Hello! I am really nervous & having a lot of anxiety about this!
1 month ago I had blood tests done and my AST was 22 IU/L and ALT 17 IU/L
I recently had them done again and it was AST 43 IU/L and ALT 55 IU/L
I am very very concerned!! I did almost zero carbs for that month because I was trying keto(hated it) but I am only 22 years old 5'10 and 165 pounds. I feel like I am too young for liver damage but everything I have read online tells me I should be worried!!! Any input? I do drink (but nothing in excess) and i've only been legal to drink for a year here in the US!!!! I am just freaking out a little bit, could my liver be damaged or diseased? The rest of my blood tests seemed normal!
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akra809
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Hello! I'd recommend that you don't panic too much regarding the blood test. ALT and AST being raised is surprising, true, but one singular blood test being raised is not a large cause for concern, at least not at those levels.
From personal experience, it takes a ridiculously large amount of alcohol, or a long time to cause liver damage. Of course, alcohol is not particularly good for your body and liver, even in small amounts, but if it's truly moderate drinking (below the recommended weekly intake), you don't have much to worry about. Of note, ketosis can also cause transient rises in liver enzymes as well, as can exercise, diet changes... etc.
If you want to follow up, you can get another blood test later on to confirm if the numbers remain raised and if so, perhaps follow up with your doctor to explore some options.
And yes it was definitely in moderation (since I got those results I am scared to even have a sip lol)
I just found it strange that they went up so fast!! However, the first results were taken literally 2 weeks before I cut out all carbs, and the second were directly a month later. So I do feel like it likely had a correlation- I decided to go back to my normal eating habits after those results, and I have already felt a lot better. I was experiencing SO MUCH FATIGUE, I felt basically starved- I definitely won't go back to keto!
I also ordered another hepatic function panel for myself so that I can go into a LabCorp and get it done whenever- but my Dr. told me to wait at least 2 weeks to give my body a chance to level out, its just hard to wait ! I have always been super anxious about my health, and just hope everything shows up in the normal range again when I have the tests redone.
Yup, sounds like ketosis, haha. The body does take a very long time to adjust to no carb/low carb diets. Carbohydrates are really quick easy access energy for your body, so being denied them does cause quite a few things in the body to rebel for a little bit. Generally, any rapid changes in diet or schedule will cause some havok in the body before equilibrium is found.
Anecdotes aren't the best proof, but I have had quite a few friends have similar things happen when they tried keto diets. Usually, the fatigue and blood tests leveled out later on in the diet, but the first few weeks were always quite awful. While it's not really recognised as a formal medical condition, many people have reported feeling almost flu-like symptoms after starting keto, before it gradually wears off. This was appropriately named "keto flu" if you'd like to look that up.
If you tested a healthy person's blood every day for the course of a year, you'd be really surprised to see how many things go out of laboratory ranges ocasionally. You only really have to check things out when they remain out of range permanently.
I definitely felt like I had the flu for about a week! I am gonna look up keto flu now- I was sweating a lot and having fever dreams- felt like I could hardly get out of bed and THE HEADACHES!!! Also, I just looked back at my UA results as well and the only other thing abnormal in all of my tests were my ketones(expected) but they were 100!! Which from what I read is waaaaaay high, I may have keto'd too hard lol I certainly feel a lot better now that my body has the energy it needs, I am still trying to be healthier
I was a college volleyball player until about a year and a half ago, and while I didn't really gain weight, I started noticing I wasn't as fit/toned as I once was. I thought it might help to try keto, because I knew it had worked for some of my friends and family. But looking back, I think I dove in way too hard and probably didn't go about it as I should, I turned to practically only eating meat which was not substantial. While I did shed some weight (about 12 pounds) the way it made me feel was not worth it, and I wasn't actually achieving the results I wanted, which was to be leaner not "skinnier" if that makes sense! I have decided to just return to my normal diet(maybe a little healthier) and get back into training like I did as an athlete, I am hoping that will be better for me and my body (and my liver enzymes lol)
Definitely looking forward to what the next tests show- hopefully they will relieve some of this anxiety
Actually now that I've looked that up a ketone level of 100mg/dl is considered "starvation ketosis" - which is dangerous (I am not diabetic and my blood sugar was completely normal) so no fear of ketoacidosis - but I was definitely starving my body of the nutrition it needed. This is likely the cause of my adverse reaction to the diet, I was being FAR too restrictive and not listening to my body.I am sure this caused my blood tests to fluctuate from the norm, but we will see!
