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Are Increased ALT Levels A Cause For Concern?
Question: Hello,
I'm a 32 year old female, I'm 5'3 and 205 pounds. After a recent physical it was discovered that my ALT levels are elevated. My orginal test showed an elevation of 44. Blood work also showed that my cholesterol was high at a level of 256. My AST was 24 and all other numbers were within normal range. I drink 4-8 pints of good craft beer on the weekends, usually 3-4 weekends a month and have been drinking in this pattern for atleast the last 4 years. For the past year I have also been taking 2-4 excedrine pills atleast 6 days a week for tension headaches. I have a very stressful life, I have a 5 year old son with Cerebral Palsey, Autism and some other nervous system problems. In the 2 weeks since I received my test results I've changed my diet completely, and cut excedrine and alcohol. Earlier this week my Doctor reran the ALT test and it was 37, one point within normal range. My Doctor reran the ALT test 2 days later when he checked my potassium and it was back up and higher then before at 46. I am still having tension headaches and have exchanged excedrine for ibuprofen. Nothing is hurting, (my ribs are a little sore but my Doctor thinks it's because of my posture) and I'm feeling my normal self- I'm just concerned about the rapid fluctuation.
I'm a 32 year old female, I'm 5'3 and 205 pounds. After a recent physical it was discovered that my ALT levels are elevated. My orginal test showed an elevation of 44. Blood work also showed that my cholesterol was high at a level of 256. My AST was 24 and all other numbers were within normal range. I drink 4-8 pints of good craft beer on the weekends, usually 3-4 weekends a month and have been drinking in this pattern for atleast the last 4 years. For the past year I have also been taking 2-4 excedrine pills atleast 6 days a week for tension headaches. I have a very stressful life, I have a 5 year old son with Cerebral Palsey, Autism and some other nervous system problems. In the 2 weeks since I received my test results I've changed my diet completely, and cut excedrine and alcohol. Earlier this week my Doctor reran the ALT test and it was 37, one point within normal range. My Doctor reran the ALT test 2 days later when he checked my potassium and it was back up and higher then before at 46. I am still having tension headaches and have exchanged excedrine for ibuprofen. Nothing is hurting, (my ribs are a little sore but my Doctor thinks it's because of my posture) and I'm feeling my normal self- I'm just concerned about the rapid fluctuation.
Brief Answer:
ALT Levels are not concerning if under 100 mg/dl
Detailed Answer:
Hello,
Thank you for asking at HCM.
I carefully read your question and understand your concern.
I am sorry you have had a stressful life and hard situations.
There are a few things I would like to address:
1. the raise in the ALT levels is not huge. Many labs have the norm up to 40 and some up to 45. So you are close to those numbers mostly. Medically we start work up to find the cause of elevate ALT when it is around 3 times the upper normal, so when it is above 100. There is nothing to worry at the moment as the levels are not so much elevated.
2. if you have not been tested for Hepatitis B and C I would recommend you to have those tests done.
3. Alcohol causes damage to the liver if you consume more than 14 units a week. it is good though that you decided to cut it down.
4. Very likely the cause of mild elevation of ALT in you case is fatty liver which happens in obese people. It is very important to take care if your weight and watch diet and try to be active. It can not all be changed in a day or in a month but you will need gradual adjustments in diet and exercise.
5. If you have tension headaches 6 days out of 7 this is a very high frequency and you might benefit from preventive treatment for tension headache with amitriptyline, your doctor has to decide and prescribe this. Amitriptyline might help with the chronic headaches, stress and anxiety also. Lorazepam is used only randomly to reduce stress and should not be used regularly as it might cause dependance.
6. medications might hurt the liver so it is good you have cut down on them. Also use of analgesics (pain killers) too often can cause headaches related to painkillers so please talk with your doctor to break this cycle of headaches and painkillers.
So to conclude: do not worry of your ALT levels, they are not so high to require investigation. Still knowing your status related to hepatitis is important. Watching weight, alcohol use and medication use might contribute in better ALT levels.
I hope this is helpful to you and answers your question.
