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Have elevated ast, tsh and hbp. Taking levothyroxine and hydrochlorothyizide. Liver disease?

Dec 2012
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Answered by

General & Family Physician
Practicing since : 2012
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I just received some lab results. My Glucose is 110 (nothing to eat or drink for 7 hours prior), my eGFR is 48 (too low) and my AST is 41 (too high), my ALT is 36.
My TSH is 75 and my blood pressure has been very high about 170/110 for a few weeks.
I was put on Levothyroxine 200mg and Hydrochlorothyizide 12.5mg (lowest dosage, I think).
Doctor wants me to come back for repeat labs and visit in 6-8 weeks.
Just wondered if I should be requesting my doctor to do more or be more concerned since bp doesn't seem to be getting any better and now this lab tests are concerning me as possible liver damage?
Posted Fri, 22 Mar 2013 in Liver and Gall Bladder
Answered by Dr. Nsah Bernard 29 minutes later

Thanks for posting on XXXXXXX
From your lab results, your fasting glycemia is slightly above normal but not diagnostc of diabetes, your GFR being low means you might have a kidney injury or failure and high transminases or liver enzyme means you might be having a liver failure which is most probably due to your chronic thyroid diseases.
Your high BP might be secondary to your kidney injury or liver diseases or both. Those need to be investigated for causes and treated. In the other hand, it might be an essential or primary hypertension. In any case, both will require antihypertensive medication as the values for weeks are extremely high. Not being able to control it soon enough could lead to a serious (probably irreversible damage).
I will recommend your see your doctor for the BP issue (probably medications) as soon as possible.

Hope this will help you and if you are satisfied please do accept my answer.
Dr Nsah
Above answer was peer-reviewed by
Follow-up: Have elevated ast, tsh and hbp. Taking levothyroxine and hydrochlorothyizide. Liver disease? 19 hours later
So it sounds as if this could be a serious issue? I will follow up with my doctor.
I have not had any kidney or liver injuries so will get follow up care to determine if I am having any kidney or liver failure?
Can you tell me what transminases test is? A lab test? I do not have any results for that so I assume doctor did not test for that. Should I request a test for this?
Like I had mentioned my ALT is 36 which is the highest number and still be consider within normal limits. Should I be concerned?
My Creatinine was 1.3 within the normal result window, however my mother's Creatinine has been very elevated for a number of years. Could there be something hereditary?
I have only seen this doctor once and do not have any real relationship with him yet - Is there anything I should asking my doctor to test for?
Answered by Dr. Nsah Bernard 11 minutes later

Thanks for updating,

Sorry liver transaminases are liver enzymes ALT and AST. ALT is within normal range so no need to worry. ALT is the enzyme that usually determimes if there is liver injury (for you no need to worry). AST can also determine liver diseases but it is not specific to liver and in this case that ALT is normal, you do not have to worry about liver.
Your creatinine is within normal range therefore kidney injury is also ruled out. Your elevated GFR how ever may signify dehydration or just a physiologic change which will be regularized shortly by homeostasis. Looking at your results, I am only concerned about your thyroid and since you are already on medications, I suggest you keep calm and continue your treatment. You can do follow-up tests regularly for thyroid hormones (T3, T4, TSH), control/check your BP regularly (placement on medication should also be included), redo fasting blood sugar daily for a few days to make sure they fall within normal limits, reduce quantity of salt, rehydrate yourself regularly.
Your doctor can redo AST, ALT, urea, creatine, BUN, blood electrolytes, T3, T4, TSH after a couple of weeks to see if they fall within normal ranges. Doing a complete blood count and lipid profile ( cholesterol levels, LDL,HDL etc) should also be amongst the tests. Ask your doctor if controlling your BP with medications should be indicated.

Hope this helps and if you are satisfied please accept my answer.
Thank you
Dr Nsah
Above answer was peer-reviewed by
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