De-ritis ratio: As you all know I got... - British Liver Trust

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De-ritis ratio

Danubian profile image
36 Replies

As you all know I got the all clear by ultrasound and MRI, my two independent gastroenterologists told me my body was DEFINATELY ok, and it was anxiety disorder causing my nausea, gastro-problems.

AST 18 ALT 14

My de ritis is 1.29. I read on this forum that the de-ritis ratio still applies even when the results are in the normal range, but also I read that when they are in normal range de-ritis means nothing. Help please!

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Danubian profile image
Danubian
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36 Replies
AyrshireK profile image
AyrshireK

Those ALT / AST figures show you have absolutely nothing to worry about, really really low and well within range. Forget about the De-Ritis Ratio.

Katie

Danubian profile image
Danubian in reply to AyrshireK

Oh thank you so much - you should see me smiling now. And coming from you! What a roller coaster of emotions - this morning tears (you known why) and now smiles. Bless you! Mark

AyrshireK profile image
AyrshireK in reply to Danubian

Mark, you've now stopped drinking, you have a normal liver. Your liver is no longer under attack therefore you should get on and enjoy life to the full. Don't start drinking again and your liver should stay really happy.

From what I read about the ratio it comes into play when results are well above the upper limit of normal and your numbers are well low so there is no ongoing inflammation. All good news.

Keep smiling my friend. :)

Katie

Danubian profile image
Danubian in reply to AyrshireK

De ritis ratio still def applies even when they are in range.I have found a couple of times on this site tho sophia1980 that some people are unaware of the deritis ratio. But it does apply at anytime not just when bloods are individually out of their range

Danubian profile image
Danubian in reply to Danubian

sorry Katie that post went wrong - I pressed the wrong button. These were the quotes from Phoenix under the "Another Fibroscan Question" !

Danubian profile image
Danubian in reply to Danubian

It was those posts by Pheonix that freaked me out - cos he generally knows his stuff! Sorry I will keep smiling and calm down so that I don't press the wrong buttons!

in reply to Danubian

Oh i do know my stuff. Dont get that confused ha. I didnt say they didnt matter if in normal range. I said a doctor wont even look at them if they are in normal range. If you were sitting at the high end of normal than maybe it would be of relavence IF you had any other indicator of liver disease which you dont!

AyrshireK profile image
AyrshireK in reply to Danubian

Most folks don't even get told any of their blood results so don't have a clue about them and therefore have nothing to worry about. My hubby has advanced cirrhosis but we rarely get told any blood results so we don't micro manage his condition, we just keep an eye on symptoms.

Don't fret the small stuff, it is showing you nothing. AST can be higher than ALT in muscle injury too so it really means not a things whilst your results are so good.

Katie

Katie is quite right. Your enzymes are practically perfect. De ritis ratio is not used to diagnose pretty much any liver disease except for alcoholic hepatitis. A 3:1 ratio is pretty much always alcoholic hepatitis. That being said no doctor will even acknowledge it if both ast and alt are in normal range. Deritis ratio is more of an observation of frequent finding in liver disease rather than it is any semblance of a diagnostic tool. "Frequent" key word. Not absolute. It isnt the same in all cases and again it isnt diagnostic. They say 2:1 ratio indicates alcoholic cirrhosis. But I have alcoholic cirrhosis and I dont have even close to a 2:1 ratio. Also my enzymes arent out of normal range either.

Just to remind your anxiety that you never drank enough to get alcoholic liver disease of any shape or form. You may have gotten a tiny bit of fat build up. But that would be long gone by now. If we could get it from a small 20 day bender everyone in the world who drank would have it. People with alcoholic cirrhosis vary in how long they drank and how much before getting cirrhosis but, one thing is true and constant and that is if you add up all the alcohol we Individually drank before diagnosis, we are talking olympic swimming pools. Some less some more but definately swimming pools of the stuff. Even at that volume only about 10 to 15 percent of people will go on to get cirrhosis from it. Im not at all down playing the harm alcohol causes but, even in heavy drinkers cirrhosis is quite the minority.

