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Routine blood test done for AST and ALT. What does the reading says?

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Internal Medicine Specialist
Practicing since : 2004
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I add a routine blood test and my AST was 51 and my ALT was 71. My doctor said not to worry and we are re-testing, but I can't help but be overly alarmed. Can you reassure me?
Posted Thu, 11 Oct 2012 in Liver and Gall Bladder
Answered by Dr. Enrique Molina 43 minutes later
I would be happy to help. Although your liver enzyme elevation is not very high, it is definitely not normal, particularly for a women. Laboratories for years have designed a normal value of up to around 40 or 50, however newer studies reveal that for women the upper limit of normal is probably around 30 for both AST and ALT.
I believe it is appropriate to re-check the blood test to confirm these results, as these occasionally come erroneously elevated due to blood clotting in the sample tube and blood "hemolyzing" (red cells breaking) making the blood results not reliable.
On the other hand, as a liver specialist I would be VERY cautious and follow this up closely, particularly with your history of Hashimoto's thyroiditis (which is an autoimmune disease, where your own body attacks your thyroid). When you have an autoimmune disease you are prone to get other autoimmune diseases, and this include the liver. There is an entity called "autoimmune liver disease", which is initially usually asymptomatic, and some people don't get to know about it until they have advanced liver disease or cirrhosis, or as in your case by routine blood tests. And of course there are many other causes of liver enzyme elevation, but this entity would be my main concern in your case. This disease can be diagnosed by some special blood tests, and if still unsure then a liver biopsy can be done.
Hope that helps, and I don't mean to scare you off, but you need to have good follow up on your repeat liver tests.
Let me know if you have any further questions or concerns.
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