Kind regards
Dr Antoneta Zotaj
ALT Levels are not concerning if under 100 mg/dl
Detailed Answer:
Hello,
Thank you for asking at HCM.
I carefully read your question and understand your concern.
I am sorry you have had a stressful life and hard situations.
There are a few things I would like to address:
1. the raise in the ALT levels is not huge. Many labs have the norm up to 40 and some up to 45. So you are close to those numbers mostly. Medically we start work up to find the cause of elevate ALT when it is around 3 times the upper normal, so when it is above 100. There is nothing to worry at the moment as the levels are not so much elevated.
2. if you have not been tested for Hepatitis B and C I would recommend you to have those tests done.
3. Alcohol causes damage to the liver if you consume more than 14 units a week. it is good though that you decided to cut it down.
4. Very likely the cause of mild elevation of ALT in you case is fatty liver which happens in obese people. It is very important to take care if your weight and watch diet and try to be active. It can not all be changed in a day or in a month but you will need gradual adjustments in diet and exercise.
5. If you have tension headaches 6 days out of 7 this is a very high frequency and you might benefit from preventive treatment for tension headache with amitriptyline, your doctor has to decide and prescribe this. Amitriptyline might help with the chronic headaches, stress and anxiety also. Lorazepam is used only randomly to reduce stress and should not be used regularly as it might cause dependance.
6. medications might hurt the liver so it is good you have cut down on them. Also use of analgesics (pain killers) too often can cause headaches related to painkillers so please talk with your doctor to break this cycle of headaches and painkillers.
So to conclude: do not worry of your ALT levels, they are not so high to require investigation. Still knowing your status related to hepatitis is important. Watching weight, alcohol use and medication use might contribute in better ALT levels.
I hope this is helpful to you and answers your question.
Kind regards
Dr Antoneta Zotaj
Above answer was peer-reviewed by :
Dr. Arnab Banerjee
Brief Answer:
The variation is normal from measurement to measurement
Detailed Answer:
Hello again,
Thank you for the further concenrs you are sharing with me.
It is true that it seems scary that there is a fluctuation of the values but I would like to reassure you it is not really someting to worry. Every measurement has a limit of variation in measurement. If you do the same test with the same blood sample it will give you pretty close measurements but different so it is normal to have some changes of values due to the measurement errors (that are generally small in most tests we use) and also some variation might be due to the vaules in blood but still 9 is not a huge variation- it can still be considered safe.
If it jumped from 40 to 80 that would be more important and still would require just observation as it is still under 100.
So the variation is very small in itself and the values are well below 100. It is almost normal.
Ibuprofen can affect the liver, a little less than paracetamol but still it might affect it- I do not think your ALT level is due to Ibuprofen. Still I recommended you to speak with your doctor on preventive treatment for tension headaches with amitriptyline which might also mildly affect the liver but is affective and will prevent you from needing other treatments to be taken so often for the headache.
I hope this is helpful
Kind regards
Dr Antoneta Zotaj
The variation is normal from measurement to measurement
Detailed Answer:
Hello again,
Thank you for the further concenrs you are sharing with me.
It is true that it seems scary that there is a fluctuation of the values but I would like to reassure you it is not really someting to worry. Every measurement has a limit of variation in measurement. If you do the same test with the same blood sample it will give you pretty close measurements but different so it is normal to have some changes of values due to the measurement errors (that are generally small in most tests we use) and also some variation might be due to the vaules in blood but still 9 is not a huge variation- it can still be considered safe.
If it jumped from 40 to 80 that would be more important and still would require just observation as it is still under 100.
So the variation is very small in itself and the values are well below 100. It is almost normal.
Ibuprofen can affect the liver, a little less than paracetamol but still it might affect it- I do not think your ALT level is due to Ibuprofen. Still I recommended you to speak with your doctor on preventive treatment for tension headaches with amitriptyline which might also mildly affect the liver but is affective and will prevent you from needing other treatments to be taken so often for the headache.
I hope this is helpful
Kind regards
Dr Antoneta Zotaj
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Above answer was peer-reviewed by :
Dr. Raju A.T
Answered by
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