Elevated ALT and AST.. how worried should I be & is it more than alchol..

Hey Guys,

As a background, I'm 27 and a relatively fit guy, though maybe carrying a little extra weight. My alcohol intake is not really that much. With work I would probably drink maybe 4 pints one night max, and nothing the rest of the week. Maybe every 2 or 3 weeks I could have one bigger night out binge drinking which could be up to 12 drinks. Generally though I am a healthy guy who does not really drink consistently and goes to the gym.

I recently went to the doctors for a yearly blood test I have to do with work. My results were as follows: (The last time I'd drunk was 2 night previous when I had maybe 8 drinks. Before that the last time I had drunk was 2 weeks previous which was a bit of a binge drink.)

AST : 286!!!

ALT: 109!!

Gamma GT: 23

Alkaline phos.. 78

Billrubin: 18

Globulin: 24

Total Protein: 75

The doctor stated its most likely liver damage caused by alcohol and to stop drinking and be retested in 3 months, I have no symptoms and am otherwise totally healthy. From your guys experience are these AST/ALT numbers extreme/worrying? Should I be concerned or pushing to get it investigated sooner in case it was something else?

Thanks

Dan

[Hidden]

HI there

I drank pretty much like you for 20 years, infact i used to drink a little bit more at times. 27 is very young for serious Liver damage with the amounts you are drinking, infact most people drink that for life without issues.

So, your numbers, ALT and AST being raised together does indicate the Liver is swollen since both these enzymes are found in the Liver. The AST/ALT inversion is usually an indicator for inflammation caused by alcohol. AST at nearly 300 is pretty high. What doesn't make too much sense to me is the GGT being so low, with Alcohol alone usually its the GGT that pops first (GGT is found in the bile ducts) . So it looks like your Liver is swollen but not the bile ducts, which is not consistent with Alcohol damage. Not impossible, but something seems a little odd here.

The normal process for high Liver numbers is to retest in a couple of months to look for a trend(hopefully down). Have you been taking any medications ? Did you do any heavy exercise before the test? I have seen people get AST/ALT to around 200 after some crazy exercise. Also after a binge numbers would likely be high for a few days, it could be a combination of the binge and exercise or it could be something else going on.

[Hidden in reply to Hidden]

Hi Ralph,

Thanks for the quick reply. Yeah I guess as I really don't drink more than friends and others that are around me I began to question how likely it is because of alcohol. The numbers seemed awfully high and thats why I've come here to seek some help/context, particularly as the other numbers were all normal. My doctor didn't seem too concerned - and just said stop drinking.

I'm not taking any other medication at all. I've had a bit of a chesty cough for a few days but other than that I'm healthy!

The exercise i did that week leading up to my test would have been :

-14th June : 30-40 minutes of boxing with a trainer (not being hit myself) -15th June: Drank maybe 2 weak shandies, 2 pints and 3 or 4 cocktails

-16th June: 30-40 minutes of boxing with a trainer(not being hit)

17th June: Took my blood test

Though my knowledge of the liver isn't great I'm assuming the numbers of my AST and ALT would be too high hitting nearly 300 to be caused by that little exercise/ slight binge?..

Yeah, you are right, the doctor recommended to get tested in 3 months time to see what the numbers do - I was just a bit concerned and looking for some context on numbers and wondering if I should be seeking some more help from a specialist or a re-test.. as waiting 3 months if it could be pointing to something more serious seems like it could be costly!

The tests were done during an overall health screening and all other numbers that were taken were normal

[AltAstRaised in reply to Hidden]

Are bile ducts typically dilated when there is alcohol liver damage?

[Hidden]

Hi Dan,

Your GGT is normal but your AST and ALT levels are extremely high. This indicates alcohol is most likely not the problem. If you have a big night out every few weeks, you may get a headache/hang-over the next day but you will not get elevated enzyme levels like that. Those numbers indicate serious liver damage, which could be caused by a viral infection.

Has your Dr mentioned Hepatitis C virus? Have you been tested for that? If not you should ask for the blood test right away.

Cheers,

[dooley1]

Hi Dan those results are high but as has been said GGT being normal is a bit of a mystery. I would guess that it's not due to alcohol but while your levels are high I would definatley stop drinking so as not to insult the liver further to what else is going on. Did you get your Ferritin levels checked as high iron in the blood can lead to deranged levels. Don't worry too much, def get a retest, 3 months seems a long way off so maybe in a month you could get one just to give you a clue which way it's going?

All the best 😃

[dckimberly]

I agree..although it's summertime and there are a lot of parties and events, etc..if you can stay off any alcohol, then they might be able to rule that out..

I'd also ask for a Hep C test.

And, here's the thing..sometimes are tests are just out of whack, and they don't always tell the tale. For instance I got a transplant last year and my blood tests had been reading close to normal or normal..Blood tests don't always tell the whole story. I had another issue that showed that my liver was indeed failing.

But again, that's kinda rare. I'd guess there is something going on. So, if you can just not drink until your next visit, then they can test you with that in mind.

I know 3 months seems like a long time, but it is normal..many of us here do not go to our clinic appointments except every 90 days, and that's with cirrhosis, etc.

Sorry you have to wait so long.

For now, try and not drink, eat a low sodium diet and ask about a Hep C. test.

good luck and let us know how you fare!

XXX

[Hidden in reply to dckimberly]

Hi guys,

Thanks for all your replies. I appreciate it. So I decided since its been a month I would get my LFTs tested again to see if they had changed, and to seek an opinion on the Hep C tests. The doctor agreed that the results were unusual and high and that alcohol was unlikely to be the major cause.

Surprisingly my AST and ALT came in completely normal. My AST has gone from 284 to 19 and ALT 109 to 22. I've been told to be retested in 6 months to make sure they stay in range. I'm still not too sure why they spiked so much. Maybe it was the combination of exercise and a night out earlier in the week. I will definitely be looking after my liver better from now on and being more careful with my alcohol consumption.

[Sshres6]

Hi Dan,

I have the same test results as you have, elevated ALT and AST, everything else is fine. If you could please share your diet or any medications you took during the period, so that I could also follow them.

Regards,

Suraj