Ast:alt ratio

[Willowjen]

Hi. I don’t know if anyone will be able to help me with this. I had a liver function test at the end of December and was told that my alt was raised at 100. Gp told me not to worry and they would repeat the test in 4 weeks. I only managed 2 weeks and went back to gp with severe anxiety as I was worried about the result and they did a liver panel. The results were all normal and left had come back down to 21. The only issues with the results was the ast:alt ratio which was 0.9. My alt was 21 and ast 19 and the report said this was out of range and could indicate fibrosis. My question is does this ratio apply even if the results are in the normal range. I have read somewhere that the ratio only applies if the enzymes are deranged? Thanks in advance.

[Hidden]

A normal healthy person's deritis ratio is around 0.8 to 1.0 and is within normal range

[Hidden in reply to Hidden]

And yes it can apply in normal range. But if your level are within range than ita a sign you dont have active inflamation. Usually a doctor will not care as long as they are in normal range unless you also have a raised GGT.

If you had say a 20 Alt and 40Ast with an elevated GGT that would be suggestive of alcoholic liver disease for example even though the Ast and Alt numbers are in normal range and should warrant further investigation.

[Willowjen in reply to Hidden]

Thank you very much for your informative reply. I suffer terribly with health anxiety and I’ve been told this ratio of 0.9 with an ast of 19 and alt of 21 is abnormal and have been referred for a fibroscan which isn’t for quite a while yet. From what I have read it is also more significant if the ast is higher than alt. Do you know if this is the case? I don’t seem to be able to get much information from anyone regarding it and it is making me unwell with anxiety and worry thinking there is a possibility I could have fibrosis. My gp doesn’t think this is the case but as the result of the ratio is just outside the normal I have been referred for the scan. Can anyone comment on what they think? Thank you very much for taking the time to reply to me, I really appreciate it.

[Hidden in reply to Willowjen]

I've never heard of a doctor finding that ratio abnormal especially when its within normal range. As for the Ast being higher that all depends on the type of liver disease. There mist be something else that's also making the doctor want to go to the degree of a fibroscan. Perhaps that you had an elevated Alt previously

[Hidden in reply to Hidden]

The Alt is usually higher in say fatty liver disease as an example

[Willowjen in reply to Hidden]

Thank you for your replies, that has helped me greatly. I feel the same and can’t really understand why they feel I need a scan. I had an ultrasound 4 months ago and all was normal, no fatty liver disease detected and I’m guessing it would be picked up on ultrasound and also it would take quite a long time to develop. The only issues I had was the rise in alt which normalised in 2 weeks. I didn’t drink any alcohol during that 2 weeks and haven’t for the past 7 weeks. I also changed my antidepressant meds which I wonder could of raised my enzymes temporarily. Is it a good sign that the enzymes returned to normal in the 2 weeks and does that rule out serious liver damage? Thank you.

[Hidden in reply to Willowjen]

The meds could definately have played role in the elevated enzymes

[Hidden in reply to Willowjen]

I'd say the fact they normalized in 2 weeks with an ultrasound that was clear is a good thing. Sometimes meds cause what are called transient elevations in the liver. Meaning it they dont last and are typically of no harm. But if the doctors willing to give you a free fibroscan go for it. It takes 5 minutes and will reassure you even more.