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Dr. Andrew Rynne

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Does intake of alcohol just 24 hours prior to testing cause elevation of liver enzymes?

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Dr. Ivan R. Rommstein

General Surgeon

Practicing since :2008

Answered : 11110 Questions

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Posted on Tue, 27 Oct 2015 in General Health
Question: In a recent check up they tested my blood (full panel). Everything came back normal, except my ALT and AST. My ALT was 93 and my AST was 45. I did not realize I was going to have bloodwork and consumed 1- 1.5 glasses of wine a night for the 2-3 weeks prior.

4. questions:
1. Are the results likely due to the moderate alcohol use the weeks leading up to the test, even though prior to a few weeks before i hadnt been consuming any alcohol.
2. How much alcohol does it take to skew the results. For example, can 1-2 glasses of wine the night or week before the test really make a difference
3. Is there any correlation between diabetes and ALT and AST
4 how bad are the levels? Are they minor, moderate or severely elevated?

doctor
Answered by Dr. Ivan R. Rommstein 1 hour later
Brief Answer:
see further

Detailed Answer:
Hi and welcome to HCM.

1. yes, it is possible that even small amount of alcohol if done 24 prior to testing can cause some elevation of liver markers
2.1-2 glasses is minor amount but still, such results are possible
3. unregulated diabetes may be one of the cause of fatty liver together with alcohol and increased blood lipids. however, hyperglicemia for itself will rarely cause permanently elevated LFTs.

4. AST and ALT are liver enzymes that are increased in blood in several liver disorders, these include alcohol induced liver damage, fatty liver,autoimmune hepatitis, viral hepatitis or gallstone issues some medications. some rare disorders are more serious an dinclude tumors and cirrhosis.
In case where bilirubin is fine and ast and alt increased, in most case this is indicating just temporary live damage.
AST is only slightly elevated and it may mean nothing,it may vary from day to day in normal conditions and even reach 50.
ALT 93 is moderately elevate but still not something significant and it may be just temporary.
SO i Suggets, if you dont have any symptoms, to repeat test in 4 weeks and see what will happen. if results persist, you should do liver ultrasound and viral markers first. Wish you good health. Regards
Above answer was peer-reviewed by : Dr. Raju A.T
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Follow up: Dr. Ivan R. Rommstein 2 hours later
Very helpful. Since my billirubin is normal indicating temp liver damage what are the most likely potential causes?

For additional background, Last year they were slightly elevated too. I assumed it was due to alcohol consumption since i had an ultrasound to rule out a fatty liver. I also tested negative for hepatitis. Lastly, I had my galll bladder removed two years ago. The doc just said to lay off the alvohol after there was nothing wrong with my liver. Similar levels as last year ( 76 alt last compared to 93 this year). Was that the right approach? Isnt it unlikely i now have a fatty liver or hepatitis since the levels are similar to a year ago or is that wishful thinking?

After your summary i am really most concerned about ALT. I avoid tylenol but did use quite a bit 2-3 months prior when i had a baby. Since then, i only use ibuprofen for pain. Is it safe to assume that high doses of acetaminophine a few minths earlier for a short period of time is not likely to be the reason?

Are you saying the alcohol intake could be the reason for the elevated levels or is it likely something else

Sorry for the redundancy in questions? ?
doctor
Answered by Dr. Ivan R. Rommstein 1 hour later
Brief Answer:
I think there is no need to worry

Detailed Answer:
Hi. first, single measures of liver enzymes with slight lft elevation is not helpful in finding exact diagnosis. Repeated testing after few weeks is required to see dynamic of these values.
Temporary elevation of Alt may occur with no obviois cause,it can be seen in smokers,in diabetics as I said causing non alcoholic fatty liver, but also many medications and even herbal products can cause it as well. Paracetamol shouldn't have effect after such long time. When we notice alt elevation then first thing to rule out is viral hepatitis,however it will go with bilirubin elevation for sure. so I don't see a reason to be worried. It may have been combination of some alcohol and blood sugar that triggered alt elevation.
Above answer was peer-reviewed by : Dr. Sonia Raina
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Follow up: Dr. Ivan R. Rommstein 2 days later
Thank you. I was retested this morning. I may follow up tomorrow after i get the results.
doctor
Answered by Dr. Ivan R. Rommstein 1 hour later
Brief Answer:
ok

