AST and ALT enzyme fluxuation

[jax1984]

Can someone please comment on whether AST and ALT levels fluxuate with cirrhosis? When first diagnosed AST was 63 and ALT was 57. Next set of labs the numbers went down a few points, then most recent lab my numbers increased to AST 69 and ALT 73. My ALT jumped 20 points from previous labs 6 months prior! Nothing has changed with my cirrhosis diet,my exercise program etc. And I am very strict with that. The only change is my thyroid levels are off and we are working on the correct dose of Synthroid for that. How concerned should I be with levels rising because I assume that means my liver inflammation is increasing, doesn't it? Any thoughts/comments would be appreciated. Thanks.

[Shelterdog]

I asked that same question once and was told that those are like a measurement in time, much like a blood pressure measurement and can fluctuate.

[jax1984 in reply to Shelterdog]

Thank you for the response. Hopefully they will fluctuate back down again.

[ThyroidDeb]

I just recently asked my hepotoligist about the vegetable/fruit vitamins they advertise. I am more of a fruit than vegetable person, thought these for vegies might be good. Was told there's nothing shown in the ingredients suggesting it might harm the liver. However, I was told that after taking it for several weeks they would want to check the liver numbers. If they go up then I shouldn't take them. I suspect until your thyroid is regulated and your dosage is correct, these numbers might move around some. What has your doctor said?

[jax1984 in reply to ThyroidDeb]

I see hepatologist next week but still wanted other's input. I was wondering about those fruit/veggie supplements too thinking they might help with more energy from fatigue. I'll be asking Dr. about that also. But what your Dr. said makes sense. Thank you for replying.

[nash2 Partner]

Hi Jax

Those values can fluctuate quite a bit day to day so it takes more tests to really know if that is a trend, but it is a red flag to pay attention to. Many things like minor viral infections can cause short term changes. It may also mean, as you say that your liver is more inflamed so you will want to get more information if you can but by itself doesn't prove anything. with one higher test.

[jax1984 in reply to nash2]

Thank you for the reply. Am seeing hepatologist next week for 6 month follow up but still wanted input from other's experiences.

[Justice1872 in reply to nash2]

nash2. In liver literature, I read that medical professionals are only heightened concerned when these numbers are at least 3x normals. Can you comment or share any information about the correlation, please. Thank you.

[nash2 Partner in reply to Justice1872]

You have to remember that for a long time medicine has only been interested when problems became clinical. By the time blood gets that far out of normal it is likely that you have a serious problem so a lot of literature reflects that attitude and it is why so many of us first learn of the problem with a cirrhosis diagnosis. It is true that blood varies a lot so you don't want to get stampeded by a short term thing but if there is a trend over time leading to bad indications we say it is smart to start looking earlier.