Doctors can’t find anything/no diagnosis. Reaching out...

[AltAstRaised]

Hi all, I read the site daily but rarely post. Asking if anyone has had similar situation as me and can offer any advice...

Raised alt/ast (40-60) range for over a year now. Been blood tested for every disease, had ultra sound, mri/mra, endoscopic ultrasound, and biopsy...all completely normal. Alt/ast continue to be raised. Is it possible all those tests missed something? Not even showing a sign of something.

I’m turning here for any advice or to see if other members had similar findings and what actions they took. I’m not asking for diagnosis or medical advice. I appreciate any info that is offered. I think I’ve run out of different google combinations looking for answers!

[Jojochr]

Do you have any other symptoms?

[AltAstRaised in reply to Jojochr]

Hi Jojochr - no real other symptoms besides some bowel issues/habits that have changed. One ultrasound found mildly dialated intrahepatic ducts and the mri found some cysts, but that’s it. No stones, no blockages.

I guess I’m concerned/curious how I could have blood tests showing liver damage/inflammation but biopsy shows none of that.

[jbrking]

Hi that’s only slightly raised. I’m on medication and my ALT is in the 80s but that’s stable for me and I’ve had NAFLD for 12 years. At point of diagnosis it was nearly 200. I think if you’ve had numerous other tests and nothing has been found then I really wouldn’t worry. Obviously stop drinking if you drink and maybe look at diet but apart from that I can’t think of anything else.

[AltAstRaised in reply to jbrking]

Thanks, jbrking, for the response. Yeah I completely cut out alcohol a year ago and exercise/eat pretty dang healthy. They remain elevated. Consistently right around that level.

Is your medication causing your nafld or was that caused by something else?

[jbrking in reply to AltAstRaised]

I wasn’t on any medication before NAFLD was diagnosed. I was tired, had bowel issues which was told IBS, since been tested and confirmed as bile acid malabsorption. So doctor did full blood works on me and my liver alt was nearly 200, my gamma gt really high (can’t remember figure) and my whole lipid (fats) profile was all high- eg cholesterol, triglycerides etc. I was a normal sized person and didn’t eat fatty things as they would go straight through me. Had so many tests and scans and they couldn’t find the reason, just that my liver couldn’t break down fats. I’m now on lots of meds to keep the fats down to the point where I have to take tablets to maintain a level of good cholesterol! The rest are statins, a feno fibrate, and binder meds for bowel. Constantly monitored because the binder meds can cause the triglycerides to go up so they’re keeping an eye on them. Fun eh.

[Kristian]

Hi, just be aware that reference ranges for labs are what is considered normal for the majority of people. However, it will always be the case that some people naturally fall outside of those norms. It's a statistics thing. So, if you are generally only slightly outside of your doctor's lab's reference range then that may just be what is normal for you. You just may be a bit less normal than everyone else 🤣🤣🤣.

It is though worth continuing to be monitored. You mentioned some anomalies that had been picked up even though everything generally looked fine. So it's worth just keeping an eye on you just to be on the safe side. But, if you feel ok, then dont worry too much about it. If things start to change then at least they should pick it up early.