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What Does My Lab Test Result Indicate?

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Posted on Wed, 7 Oct 2015
Twitter Wed, 7 Oct 2015 Answered on
Twitter Fri, 30 Oct 2015 Last reviewed on
Question : New test results today show an increased AST And ALT.

At the end of Aug my AST was 45 and ALT 93. Today's results show a 68 AST and a 178 ALT. I am really worried as the ALT almost doubled. Additional blood test results all normal. (Below are the key stats)

Albumin 4.6
Bilirubin .9
GGT 24
Ldh 124
Iron 109
Glucose 85
Sodium 137
Potassium 3.9
Chloride 105
Calcium 9.7
Cholesterol 168
Hdl cholesterol 61
Ldl chokesteral 94
Risk ratio ldl/cholesterol. 1.53

One number out of range A1C at 5.7%

A couple additional things to note:
CT scan of abdominal area came back normal. All they noted was some calcification around appendix.

I had an ultrasound this morning and, although I dont have the results, they inferred that the results would match CT from 4 weeks ago.

Last year I had a hep test and it came back negative.

I didnt drink 10 days before the test and when i drank 10 days ago, it was 3 glasses of wine/weekly.

I dont use acetaminophen either. My only prescription which I started s month ago is birth control and i take advil for pain.

What am i missing? Is there something serious likely going on? If so, i have no idea what is causing it. Is it serious and life threatening at those alt/ast levels?

Lastly, could the AIC which would place me just at pre diabetic ramge have any impact? I assume no without the presence of a fatty liver.

Please help me understand what may be going on.
doctor
Answered by Dr. Indu Kumar (3 hours later)
Brief Answer:
Increased ALT and AST may indicate liver injury

Detailed Answer:
Hello

Increased ALT and AST may indicate liver injury.It may be due to many reasons like hepatitis,alcohol intake,altered lipid profile,medicines,auto immune causes etc.
It may be due to alcohol intake in your case.
It is good that other investigations are normal.

I suggest to take tablet ursodeoxycholic acid 300 mg twice daily for three months.It helps in regeneration of liver cells.

This is not a very serious finding.You should avoid alcohol completely,findings will reverse.
This is a manageable condition.It is most likely not related to prediabetic state.

Get well soon.
Hope I have answered your question.
Further queries are most welcome.

Take Care
Dr.Indu XXXXXXX
Above answer was peer-reviewed by : Dr. Neel Kudchadkar
doctor
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Follow up: Dr. Indu Kumar (2 days later)
Update. I received a comprehensive blood work up through my GI doc. Everything that could be tested associated with elevated AST and ALT was tested.

All was normal. I am not in liver failure, negative for Hepatitis, iron and copper is normal. Nothing viral detected. I dont have liver disease. INR normal.

The only result pending is auto immune. If that comes back negative, what is left that only a biopsy would uncover? The US and CT ruled out cancer.

Could i still have early stage fatty liver only detectable via biopsy produce alt levels at 178 and ast at 68?

What could the biopsy possibly uncover that a full blood work up, CT and US doesnt uncover?

Is there something potentially life threatening, when I am otherwise healthy. Nothing other than these numbers have come back high.

I will note that my doc is concerned by the 178. She is especially concerned that it doubled in 5 weeks .
doctor
Answered by Dr. Indu Kumar (19 hours later)
Brief Answer:
Autoimmune causes can be ruled by estimating ANA etc.

Detailed Answer:
Hello
Sorry for replying late

It is good that all related investigations are normal.Autoimmune causes can be ruled by estimating ANA etc.
Fatty liver can cause raised ALT but fatty liver can be diagnosed by CT scan and ultrasound.
Liver biopsy may be advised lastly.

Though ALT is raised in short duration but I don't think it is a very serious issue.It may be related to alcohol intake.It is not life threatening at all.
Try to avoid alcohol completely.
If all investigations are normal then you may only need urosodeoxycholic acid tablet.

Get well soon.
Hope I have answered your question.
Further queries are most welcome.

Take Care
Dr.Indu XXXXXXX
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Indu Kumar (2 days later)
Another update. My levels comtinue to increase.

72 hour increase:
Alt: 331 (up from 178)
Ast: 138 (up from 68)
All other LFTs still normal.

These results are from last Thursday so it is likely to assume that they are mych higher today.

All common and less common reasons have now been excluded. The last test was of autoimmune diseases which came back negative.

Questions:
1 What could this be attributed to? What are a list of potential options?
2 At what level does serious liver damage occur?
3 What levels are life threatening.
doctor
Answered by Dr. Indu Kumar (17 hours later)
Brief Answer:
You may need liver biopsy.

Detailed Answer:
Hello

As all related causes and investigations are normal,lastly you may need liver biopsy.
Liver biopsy is very helpful in assessing exact nature of disease.
Your findings need immediate medical attention.
You may need to start ursodeoxycholic acid tablet immediately.
You may need detail clinical evaluation by a gastroenterologist.

Findings are not life threatening.Five fold increase in ALT need immediate medical attention.
Findings above 500 may cause serious damage.

Get well soon.
Hope I have answered your question.
Further queries are most welcome.

Take Care
Dr.Indu XXXXXXX
Above answer was peer-reviewed by : Dr. Vinay Bhardwaj
doctor
Answered by
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Dr. Indu Kumar

Radiologist

Practicing since :2004

Answered : 6728 Questions

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What Does My Lab Test Result Indicate?

Brief Answer: Increased ALT and AST may indicate liver injury Detailed Answer: Hello Increased ALT and AST may indicate liver injury.It may be due to many reasons like hepatitis,alcohol intake,altered lipid profile,medicines,auto immune causes etc. It may be due to alcohol intake in your case. It is good that other investigations are normal. I suggest to take tablet ursodeoxycholic acid 300 mg twice daily for three months.It helps in regeneration of liver cells. This is not a very serious finding.You should avoid alcohol completely,findings will reverse. This is a manageable condition.It is most likely not related to prediabetic state. Get well soon. Hope I have answered your question. Further queries are most welcome. Take Care Dr.Indu XXXXXXX