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What causes elevated AST and ALT levels?

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General & Family Physician
Practicing since : 2012
Answered : 2652 Questions
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Hello-I just received my blood work from my endocrinologist. Everything looked fine except my AST was 303 and my ALT was 281-high liver enzymes. I am about to turn 50. The only thing I have done differently is taking AZO standard for a bladder problem. I have urethritis and back in April and May I did use AZO off and on. I am not a drinker or smoker. I will go see my family doctor this week. But today is Sunday and I am worried. I have always been and overall healthy person. Any ideas?
Posted Wed, 20 Aug 2014 in Thyroid Problem and Hormonal Problems
 
 
Answered by Dr. Muhammad Sareer Khalil 2 hours later
Brief Answer:
Possible Acute viral hepatitis..

Detailed Answer:
Hello and welcome.

I have read your history carefully.

AST (SGOT) and ALT (SGPT) are reasonably sensitive indicators of liver damage or injury from different typeThe interpretation of elevated AST and ALT results depends upon the entire clinical evaluation of an individuals of diseases or conditions.

All forms of viral and drug induced hepatitis give an elevation of both total and direct bilirubin which clinically presents as jaundice. ALT and AST both are elevated in acute viral hepatitis.

Elevated levels , based on cause can be divided into mild (< 100) , moderate ( 100 to 300) major elevation is greater than 300

the main cause to rule out first , taking into consideration your history is Acute Viral hepatitis.

Other causes may include
Alcoholic or non alcoholic steato hepatitis
Autoimmune hepatitis
Drug induced e.g Paracetamol
Acute on chronic hepatitis i.e flare of chronic hepatitis

I would advise the following initial screening test in my clinic for such rise in LFTs

ultrasound abdomen
Anti HAV igM ,Hbsag n hcvab for hepatitis a , b and c
Autoimmune profile (igm and AMA levels)
Ferritin
Cerruloplasmin
Immunoglobulins

the treatment and further management will depend on the cause of the elevated transaminases
I would advise you to refrain from any drugs that are metabolized in the liver like tylenol or paracetamol for the time being till you consult your doctor.

let me know if you have any query
I will be more than glad to help

thanks
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