What Do These AST And ALT Levels Indicate?

Posted on Fri, 15 May 2015

Medically reviewed by Ask A Doctor - 24x7 Medical Review Team

Fri, 15 May 2015 Answered on

Fri, 5 Jun 2015 Last reviewed on

Question : AST is 41
ALT is 32 Bilirubin is normal

Answered by Dr. Anshul Varshney (26 minutes later)

Brief Answer:
I need further details.

Detailed Answer:
Welcome To HCM. I am Dr Anshul Varshney. I understand your concern.
Your ALT is slightly raised and this requires evaluation. Most common causes being Alcohol, Viral hepatitis, Infection, Drugs.
To help you better I need following details:
1. Why did you get tested?
2. Any fever?
3. Any history of Alcohol consumption?
4. Any pain killers intake ?
5. Any pain abdomen?
Revert with the asked details for a better help.
Stay Healthy.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Anshul Varshney (1 hour later)

1. Tested due to annual physical.
2. No fever.
3. Alcohol consumption on and off for years. Drink when anxious. Never had elevated results before. Drank 4 oz of vodka 2 nights before lab test due to worries about upcoming labs. (Dumb, right?!)
4. Painkiller intake. 100 mg sustained release morphing per day for last 22 years due to severe spine injury. Took 10 mg. Vicodin 3 or 4 times per day for last 5 months due to severe multiple fractures of wrist. No longer taking Vicodin unless pain is extreme.
5, Nausea while taking Vicodin--now gone.

Actually my ALT was slightly elevated at 32 (as reported in my question), my ALT was normal. (Normal ALT range at my lab is 0 to 60/UL,)

Instead, it was my AST that was elevated at 41 (also as correctly reported in my original question.) Normal AST range at my lab is
0-37 U/L.)

I believe you got confused. Please reconsider and provide your opinion.

Answered by Dr. Anshul Varshney (6 hours later)

Brief Answer:
Both AST and ALT are liver enzymes.

Detailed Answer:
Hello. Yes according to reference range of your laboratory, your AST is raised. Both AST and ALT are liver enzymes and are found to be increased in case of any liver insult.
In your case it seems to be due to alcohol and vicodin.
The Morphine doesn't effect liver usually.
In my opinion you need to quit vicodin and alcohol. For pain you may consider plain Tramadol.
I would also recommend testing for hepatitis B and C and an Ultrasound Abdomen to see for the status of liver.
If you have any further query, please ask me.
Stay Healthy.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar