Since liver enzymes drifting keeps coming up, it should probably be a maintained page rather than a recurring thread. I am happy to draft it if someone with more direct experience will review it.
Liver enzymes drifting down and what that usually means — setting out what I have, and where I think it stops being reliable.
A methods question rather than a substantive one, about liver enzymes drifting.
Everyone quotes the same figure and I cannot find anyone who says how it was arrived at. That is not an accusation; it usually means the derivation is somewhere obvious and I have missed it.
This follows the opening post rather than contradicting it.
A trend needs at least three points to be a trend. Two points are a line and a line through noise is still a line.
One more thing on liver enzymes drifting that took me far too long to see: the two figures people quote are not measuring the same quantity. Once you notice that, the apparent contradiction disappears.
Sensible. I would want the same detail before I acted on it either.
Taking post #3 at face value and following it one step further.
General information rather than advice about anyone's care. A single value outside a reference interval, on a single draw, in an otherwise unremarkable panel, is usually uninformative.
The literature is thinner on this than the confidence in the thread implies.
Nothing to add, except that this is the answer I would give if asked.
Since liver enzymes drifting keeps coming up, it should probably be a maintained page rather than a recurring thread. I am happy to draft it if someone with more direct experience will review it.
I read the earlier replies on liver enzymes drifting twice before writing this, because I had assumed the opposite and wanted to be sure I was disagreeing with what was said rather than what I expected.
Repeat before acting is standard practice for an isolated abnormal result on most analytes, and it is standard for a reason.
On balance I think that is right, and I would not bet much on it.
Fine by me. I had wanted a stronger conclusion and there is not one available.
On post #10 — agreed on the reasoning, with one qualification.
Where a panel includes a calculated value, that value inherits the imprecision of everything it was calculated from and is usually reported without an interval.
The arithmetic on liver enzymes drifting is the easy part and it is where the errors are, which is an uncomfortable combination. Show your working and someone will catch it.
This follows post #12 rather than contradicting it.
Liver enzyme changes during rapid weight loss are commonly reported and have several possible explanations, which is exactly why they need clinical interpretation rather than forum interpretation.
Sample handling before analysis affects several analytes, and a haemolysed sample produces predictable artefacts that a laboratory will usually comment on.
Helpful, and short, which on this subject is harder than long.
Reference intervals: constructed to contain the central 95% of a reference population, which means one in twenty healthy people falls outside one by definition. Add biological variation and analytical imprecision and the base rate of a meaningless flag is substantial.
The general answer and the answer for your case may diverge here.
Glycaemic markers integrate over different periods. A point glucose and a longer-term marker disagreeing is not a contradiction; it is two different questions.
Adding this to the thread rather than to the wiki, because I am not confident enough for the wiki.
That is consistent with mine, for whatever one more account is worth.
Narrowing post #22, because the general version has more than one answer.
What I want from this liver enzymes drifting thread is the list of things that would need to be true for the claim to hold. If we can write that list, we can check it.
Time of day: some biomarkers vary across the day. Cortisol in the morning differs from cortisol in the evening. Comparing results from different times of day is comparing things that are not the same.
I have said this before in a thread nobody could find, so it is worth repeating.
Careful with the language on liver enzymes drifting. "Not detected" and "not present" are different findings and the first is a statement about the method.
Post #27 is the version of this I will quote in future. One addition.
Small methodological point on liver enzymes drifting: repeating a measurement is cheap and resolves most of what is being argued about here at no cost to anyone.