Worried about AST/ALT ratio

[LaceGole]

Hi all. This is my first post. I’m a 38 year old female from the United States currently going through a stressful divorce. Unfortunately for the last year to year and a half I've turned to alcohol as a crutch. Drinking very heavily the last year. Near daily with few breaks and waaaay too much each day.I have 3 lovely children whom I adore and they adore me as well. They are 16, 11, and 8. I have cut way back on the alcohol and only had some Saturday night but it was too much. Enough to make me feel yucky Sunday. I became scared of my heavy use a few weeks ago, when I had bad encounter with future ex, and I drank so much I passed out and didn’t remember half the night and decided this isn’t good. I have some abdominal pain on right side under the bottom part of rib cage and trouble sleeping and get sweaty at night, but all these symptoms usually just occur when I drink very heavily. I decided I need to get checked out. Here in my town I can go to direct access lab and pay money out of pocket and get blood work done. So I did that on October 22. My ALT was 36 and my AST was 40. My ALT usually runs a little higher than that in low 40s. AST usually in 30s. Didn’t have option to do GGT but all other numbers were normal. I had an ultrasound last November to check out my gallbladder and that was completely normal. But that was last year. I felt ok with these numbers until I read about the AST/ALT ratio and now I’m freaking out. I have a history of hypochondria and anxiety and I’m well on my way back there. So scared. I am not asking for medical advice just reaching out because I’m worried and looking for others experiences. Just a note my HDL was 115! It’s always kinda crazy high and has been climbing over the years but that number is ridiculous. I see my gp on Wednesday this week. Thank you

Lacey

[AyrshireK]

Hi LaceGole, welcome to the forum. Obviously you know you need to rethink your relationship with alcohol as it's obviously not doing you any good. It's a good thing that you have an upcoming appointment with your GP as they are obviously the best people to explain your results or sort out any further tests you're likely to need.

I would say though that your ALT and AST are pretty normal and the De Ritis Ratio only really comes into play if your results are massively elevated above normal so you perhaps don't need to fret on that score.

By HDL I assume you mean High-Density Lipoprotein /Cholesterol. A quick read about this revels it gets called the 'good cholesterol' and the higher number the better. webmd.com/cholesterol-manag...

Too much Dr Google is often not a good thing so go with doctors advice and tests rather than convincing yourself you have more going on than you actually do.

Katie

[LaceGole in reply to AyrshireK]

Thank you so much for replying. I’m just sick with worry and trying so hard not to. I’m hoping the fact that I otherwise have a healthy diet and am in very good shape as I run 3-5 miles 3-4 times per week and have a good weight lifting regimen, has helped some with the last year of heavy drinking. I will wait and see go Wednesday and try to get an ultrasound. Is ultrasound or ct scan better? I’m sure with insurance there is a first step and it’s probably ultrasound

[Hidden in reply to LaceGole]

Just to say and I know it’s not easy but the best way to get rid of your worry is to stop drinking completely. I spent 15 years running to the mirror each morning to check if my eyes had gone yellow and had pain over my liver. I also had blood test where my alt was high back then. Whilst it appears I’ve escaped any damage, to keep drinking knowing your liver isn’t comfortable and the numbers are showing so is gambling the health of your liver.

Although I escaped liver damage what most don’t realise it that alcohol damages the nervous system and my autonomic Nervous system is certainly damaged. My bladder feels permanently full to bursting, my blood pressure is low and I get dizzy and feel like I’m going to black out if I bend over or get up from sitting. I’m at a point I’m considering a wheelchair for outdoors so I can go places without feeling like I’m collapsing. It’s not fun and if only I could turn back the clock when I was your age. Xx

[LaceGole in reply to Hidden]

You know what I know you’re right. I’ve only been drinking heavily for a little over a year but I do the same. Constantly looking at my eyes thinking I’m dying. I still look at myself and just know I look yellow. It isn’t easy but when I look at my kids, it gets much easier. May I ask if you were a heavy drinker and did you drink daily or just weekends? I’m trying so hard not to worry but it’s hard when I know what I’ve been doing to myself.

