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How Long Does It Take Elevated AST And ALT Levels To Become Normal?
Question: How long does it take elevated AST and ALT levels to come down due to fatty liver? What about from a medicine reaction? Is there a difference? Here is why I ask. On February 8th of this year, I fell down our hard wood stairs from the top, all the way down to the bottom and landed on my head. Although conscious, I couldn't talk and had no idea who or where I was. I went by ambulance to the hospital and spent the entire day having tests run. I don't remember any of it. I was ultimately diagnosed with a severe concussion and a traumatic brain injury. I'm still having some residual memory problems and problems with speech and remembering words. It's been really scary.
Anyways, once I got home from the hospital, we noticed that my AST and ALT were elevated. I'm going to give you a timeline of the elevations and what I have done to get the numbers back down. I am terribly confused as to the reason for the increase. I did have an ultrasound and was found to have moderate to severe fatty liver. Since then, I have lost 60 pounds, been walking 5 miles a day and eating a very healthy liver diet. Depending on which lab reference range I look at, sometimes I am in range, and sometimes I am out.
Here's where the confusion lies. I was taking a medication at the time of my hospital that is known to potentially elevate liver enzymes. I don't know if my liver enzymes have come from the weight loss, healthy eating and exercise, or from removal of the medication (perphenazine). I wonder if the time frame of my enzymes coming down can help us decipher drug toxicity, from XXXXXXX which is what my doctor diagnosed me based on elevated liver enzymes and fat in my liver (but with no biopsy). I am so confused and this has scared me to death. I have a wonderful hubby and two wonderful teenage girls. I want to be around for them and I can't seem to get any definitive answers.
I am going to list you a timeline and would love your opinion if you could give it. Thank you so much!
XXXXXXX
1/23/14 Started taking perphenazine for anxiety
2/8/14 Fall down the stairs, head injury and elevated liver enzymes.
ALT 72 AST 58
2/27/14 Followed up on liver enzymes with my PCP and they were even higher.
ALT 108 AST 63
3/5/14 Liver ultrasound showing moderate to severe fatty liver with no other remarkable findings.
At this point, my PCP said that I had NAFLD, specifically XXXXXXX as indicated by the elevated numbers and fat seen on the ultrasound. No biopsy. No elevated enzymes in the past.
3/6/14 Starting eating a liver friendly diet, exercising and losing weight. Lost 60 pounds between February and October.
4/21/14 ALT 59 AST 37
7/21/14 ALT 51 AST 33
I had my blood drawn again today (11/3/14) and should find out the numbers tomorrow. Needless to say, I am terrified. What nobody can seem to tell me is if I have a progressive liver disease that can kill me, or if I can reverse this by lifestyle changes. Also, do liver enzymes come down that fast with fatty liver? Would it be more likely that their decrease are demonstrative of liver toxicity from the medication I was taking?
The other reason I am scared is because the lab I went to today has a MUCH lower "normal" range than the lab that processed my blood work in July. Specifically, ALT top range for a female my age according to my initial testing is 56, which puts me in range. According to the lab that drew my blood today, ALT top range for a female my age is 33. My AST range is already within the lower range at the new lab, so I feel okay about that.
I don't think there's any possibility that my liver enzymes have gone down (ALT) from 51 to under 33 in 3 months.
I hope this doesn't prompt my doctor to refer me for a liver biopsy. I really am so confused. Can you sort any of this out based on the numbers and dates I've given you? All other blood tests are normal and I am now at 60 inches and 130 pounds. My BMI is somewhere around 21.6. No diabetes, but glucose got a little high (111) and now down to (101) just one point high. No high blood pressure. On Prevastatin 40mg/day and have been for several years for high cholesterol. Cholesterol is great and It's never affected my enzymes before.
Can you give me any insight? Does this sound like I have NASH? I'm so scared and confused!
Thank you for your help!
XXXXXXX
Anyways, once I got home from the hospital, we noticed that my AST and ALT were elevated. I'm going to give you a timeline of the elevations and what I have done to get the numbers back down. I am terribly confused as to the reason for the increase. I did have an ultrasound and was found to have moderate to severe fatty liver. Since then, I have lost 60 pounds, been walking 5 miles a day and eating a very healthy liver diet. Depending on which lab reference range I look at, sometimes I am in range, and sometimes I am out.
Here's where the confusion lies. I was taking a medication at the time of my hospital that is known to potentially elevate liver enzymes. I don't know if my liver enzymes have come from the weight loss, healthy eating and exercise, or from removal of the medication (perphenazine). I wonder if the time frame of my enzymes coming down can help us decipher drug toxicity, from XXXXXXX which is what my doctor diagnosed me based on elevated liver enzymes and fat in my liver (but with no biopsy). I am so confused and this has scared me to death. I have a wonderful hubby and two wonderful teenage girls. I want to be around for them and I can't seem to get any definitive answers.
I am going to list you a timeline and would love your opinion if you could give it. Thank you so much!
