/AST came within limits and GGT drops marginally with these medications. Presently, I am taking no medications for liver except ayurvedic and Storvas 5 mg. Please advise.

A:There are several issues that I note from the details that you have provided:

1. You have history of fatty liver with deranged LFTs.
2. Hyperlipidemia
3. History of moderate drinking
4. Overweight
5. Medications: Ayurvedic and Statins

All these factors can be liked to one another in some way. I believe that you may be having a component of NAFLD (non alcoholic fatty liver disease), which is getting aggravated when you consume alcohol. In a strict sense, if there is a history of significant alcohol consumption, then the liver disease is attributed to alcohol until and unless proven otherwise. Also ayurvedic medications may sometimes have an untoward effect on liver itself. If not already done, please get these additional liver tests done: HBsAg, Anti HCV, Autoimmune markers (ANA, ASMA, Anti LKM1), Serum Ferritin Upper GI endoscopy. Please follow up with a Hepatologist (liver specialist) who can guide you regarding further treatment.