Danubian profile image
Danubian in reply to

Thanks Phoenix - I must have misunderstood your postings on "Another Fibroscan Question" Best wishes, Mark.

in reply to Danubian

I think yes you misunderstood. My hepatologist agrees that it still applies if its in normal range. But she doesnt care what it says regardless because its not diagnostic of anything and because most importantly if its in normal range than there is no current inflammation and that is a great thing. Its an observation that may lead them to look further. l give you a quick example of where it may have relevance. If your ALT was 10 and your AST was 40 a hepatologist would see that and likely test your other liver functions and give you a scan or two. If that all checked out clear than those enzymes levels wouldnt be of concern. Thats a hepatologist. A GP would see its in normal range and not bat an eye about it most likely.

If you had that same ALT of 10 and AST of 40 with elevated billirubin and lowered albumin. Then all that together is pretty indicative of liver damage of some sort. HOWEVER.. the fact that the ALT and AST in that example are in normal range would mean you dont have any ongoing inflammation. Which is most important.

When I was in the hospital last year it was written on my medical chart that my ALT/AST was of a 3:1 ratio and had " suggests alcoholic hepatitis" written and circled. Because again thats pretty much the only time the ratio is pretty cut and dry. But AST 18 and ALT 14 with no other abnormal enzymes or liver problems indicated?. There isnt a doctor in the world that would care about those numbers.

Danubian profile image
Danubian in reply to

Thanks Phoenix

in reply to Danubian

Anytime man. Now go do some modeling you handsome bugger and stop worrying about your healthy liver!!

Danubian profile image
Danubian in reply to

Thanks Pheonix (me grinning and smiling). Never mind the gastro-doctors, it is you and Katie who have finally convinced me (I hope the Liver Trust does not misunderstand me on that one - like I misundertood you). As Notorious said "and it's still all good!" You take care Phoenix.

in reply to Danubian

" and if you dont know, now you know"

🙂

Keep it Juicy!

Popel profile image
Popel in reply to

Hi Phoenix you do know your shit. all I ever kept an eye on were my sodium,İNR and platelet levels.well reading your post it looks like you know your know your shit.perhaps the post is confusing me with abbreviations and numbers lol.just like Katie I’ve had to squeeze information out of these doctors cause they’ve got this habit of telling you nothing.paul

in reply to Popel

Thank you kindly Popel. Its true that the doctors think we wont understand it maybe? Under estimation of us I think. The stuff Katie has squeezed from them is impressive. Especially with such a complicated one like autoimmune hepatitis. Ive seen doctors baffled by auto immune liver disease. I think Katie should become a doctor and specialize in it!

Danubian profile image
Danubian in reply to

I think she should be made a saint before becoming a doctor!

AyrshireK profile image
AyrshireK in reply to Danubian

Stop yous are making me blush. xx

in reply to AyrshireK

❤ your truly admired by us all Katie

jojokarak profile image
jojokarak

My god I wish I had those results 😍

Well done, and for once I don't know anything about de-retis and I think if someone post transplant knows nothing about it then you really shouldn't be worried about it as I am a bugger with the consultants wanting to know the ins and outs of all my bloods x

Danubian profile image
Danubian

you are all wonderful, absolutely wonderful :-*

Isabelle2 profile image
Isabelle2

Now breathe and then RELAX 😘

Danubian profile image
Danubian in reply to Isabelle2

Doing my best Isabelle - I have an appointment with the psycho-doctor tomorrow! :-)

Isabelle2 profile image
Isabelle2 in reply to Danubian

How did it go?

Danubian profile image
Danubian in reply to Isabelle2

Thanks for asking - well it was OK but he was a depth psychologist, I need one more skilled in congnitive behaviour therapy. On Tuesday I went to skin doctor about a mole on my face I thought was getting bigger! Been in the sun many years -All OK. Today I had a scan in Hamburg because I had wheezing and I thought I had lung cancer - all OK. Yeah finally nausea is waning without psychodoc!

Isabelle2 profile image
Isabelle2 in reply to Danubian

I know people who have found CBT very good.

Owlie profile image
Owlie

Awesome news, well done and keep it up!

Danubian profile image
Danubian in reply to Owlie

Thanks Owlie,

in reply to Danubian

Hi

So pleased for you. Take care Lynne

Healthanxiety profile image
Healthanxiety

Dude - those numbers are fabulous. And I thought my anxiety was out of control! Thanks for your reply to mine about my concerns! But you’re in the clear. It’s amazing what health anxiety does to us. My ast is 30, alt 39 and GGT 63. U/s tomorrow.

Please set your mind at ease now. Move onto the next disease you’re dying from. 😉

Danubian profile image
Danubian in reply to Healthanxiety

HealthAnxiety I moved from AIDS to liver disease. Dude - you should have seen me two and a half months ago. The skin on my upper arms was shrivelling up from loss of fat and muscle and despite losing weight I had no appetite - I had red patches on my skin and sores in my mouth from malnutrition (I think it was amongst others vitamin B12 defficiency). The HNO (Hals Nasen Ohren) doctor (ENT in UK) looked in his book of pictures - couldn't find anything - and sent me to the skin and nasty disease doc - checked me out. Foodwise I could barely get a roll down per day! Was pretty scary 'cos I also believe 100% there are only two places where we go after .. well you know. Got a white tongue and was told to get it seen too - I did - the gastro doctor knew it was due to not eating. The nausea was absolutely debilitating - waking up at 2 in the morning with unpleasant dreams/nightmares. I never had any health problems previously - none. In one dream I was vandalising the clinic (would never do that in real life) saying "I ain't stopping until I get a da**ed diagnosis". I think it all started after I became aware of the fragility and mortality of us all! Dude I have had my battles and wars and I thought government was mine and mankind's worse enemy - but I need only to have looked in the mirror LOL. EVERYTHING is for a reason - and it has opened my eyes - progress only comes through pain and suffering. The beautiful heights which we eventually reach are only attained by enduring the deepest darkest depths and coming out victorious. Praying for you and your U/s tomorrow and all who are suffereing here!

anon_username profile image
anon_username in reply to Danubian

I wrote this in another post, but since giving up alcohol the illness anxiety (which I had never experienced prior to detox) has been absolute hell. In the first few months I had fully convinced myself I was dying. I had been in and out of the hospital four times since October with what I now know is just anxiety. I had convinced myself I must have cirrhosis from the last 5 years of heavy drinking, hepatitis, hiv, some incurable std, meningitis, infected gallbladder/appendix, sepsis, black mold, even lead in the water. Something!! But every test coming back normal. Is my partner poisoning me? Lol. Idk.

I had become obsessed with my fingernails and spent hours googling terry's nails (how I first found this site and of which multiple doctors have confirmed I do not have). I was waking up with terrible heachaches and thinking I must have developed a tumor or clot in the brain. I'm definitely dying! ...Until both an MRI and CT came back normal... Now, no more headaches. Weird, huh. Anxiety can do some crazy things.

But as time goes on it's getting easier and the list of things I'm sure I'm dying of is getting smaller. So, trusting the results of many many tests (FibroSURE, CT, MRI, etc), my liver is fine and I'm moved on to other things to worry about. Haha.

Danubian profile image
Danubian in reply to Healthanxiety

Dude - up until December last year I was fit as a fiddle - swimming an hour every second day - in the Baltic in the afternoon when the temperature was above 15° C - yes for an hour!. I drank above average but never worried about my consumption. Got on with my work and life - and then BANG - the health anxiety hits me after a little ailment started. That was was a spark that ignited the powder keg of worries.

davianne profile image
davianne

Danubian, those results are GREAT!!!!👍 , now go and enjoy your healthy life, If you ever want to sell them, give me a call🤣🤣 We are indeed fortunate with the wealth of knowledge we have here from Katie, Phoenix and many others.

David

PoorlyLiver profile image
PoorlyLiver

I am worried about mine too - AST 20 ALT 13. However I am still "responding" to meds for autoimmune hepatitis in that my levels are both descending ... usually they are closer together but last test showed a sudden dive on the ALT .. according to online calculators I have cirrhosis with these readings. I shall ask when I have my next consultation in January about this, although by then maybe my AST level will also have dropped nearer to the ALT value by then. Would like to think ratio is irrelevant if enzymes in normal range... that would be a relief!

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