AST and ALT levels

[April1970]

Hi there I know I've posted before but a while ago my ALT's were raised at 88 and blood tests in December my ALT was 38 but my AST has risen to 47. My consultant wrote to me and said that now my ALT and AST ratio has reversed that that is the sign of my liver scarring. I wasn't too worried as I know some others levels are a lot higher than mine but now I've read that once cirrhosis starts your ALT levels come down to normal which mine has. What does anyone else think please? X

[Hidden]

Deritis ratios are not concrete diagnostic rules.

Generally any ratio above 1 suggests cirrhosis. But that isnt always the case. Its overall use to determine a liver disease cause is not very great except for alcoholic hepatitis. A deritis ratio of 3:1 is almost always indicative of AH. The ratios are really to catch a doctors attention and must be interpretred with caution and with the patients whole medical picture considered.

Take a look at these links they may be helpful to you in understanding some of the tests and what they can mean.

ncbi.nlm.nih.gov/pmc/articl...

clevelandclinicmeded.com/me...

Please if you have any other questions after feel free to ask.

[April1970 in reply to Hidden]

My ratio came out at 1.24

[mncold]

Hi April1970,

I've never heard that any levels change other than for improved health.

I would suggest you talk with your doctor and make sure you understand what is going on.

Best wishes,

Mary

[April1970 in reply to mncold]

In some liver diseases, especially when the bile ducts are blocked (cholestasis), when a person has cirrhosis, or when liver cancer is present, the concentration of ALT may be close to normal.

[Hidden in reply to April1970]

Thats true for alot of types of cirrhosis though.. alt levels can be even completely normal in any type of cirrhosis not just choleostatic types. It happens in sinsusoidal types as well. This is why even though the ratio can have certain indications it is not diagnostic because not everyone in a liver disease category will have the same ratio even if the etiology is exactly the same. Like I said before the only type that is usually 100 percent accurate to the ratio is alcoholic hepatitis. A 3:1 ratio is almost always if not is always AH.