Just curious but have your thyroid levels been checked as well? My liver enzymes kept going up when my thyroid was dying and as soon as I started medication for my thyroid my enzymes went back down.
I have not ! BUT I NEED TO!!! Both my mom and my dad are on thyroid medication, and my grandma had to have her thyroid removed in her early 30’s. I didn’t think of that possibility, but I will definitely get it checked out - thank you
Did u ever figure out why ? I havnt drank in 11 months as I was just pregnant and they were normal range January then after have baby they raised 41 ast and 58 atl and they don’t know why they told me the bayer I took week even before they think had to be it since I had ultrasound and liver was fine and all that and unsure what it could be as hep c and hep b weee both negative few months previously
I haven’t yet- I am going to get another test done in a week! My dr. Doesn’t really have any answer for me as of now- he says I “don’t have anything to worry about” but like you I am still wanting some answers ! I will update as soon as I figure it out
Ocoms razor may apply here. Diet usually causes changes slowly, and the fact you say you drink..and enzymes known to go up from to much good stuff have quickly elevated …. There is a ratio that dictates if it was likely from alcohol or not, think it’s >=2:1 ast/alt.
Best diet for liver is no alcohol - I’d start there before trying to self medicate by diet changes. Unfortunately Wandered’s experience of quantity/time isn’t a hard rule. It took me only 4 years to cook my liver. Alternatively if your drinking is in moderation, eat normally with your usual nights out and see what happens. What does your doctor say? Was your ggt raised to?
This carbs are the devil attitude has been a great success for supplement companies. Heaven knows how the human race survived to where we are with all the carbs we used to scoff before we knew what a carb was 😅.
Btw ketoacidosis is a problem in its own right - you don’t need to be diabetic or have ok blood sugar for it to not be an issue.
All IMO of course - and nothing to panic about from what you said.
My doctor actually didn’t say anything until I brought it up! I was concerned when I got my results but he only responded by telling me “it’s nothing to worry about, things fluctuate sometimes” as I haven’t had any symptoms related to my liver (although I know sometimes they don’t happen until it’s too late) so I wanted to be safe and get re-tested.
I had the blood work done the first time because I have been having some other issues with my stomach (now diagnosed with a peptic ulcer) which I’ve had in the past, 2 times due to H Py Lori. Definitely won’t be drinking at all as it aggravates it and the results scared me lol. The 2nd test was done after a month when I was in the ER - where they finally discovered the new ulcer which was causing my stomach pain and is now being treated. I also noticed that the keto diet seemed to really exacerbate the stomach pain.
But I was probably drinking about 2 sometimes 3 seltzer’s at a time, maybe 2 times a week 3 at max. I have never been one to drink in excess, it makes me sick lol. On a night out I’ve had at most 4 or 5 drinks and that’s like once every other month if even that, I don’t go out much lol - and usually just seltzer’s (I’m celiac so it’s always been safe to stick with that)
My ggt was normal - 22
Looking forward to seeing what my next results show now that I’ve returned to my normal diet
I did read a case study about a woman who did keto for a short period of time and her levels went from the normal range to AST 67 and ALT 117 - she went back to her regular diet and her levels decreased within 2 weeks and were normal within 8 months - this was only 1 case so it’s not dispositive I know ! But I’ve attached it, as well as another report I found on the correlation between low carb diets and elevated liver enzymes and possibility of NAFLD.
Other than the test results I have felt fine, other than the ulcer, and MUCH better now that I am eating carbs again I’ll update when I get my next test results!
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Alt/AST ratio...
AST/ALT Ratio
Alt 78 ast 45
ALT and AST increase. 
Elevated AST and ALT levels. 
