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Dr. Andrew Rynne

Family Physician

Exp 50 years

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What causes elevated liver enzymes and glucose levels?

Answered by
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Dr. Shehzad Topiwala

Endocrinologist

Practicing since :2001

Answered : 1663 Questions

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Posted on Tue, 2 Sep 2014 in Liver and Gall Bladder
Question: 37 year old female 5' 4 " 325 lbs XXXXXXX labs fasting ALT 76 Insulin 46
July labs not fasting ALT 106 AST 76 Glucose 150
these are the out of range results
I take metforemin 500 mg for pcos (no finding on pelvic ultrasound) Lexapro 20 mg for anxiety Claritan for sinus issues Flonaise for sinuses
gnc women's ultra mega vitamins fish oil vitamin D vitamin C cranberry supplement just started milk thistle. Can you explain cause of results? elevated alt?
doctor
Answered by Dr. Shehzad Topiwala 30 minutes later
Brief Answer:
Fatty liver likely

Detailed Answer:
The is a moderate increase in the liver enzymes along with the glucose levels.

The commonest condition I come across in this realm is called NAFLD (Non Alcoholic Fatty Liver Disease) or XXXXXXX (Non Alcoholic Steato Hepatitis).

The first pre requisite to make this diagnosis is that the individual is not a heavy consumer of alcohol.

Further when I see someone who comes to me with a presentation like yours, I order 2 things:

1 Hepatitis profile

2 Ultrasound of the liver

The first eliminates the possibility of chronic hepatitides like hepatitis B and C that can cause ALT and AST to be elevated like this.
This is a blood test that can be done at anytime of the day and does not require fasting

The ultrasound examination then looks for the presence of fat in the liver, in addition to other potential causes.

I also recommend
CBC
CMP
HbA1c
TSH
Free T4

Checking the thyroid is important too (TSH, Free T4) and the HbA1c will give an average of the previous 3 months glucoses. Your random glucose reading of 150 alone gives little information.
I would suggest seeing an Endocrinologist in person with the results of these tests so (s)he can interpret them for you and make a management plan.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Shehzad Topiwala 5 minutes later
thyroid panel done and is fine. hep a b & c negative. a1c was 5 or 6 I believe. no I don't drink.
doctor
Answered by Dr. Shehzad Topiwala 28 hours later
Brief Answer:
Follow up

Detailed Answer:
I have noted the results.

A1c 5 is normal and 6 is not. An A1c of 6 % is defined as pre diabetes
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Shehzad Topiwala 9 hours later
what would the cause of alt ast? same fatty liver?
doctor
Answered by Dr. Shehzad Topiwala 55 minutes later
Brief Answer:
Second follow up

Detailed Answer:
If the hepatitis profile is negative and USG liver shows only fatty liver , and no medications are deemed responsible then the most common cause of such AST ALT elevations is Fatty liver
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Shehzad Topiwala 57 minutes later
usg?
doctor
Answered by Dr. Shehzad Topiwala 2 days later
Brief Answer:
Third follow up

Detailed Answer:
USG means Ultrasonography. I meant, if Ultrasonography of the liver shows only fatty liver then no medications are deemed responsible.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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