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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Elevated Liver Enzymes. No Fatty Liver Disease. Should I Check For Other Types Of Hemochromatosis?

I had elevated liver enzymes ( AST 39, ALT 98) so my doctor ordered a number of blood exams ( acute hep, iron TIBC and ferritin, hepatic function, GGt, ANA IFA screen, HIV AB, HIV 1/2). Everything came back normal ( AST down to 20, ALT down to 26) except for total iron- 179 and % saturation at 53%. Iron binding capacity was 338 and Ferritin was 128. Also had an ultrasound of my liver to rule our fatty liver disease , which we did. My doctor thought I could have hemochromatosis , so we checked the HFE gene and it came back that I do not have type and I am not a carrier. My doctor said sometimes fluctuations occur and that I have nothing to worry about since Iron and % saturation are near normal. We will check blood ( hepatic, iron, Ferritin, and TIBC) in a few months. I m a 26 year old male and don t take vitamin supplements or medicines that affect liver function. Do you think I should check for other types of hemochromatosis? Should I see a specialist ( my doctor was not familiar with other types of hemochromatosis)? Thanks
Mon, 22 Jul 2013
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General & Family Physician 's  Response
Hello,
Thanks for the query to H.C.M. Forum.
A S T & A L T , the normal values of both enzymes are 5-50 IU.
As if value elevated more then 300 then it is specific , otherwise non-specific.
Mere mild to moderate degree elevated level of AST .
However A L T only found in liver but this reading ( 98) is non-specific.
If you haven't any disease or disorder, in my opinion there is no need of any examination.
Good luck.
Dr. HET
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Cardiologist Dr. Anantharamakrishnan's  Response
Hi friend,
Welcome to Health Care Magic

Elevation 3 or more times the upper limit of normal is called significant and needs extensive investigations.
Now that they have returned to normal, it is reassuring.
There is a battery of advanced investigations (including liver biopsy!) – one may not need...
You just need follow up – a hepatologist (Gastro-enterologist) is the one for liver / a Haematologist is the one for Haemochromotosis – either could guide...
Discuss with your doctor...

Take care
Wishing speedy recovery
God bless
Good luck
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Elevated Liver Enzymes. No Fatty Liver Disease. Should I Check For Other Types Of Hemochromatosis?

Hello, Thanks for the query to H.C.M. Forum. A S T & A L T , the normal values of both enzymes are 5-50 IU. As if value elevated more then 300 then it is specific , otherwise non-specific. Mere mild to moderate degree elevated level of AST . However A L T only found in liver but this reading ( 98) is non-specific. If you haven t any disease or disorder, in my opinion there is no need of any examination. Good luck. Dr. HET