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What Do Raised AST And ALT Levels Indicate?

Posted on Mon, 24 Mar 2014

Question: I have asked a Dr previously that gave me great advice but was hoping to get a second opinion just to have the info confirmed. I recently had routine blood work that showed my AST - 66 & ALT 18. I had been drinking regularly prior to the test. I stopped drinking immediately and retested a week later thinking for sure that my levels would go down or at worst stay the same. They actually raised to AST 99 & ALT 27. I'm very worried. I'm healthy aside from these numbers and am negative for hep ABC. The elevated numbers in just a weeks time without drinking scares me. How bad is this and what could it be? I am 33 female 5'7 155 pounds and take no medication or Tylenol.

Answered by Dr. Dr.P.Ratnakar Kini (26 minutes later)

Brief Answer: Answer given below Detailed Answer: Hi, Thanks for posting your query. I am Dr.Ratnakar Kini and I am pleased to assist you. Your AST level is high and the AST/ALT ratio is more than 2. This is suggestive of alcoholic hepatitis. The first and foremost step in the treatment is to quit drinking alcohol which you have done. It takes a few weeks of abstinence before the levels return to baseline. Meanwhile you can take s.adenosyl methionine and metadoxine supplements for better and faster recovery. The bilirubin level and Prothrombin levels are also needed to calculate a score called Maddrey's Discriminant function. It will help to know how you will recover from alcoholic hepatitis. If it is more than 32 you may have to take steroids or pentoxifylline for better recovery. You can repeat the liver function test after 4 weeks to see how it has improved. I hope that answers your question. Let me know if I can assist you further. Regards, Dr.Ratnakar Kini

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

Follow up: Dr. Dr.P.Ratnakar Kini (23 minutes later)

Thank you for your response. My bilirubin levels were normal. The spike in a weeks time...is that indicative of how badly damaged my liver is? Where can I find the supplements mentioned and is there another name for them? Thanks

Answered by Dr. Dr.P.Ratnakar Kini (14 minutes later)

Brief Answer: Answer given below Detailed Answer: Hi, Thanks for getting back to me with more questions. I will got give much importance to the mildly raised levels within a week. They just indicate you have alcoholic hepatitis. Since the bilirubin level was normal, it is very likely that your Maddrey's DF would be less than 32 and you can expect good recovery. Repeat liver function test after 4 weeks. For the supplements mentioned, they are available OTC or you can ask your GP for a prescription. I hope that answers your question. Let me know if I can assist you further. Regards, Dr.Ratnakar Kini

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

Follow up: Dr. Dr.P.Ratnakar Kini (40 minutes later)

So in your opinion from the information I gave you, alcoholic hepatitis is recoverable from?

Answered by Dr. Dr.P.Ratnakar Kini (8 minutes later)

Brief Answer: Answer given below Detailed Answer: Hi, Yes, from the information you have given me, I can assure you, you can have a complete recovery from alcoholic hepatitis. This is possible if you quit drinking alcohol. Meanwhile you can get an ultrasound scan of the abdomen done to see the status of the liver and see whether it is normal otherwise. I hope that answers your question. Let me know if I can assist you further. Regards, Dr.Ratnakar Kini

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