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What Does Elevated ALT,normal AST And Low TSH Indicate?

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Posted on Fri, 21 Mar 2014
Question: Six weeks ago I had some routine blood work. My ALT was slightly elevated (59) and my AST was normal (24) My TSH was low (0.31). Included was a hepatitis C test which was negative. Since the results I have been worried about Hepatitis B and have been very nervous. I now have itching skin which I don't know if it is from anxiety or something else. I also was taking a cold medicine that contained acetaminophen for four days prior till Monday. The test was done three days later on a Thursday. Prior to this all the other times I have had routine lab work over the years my numbers were always in the normal range. As for the TSH I did use a cream vytorin prescribed by my dermatologist for three days prior and I read that vytorin can effect Thyroid test numbers. I had a retest of the labs yesterday including complete liver and thyroid study. Do I have to be concerned with anything like Hepatitis B or anything else. What could the lab results mean?
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Answered by Dr. Anshul Varshney (35 minutes later)
Brief Answer: Lipitor can cause derangement in ALT Detailed Answer: Dear Friend. Hi , I am Dr Anshul Varshney , I have read your query in detail , I understand your concern. A rise in ALT level in your case can be attributed to the following reasons : 1. Lipitor - Hepatitis is a well known side effect of Atorvastatin. 2. Acetaminophen - Can cause but if taking in excessive doses. Mostly cold medicines contain maximum of 500 to 650 mg of Acetaminophen , that would not cause hepatitis. 3. Since you had cold , a viral infection can also transiently derange your ALT Levels. In case you consume alcohol , it can also cause the same. There is no point in getting worried about Hepatitis B , if you had any risk exposure , or even if not , simply get tested! I recommend in such case to get Liver Function Test Repeated that you have already done. Share the reports with me once available. Now coming to your TSH part , to give you a reliable and a good comment , i would like to see your Thyroid Profile Report. Scan and attach it. I need to see reference range of your laboratory and also FT3 and FT4 reports. Also , share with me composition of Vytorin cream you are using (you can see that on the label). This is my personal opinion based on details available here. If you have any other query you may please ask me. Stay Healthy. Dr Anshul Varshney , MD
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Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Dr. Anshul Varshney

Internal Medicine Specialist

Practicing since :2009

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What Does Elevated ALT,normal AST And Low TSH Indicate?

Brief Answer: Lipitor can cause derangement in ALT Detailed Answer: Dear Friend. Hi , I am Dr Anshul Varshney , I have read your query in detail , I understand your concern. A rise in ALT level in your case can be attributed to the following reasons : 1. Lipitor - Hepatitis is a well known side effect of Atorvastatin. 2. Acetaminophen - Can cause but if taking in excessive doses. Mostly cold medicines contain maximum of 500 to 650 mg of Acetaminophen , that would not cause hepatitis. 3. Since you had cold , a viral infection can also transiently derange your ALT Levels. In case you consume alcohol , it can also cause the same. There is no point in getting worried about Hepatitis B , if you had any risk exposure , or even if not , simply get tested! I recommend in such case to get Liver Function Test Repeated that you have already done. Share the reports with me once available. Now coming to your TSH part , to give you a reliable and a good comment , i would like to see your Thyroid Profile Report. Scan and attach it. I need to see reference range of your laboratory and also FT3 and FT4 reports. Also , share with me composition of Vytorin cream you are using (you can see that on the label). This is my personal opinion based on details available here. If you have any other query you may please ask me. Stay Healthy. Dr Anshul Varshney , MD