I have been experiencing headaches, fatigue, dry eyes, and undereye swelling. Could it be due to liver disease or iron deficiency, as my blood report suggests?

Q. What could be wrong if a person has persistent headaches, fatigue, dry eyes, and undereye swelling?

Answered by
Dr. Basuki Nath Bhagat
and medically reviewed by iCliniq medical review team.
This is a premium question & answer published on Nov 26, 2022 and last reviewed on: Jul 05, 2023

Hello doctor,

I have been experiencing daily headaches, fatigue, dry eyes, and morning swelling under my eyes. Since the beginning of this year, I have visited many doctors and specialists, and we cannot find anything wrong. I had blood tests done a few months back and recently again this month. My primary doctor does not seem concerned, but there were a few red flags in the blood work.

1. Previously my ALT level was 12 U/L. This month it is 68 U/L.

2. Previously my AST level was 15 U/L. This month it is 47 U/L.

3. Previously my Albumin was 4.8 g/dL. This month it is 5.0 g/dL.

4. Previously my MCHC was 32.6 g/dL. This month it is 31.7 g/dL.

Based on my results, I either have a liver issue or an iron deficiency. What do you think and advise?

Please help.



Welcome to icliniq.com.

I read your query and can understand your concern.

Routine blood test results for typical liver function tests include:

  1. ALT- 7 to 55 units per liter (U/L).
  2. AST- 8 to 48 U/L.
  3. Albumin- 3.5 to 5.0 grams per deciliter (g/dL).

Normal results vary from laboratory to laboratory.

Your ALT level this month is 68 U/L which is just above the upper limit. This ALT level does not correlate with liver tissue deficiency, as you suspect.

You may be comparing this with the value you got a few months ago, but there is nothing to worry about.

Your AST level this month is 47 U/L which is within the normal upper limit.

Your Albumin is 5 g/dL, which is normal and good.

If there is any liver injury, there would be an increase in twice to thrice or even much more (depending upon etiology) in the liver enzymes value and a decrease in albumin. Your liver is functioning normally (based on the above laboratory values), and nothing to worry about as of now. But what about other liver enzymes, such as Alkaline phosphatase and GGT?

The average values for MCHC are 34 ± 2 g/dl. Your recent MCHC is 31.7 g/dL, which is again normal. There should be low ferritin and serum iron levels for iron deficiency. At this MCHC value, you do not have any iron deficiency.

I would like to ask a few questions-

1) Have you done an iron profile test?

2) Can you please explain symptoms in detail and any history of chronic disease to assess your medical condition and guide you accordingly?

Please reply to the above questions so that I can guide you better.

I hope this helps.

Thank you and take care.

Hello doctor,

Thanks for the reply.

1) My Alkaline phosphatase is 66 U/L, and I cannot find my GGT (but as we agree, it is in range).

2) I have not done an iron profile test, but I will ask my doctor to explore that.

I wake up almost every day feeling tired and not fully energized like I used to be. My eyes are dry, and I have swelling, which resolves a few hours after waking up. The swelling is just under my eyes. As the day goes on, I always experience a headache that lasts several hours. It feels like a tension headache. Towards 3 to 5 pm, I am always exhausted and feel like I want to take a nap. The problem is that before this year, I never napped during the day and never had swelling under my eyes. The same goes for headaches. This has been exhausting, and I constantly feel fatigued.

There is no history of chronic disease in my family related to liver or anemia. However, my grandparents had prostate cancer, and my mom suffered from depression and anxiety.



Welcome back to icliniq.com.

I read your query and can understand your concern.

Please answer the following questions-

1) Do you have any anxiety issues lately?

2) Any psychological conflict within yourself?

3) Any increase in work pressure?

4) Are you getting enough sleep for 6 to 8 hours without interruption? Lack of adequate sleep duration also explains present symptoms.

5) Have you checked your thyroid levels? If not, you should check your thyroid values.

Hypothyroidism partially explains your symptoms. However, laboratory values should correlate with low thyroid levels to diagnose hypothyroidism.

If needed, I suggest you can do an iron profile test, but I think, most likely, it would come up normal.

I am sorry about the prostate cancer and anxiety disorder in your mother.

Please reply to the above questions to possibly guide you about your medical condition.

Please follow up if you have any further queries about it in the upcoming time or if you want to discuss any laboratory value.

I hope this helps.

Thank you and take care.

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