Elevated ALT

[Arctic2024]

Hello there,

I'm a 42-year-old man. I've been experiencing significant anxiety over the past weeks as I'm preparing for a medical check required for a residency visa in a foreign country after about 3 weeks week. I've been feeling fatigued and very tired, so I decided to have a general blood test before the upcoming health check abroad. Below are the results:

ALT 53 u/L (elevated), AST: 26 U/l, GGT: 32.5 u/L, ALP: 34 u/L, LDH: 128 u/L, Albumin: 46 g/L, Bilurubin: 10.5 µmol/L, WBC 6.54, RBC 5.27, HGB 15.3 g/dL, HCT 44.5%, MCB: 84.4 fL, MCH: 29 pg, MCHC: 34.4 g/dL, Ferritin 379.1 µg/L, Iron: 17.3

As you can see, most of the results are within the normal range. Still, I'm very worried about the elevated ALT and I've been having some terrible thoughts that it could be hepatitis, especially since I had 3 protected insertive vaginal intercourse with a female about 45 days ago. Note that I took one tablet of panadol (paracetamol the night before the test) and I had one shot of vodka about 36 hours before the test, I also had very spicy Thai food one day before the test and I had stomach problems in the washroom in the morning I had the test. My stool colour isn't dark brown. In fact, it leans more towards light brown but it's not yellowish. I didn't notice any yellow skin or eyes. Note that my Ferritin is also on the higher side but my Ferritin has always been on the higher side but it's the first time ever I experience an elevated ALT and it's accompanied by fatigue and bad mood.

Should I worry about my elevated ALT levels? What could it be? I'm worried that it could be something such as hepatitis. Please advise.

[AyrshireK]

That elevation of ALT is next to nothing - barely above upper limit of normal (certainly not into Hepatitis ranges where you would see elevations 3 to 4 times upper limit of normal right up into the many hundreds or thousands). Your ALT can bounce about and be recorded differently even within the same day and it is barely elevated at 53.

Each labs seems to use it's own guidance range - for some labs 53 would be within range.

ALT can rise with exercise, when your body is fighting minor bugs and a whole lot more. You wouldn't automatically jump to any sort of liver disease diagnosis based on a single set of blood tests. It's only if there is a pattern of elevation that doctors would be concerned.

You might want to be careful with your behaviours in future - certainly unprotected sex with a non-regular partner is potentially risky. What is your alcohol usage like? Is that contributing to anxiety levels?

Katie

[Arctic2024 in reply to AyrshireK]

Hello Katie. Thank you for reassuring me that I shouldn't worry too much about my slightly elevated ALT. I truly appreciate it. About the sexual intercourse, it was a protected intercourse with someone so condom was used and didn't break. I rarely drink alcohol, only when I travel or in special occasion. The shot of vodka I drank 36 hours before the test was my first in a month. I'm not sure what exactly contributes to my anxiety. I guess I overthink too much about health issues especially that I'm relocating to a new country for a great job contract but if I fail the medical test for whatever reason (such as carrying hepatitis, HIV, or TB) then I will not be able to get my residency permit there and I will lose this amazing opportunity. I hope that my problem is only mental. Thanks once again, I appreciate it!

[Smegmer]

You won't have yellow eyes or skin since your Billirubin is normal. Some labs have ALT top range as 56U/L too. Worst case a slightly elevated ALT. Hepatitis can chip away slowly under the radar, but 45days wouldn't be enough to cause serious damage; by all means, get a test, though, to be sure.

An infection or even going to the gym the day before your blood test can cause a bump in ALT.

Google will scare the crap out of you.

[Arctic2024 in reply to Smegmer]

I will repeat the liver functions test on Saturday and see how the results are. I don't have the courage to do hepatitis test now. I hope the ALT level will go back to normal. The night before the test I took a tablet of paracetamol and I had digestive problems because of extremely spicy food I had the day before the test so maybe that put some stress on the liver. I really hope that these factors contributed to the slightly elevated ALT, not any viral infection.

[Smegmer in reply to Arctic2024]

It shouldn't be the paracetamol.

[Arctic2024 in reply to Smegmer]

Would it be the stomach upsets I had the morning of the test? Or maybe the shot of vodka I had 36 hours before the test?

[Smegmer in reply to Arctic2024]

Doubtful on the Vodka. Stomach upset could be an infection and that could do it.

[Arctic2024 in reply to Smegmer]

I hope it's the case.

[Smegmer in reply to Arctic2024]

Dont Google for now, I went there some years back and nearly ended up mental, anxiety through the roof.

[Arctic2024 in reply to Smegmer]

Same here my friend, same here! I was so anxious this morning but felt much better after I have received a response from Katie above. I am so grateful.

[Smegmer in reply to Arctic2024]

I learned a fair bit about the Liver, though, when I was reading everything I could find on the tests and scans etc. It's a tough organ. I just listened to a guy Manny Vitale, who drank 1 litre of Whiskey a day for decades and ended up with Liver, Kidney, Pancreas failure and had 48 hours to live in 2020. He is still here in 2024. His numbers were crazy, as you can imagine. They would have been crazy many many years before though.

I have seen 1000s of bloods by now, ive seen ALT, AST, GGT at ~3000 and more.

[Grassroots112]

My GTT was over 1,800 I believe at one time, now it’s back to what I’m told is not just normal, but the best side of normal. I agree on the Internet, it’s a scary place for trying to figure out symptoms and can end up like a game of whack a mole trying to figure out what this or that could mean so try and refrain from that.

Its a great learning resource, however, when researching something like the liver for example. I honestly feel I now know more about the liver than my own GP who I’ve since learned like many are textbook GPs in that their knowledge and understanding is learned from textbooks mostly, not actual physical or real world real life experience of treating people with actual liver disease, much less understanding what people with liver disease experience and therefore require.

And that’s not me having a go at my GP, he’s not a liver expert that much is certain and while I’m no GP, thanks to my own textbook like research and actual self experience I now have a pretty good understanding of liver disease and a level of knowledge about it all which helps me massively in dealing, managing and self treating my own.

It’s more preferable to my GP’s ‘let’s try (insert medication name here) and see if that helps’ or scanning a bunch of previous bloods and LFTs from my medical records to form some kind of conclusion about my liver disease. To this day my GP is the only person who has said I have cirrhosis, and that’s because he read my history file when at one point it indicated I did.

It’s frustrating because if I didn’t know what I now do, I’d be none the wiser, just like my GP and that’s kind of scary. In short don’t read the Internet for self diagnosis, but do learn as much as you can about your own heath wherever possible, it may keep you away from your own GP’s overcrowded waiting room…

[cmj33g]

l am not medical and l can only talk from my experience. I do remember my doctor saying as ALT values can go up or down over the day, anything upto 53 is ok. Different labs have different normal ranges.

l think you can find more info on reputable sites on the internet. Again don’t frighten yourself.

[Arctic2024 in reply to cmj33g]

Thanks for the advise. I appreciate it!

[Readlots]

A liver specialist told my Mum that the worst thing for your liver is stress, so personally I’d forget about the blood test and look forward to your new life abroad. Good luck with the medical

[Arctic2024 in reply to Readlots]

I think he's absolutely right! Stress can cause terrible things. I will try to relax and re-test on Saturday. I hope the ALT will go back to the normal range. Thanks for the support.

[Arctic2024]

Good news. I retested today and luckily, ALT fell from 53 to 34!

The new results are: ALT 34, AST 18, GGT 33.5, ALP 35, Albumin 46.5, Bilirubin Total 16.8

Thank you all for the support