Isolated raised GGT

Gastroenterology and hepatology · Abnormal laboratory result · updated 2026-10-31

BioMG follows French guidelines. Adapt it to the guidelines and the tests available where you practise.

Frequency: In the United Kingdom, 30% of liver function tests requested in general practice (38 636 out of 130 849, Birmingham, 2016) had at least one out-of-range value; the frequency of raised GGT alone is not given ^[1].

Isolated raised GGT: minimal tests

Fasting sample.

Fasting laboratory tests

AST
ALT
Alkaline phosphatase
Bilirubin (check that the abnormality is isolated)
GGT (follow-up)
FBC with platelets (MCV, FIB-4 calculation)
Fasting plasma glucoseif needednon-French guidelineOverweight, abdominal obesity, hypertension or known diabetes: look for metabolic syndrome, a common cause of raised GGT ^[2].
Lipid profileif needednon-French guidelineOverweight, abdominal obesity, hypertension or known diabetes: look for metabolic syndrome, a common cause of raised GGT ^[2].
Carbohydrate-deficient transferrin (CDT)if neededSuspected excessive alcohol consumption denied by the patient: CDT, highly specific, helps to attribute liver injury to alcohol; never for routine screening ^[3].

Detailed explanation and international comparison (in French): read it in English (machine translation)

Do not order

GGT, MCV or CDT to routinely detect alcohol misuse: less effective than questionnaires (AUDIT), poorly sensitive; the interview remains the tool ^[3]
GGT to screen for liver disease when other liver tests are normal: too non-specific ^[4]

Persistently raised GGT without identified cause

Laboratory tests

Hepatitis B serology (HBsAg, anti-HBc and anti-HBs antibodies)
Hepatitis C serology
Serum ferritin
Transferrin saturation
Tissue autoantibodies on triple substrate (antimitochondrial, anti-smooth muscle, antinuclear)
IgG, IgA, IgM
Abdominal ultrasound (not a laboratory test)

Detailed explanation and international comparison (in French): read it in English (machine translation)

Sources (8)