Detailed Answer:
Ok, contact me with new results.
Above answer was peer-reviewed by : Dr. Neel Kudchadkar
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Follow up: Dr. Ivan R. Rommstein 28 hours later
Im really at a loss. My ALT ad AST are still elevated. I was left a message with the info but not given the numbers. My asumption are that they are in same ballpark. 45 AST and 93 ALT.

My glucose came back normal so thats not it. I dont smoke. Over the last 6 weeks, i have averaged 3 glasses of wine a week with no alcohol 10 days before the test. I dont take tylenol/acetsminophen ever.

Last year (ALT at 75) was tested for Hepatitis and although not immune to it, did not have it. I also had an ultrasound of liver and it was normal.

6 weeks ago, i had a CT. The liver, spleen, pancreas and kidneys all came back normal. They only noted some calcification around Appendix. Since it was the gastro doc that ordered the test, i assume she wasnt concerned with the calcification. I call it out though for your feedback. Lastly, the CT would have noted an enlarged liver or tumor. Does it not work to detect fatty liver? If i didnt have a fatty liver at 75 level does it seem unlikely i wiuld now?

How bad is 93? Is there a serious condition at that level? When I look at all causes, none seem applicable. Thoughts
doctor
Answered by Dr. Ivan R. Rommstein 19 hours later
Brief Answer:
no need to worry

Detailed Answer:
93 is not some significant elevation especially if bilirubin is fine. It may be caused by smoking or even minor alcohol consumation and may occur with no specific reason. If CT scan is clear then there is no need to worry. it is important that there is no malignancy, liver cirrhosis or some other hepatitis. Fatty liver may be seen only in severe stages. early fatty liver changes wont be noticed but it doesnt play any role. Some medications, alcohol or eve food may have caused alt elevation, i wouldnt be concerned about it as long as you dont have any symptoms and there is no elevation of other parameters. Wish you good health. Regards
Above answer was peer-reviewed by : Dr. Neel Kudchadkar
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Follow up: Dr. Ivan R. Rommstein 1 hour later
I will try not to drag this communication out but found out my ALT is now 178 and AST at 68. Is the ALT still at moderate or now serious level? Should I be freaked out as I am noe terrified. Bilirubin is still normal.

Are you saying there is a chance of early stage fatty liver that isnt detectable yet via CT and ultrasound? I assume a tumor/malignancy definitely would be but please confirm?

I had a hep test last year when my level was 55 not 75 and it was negative. I cant imagine I picked it up over the last year but may want to have them test.

I did have an A1C test this werk and it came back at 5.7% which indicates pre diabetes. I know the only correlation is that diabetes produces fatty liver. not sure if/how that may play into it.

Lastly, the only change to my regimen is the addition of low estrogen birth control. Could that do it?

The most impt question is if 178 is severe and an indication of serious problem. Reading online shows some scary info and not sure what is real or not.

Thank you

I don't smoke and didnt drink 10 days before the test. Even then, i only drank a few drinks a week. !
doctor
Answered by Dr. Ivan R. Rommstein 3 hours later
Brief Answer:
hi

Detailed Answer:
Well, you should say for estrogen before. this can definitely cause liver changes and elevated liver markers, diabetes as well. estrogen can even cause adenomas of the liver which would however be seen on CT scan.
ALT of 178 is moderately high and some serious liver damage goes with ALT +250 and usually this is accompinied with AST, ALP and definitely bilirubin elevation.

I definitely suggest to recheck hepatitis markers,ALT may indicate viral hepatitis. Early stage of fatty liver is not seen on CT scan.
Above answer was peer-reviewed by : Dr. Yogesh D
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