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What do these AST and ALT levels indicate?

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Posted on Thu, 19 May 2016
Question: Hello-here is my lab results with question to follow.

1/29-
AST-57; ALT-64; ALB- 4.7; ALK-42; TBili-.63
Ultrasound would show fatty liver a week later likely due to alcohol consumption.

Recently had labs done again, see below.
3/9
AST-42; ALT-46; ALB-4.5; ALK-56; TBili-1.00

For the first month i did nothing but eat well, excercise, and i did not drink at all. Feeling great! I fell off my regimen for about a week and wasnt feeling great. I went back to doc and got the labs done since i had a week of drinking and eating not as well. My doc said my numbers dropped but were still slightly elevated amd to make sure i get back ont health kick, which i have.

Question: although in the normal range i am concerned that my TBili went up that much that quickly. Ive read that TBili rising and other enzymes being in a normal range could be a sign of liver damage.
Either way, given the 2 labs shown is there any reason to be concerned about the rise from .63 to 1.0??
doctor
Answered by Dr. Amit Jain (1 hour later)
Brief Answer:
There is nothing of concern

Detailed Answer:
Hello! Thanks for putting your query in HCM. I am a Gastroenterologist.

I don't think there is anything of concerns as:
1. Your bilirubin is still in the normal range
2. To be significant bilirubin should be increased at least two times
3.Isolated elevation of bilirubin usually don't indicate liver disease, as it may be due to some other non-hepatic causes like haemolysis, lab error XXXXXXX Syndrome etc

As I already explained that isolated elevation of bilirubin , without elevation of AST or ALT, usually is of non-hepatic cause. As AST and ALT are more specific tests for liver function instead of bilirubin. Whenever there is damage to hepatocyte that is liver cells, AST and ALT will definitely increase

I hope I have answered your query and this will help you . Wish you a good health
Above answer was peer-reviewed by : Dr. Sonia Raina
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Follow up: Dr. Amit Jain (23 minutes later)
Ok. This helps. I guess my concern is that after i was diagnosed with fatty liver i excercises daily (jogged 3 miles or made sure i took at least 1k steps) ate very well and cut out alcohol all together. I kept this up for 4 straight weeks. Then on the 5th week i drank every day for 7 days sometimes a lot. Realized i needed to stop and i did. Shortly after i lost appetite, intermittent pain in abdomen, and had nausea. That is why i got the labs done. Since i got my done right after i had 7 days of drinking and eating poorly im concerned that the bilirubin numbers could still on the rise. Is that possible?

Also ive read that at early stages of cirhossis, Bilirubin will rise and other enzyme numbers could be normal. Have you heard of this? Any truth to this?
doctor
Answered by Dr. Amit Jain (19 hours later)
Brief Answer:
AST AND ALT are increase rather than bilirubin in cirrhosis

Detailed Answer:
Welcome back and sorry for delay

No its not true. In cirrhosis it is the AST AND ALT which increase first rather than bilirubin

Also I have already explained that your bilirubin level is still within normal range so need not worry. But definitely you should avoid this drinking pattern of taking alcohol 7 days continously

Take care and good bye
Above answer was peer-reviewed by : Dr. Sonia Raina
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Answered by
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Dr. Amit Jain

Gastroenterologist

Practicing since :2000

Answered : 1524 Questions

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What do these AST and ALT levels indicate?

Brief Answer: There is nothing of concern Detailed Answer: Hello! Thanks for putting your query in HCM. I am a Gastroenterologist. I don't think there is anything of concerns as: 1. Your bilirubin is still in the normal range 2. To be significant bilirubin should be increased at least two times 3.Isolated elevation of bilirubin usually don't indicate liver disease, as it may be due to some other non-hepatic causes like haemolysis, lab error XXXXXXX Syndrome etc As I already explained that isolated elevation of bilirubin , without elevation of AST or ALT, usually is of non-hepatic cause. As AST and ALT are more specific tests for liver function instead of bilirubin. Whenever there is damage to hepatocyte that is liver cells, AST and ALT will definitely increase I hope I have answered your query and this will help you . Wish you a good health