XXXXXXX
1/23/14 Started taking perphenazine for anxiety
2/8/14 Fall down the stairs, head injury and elevated liver enzymes.
ALT 72 AST 58
2/27/14 Followed up on liver enzymes with my PCP and they were even higher.
ALT 108 AST 63
3/5/14 Liver ultrasound showing moderate to severe fatty liver with no other remarkable findings.
At this point, my PCP said that I had NAFLD, specifically XXXXXXX as indicated by the elevated numbers and fat seen on the ultrasound. No biopsy. No elevated enzymes in the past.
3/6/14 Starting eating a liver friendly diet, exercising and losing weight. Lost 60 pounds between February and October.
4/21/14 ALT 59 AST 37
7/21/14 ALT 51 AST 33
I had my blood drawn again today (11/3/14) and should find out the numbers tomorrow. Needless to say, I am terrified. What nobody can seem to tell me is if I have a progressive liver disease that can kill me, or if I can reverse this by lifestyle changes. Also, do liver enzymes come down that fast with fatty liver? Would it be more likely that their decrease are demonstrative of liver toxicity from the medication I was taking?
The other reason I am scared is because the lab I went to today has a MUCH lower "normal" range than the lab that processed my blood work in July. Specifically, ALT top range for a female my age according to my initial testing is 56, which puts me in range. According to the lab that drew my blood today, ALT top range for a female my age is 33. My AST range is already within the lower range at the new lab, so I feel okay about that.
I don't think there's any possibility that my liver enzymes have gone down (ALT) from 51 to under 33 in 3 months.
I hope this doesn't prompt my doctor to refer me for a liver biopsy. I really am so confused. Can you sort any of this out based on the numbers and dates I've given you? All other blood tests are normal and I am now at 60 inches and 130 pounds. My BMI is somewhere around 21.6. No diabetes, but glucose got a little high (111) and now down to (101) just one point high. No high blood pressure. On Prevastatin 40mg/day and have been for several years for high cholesterol. Cholesterol is great and It's never affected my enzymes before.
Can you give me any insight? Does this sound like I have NASH? I'm so scared and confused!
Thank you for your help!
XXXXXXX
Brief Answer:
All queries addressed ma'am
Detailed Answer:
Hello XXXXXXX and welcome.
Thank you for writing to us.
I have gone through your query with diligence and would like you to know that I am here to help. I really appreciate the detailed query as it leaves no doubt in a doctors mind and helps to establish a diagnosis quicker. I feel I should start by giving you some information on XXXXXXX after which most of your doubts should be cleared.
XXXXXXX (non-alcoholic steatohepatitis) is a condition in which liver inflammation has occurred from the build up of fat mostly in patients who have previously been diagnosed with fatty liver, but have off late experienced a worsening of symptoms of liver enzyme levels. There are various contributing factors to the development of XXXXXXX but please note that not always have there been triggering/contributing factors found in patients who have been diagnosed to have XXXXXXX
Let me list some of the most common triggering factors which have most certainly been found to make a patient with fatty liver develop XXXXXXX they are:
-Metabolic syndrome
-High cholesterol and triglyceride levels
-Type 2 diabetes
-Obesity
From the above listed causes, we know that you have at least 2 of the triggering factors which could have made your liver enzyme levels go haywire and led to XXXXXXX It is important to note that XXXXXXX is diagnosed by an increase in the fat deposition, and not just inconsistencies with the liver enzyme levels.
The next point I would like to discuss is the use of perphenazine. From studies conducted, perphenazine has found to contribute to elevation of lier enzyme levels, but only a mild elevation, which is exactly what is seen in your case. I should inform you ma'am, that your liver enzyme elevation is considered mild and not moderate or severe, as there are patients who have levels of 2000 (AST and ALT), which is considered severe. As I was saying ma'am, there is only a mild elevation of liver enzyme levels with perphenazine use, and this elevation usually comes down even while still on the medication and most certainly comes down once it is discontinued. As the elevation is considered mild, there is nothing much to be done and no cause for concern. Usually just a hepatoprotector is prescribed, and nothing more.
From the time line provided by you ma'am, your liver enzyme levels came down purely due to the initiative taken by you (exercise, diet, etc.), along with a possibility of your levels coming down gradually as is seen in patients on perphenazine.
I hope all of the above information is clear to you and puts you at rest, ruling out liver toxicity, liver failure, etc. The elevation in my opinion was purely due to XXXXXXX and the use of perphenazine. But your lifestyle changes along with the gradual regularisation of AST and ALT levels seen with perphenazine levels, is what brought your levels down.
The normal range does not hold much relevance as your levels do not raise concern, and should not cause anxiety in either you or your doctor. But in response to your question, there is a possibility that you have XXXXXXX but this is well controlled and will get better with lifestyle changes that you have already employed.
Also, there is no fixed time range that I could provide to you about how long AST and ALT levels take to return to normal with fatty liver as it depends entirely on the lifestyle, medications, etc. But with medications, in most cases the levels return to normal soon after discontinuation of the medication, but in some (like with perphenazine) the levels can return to normal within 2-4 weeks of use (while still on the drug).
I hope you find my response both helpful and informative. Please feel free to write back to me for any further clarifications, I would be more than happy to help you.
Best wishes.
All queries addressed ma'am
Detailed Answer:
Hello XXXXXXX and welcome.
Thank you for writing to us.
I have gone through your query with diligence and would like you to know that I am here to help. I really appreciate the detailed query as it leaves no doubt in a doctors mind and helps to establish a diagnosis quicker. I feel I should start by giving you some information on XXXXXXX after which most of your doubts should be cleared.
XXXXXXX (non-alcoholic steatohepatitis) is a condition in which liver inflammation has occurred from the build up of fat mostly in patients who have previously been diagnosed with fatty liver, but have off late experienced a worsening of symptoms of liver enzyme levels. There are various contributing factors to the development of XXXXXXX but please note that not always have there been triggering/contributing factors found in patients who have been diagnosed to have XXXXXXX
Let me list some of the most common triggering factors which have most certainly been found to make a patient with fatty liver develop XXXXXXX they are:
-Metabolic syndrome
-High cholesterol and triglyceride levels
-Type 2 diabetes
-Obesity
From the above listed causes, we know that you have at least 2 of the triggering factors which could have made your liver enzyme levels go haywire and led to XXXXXXX It is important to note that XXXXXXX is diagnosed by an increase in the fat deposition, and not just inconsistencies with the liver enzyme levels.
The next point I would like to discuss is the use of perphenazine. From studies conducted, perphenazine has found to contribute to elevation of lier enzyme levels, but only a mild elevation, which is exactly what is seen in your case. I should inform you ma'am, that your liver enzyme elevation is considered mild and not moderate or severe, as there are patients who have levels of 2000 (AST and ALT), which is considered severe. As I was saying ma'am, there is only a mild elevation of liver enzyme levels with perphenazine use, and this elevation usually comes down even while still on the medication and most certainly comes down once it is discontinued. As the elevation is considered mild, there is nothing much to be done and no cause for concern. Usually just a hepatoprotector is prescribed, and nothing more.
From the time line provided by you ma'am, your liver enzyme levels came down purely due to the initiative taken by you (exercise, diet, etc.), along with a possibility of your levels coming down gradually as is seen in patients on perphenazine.
I hope all of the above information is clear to you and puts you at rest, ruling out liver toxicity, liver failure, etc. The elevation in my opinion was purely due to XXXXXXX and the use of perphenazine. But your lifestyle changes along with the gradual regularisation of AST and ALT levels seen with perphenazine levels, is what brought your levels down.
The normal range does not hold much relevance as your levels do not raise concern, and should not cause anxiety in either you or your doctor. But in response to your question, there is a possibility that you have XXXXXXX but this is well controlled and will get better with lifestyle changes that you have already employed.
Also, there is no fixed time range that I could provide to you about how long AST and ALT levels take to return to normal with fatty liver as it depends entirely on the lifestyle, medications, etc. But with medications, in most cases the levels return to normal soon after discontinuation of the medication, but in some (like with perphenazine) the levels can return to normal within 2-4 weeks of use (while still on the drug).
I hope you find my response both helpful and informative. Please feel free to write back to me for any further clarifications, I would be more than happy to help you.
Best wishes.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thank you so much for your answer, Dr. XXXXXXX I'm so sorry, but I'm still a bit confused. What are the symptoms I have that would indicate XXXXXXX and not just simple fatty liver? Is this a deadly disease? What can I do to keep my ALT and AST levels down? Any specific symptoms I should be looking for with regards to NASH? Thank you again, XXXXXXX
Brief Answer:
Please write to me if anything is unclear
Detailed Answer:
Hello once again XXXXXXX
It is my pleasure entirely. The information you have asked for in your second response is information I have not provided in my previous response, so I would like to know if all the information provided in my previous response is clear or not. If there is anything unclear or anything I have not explained, please do not hesitate to write to me about it, and I would be more than happy to help you with it.
As for the latest queries you have, I shall gladly clear them for you:
Symptoms of XXXXXXX include the following:
-General weakness
-Weight loss (without apparent stimulus)
-Exhaustion
-Abdominal pain (upper right quadrant)
Although some of the symptoms can match fatty liver, but the above mentioned symptoms are specifically seen with XXXXXXX
I wouldn't say this is a deadly disease, but more of an indication that things are not going well. This condition is usually diagnosed with the help of:
-CT scan
-Abdominal ultrasound
-MRI scan
-Blood investigations
All the above investigations show an increase in fat deposition in the liver, and so the main approach to treating XXXXXXX and a fatty liver in general are the same, and are the following:
-I assume you do not drink alcohol (if you do, then please avoid it completely)
-Control your blood sugar levels
-Control your cholesterol and triglyceride levels
-Targeting weight loss with lifestyle changes
-Regular exercise
-Avoid fatty/fried/oily food
-Avoid sugar and carbohydrates as much as possible
Other than this, there is nothing much required ma'am. I am sure you are already on the path to good health, as you have achieved weight loss and should continue to do so.
I hope all this is clear to you ma'am, please do not hesitate to ask me any further queries or write to me about anything that I have failed to explain to you in a manner best understood by you.
Best wishes XXXXXXX
Please write to me if anything is unclear
Detailed Answer:
Hello once again XXXXXXX
It is my pleasure entirely. The information you have asked for in your second response is information I have not provided in my previous response, so I would like to know if all the information provided in my previous response is clear or not. If there is anything unclear or anything I have not explained, please do not hesitate to write to me about it, and I would be more than happy to help you with it.
As for the latest queries you have, I shall gladly clear them for you:
Symptoms of XXXXXXX include the following:
-General weakness
-Weight loss (without apparent stimulus)
-Exhaustion
-Abdominal pain (upper right quadrant)
Although some of the symptoms can match fatty liver, but the above mentioned symptoms are specifically seen with XXXXXXX
I wouldn't say this is a deadly disease, but more of an indication that things are not going well. This condition is usually diagnosed with the help of:
-CT scan
-Abdominal ultrasound
-MRI scan
-Blood investigations
All the above investigations show an increase in fat deposition in the liver, and so the main approach to treating XXXXXXX and a fatty liver in general are the same, and are the following:
-I assume you do not drink alcohol (if you do, then please avoid it completely)
-Control your blood sugar levels
-Control your cholesterol and triglyceride levels
-Targeting weight loss with lifestyle changes
-Regular exercise
-Avoid fatty/fried/oily food
-Avoid sugar and carbohydrates as much as possible
Other than this, there is nothing much required ma'am. I am sure you are already on the path to good health, as you have achieved weight loss and should continue to do so.
I hope all this is clear to you ma'am, please do not hesitate to ask me any further queries or write to me about anything that I have failed to explain to you in a manner best understood by you.
Best wishes XXXXXXX
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thank you so much for your patience, Dr. XXXXXXX I guess I was hoping that my enzyme elevations were from a toxin, rather than XXXXXXX My reason for this is that I knot that XXXXXXX can progress to cirrhosis and beyond. On the other hand, if the elevations were due to a medications and now XXXXXXX I don't have to worry about it coming back. I don't understand how doctors can diagnose XXXXXXX without a biopsy. I thought that both simple fatty liver and XXXXXXX could both cause enzymes. I guess I was just really hoping that my reduced elevations were a good sign that I don't have XXXXXXX Finally, could you please address why one lab would have such differences in their ALT/AST reference ranges? Thanks so much for putting up with all of my questions! I really appreciate it! XXXXXXX
Brief Answer:
Simple explanation to that ma'am
Detailed Answer:
Hi XXXXXXX
XXXXXXX can only progress to cirrhosis and beyond if it is not well controlled, and if the fat deposition continues it in turn results in worsening (i.e. cirrhosis, etc.). But all you need to do to avoid that is take your medications (to control diabetes and cholesterol), go on a good diet and exercise well enough, and complications like cirrhosis can be averted.
XXXXXXX is usually diagnosed with a combination of 3 things:
1. Medical history and current clinical picture
2. At least one non-invasive investigation (e.g. ultrasound, MRI, CT scan)
3. Liver biopsy
As two of the above have been conducted and point towards XXXXXXX I would strongly recommend a liver biopsy to confirm it completely. Until the biopsy is done, XXXXXXX is only a 'suspected diagnosis' and not 'a diagnosis'.
Different labs choose different normal ranges simply because there are different factors that can influence test results like technique employed to collect blood sample time taken to test the sample, position of the patient; among other factors like age, genetics, etc.
So as different labs have different lab technicians, different techniques employed, differences in time taken to send the sample to the lab, etc; different labs use different reference ranges in order to provide the patient with a more accurate result (i.e. whether their result is normal or not within the normal range).
I am more than happy to be of assistance to you ma'am. Please do not hesitate to write to me about anything, and please do not embarrass me by saying that I am putting up with your questions. It gives me a lot of XXXXXXX to be able to clear queries and doubts all my patients have, so please do not ever think twice to write to me. Here is my direct link for future reference: http://doctor.healthcaremagic.com/doctors/dr-shoaib-khan/64581
or just post a query specifically asking for me.
Best wishes.
Simple explanation to that ma'am
Detailed Answer:
Hi XXXXXXX
XXXXXXX can only progress to cirrhosis and beyond if it is not well controlled, and if the fat deposition continues it in turn results in worsening (i.e. cirrhosis, etc.). But all you need to do to avoid that is take your medications (to control diabetes and cholesterol), go on a good diet and exercise well enough, and complications like cirrhosis can be averted.
XXXXXXX is usually diagnosed with a combination of 3 things:
1. Medical history and current clinical picture
2. At least one non-invasive investigation (e.g. ultrasound, MRI, CT scan)
3. Liver biopsy
As two of the above have been conducted and point towards XXXXXXX I would strongly recommend a liver biopsy to confirm it completely. Until the biopsy is done, XXXXXXX is only a 'suspected diagnosis' and not 'a diagnosis'.
Different labs choose different normal ranges simply because there are different factors that can influence test results like technique employed to collect blood sample time taken to test the sample, position of the patient; among other factors like age, genetics, etc.
So as different labs have different lab technicians, different techniques employed, differences in time taken to send the sample to the lab, etc; different labs use different reference ranges in order to provide the patient with a more accurate result (i.e. whether their result is normal or not within the normal range).
I am more than happy to be of assistance to you ma'am. Please do not hesitate to write to me about anything, and please do not embarrass me by saying that I am putting up with your questions. It gives me a lot of XXXXXXX to be able to clear queries and doubts all my patients have, so please do not ever think twice to write to me. Here is my direct link for future reference: http://doctor.healthcaremagic.com/doctors/dr-shoaib-khan/64581
or just post a query specifically asking for me.
Best wishes.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Hi Dr. XXXXXXX
I am sending a copy of my liver lab panel to this email for your review. Talk about confusion with my ALT. The number is lower than it's been in months, but I went to a different lab and their range is lower, thus putting me out of the range again, with a MUCH lower number. I don't know how to interpret this......is this a good number compared to the last, where the limit was set at 56, even though this test's limit is 32 and my number is 36? Am I getting better or worse? Argh! So sorry for the confusion. I think this is even harder than having two sassy (but loving) teenage daughters! I hope you've had a nice day!
Just to be sure that you got this. The other test had a range of 7 to 56 and on July 21st, I was just under that number at 51 then. Now today, a different range that is acceptable and much lower, with a result of 36....4 points over the top of Labcorp's range. Sorry if I am sending this twice....I wasn't sure if it was sent correct the first time.
XXXXXXX
I am sending a copy of my liver lab panel to this email for your review. Talk about confusion with my ALT. The number is lower than it's been in months, but I went to a different lab and their range is lower, thus putting me out of the range again, with a MUCH lower number. I don't know how to interpret this......is this a good number compared to the last, where the limit was set at 56, even though this test's limit is 32 and my number is 36? Am I getting better or worse? Argh! So sorry for the confusion. I think this is even harder than having two sassy (but loving) teenage daughters! I hope you've had a nice day!
Just to be sure that you got this. The other test had a range of 7 to 56 and on July 21st, I was just under that number at 51 then. Now today, a different range that is acceptable and much lower, with a result of 36....4 points over the top of Labcorp's range. Sorry if I am sending this twice....I wasn't sure if it was sent correct the first time.
XXXXXXX
Brief Answer:
This is great news
Detailed Answer:
Hello once again ma'am.
Yes indeed, the new numbers do indicate an improvement. Just make sure you follow the reference range provided by the same laboratory you got your tests conducted at. You are getting better and this could be due to the two reasons explained earlier: 1. Your lifestyle changes have helped
2. The perphenazine as expected has a temporary effect which initially causes an elevation in liver enzymes and then a gradual normalisation
Haha, your daughter's must be a real task as is my younger sister. Being a late child, her responsibility is on my older brother and me, more than our parents.
Thanks for the clarification, the latest results do in fact report an improvement and that is great news.
I hope you find my response helpful XXXXXXX Please do not hesitate to write back to me for any further assistance, I am always here to help.
Best wishes.
This is great news
Detailed Answer:
Hello once again ma'am.
Yes indeed, the new numbers do indicate an improvement. Just make sure you follow the reference range provided by the same laboratory you got your tests conducted at. You are getting better and this could be due to the two reasons explained earlier: 1. Your lifestyle changes have helped
2. The perphenazine as expected has a temporary effect which initially causes an elevation in liver enzymes and then a gradual normalisation
Haha, your daughter's must be a real task as is my younger sister. Being a late child, her responsibility is on my older brother and me, more than our parents.
Thanks for the clarification, the latest results do in fact report an improvement and that is great news.
I hope you find my response helpful XXXXXXX Please do not hesitate to write back to me for any further assistance, I am always here to help.
Best wishes.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Yes, I love my girls, they sometimes are so sassy and drive me and my hubby bananas! :o) I'm sure you can understand given you have a younger sister.
I just have one more question and then I promise to stop harassing you. How is it that an ALT of 56 that has an upper limit of 56 and in range not be as good as an ALT of 36 and out of range, as the upper limit of the range is 32.
Definitely I think that 36 sounds a ton better than 56, but with the reference limits being so different, I am worried about the lower number (36) because it's not even inside the lab's limit. Why does this happen and how is this an improvement? Just curious.
