Alt level

[Fliss2556]

Hi, I wonder if anyone can shed some light on a recent result I got. My ALT levels went from 16 last November 2020 to 25 in Novemebr 2021 and then 3 weeks later to 41. All my other results came back normal. My doctor is away and can't answer so I was wondering if anyone else has had this happen? Is this considered a large increase? Thanks.

[AyrshireK]

The lab range for ALT varies from lab to lab so whether yours are considered elevated or not depends on what your lab range is. That being said yours don't appear too high, a significant elevation is when your ALT goes higher than 3 x upper limit of normal and where this degree of elevation is more than just a 'blip' i.e. a pattern of elevation. (Yours is no where near this).

ALT isn't solely related to the liver and can rise in response to exercise or when your body is fighting any sort of infection.

As all other results are normal it doesn't sound too worrying but obviously you'll still want to check it over with your doctor when you can.

Katie

[Fliss2556 in reply to AyrshireK]

Hi Katie, thanks for your reply. The lab values said 10 - 55 that were the normal range. Of course I decided to Google everything and I come across things that only tell me back things, which of course makes me worry more. I will be following up with the doctor when he comes back but I was just worried since they had raised over the last year and then within the space of a few weeks again. I also wasn't aware that something else can raise the ALT levels too. I should probably stop searching Google! Thanks again.

[AyrshireK in reply to Fliss2556]

Your ALT can fluctuate even during a day so as the results are all spot on within normal range there is nothing to worry about as regards your LFT's. Definately leave Dr Google alone as it'll convince you of worst case scenarios all the time and fuel anxiety big time.

[Fliss2556 in reply to AyrshireK]

I think I've spent the whole day trying to figure it out! Thanks so much for the reply and explaining it too. I had read that it can increase during the day but I suppose with the 3 different changes it made me curious and then anxious! I'll make sure to follow as well. Thanks again ☺

[kensimmons]

Alt can go up and down by as much as 45% from day to day. It is the one reason I have always questioned its utilization for things like liver transplants, fib-4 scores, etc. So if I get the score on a Monday a patient has a bad liver, but Tuesday it changes and now the doc says you have a good liver? I guess the answer is "get it taken for 14 days straight and look at the tendency" but I have never heard of that being done apart from a hospital setting. I mean, transplants can be granted or not granted due to this. Crazy.

AST also fluctuates but not as much (30%)

clinlabnavigator.com/alanin....

[Millytam in reply to kensimmons]

My ALT had been stable at bout 15 so started tapering down from 20mg, got to 5mg and started going up. Thought it might be an infection or due to 3rd primary dose, that was ruled out. Increased Tacrolimus and steriods to 10mg, currently ALT 679 😢 waiting for recent bloods results, consultant was meant to ring me on 6th but still waiting .

[MINTVCX in reply to kensimmons]

Fib-4 and other noninvasive tools say only about some probability of liver status. They have different sensivity, specificity, PPV, NPV etc. Each of them can be better for fatty liver other for AIH. Moreover you have to take into considaration the prevalence of each disease in population (that's why even very accurate test performs as screening test amongst healthly people show more false positive results).

I think never only ALT level is any indication for liver transplant. To be honest ALT is very often in normal when liver is at the very end stage.

[kensimmons in reply to MINTVCX]

Good points, no disagreement. Really was just pointing out its considered an indicator but it can vary greatly. Thanks.

[Fliss2556 in reply to kensimmons]

I had heard that it can fluctuate during the day but I just didn't think it would be that much going up to 41! Also when I read online then about anything over 25u/l for a women was bad and then the possibility of NAFLD that's when worry set it. Thanks for the reply too.