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Dr. Andrew Rynne

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Quitted smoking. Test showed raised ALT, mildly raised AST and bilirubin level. Any suggestion?

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Dr. Ratnakar Kini

Gastroenterologist

Practicing since :1996

Answered : 1860 Questions

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Posted on Thu, 24 Jan 2013 in X-ray, Lab tests and Scans
Question: I got my blood work done and I am little concern about the results. I am 35 years old I quit smoking about a month ago. My bilirubin and ALT, AST are not looking good. Can you please comment on these ? I am very worried.

value standard range
ALBUMIN      4.7     3.8 - 5.0      g/dL
PROTEIN,TOTAL     8.0     6.0 - 8.0      g/dL
GLOBULIN      3.3 2.0 - 3.7      g/dL
A/G RATIO      1.4     1.0 - 2.0     
BILIRUBIN,TOTAL     2.0     0.2 - 1.2      mg/dL
BILIRUBIN,DIRECT     0.5     0.1 - 0.5      mg/dL
BILIRUBIN,INDIRECT      1.5     0.2 - 0.8      mg/dL
ALK PHOSPHATASE      53     50 - 136      IU/L
ALT (SGPT)      105      8 - 45      IU/L
AST (SGOT)      43     2 - 40      IU/L
doctor
Answered by Dr. Ratnakar Kini 1 hour later
Hi,
Thanks for posting your query.
I am Dr.Ratnakar Kini and I am pleased to answer your query.

Your bilirubin and AST are only mildly raised.
But ALT is significantly raised.
The most common cause is fatty liver disease.

I would advise you to get ultrasound scan of the abdomen done to rule out fatty liver.
If confirmed, tests for the underlying cause including diabetes and dyslipidemia should be done.

Other causes like viral infection ( hepatitis B and C) should also be ruled out.

I hope that answers your question.

If you have no more questions, kindly accept this answer and rate this service.

Regards,
Dr.Ratnakar Kini
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Ratnakar Kini 14 minutes later
Thank you for your reply doctor.
I should have mention the fact that I was on TRIMETHOPRIM-SULFAMETHOXAZOLE, 160-800 MG for 2 weeks due to prostatitis condition that I have. Could this medication alter my ALT/AST levels ?
doctor
Answered by Dr. Ratnakar Kini 1 hour later
Hi,
Yes it can alter AST and ALT levels.
Stop that medication and repeat liver function test after 4 weeks.
Meanwhile as suggested earlier get ultrasound scan of the abdomen and tests for HBV and HCV done.

I hope that answers your question.

If you have no more questions, kindly accept this answer and rate this service.

Regards,
Dr.Ratnakar Kini

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Ratnakar Kini 18 minutes later
Thank you so much.
This would be my last question. Before I started this treatment I had some blood test done. This is the result:
Would you be so kind to comment in detail ? My ALT AST levels were almost OK. After the treatment they went up.

SODIUM      139     135 - 145     mmol/L
POTASSIUM      4.5     3.5 - 5.0     mmol/L
CHLORIDE      102     98 - 107     mmol/L
CO2,TOTAL      23     21 - 31     mmol/L
ANION GAP      14     5 - 18     
GLUCOSE      100     65 - 100     mg/dL
CALCIUM      10.3     8.5 - 10.5     mg/dL
BUN      12     8 - 25     mg/dL
CREATININE      0.96     0.72 - 1.25     mg/dL
BUN/CREAT RATIO      13     10 - 20     
GFR if African American      > 60     > 60     ml/min/1.73m2
GFR if not African American     > 60     > 60     ml/min/1.73m2
ALBUMIN      4.6     3.8 - 5.0     g/dL
PROTEIN,TOTAL      8.1     6.0 - 8.0     g/dL
GLOBULIN      3.5     2.0 - 3.7     g/dL
A/G RATIO      1.3     1.0 - 2.0     
BILIRUBIN,TOTAL      1.7     0.2 - 1.2     mg/dL
ALK PHOSPHATASE      53     50 - 136     IU/L
ALT (SGPT)      58     8 - 45     IU/L
AST (SGOT)      29     2 - 40     IU/L
doctor
Answered by Dr. Ratnakar Kini 39 minutes later
Hi,
Both Bilirubin and ALT are only mildly raised which are not significant.
Rest of the report appears normal.

I hope that answers your question.

If you have no more questions, kindly accept this answer and rate this service.

Regards,
Dr.Ratnakar Kini

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