Have you noticed my Generalized Anxiety yet? So sorry you were the doctor who got lucky enough to get me as an online patient! :o)
I actually just reread your answer above and see that you already answered this question. The numbers just seem SO far apart in terms of their upper limits. I guess since I'm not a doctor, I just don't understand the technicality of it all! Thank you so much for your help! XXXXXXX
I just have one more question and then I promise to stop harassing you. How is it that an ALT of 56 that has an upper limit of 56 and in range not be as good as an ALT of 36 and out of range, as the upper limit of the range is 32.
Definitely I think that 36 sounds a ton better than 56, but with the reference limits being so different, I am worried about the lower number (36) because it's not even inside the lab's limit. Why does this happen and how is this an improvement? Just curious.
Have you noticed my Generalized Anxiety yet? So sorry you were the doctor who got lucky enough to get me as an online patient! :o)
I actually just reread your answer above and see that you already answered this question. The numbers just seem SO far apart in terms of their upper limits. I guess since I'm not a doctor, I just don't understand the technicality of it all! Thank you so much for your help! XXXXXXX
Brief Answer:
Helping you makes me happy
Detailed Answer:
Hi Mrs. XXXXXXX
I did notice a little curiosity, but nothing that would make me think that you are anxious. Haha, it is my pleasure entirely to be of assistance, and please do not hesitate to write to me anytime in the future (god forbid you or your family ever need a doctor, but please do not ever hesitate to write to me). You have no idea how happy it makes to help you and all the other people who need it, so please do not be formal or consider your queries to be a harassment to me as I am always happy to receive your queries.
There is a very simple answer to your question, have you considered the time gap between the two investigations? If I understood you right, you said that one lab reported a result of 56 with an upper range of 56 and the second reported a result of 36 with an upper limit of 32. Both of which are close to the upper limit, which is all that matters ma'am.
Scenario 1: If the first test was conducted on day 7 (for example) and reported a result of 56 which was the upper limit, and the second test conducted a few days later (may be day 9 or later) reported a result of 36 with the upper limit being 32; this means that there may be a slight rise of ALT (not necessarily indicating the worsening).
Scenario 2: If the first test was conducted on day 7 (for example) and reported a result of 36 with the upper limit of 32, and the second test conducted a few days later (may be day 9 or later) reported a result of 56 with the upper limit being 56; this means that there may be normalisation of ALT with mild improvement.
So I am sure there is a time gap between the two tests conducted and so the difference. As I mentioned earlier, do not consider the value of 36 for the laboratory with the upper limit of 56. I understand how 36 may sound better than a value of 56, but you should also consider that each of these laboratories have a different upper limit.
I hope I have explained things in a manner best understood by you, please do not hesitate to write back to me for any further clarifications, I am always here to help you ma'am. I have also provided you with my direct link, so keep in touch and best of luck with your daughter, I am sure they will grow up to be your angels, your pillars of support and your very reason for happiness.
Best of luck and best wishes XXXXXXX
Helping you makes me happy
Detailed Answer:
Hi Mrs. XXXXXXX
I did notice a little curiosity, but nothing that would make me think that you are anxious. Haha, it is my pleasure entirely to be of assistance, and please do not hesitate to write to me anytime in the future (god forbid you or your family ever need a doctor, but please do not ever hesitate to write to me). You have no idea how happy it makes to help you and all the other people who need it, so please do not be formal or consider your queries to be a harassment to me as I am always happy to receive your queries.
There is a very simple answer to your question, have you considered the time gap between the two investigations? If I understood you right, you said that one lab reported a result of 56 with an upper range of 56 and the second reported a result of 36 with an upper limit of 32. Both of which are close to the upper limit, which is all that matters ma'am.
Scenario 1: If the first test was conducted on day 7 (for example) and reported a result of 56 which was the upper limit, and the second test conducted a few days later (may be day 9 or later) reported a result of 36 with the upper limit being 32; this means that there may be a slight rise of ALT (not necessarily indicating the worsening).
Scenario 2: If the first test was conducted on day 7 (for example) and reported a result of 36 with the upper limit of 32, and the second test conducted a few days later (may be day 9 or later) reported a result of 56 with the upper limit being 56; this means that there may be normalisation of ALT with mild improvement.
So I am sure there is a time gap between the two tests conducted and so the difference. As I mentioned earlier, do not consider the value of 36 for the laboratory with the upper limit of 56. I understand how 36 may sound better than a value of 56, but you should also consider that each of these laboratories have a different upper limit.
I hope I have explained things in a manner best understood by you, please do not hesitate to write back to me for any further clarifications, I am always here to help you ma'am. I have also provided you with my direct link, so keep in touch and best of luck with your daughter, I am sure they will grow up to be your angels, your pillars of support and your very reason for happiness.
Best of luck and best wishes XXXXXXX
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Okay, so actually, this doesn't sound like a good thing.
7/21/14 ALT 51 with upper limit of 56
11/3/14 ALT 36 with upper limit of 32.
