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Blood Test Shows Elevated AST And ALT. What Is Wrong?

Posted on Fri, 12 Apr 2013

Question: Yes just got back my blood test liver enzymes tests show AST at 208 and ALT at 83 - what's up with that?

Answered by Dr. Dr. Ivan Romich (57 minutes later)

Hi and welcome to XXXXXXX
You have elevated liver enzymes what indicates that there is some kind of liver damage. More info about bilirubin and ggt would be helpful,but these parametres are significantly raised and further tests shouod be done to find the exact cause of liver damage. It sounds serious but dont worry because liver regenerate fast and there is no danger about liver failure.
Most common causes of elevated findings are alcohol abuse, viral hepatitis, gallbladder stones or side effects of drugs.
YOu should rule these ones out first and then consider some less common diagnosis.
First test to be done is ultrasound of liver and abdomen to see liver morphology. It can tell us is there only fattyliver or signs of fibrosis.
Till you do that you can change your dietary habbits,avoid alcohol,fats and smoking and do exercise.

Hope I have answered your query. If you have any further questions I will be happy to help"

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Dr. Ivan Romich (8 minutes later)

I currently have an ultrasound schedule for Friday morning. I do drink and am a little over weight 5'9" and 210 lbs. but I do not do drugs and feel fine. How would I get viral hepatitis if thats what it is and is it curable? About three months ago I was cuts by a guys at the airport who was carrying a piece of metal and he ran into me and slashed my arm.

Answered by Dr. Dr. Ivan Romich (8 minutes later)

There is a minor possibility that you got infected on this way,dont worry. But you should do viral markers just to be sure (your GP knows what it is).
Well considering your weight you probably have just a fatty liver which isnt serious condition and it is easily treated by some medicines and especially by lifestyle changes.
It is good to decrease your blood lipids, glucoase level and alcohol drinking till liver enzymes stabilise. You ll know how serious liver damage is after ultrasound,but I am sure it isnt much because your enzymes arent so much elevated.If you dont have jaundice,dark urine or any other abdominal symptom you shouoldnt be concerned.
Hope I have answered your query. If you have any further questions I will be happy to help"

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Dr. Ivan Romich (59 minutes later)

Ok, I just read something about muscle issues causing raised enzyme levels- I just started working out on Monday and was in extreme pain from workout (could not even straighten out my arms) had blood test on Friday - could that be an issue or is that wishful thinking

Answered by Dr. Dr. Ivan Romich (7 hours later)

Yes.muscle straining or excessive exercise can cause it but ast would be less elevated then. i would consider this as liver issue until the opposite is proven. the best way to see it is to do tests again after 7-10 days and dont do workout till that.
Regards.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Dr. Ivan Romich (10 hours later)

My test results are as follows:
CHOLESTEROL 217 mg/dL 125-200 [H]
LDL-CHOLESTROL 152 mg/dL <130 [H]
GLUCOSE 101 mg/dL 65-99 [H]
SODIUM 141 mmol/L 135-146
POTASSIUM 4.2 mmol/L 3.5-5.3
CHLORIDE 101 mmol/L 98-110
CARBON DIOXIDE 28 mmol/L 19-30
CALCIUM 9.8 mg/dL 8.6-10.3
PROTEIN 7.7 g/dL 6.1-8.1
ALBUMIN 4.9 g/dL 3.6-5.1
GLOBULIN 2.8 g/dL 1.9-3.7
BILIRUBIN 0.8 mg/dL 0.2-1.2
ALKALINE PHOS 59 U/L 40-115
AST 208 U/L 10-35 [H]
ALT 83 U/L 9-60 [H]
TSH .38 mIU/L .40-4.50
URINALYSIS REFLEX
COLOR YELLOW
APPEARANCE CLEAR
PH 6.0 5.0-8.0
BILIRUBIN NEGATIVE
Everything else is negative or within limits.
My last blood test March 2009 AST 34 ALT 44 and July 2010 AST 19 ALT 23
Based on all this information what is your best guess what has caused this?

Answered by Dr. Dr. Ivan Romich (1 hour later)

Hi. bilirubin level is normal.this is important for normal liver function and means that there is no significant livet damage. you have slightly elevated cholesterol and it can be reason for fatty liver and elevated enzymes. i consider this as a possible reason for your problem.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Dr. Ivan Romich (1 hour later)

Just got back my Hepatitis panel and everything was non-reactive. Sorry for all the questions - hepatitis scares he shit out of me and I couldn't figure out where I would have gotten it. Thanks for everything.
One last question, does this still mean my liver is damaged and I should not drink?

Answered by Dr. Dr. Ivan Romich (9 hours later)

Try to reduce drinking. XXXXXXX 2 glass of wine or 2 beers per day and check your lab for 1 month and see will your liver enzymes fall. Depending on it you can see what is the amount of alcohol which your liver can metabolize. Ultrasound will show you more but if there is damage it is minor and reversible because bilirubin is normal and enzymes arent seriously elevated.so you dont have to worry at all. wish you good health.

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Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar