Elevated ALT and scared

[scaredcanadian]

Hello, I’m 31 and had some bloodwork done last week and I had an ALT of 60, everything else was normal. My doctor didn’t seem very concerned. I am quite overweight and for the first time in my life, trying to lose weight. I’ve lost about 5 kilo in the last 2 months and have about 30 to go. My diet has been terrible through my life and I’ve cut out sugar on most days and being mindful of how much I eat. On the positive side I guess, I don’t drink at all.

My ALT has always been on the higher side of normal (this seems to run in the family, my dad’s has also always been high with no issues) and about 9 years ago while having an ultrasound for another reason it did show fatty liver. None of my doctors made a big deal of it so I didn’t do anything about it. Now I’m terrified that it’s too late and I have permanent damage. I also take the antidepressant Cymbalta which can cause liver issues, I’ve been on that since back then and I’m scared that’s damaged my liver. I am going to ask my doctor to take me off of it.

I guess I’m looking for some reassurance that I will be okay, I’m so scared reading these stories online of people who progressed to cirrhosis quickly. In any case this has been a wake up call to take better care of myself.

[AyrshireK]

Your ALT is barely elevated at all and it can be up and down throughout the day and even in relation to sudden dietary changes, fighting infection and even exercise. An isolated ALT rise in the absence of any change in other bloods isn't too scary - it's when there is an elevation 3 to 4 times upper limit of normal (or into the 100's and 1000's) that you need to worry or if there is a continued pattern of elevation or in conjunction with derangement of other bloods.

Having fatty liver needs attention so as you've made a start on your healthy living changes you need to continue with that. The BLT has an excellent downloadable leaflet on treating non alcohol related fatty liver disease with healthy diet and exercise which may give you some more good guidance. britishlivertrust.org.uk/do...

Katie

[scaredcanadian in reply to AyrshireK]

thank you. I have a cold right now so I’m wondering if I was infected already when I had blood drawn. Who knows.

Definitely working on improving my diet and exercising, I became quite sedentary over the pandemic (used to at least get my steps in commuting to work but now work at home permanently). I know most people are able to turn this around (and that most obese people have fatty liver and just don’t know) but the stories of those who can’t are really scary.

[Male47]

If everything else is OK alt of 60 should be able to be correct by healthy eating.I would just be sensible and try not to worry

[MINTVCX]

Fatty liver is something you should monitor. But usually is not a serious problem. Maybe ask your doctor for checking your FIB-4?

[scaredcanadian in reply to MINTVCX]

I checked my FIB-4 score with the online calculator and it was 0.4, so low risk (I have very good platelets which I guess is a good sign). Thanks for the tip.

[MINTVCX in reply to scaredcanadian]

That's good however I have checked your age - 31. So: "Use with caution in patients <35 or >65 years old, as the score has been shown to be less reliable in these patients."

[Readlots]

Don’t be scared be active. You’re doing all the right things to keep your liver healthy, not drinking, and losing weight. Lots of medication affects your liver, that’s why they monitor it and will take you off a medication if it is causing harm. But it’s a balancing act: if your medication helps your mental health, that might be the priority right now, if your mental health is OK, it might be worth coming off it. But do it gradually under supervision, not as a knee jerk reaction to one blood test result.

Although liver disease can seem scary, there are lots of us living with it and having near normal lives so don’t leap straight to worst case scenario and terrify yourself. I’d suggest not looking on here unless you’ve got a definite diagnosis of liver disease.