I don't think this is a good thing at all. Looks like my ALT levels are actually going up.
7/21/14 ALT 51 with upper limit of 56
11/3/14 ALT 36 with upper limit of 32.
I don't think this is a good thing at all. Looks like my ALT levels are actually going up.
Brief Answer:
No ma'am, this does not prove anything
Detailed Answer:
Hey.
XXXXXXX this rise is negligible and does not mean anything. Trust me, if you consider both values to be same and to have been conducted from the same lab they would look something like this:
Lab 1: 51 with upper limit 56
Lab 2: 58 with upper limit 56
or
Lab 1: 30 with upper limit 32
Lab 2: 36 with upper limit 32
This is a mild rise and according to a doctor would not be anything to worry about, I say this with absolute honesty. A value of 58 is still considered to be normal, as much as 51 is (with an upper limit of 56). So please do not consider this to be a bad sign, and try your best to conduct the tests in the same lab from now onwards to avoid laymen confusion.
Trust me, the changes do not prove anything.
No ma'am, this does not prove anything
Detailed Answer:
Hey.
XXXXXXX this rise is negligible and does not mean anything. Trust me, if you consider both values to be same and to have been conducted from the same lab they would look something like this:
Lab 1: 51 with upper limit 56
Lab 2: 58 with upper limit 56
or
Lab 1: 30 with upper limit 32
Lab 2: 36 with upper limit 32
This is a mild rise and according to a doctor would not be anything to worry about, I say this with absolute honesty. A value of 58 is still considered to be normal, as much as 51 is (with an upper limit of 56). So please do not consider this to be a bad sign, and try your best to conduct the tests in the same lab from now onwards to avoid laymen confusion.
Trust me, the changes do not prove anything.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Hi Dr. XXXXXXX
I wanted to let you know that I went back to my regular doctor today and had my blood drawn. I am such a problem patient!! Be glad that you are not my doctor. I had to admit to them what I had done and was so embarrassed. Regardless, they drew my blood to retest my ALT and AST levels with the lab they use. I will hopefully have my results by the end of the day tomorrow. I pray that I do, as I don't want to be worried about this all weekend.
I did find something interesting and wondered what you thought about it. Apparently, back in 2008-2009, LabCorp changed their reference ranges for ALT. Specifically, they lowered their ranges from 0-55 to 0-32 for adult women. I talked to them today and was reassured that they did NOT change their procedure, but just their reference range. The reason they chose to do this was based on a study done that said that ALT ranges were too high and were missing sub-clinical liver problems that could benefit from early intervention. The study group were all healthy individuals with no known liver problems, so the numbers were very low. Thus, LabCorp made the decision to lower their reference range so as not to miss any early liver problems. This leads me to believe that I may be above their range, but that since my doctor's lab's range is so much higher, that I am within that range and that it is continuing to come down, as the numbers are 51 to 36 from July until now. I realize that the reference ranges are different, but before a few years ago when they changed their reference ranges, they were almost identical to the lab my doctor uses.
In XXXXXXX do liver enzymes (ALT) go up and down, despite a healthy diet, weight loss and exercise? I've read that XXXXXXX is reversible. Would you agree with this? (Given that you eat right, lose weight and exercise.) I'm just really scared right now. Also, I have heard that XXXXXXX progresses very slowly. I worry about fibrosis, but my doctor will not do a biopsy, as she says that as long as my enzymes stay down, that nothing is progressing.
Any thoughts? I will try to write you tomorrow if I indeed get my results. I hope I do and I hope that they are good. My hubby is taking me to see my favorite Contemporary Christian group, Casting Crowns tomorrow night and I don't want this to be lingering in the back of my mind.
Have a great night!
Just wanted to let you know that my ALT came back at 21 and my AST at 24 by the lab I usually use. YAY!!! Thank you so much for your help!
XXXXXXX
I wanted to let you know that I went back to my regular doctor today and had my blood drawn. I am such a problem patient!! Be glad that you are not my doctor. I had to admit to them what I had done and was so embarrassed. Regardless, they drew my blood to retest my ALT and AST levels with the lab they use. I will hopefully have my results by the end of the day tomorrow. I pray that I do, as I don't want to be worried about this all weekend.
I did find something interesting and wondered what you thought about it. Apparently, back in 2008-2009, LabCorp changed their reference ranges for ALT. Specifically, they lowered their ranges from 0-55 to 0-32 for adult women. I talked to them today and was reassured that they did NOT change their procedure, but just their reference range. The reason they chose to do this was based on a study done that said that ALT ranges were too high and were missing sub-clinical liver problems that could benefit from early intervention. The study group were all healthy individuals with no known liver problems, so the numbers were very low. Thus, LabCorp made the decision to lower their reference range so as not to miss any early liver problems. This leads me to believe that I may be above their range, but that since my doctor's lab's range is so much higher, that I am within that range and that it is continuing to come down, as the numbers are 51 to 36 from July until now. I realize that the reference ranges are different, but before a few years ago when they changed their reference ranges, they were almost identical to the lab my doctor uses.
