### instruction:
If you are a doctor, please answer the medical questions based on the patient's description.

### input:
Hi Doctor, I am 28yo and have being battling depression for the good part of 15months. The reason for me asking a question is that my blood results just came back and my Gamma G.T is 127 U/L which my GP told me is quite high and possibly caused by the medicines I am on.I am currently taking Avanza 60mg, Effexor 150mg, Pariet, Stemetil, Serequel, Panadene Forte throughout each day and now on Targin 10/5mg. In the past 4 weeks I formed an addiction to Endone 5mg (got to the point of taking 30mg daily for a while) and when I was getting off that, I started taking Targin 20/10 and then 15/7.5 but now on 10/5. For a recent few months I was also taking Hypnodorm (Fluintrapazem 1mg) and Naproxen - now off those both.My alcohol intake is on average 1 standard drink a week, IF THAT - rarely drink for the last 9months. The blood screening also covered Serum Chemistry and my Sodium, Creatine, Protein, ALT, LD, Calcium etc all came back as normal levels. HIV 1/2 negative and Hep A, B and C all negative. Cholesterol is 5.7mmol/L which is the only other somewhat high amount. I feel nauseous throughout the day so dont consume anything until late at night and during the day I tend to get sick and throw up quite a bit, even if it is only water that was consumed. Cannot seem to shake off the anxiety and nauseous feeling for the last 15 months! I also take a daily multivitamin and Krill Oil. Would the medicine I have been and am taking be the cause of my rather high Gamma G.T?? Considering that all other levels are normal?? and MAIN two important questions are, Is there anything I could do to lower it?? And should I be concerned of the high number?? Thank you in advance Dr!

### output:

Hi, Your elevated Gamma GT levels are due to your opioid intake, especially morphine (Avila). Opioids cause constriction of bile ducts and spasm of Sphincter of Odd, which prevents the flow of bile into the duodenum. As a result, bile gets accumulated in the biliary calculi of the liver. When the amount of accumulated bile increases, some bile oozes out and damages the liver cells causing elevated Gamma GT. In later stages, when this worsens, other liver enzymes and serum bilirubin also gets elevated. Yes, you need to be concerned about it as it can end up causing jaundice later. You can try to control it by cutting down on your opioid intake, specifically morphine. Also avoid fatty foods which will be difficult to digest for you right now. Hope this helps you. Best wishes.