Bloods = "Satisfactory" - can anyone interpret for me?

[cruisingwater]

Hi all. Hope looking after yourselves.
Adding background, for context. I have had an "unhealthy" but completely hidden relationship with Alcohol for approx. 11 years. I used alcohol initially to boost my confidence socially & professionally in my 20s - I'm ashamed to say I used to secretly drink at work to get me through stressful meetings where I'd have to present/lead with confidence - else I'd get embarrassed, go red and stumble.
I have drunk most days for 11 years aside from during pregnancies and the odd shot of "Dry Jan" or trying to have 2-3 days alcohol free a week. I would say however that I have drunk, on average, 30-40 units per week.

Most of my drinking is secret - a swig of wine or shot of spirit. Putting alcohol in disguised vessels such as coffee cups in the evening so my family think it's just a cup of tea. Using it in the evenings to 'get through' bath/bed time routine with kids. Using it as both something to keep me upbeat and sociable and also as a relaxant. I would say I have been a highly functional alcoholic during this time. I am a great mum otherwise (IMO). I have NOT used alcohol during the working week during the daytime for about 7 years now. However, weekends I often start drinking earlier in the day.

I have somehow managed to keep ALL of this hidden from my family and friends. My husband thinks I hardly drink.
I can hold alcohol well and drink with my husband and friends weekend evenings and on holidays, parties etc. However, I have had the odd black-out over the last few years so know on occasion I do take it too far. I also have obviously experienced poor sleep, dehydration and bad hangovers (regularly) over this time & hidden them. I often have said to myself I will give it up / not drink today etc. etc. but never manage it.

Until now. Currently 10 days sober. I am committed to OYNB (one year no beer). This is a challenge. I've had a health shock and honestly feel it is due to my drinking. I want to be here to see my children grow up. I cannot believe I have wasted so much time to alcohol.

Health issue raised is INCREDIBLY itchy skin. Arms, legs, chest and face. Am using some medicated cream which is helping and generally the itchiness is calming.
I had my bloods done - these are the results attached. I was incredibly stressed all over Xmas waiting the results and thinking I'd done some serious damage / was dying. I'd also been experiencing some lower back pain, possibly kidneys. I know blood tests can't really tell liver damage and I know I may still have caused irreparable damage. The doctor's receptionist told me the results are 'Satisfactory' - no further action needed. You can see my ALT score is out of range slightly. Any blood experts tell me anything else looking not great?
I'm stopping drinking. Will ask for more bloods later this year to compare.

Thanks for reading & good luck to anyone else doing Dry Jan etc. I'm finding podcasts and recording my progress is helping.

@cruisingwater Hi. I’m not a doctor but do have a health related background and I've done a lot of research around this being a heavy binge drinker for years.

This looks to me like your GP has not done what would be a typical alcohol misuse set of bloods – I take it they don’t know about your drinking? Were the bloods to try and find out the source of the itching?
The reason I say this is that there are some key omissions if one was checking for alcohol related liver disease – namely AST is ‘missing’ from the liver function test and there is no GGT (Gamma–Glutamyltransferase). ALT on it’s own doesn’t really mean anything in cases of alcohol misuse – it’s the AST:ALT ratio that is a marker of alcohol related liver disease. A normal AST:ALT ratio should be less than 1. In people with alcohol related liver disease, the AST:ALT ratio is highly likely to be greater than 1.

GGT is a marker of prolonged, chronic alcohol intake. The blood test the DVLC use to determine if someone should get their license back or not is CDT (carbohydrate deficient transferrin) which is much more sensitive and specific and therefore a stronger indicator of alcohol use/misuse – but also more expensive to do so it’s not done routinely on the NHS. Raised MCV and MCH are also indicators of heavy alcohol use and yours are getting pretty close to the upper limit of ‘normal’. I say this not to scare you, but to hopefully spur you to stop/cut down. I’m only on day 6 of the millionth time of trying to stop and am a sleeping-in-a-hedge-passed-out binge drinker so no judgement. Before that, I was a "successful" secret drinker too - please don't get to where I am as it is simply devastating.

Also – itchy skin can be a sign of liver damage in people with alcohol misuse but that is rare unless the person has noticeable jaundice.
You may find this paper helpful although it is quite scientific.

pubs.niaaa.nih.gov/publications/assessingalcohol/biomarkers.htm

@cruisingwater as a PS - if you want more alcohol related bloods but don't want to tell your GP, you can get them done in the UK by private companies and private GPs. Just a thought albeit a controversial one.

Have you ever been diagnosed hypothyroid?

A TSH of 3,43 merits further testing, but you may need to do that privately. ThyroidUK can advise on providers.

One cause of severe itchy skin is urea build up caused by kidney failure, however your kidney function is excellent so that's ruled out.

@2023forme Hi. How are you? Did you manage to keep going past day 6 dry? - well done for getting to that point. Hope it is going OK for you. Thank you very much for answering this for me - apologies it has taken me so long to reply. I really appreciated your response.

You are right - I have not/will not mention my alcohol use to the doctor as don't want anything on my record (intend to get private health insurance and don't want to tarnish it which obvious pre-existing conditions). So, I guess I just had a normal set of bloods done to see if the itching was caused by anything obviously abnormal in my bloods..not quite sure the rationale as it wasn't like they were doing specific allergy tests.

Thank you for the info re. AST:ALT. I understand that the bloods weren't really checking what I was hoping to check (liver function). Additionally, understand without a full proper liver function tests bloods don't necessarily spot issues anyway.

I do know about the enhanced tests done for drink drivers - but didn't know the science behind it - so again, really helpful to understand. I say this because my father lost his driving license two years ago due to drink driving and needs to have the medical to see if can get his license back. He is delaying this. Probably because he knows his CDT levels will still be too high. Probably best he doesn't get it back.

As you can see alcohol issues run in the family :(

Thank you for your words. I have been trying to cut down on my drinking for years. TBH the effects of alcohol have only in the last couple of months really dawned on me. I am getting wrinkly skin - never have I put this down to alcohol before. My productivity being non-existent in the evening - all down to alcohol. This is a long-standing battle, and nothing has really spurred me on to stop UNTIL this rash happened.

Now - the rash - I am not sure it was due to my liver (although the whites of my eyes were definitely yellowing). BUT I had started using some new shower gel (elemis!) that i stopped and then the rash got marginally better. Re-started the gel and rash was awful again. Cut it out and rash gone. So even though think was the shower gel - I was already scarred shitless and intending to stop drinking as thought was the cause (still may have been!).

Right, for the good news - I am 30 days alcohol free! Been doing Dry Jan. I'm going to keep going - can't say how long but I already look a lot better in my face, have a flatter stomach and generally realising I just don't need the booze. That said, I haven't done anything particularly social involving booze. Have a party this weekend but i'm really not at all bothered re not drinking. So hopefully I stick with it - my family and my life are FAR more important than a drink.

Thank you again @2023forme .

@TheOtherHotstepper - thanks. No, never been diagnosed with anything. I don't think have a thyroid issue, but thanks for highlighting & good to know. I don't have any of the symptoms of an under or over-active thyroid.

Thanks also @MissKittyFantastico84 - i did wonder whether kidneys too initially as they were aching in December. Was quite thankful to see they seem to be functioning OK.

Thanks everyone again, good luck with your journeys.