In XXXXXXX do liver enzymes (ALT) go up and down, despite a healthy diet, weight loss and exercise? I've read that XXXXXXX is reversible. Would you agree with this? (Given that you eat right, lose weight and exercise.) I'm just really scared right now. Also, I have heard that XXXXXXX progresses very slowly. I worry about fibrosis, but my doctor will not do a biopsy, as she says that as long as my enzymes stay down, that nothing is progressing.
Any thoughts? I will try to write you tomorrow if I indeed get my results. I hope I do and I hope that they are good. My hubby is taking me to see my favorite Contemporary Christian group, Casting Crowns tomorrow night and I don't want this to be lingering in the back of my mind.
Have a great night!
Just wanted to let you know that my ALT came back at 21 and my AST at 24 by the lab I usually use. YAY!!! Thank you so much for your help!
XXXXXXX
Brief Answer:
Amazing news, you made my day!!!
Detailed Answer:
Hello ma'am.
My most sincere apologies as I was shifting my home, and if you have experience with something like that you would know that it is a horribly exhausting experience.
About LabCorp, in my opinion the reference ranges had to be changed especially after the study they conducted because their technique did not correlate with the previous reference ranges and so even healthy individuals were having a value out of the normal range.
As for XXXXXXX yes I completely agree to this condition being reversible. With the right diet, lifestyle changes, medications to control cholesterol, diabetes and hypertension; this condition can be well tackled.
As for your latest values, you made my day. The first relaxing thing I have heard all day. I am more than happy to learn about your complete recovery and would like you to know that I am done nothing much to help. God is great and you should know that I value every patient of mine, and am more than happy that you are my patient (although sadly onlt through an online consultation). You should know by now that I am always here to help.
My best wishes always.
Amazing news, you made my day!!!
Detailed Answer:
Hello ma'am.
My most sincere apologies as I was shifting my home, and if you have experience with something like that you would know that it is a horribly exhausting experience.
About LabCorp, in my opinion the reference ranges had to be changed especially after the study they conducted because their technique did not correlate with the previous reference ranges and so even healthy individuals were having a value out of the normal range.
As for XXXXXXX yes I completely agree to this condition being reversible. With the right diet, lifestyle changes, medications to control cholesterol, diabetes and hypertension; this condition can be well tackled.
As for your latest values, you made my day. The first relaxing thing I have heard all day. I am more than happy to learn about your complete recovery and would like you to know that I am done nothing much to help. God is great and you should know that I value every patient of mine, and am more than happy that you are my patient (although sadly onlt through an online consultation). You should know by now that I am always here to help.
My best wishes always.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thank you so much for your kind words. You really did help me, so please don't be so modest! :o) I am attaching a link below for you to hear the group we saw tonight. This song specifically, has been a comfort to me as I've been so scared about this whole liver thing. Today, when I got my results back, I realized that God's been walking with me since this whole thing started in February. It's now my job to walk with others through their difficult times and to share God's love with them like this musical group did for me. You are a blessing....you show compassion and empathy towards your patients, while sharing your medical knowledge/expertise with them. What a perfect combination....not all doctors have these traits! Thank you for all of your help! Keep up your wonderful way of caring for your patients! Sincerely, XXXXXXX
https://www.youtube.com/watch?v=Ype1xE0wzsg&index=2&list=RDFWMebzGZGZc
You may have to copy and paste the above link, as it may not just let you click on it. God bless you!
https://www.youtube.com/watch?v=Ype1xE0wzsg&index=2&list=RDFWMebzGZGZc
You may have to copy and paste the above link, as it may not just let you click on it. God bless you!
Brief Answer:
Your words really made a difference
Detailed Answer:
Thank you so much, you filled my heart with XXXXXXX I really appreciate your appreciation and God, who helped me reach this place from where I can help other people.
Wow, Casting Crowns really have a huge fan following. Their songs are quite touching, I shall follow them to learn more. Thank you so much XXXXXXX I wish you good luck and health, now and forever.
Please also know that I am always here for you and your family, now and forever. I hope none of you need my assistance ever, and enjoy good health always, but if something does come up please do not hesitate to write to me.
Best of luck and best wishes always.
Your words really made a difference
Detailed Answer:
Thank you so much, you filled my heart with XXXXXXX I really appreciate your appreciation and God, who helped me reach this place from where I can help other people.
Wow, Casting Crowns really have a huge fan following. Their songs are quite touching, I shall follow them to learn more. Thank you so much XXXXXXX I wish you good luck and health, now and forever.
Please also know that I am always here for you and your family, now and forever. I hope none of you need my assistance ever, and enjoy good health always, but if something does come up please do not hesitate to write to me.
Best of luck and best wishes always.
Note: For further follow up on related General & Family Physician Click here.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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