ALT (SGPT)

SERUM GLUTAMIC PYRUVIC TRANSAMINASE (SGPT) (ALT)

SGPT is primarily a liver function test. It has a maximum concentration in the liver (fatty membranes) sinusoids. Low concentrations of SGPT are also found in the kidneys, heart, and skeletal muscle.
In pathological states, elevations indicate liver disease.
ALT is found in serum and in various bodily tissues but is most commonly associated with the liver. It catalyzes the transfer of an amino group from alanine to alpha-ketoglutarate, and the products of this reversible transamination reaction being pyruvate and glutamate.
glutamate + pyruvate ⇌ alpha-ketoglutarate + alanine
Alanine transaminase delivers skeletal muscle carbon and nitrogen in the form of alanine to the liver.
In skeletal muscle, pyruvate is transaminated to alanine, thus affording an additional route of nitrogen transport from muscle to liver. In the liver, alanine transaminase transfers the ammonia to A-KG and regenerates pyruvate. The pyruvate can then be diverted into gluconeogenesis. This process is referred to as the glucose-alanine cycle. The glucose-alanine cycle is used primarily as a mechanism for skeletal muscle to eliminate nitrogen as the muscles replenish their energy supply. Within the liver, alanine is converted back to pyruvate and is then a source of carbon atoms for gluconeogenesis. The newly formed glucose can then enter the bloodstream for delivery back to the muscle. The amino group transported from the muscle to the liver, in the form of alanine, is converted to urea in the urea cycle and then excreted.
In physiological states SGPT is a primary kreb cycle expressant and as a result causes the release of catabolic fats. SGPT occurs in serum as a consequence of substances being released by the fatty membranes of the liver sinusoids, and lymphatic ducts. The liver sinusoids store food, and the lymphatic ducts house toxins.
Picture a layer of fat that holds foods or toxins in the cell. Now as that layer of fat is being burned off, foods and toxins are being released in a controlled manner. This allows foods or toxins to be directed to their next destination.
Please note that most lab ranges for this test start at 0, which in actuality is false since this is a measurement of liver function, and 0 would mean that the liver was not functioning at all. A low range then should be around 15.
Therefore, from a physiological perspective, a low SGPT between 15-20 would indicate a sluggish liver causing many metabolic disturbances.
Typically these people have no energy, get sick a lot, cannot tolerate food well and have a slow metabolism.

GGT

GAMMA GLUTAMYL TRANSPEPTIDASE (GGT)

Is a biliary enzyme useful in the diagnosis of obstructive jaundice, intrahepatic cholestasis and pancreatitis. GGT is more responsive to biliary obstruction than are aspartate aminotransferase (AST) (SGOT) and alanine aminotransferase (ALT) (SGPT). 1. GGT is increased in hepatoma and carcinoma of the pancreas and useful in the diagnosis of metastatic carcinoma of the liver. Increasing levels in carcinoma patients relate to tumor progression and a dubious outcome.
1. CEA, alkaline phosphatase and GGT together are useful markers for hepatic metastasis from the breast and colon.
2. May be useful in the diagnosis of chronic alcoholic liver disease. Follow-up blood chemistries of serum GGT, AST and ALT levels can distinguish recovering alcoholics who resume drinking from those who do not.
3. Increase in body mass correlates with increased GGT levels.
4. GGT along with MCV is a useful test for alcoholism.
5. GGT is the test of choice for pregnant females who may have cholestasis.
6. GGT levels are elevated in cirrhosis and hepatitis.
7. The transaminases, AST and ALT rise higher in acute viral hepatitis; then GGT.
8. Increased in systemic lupus erythematosus

GGT IS HIGH WHEN
General considerations:
If patient has been on a very low-fat diet for long periods of time then increase fat intake

Total Iron

Total Iron Binding Capacity (TBIC)—measures the amount of transferrin,
which is a blood protein that transports iron from the digestive system to cells that
will be utilizing the iron. Your body produces transferrin in relationship to the
body’s need for iron. When iron stores are low, transferrin levels will increase
and when transferrin levels are low, too much iron is present. Usually, about one
third of the transferrin is being used to transport iron at any one time. Because of
this, your blood serum has considerable extra iron-binding capacity, which is
called the Unsaturated Iron Biding Capacity (UIBC). The TIBC then equals
UIBC plus serum iron measurement. Some laboratories may measure UIBC,

some measure TIBC and others measure transferrin. TIBC is increased in iron-
deficiency, acute hepatitis, during pregnancy or when oral contraceptives are

used. TIBC is decreased in hypoproteinemia from many causes, cirrhosis of the
liver, nephrosis and thalassemia or from a number of inflammatory states.

TOTAL IRON
IRON
Men 65-175ug/dL 11.6-31.3 umol/L
Women 50-170ug/dL 9.0 -30.4 umol/L
Children 50-120ug/dL 9.0-21.5 umol/L
Newborns 100-250 ug/dL 17.9-44.8 umol/L