1. < Digestive Health

Stubbornly elevated ALT and AST

Posted by Sophie93 @sophie93, Feb 21 1:50pm

What could be causing those?
ALT in particular has been in the triple digits over the past few months, AST varies all over the place but it is again over the reference range.

For reference, I don't drink, I don't do any recreational drugs and I eat a healthy diet. I am really into physical activity as well. I don't have a problem with obesity, in fact, I am underweight. I don't take NSAID drugs or any other drug that is notorious for liver health

My doctor has done a series of tests in order to exclude any possible issues with my liver, such as ultrasound (no issues found i.e. I DO NOT have a fatty liver), tests for Hepatitis A, B and C (all negative). No issues with my gallbladder or any other part of my digestive system. My thyroid is functioning well.

Is there anything "hidden" that could be causing the stubbornly elevated ALT and AST? I'm particularly worried about the ALT, because it has been rising over time.

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Sophie93 | @sophie93 | Feb 23 2:29pm
In reply to @bobweller "I copies a paragraph from a Google search that sums up my issue years ago: Changes..." + (show)
@bobweller

I copies a paragraph from a Google search that sums up my issue years ago:

Changes in biochemical test results due to biliary obstruction are generally marked by elevated ALP, GGT, and bilirubin levels. Generally speaking, within 24 hours after obstruction, AST and ALT levels are markedly elevated.

Here is the link:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9648910/#:~:text=Changes in biochemical test results,are markedly elevated %5B6%5D

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Thank you for the link!

However, my ALP, GGT and bilirubin are within ranges all the time.
It's only the ALT and AST that are elevated. ALT is the biggest issue... It seems to increase over time.

REPLY
1 reply
cmdw2600 | @cmdw2600 | Feb 26 7:22am
In reply to @sophie93 "Thank you for the link! However, my ALP, GGT and bilirubin are within ranges all the..." + (show)
@sophie93

Thank you for the link!

However, my ALP, GGT and bilirubin are within ranges all the time.
It's only the ALT and AST that are elevated. ALT is the biggest issue... It seems to increase over time.

Jump to this post

I’m not suggesting that you do have hemochromatosis, only that it should be ruled out.

Here’s how it went for my husband: shoulder injury lead to a scan of some sort. That scan showed a spot on his lung which lead to another scan. The lung was fine but in that broader scan, his liver appeared black! We were concerned that it was liver cancer or cirrhosis. A biopsy was performed and that’s when it was discovered that his liver was loaded with iron. He underwent over thirty phlebotomies over the course of several months to remove the iron. Think of it like getting an oil change. This was about twenty years ago and I feel certain he’d be dead by now if this hadn’t been discovered in a random way.

Currently he gets his levels checked (TIBC, ferritin and percent saturation) every two months or so and if out of range, off loads some blood and makes more. Diet is not a significant factor (according to his doctors).

Prior to menopause, women shed blood regularly and make new but that changes later in life. If a person is eligible it can be idea to donate blood-mainly because it helps another human being but it can also be benefial to the donor.

When hemochromatosis is mentioned to some doctors, they look at the patient and say “I don’t think you have that” but without the separate iron panel blood tests, they can’t know.

Best wishes,
Cindy

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alh4 | @alh4 | Feb 26 11:41pm
In reply to @sophie93 "Hi Cindy! Thank you for the reply! This is the first time I'm reading about this..." + (show)
@sophie93

Hi Cindy!
Thank you for the reply!

This is the first time I'm reading about this condition, so it goes without saying haven't been tested for it...
My iron levels have always been in the higher end of normal, I don't know if that is relevant?

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Yes, please get tested for this. This condition can eventually effect your organs. Several in my family have it and have phlebotomies at various times. I was treated for years then after genetic testing it was determined I did not have it although I had developed cirrhosis due to fatty liver.
Had liver transplant in 2020. I do often wonder if I did have it. My brother who has it has cirrhosis now.
I wish you the best and hope you find answers soon.

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dw27 | @dw27 | Feb 27 1:00pm

Did they check for blocked bile duct

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