[Hidden in reply to LaceGole]

I drank every day for 15 years and I’m female 4 sometimes 5 pint cans cider and in the end a litre bottle of wine 4 nights per week which went on for 2 years. I would drink that in the space of about 3-4 hours until I passed out. I never remembered eating or going to bed. I drank a lot longer than 15 years but not daily.

How I’ve escaped liver damage I have no idea, I don’t even have fatty liver! I have just had a letter today to Say I have acute chronic cholecystitus and have to have my gallbladder removed ASAP. This is why my liver enymes are deranged... CT scan clear of any liver damage or fibrosis as was recent ultrasound.

So I’ve had a somewhat lucky escape aside from nervous system damage which there is no cure for.

I’m certain you will be 100% fine if you stop 💖

[LaceGole in reply to Hidden]

Thank you for your kind reply. Wow, you are truly blessed to have no damage. That’s great that you don’t. How did you finally end up stopping? I am encouraged to 86 the alcohol completely because I have no control when I drink. Which is probably the case with most who abuse alcohol. Don’t know how to stop once I start. So just drinking even one night a week is not worth it. I’ll binge. Which is just as bad or worse. Thank you for the encouragement. Also two questions, it’s a good possibility at the time I had my last bloodwork done I could’ve had covid and I had eye surgery October 1. Can either of those things skew results?

[Hidden in reply to LaceGole]

Believe it or not vertigo. Out of nowhere one evening I suddenly felt like I was on a boat, it was horrific. The room went upside down the lot and I couldn’t walk. Then I got vestibular problems and lights made me dizzy, and my anxiety got so bad I could barely talk and stopped eating. I spent 3 months straight crying and frightened and started thinking the worst thoughts a human can about what to do about it. Thankfully I’m still here. Since the day i got vertigo I haven’t touched a drop. I still get vertigo now. The last thing I want to do is take anything that changes my balance like a drink certainly would.

Like you I had no control, I couldn’t just have one drink and feel a bit fuzzy, I had to drink until I passed out.. madness but that’s me.

Re your bloods, I can only advise what I did about 12 years ago when a random blood test showed raised ALT and high cholesterol at 7.5!!! I Stopped drinking and had another blood test done after 3 months. ALT was back under 20 and cholesterol down to 4.. My liver must have been struggling and stopping the drink allowed it to recover and work more efficiently.

After that I stared drinking again but it showed my ALT and cholesterol were raised due to my drinking.

In your position I wouldn’t be freaking out at all, I’d just be working out how to help myself stop drinking and let the liver look after you without you harming it xx

[kensimmons in reply to Hidden]

Hidden. Please realize I am not a doctor. And I know you did not ask for any advice. I was thinking of not posting because you might get angry at someone stepping in, but since I kinda went through a similar stretch I thought maybe this might be of some use. And again, I am NOT a doctor. That said...

A lot of your problems could be at least partially stress related. I bet if not entirely stress related, then your self admitted anxiety is almost certainly if not causing these problems then it is making them worse. Lose the worrying, these problems will abate a bit. You'll feel better if you get 8 hours of sleep on two nights back to back. Two nights of good sleep in a row caused my anxiety, restlessness, tiredness to drop by 80% (if not even more than that).

Bladder - Could be stress

calmclinic.com/anxiety/symp...

Vertigo - Could be stress

anxietyboss.com/can-stress-....

Vertigo and Low Blood Pressure - Are related - Could be stress

calmclinic.com/anxiety/symp....

Vestibular Problems - Related to all of the above - Could be stress

healthline.com/health/can-s....

In fact one of the worst things you can have is the feeling of hopelessness which comes through your post. (There is not cure..etc.). Maybe, just maybe, it's not so bad. See a psych doctor. Get a second opinion from a different GP. Think about dietary things. Think about a foreign country for treatment (I would personally never do that especially now during COVID, but many people are delighted with the turnarounds they have had in India and Mexico and Eastern Europe. There are some very good doctors there and its not expensive). You have very good blood results so you at least you already had less to worry about. There are options. There is hope.

Good luck and God bless!

[Kettl]

Hey LaceGole did you get to the bottom of this?