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What Do These AST And ALT Levels Indicate?
Question: Dr. XXXXXXX Berger-Durnbaugh
Hi. Me again.
3/28 ER (labs only)
AST-39
ALT-46
TBili-.9
3/31
AST-24
ALT-25
Tbili-.46
Crazy how they dropped so quickly in 3 days. The other LFTs didnt move much.
At recent doc appt. she examined my liver and said it felt enlarged. I mentioned my symptoms so she ordered labs and referred me to liver clinic. When labs came back she just wrote liver function is normal. I replied asking if given my symptoms and that cirhossis can be present even with normal LFTs is there any reason for concern? She did not reply back and given my LFTs the liver clinic wont see me until the beginning of XXXXXXX
I have had very red blotchy palms for 3 weeks, intermittent rashes on torso, ongoing mild pain in stomach and just below my rib cage. Mild itching all over. Also, ive lost nearly 25 pounds. Which is good but only problem is i stopped excercising about a week ago due to horrible joint pain in knee. I still lost 4 pounds since i stopped excercising. Obviously all of these are symptoms of cirrhosis.
Havent consumed alcohol in nearly 4 weeks.
Not sure what to do. You see any issues with all of this?
Hi. Me again.
3/28 ER (labs only)
AST-39
ALT-46
TBili-.9
3/31
AST-24
ALT-25
Tbili-.46
Crazy how they dropped so quickly in 3 days. The other LFTs didnt move much.
At recent doc appt. she examined my liver and said it felt enlarged. I mentioned my symptoms so she ordered labs and referred me to liver clinic. When labs came back she just wrote liver function is normal. I replied asking if given my symptoms and that cirhossis can be present even with normal LFTs is there any reason for concern? She did not reply back and given my LFTs the liver clinic wont see me until the beginning of XXXXXXX
I have had very red blotchy palms for 3 weeks, intermittent rashes on torso, ongoing mild pain in stomach and just below my rib cage. Mild itching all over. Also, ive lost nearly 25 pounds. Which is good but only problem is i stopped excercising about a week ago due to horrible joint pain in knee. I still lost 4 pounds since i stopped excercising. Obviously all of these are symptoms of cirrhosis.
Havent consumed alcohol in nearly 4 weeks.
Not sure what to do. You see any issues with all of this?
Brief Answer:
Some thoughts:
Detailed Answer:
Hi -
I am sure you are very concerned, but your symptoms do not necessarily add up to cirrhosis. For example, in cirrhosis when people have generalized itching, it is from jaundice. With a normal bilirubin you would not be jaundiced. Other problems can cause the symptoms you described. I suggest you ask your doctor for a CBC (complete blood count) with a "differential" (where the different types of white blood cells are counted). Also a TSH to check your thyroid.
Weight loss can happen when people stop drinking alcohol because they aren't getting as many calories anymore (alcohol has a lot of calories). But if you are feeling unwell, it would be reasonable to look into other causes of weight loss (that's why the CBC and TSH).
I still doubt that you have cirrhosis because it takes time for this to develop, and you just had an ultrasound a few months ago that only showed fatty liver changes.
However, if your abdominal symptoms worsen, then it would be a good idea to go back to your primary and she may order another abdominal ultrasound or perhaps even an abdominal CT.
The reason the liver clinic did not get you in sooner is because your liver enzymes are looking good, and this is usually a pretty accurate reflection of how your liver is doing.
So while it is a good idea to follow up, I think the chance that it is cirrhosis causing your symptoms is unlikely.
Some thoughts:
Detailed Answer:
Hi -
I am sure you are very concerned, but your symptoms do not necessarily add up to cirrhosis. For example, in cirrhosis when people have generalized itching, it is from jaundice. With a normal bilirubin you would not be jaundiced. Other problems can cause the symptoms you described. I suggest you ask your doctor for a CBC (complete blood count) with a "differential" (where the different types of white blood cells are counted). Also a TSH to check your thyroid.
Weight loss can happen when people stop drinking alcohol because they aren't getting as many calories anymore (alcohol has a lot of calories). But if you are feeling unwell, it would be reasonable to look into other causes of weight loss (that's why the CBC and TSH).
I still doubt that you have cirrhosis because it takes time for this to develop, and you just had an ultrasound a few months ago that only showed fatty liver changes.
However, if your abdominal symptoms worsen, then it would be a good idea to go back to your primary and she may order another abdominal ultrasound or perhaps even an abdominal CT.
The reason the liver clinic did not get you in sooner is because your liver enzymes are looking good, and this is usually a pretty accurate reflection of how your liver is doing.
So while it is a good idea to follow up, I think the chance that it is cirrhosis causing your symptoms is unlikely.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thanks. Now that you mention that, i just pulled the lab results and they actually took the CBC on the 28th. Everything came back normal. WBC was in normal range if anything they were closer to the high end which is good with my concerns. PLT count was very normal as well. I read that platelet count was very sensitive to something like cirhossis. Is this true? Is the CBC test a better indicator than standard LFTs? My symptoms are just crazy to me, the red palms, rashes, joint pain....i didnt even realize they were symptoms of cirhossis until after they surfaced. I'm not very informed and paranoid i guess. You ha
Brief Answer:
Regarding cirrhosis
Detailed Answer:
Normal liver function tests plus the abdominal ultrasound showing only fatty liver are better indicators of not having cirrhosis, but having a normal CBC is supportive of the overall picture.
Please keep in mind that the period of time when you had the ultrasound till now is not enough time to develop cirrhosis.
The red blotches are not especially dermatological symptoms of cirrhosis, by the way. With cirrhosis the skin is usually quite yellow and the red marks look like thin red spiders.
Regarding cirrhosis
Detailed Answer:
Normal liver function tests plus the abdominal ultrasound showing only fatty liver are better indicators of not having cirrhosis, but having a normal CBC is supportive of the overall picture.
Please keep in mind that the period of time when you had the ultrasound till now is not enough time to develop cirrhosis.
The red blotches are not especially dermatological symptoms of cirrhosis, by the way. With cirrhosis the skin is usually quite yellow and the red marks look like thin red spiders.
Note: For further follow up on digestive issues share your reports here and Click here.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
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