High AST & ALT

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My AST was 186 and ALT was around 72. I’m 28 mother of 2, live a pretty healthy lifestyle, could probably exercise more. I have PCOS (polycystic ovarian syndrome) and I know that can lead to liver issues. Does anyone have any info on why my numbers are so high? I enjoy drinks from time to time but don’t over do it...I’m just extremely taken back by those numbers

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Doctors normally don't get too alarmed about an isolated spike in enzymes, & typically order a re-test at around 90 days to see if enzymes are chronically out of whack.

The AST enzyme is also found in muscle tissue, and even a moderate workout can pop AST high for several days. Avoid any exertion or exercise the week before your retest and hopefully AST will look better.

Elevated ALT can be related to toxic exposures either at work or home. Many prescription meds and even over the counter pain meds can bump ALT high. High ALT is also associated with fatty liver.

If enzymes are still high on retest, an abdominal ultrasound may help with a diagnosis.

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You should stop drinking alcohol even if it isn't the cause of the raised enzymes. Women with polycystic ovarian syndrome tend to be prone to insulin resistance & fatty liver so you need to make sure that your body mass index is in the normal range through diet & exercise.

An ultrasound to check your liver should be done and if the cause for the raised enzymes can't be determined you should be referred to a specialist. As the quote below indicates an AST higher than ALT in a ratio like yours is often a result of alcohol abuse but there are many other possible causes.

Dr. Melissa Palmer's Guide To Hepatitis and Liver Disease:

"The ratio of the ALT and AST may also provide useful information regarding the extent and cause of liver disease. Most liver diseases are characterized by greater ALT elevations than AST elevations with two important exceptions. Both cirrhosis and alcohol abuse are associated with higher AST levels than ALT levels, often in a ratio of approximately 2:1.

Elevations of the transaminases occur as a result of so many causes that they give the doctor only a vague clue of the diagnosis. Additional testing is required in order to determine more precisely what is wrong with the liver. Some possible causes of elevated transaminase levels include the following:

• Viral hepatitis

• A fatty liver

• Alcoholic liver disease

• Drug/medication-induced liver disease

• Autoimmune hepatitis

• Herbal toxicity

• Genetic liver diseases

• Liver tumors

• Heart failure

• Strenuous exercise"