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Blood work shows elevated ALT levels. What does it indicate?

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Was recently seen for routine medical exam. I am 28. In good health. No signs or symptoms of disease. Other than sinus infection 2 months prior.

During routine blood work up i was found to have alt level of 63 with norm range of up to 45. I then switched doctors and had test completed two days later. Test was then 67 with norm range of 55. Two weeks later was tested again and was 72 with norm range of 55. Then started to eat better and exercise. Went from being 6 foot 3 and 207 ( i was 215 at peek few months back) down to 195 now 4 weeks later. Was retested yesterday and was told was 62 with normal range of 55.

Other health history is as follows. 18 months ago i was tested for ldl it was 133 and had cotinued to eat hight fat diet until 4 weeks ago when test was 72. Ultrasound was completed abd was negative. I will attach test results.

My question what is causing this number. Is it actually healing or too early to tell or within margin of error. Also dr had mentioned autoimmune diseases alpha 1 antitrypsin and autoimmune hepatitis. These really scared me when he said was unlikely but possible. What is your opinion and why.

Posted Mon, 18 Nov 2013 in Digestion and Bowels
Answered by Dr. Amit Jain 6 hours later
Brief Answer:
Please see the details

Detailed Answer:
Hello! Thanks for putting your query in XXXXXXX I am a Gastroenterologist (DM).

It appears that you are having NAFLD (Non alcoholic fatty liver disease).

It was nice to hear that you have reduced your weight to 195. Your BMI is 24.4. You need to reduce few more and maintain that by continuing with regular exercise at least for 30 minutes per day and taking low fat diet. Also take Tablet ursodeoxycholic acid and capsule evion which I found very useful in my patients.

Increase in AST or ALT suggest that there is inflammation of liver cells which has many causes as I discussed earlier and few for which you have already been evaluated.

These tests like alpha 1 antitrypsin, autoimmune hepatitis and XXXXXXX disease are done routinely in patients with increased AST or ALT. These are although rare but possible and treatable cause. If these disease are detected in time they can be treated but when they are advanced they are difficult to treat.

It may take three to 4 months for ALT level to normalize if you continue with above.

I will further advise:
1. Alcohol if you are taking then please avoid it
2. I have gone through all the reports you have given. I will advise you to be evaluated for other common and treatable causes like Serum ceruloplasmin for XXXXXXX disease, ANA and SMA for autoimmune disease
3. Lipid profile and Ultrasound abdomen to see for liver echotexture

I hope I have answered your query and this will help you. If you have any further query I will be happy to answer that too. Remain in touch and get-well soon.
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