in the last year I have had my liver enzymes shoot up extremely high. The first time it happened my alt was over 1000 and my ast was over 800. It slowly normalized but took 3 months. A few months later it happened again. This time my ALT was over 800 and my AST was over 500, it always comes with extreme pain and extreme orange yellow urine and jaundice.. I do have auto immune (RA), and I was checked for auto immune hepatitis, which was negative. I don’t appear to have gall stones and all my bile ducts appear normal according to a recent mri. Nothing out of the ordinary with the exception of mild fatty liver and polyps in gall bladder. I had a fibroscan scan during that time when my liver enzymes were elevated and it said mild to moderate fibrosis, but the recent mri did not show that. Is it possible to have auto immune hepatitis that doesn’t show in a blood test? Is it possible to have it and not have it show up? All my test keep coming back normal so it’s very frustrating to not get answers.
Extreme liver enzyme elevation - Living with Fatty...
Extreme liver enzyme elevation
I am so sorry for what you're going through it is very strange. Do not give up hope and keep pushing for answers. You might need to get a biopsy. It is my opinion you probably do have auto immune. I'm thankful for the times when your levels go normal. Keep searching for those answers, And treat your liver as best as you can with a great diet. I myself have elevated liver enzymes and I am healing it with fasting and weight loss and only eating real whole food. Trying not lower salt and low sugar. I fast eighteen to twenty hours a day. And then eat only two meals. It aids in weight loss, But it also helps my elevated blood sugar and gives my liver a rest. Please let us know how your journey goes and i'm praying for you.
Hi Max
Autoimmune is hard to diagnose. There are some particular signs in a biopsy. The MRI can't really tell you much about fibrosis and was really looking for liver cancer probably. Blood values can vary quite a lot. It sounds like you have fibrosis but you might talk with your doc about possible viral infection. Fibrosis itself typically wouldn't come down like that so just a guess from the stadium but something else is hitting you from time to time. Could be a toxin of some kind also.
Is there a viral panel or a toxin panel in the lab to check for this or a certain type of liver Dr that specializes in these types of issues?
There are a variety of viruses to check for. If you can see a hepatologist they normally run a battery of tests for viruses. If one of those isn't available you might try to see a hematologist, a blood doctor, as there are other things that can cause trouble including some genetic things. Hard to diagnose without your full medical record and covid probably didn't help.
I too have elevated enzymes as high as 800-1,000. Mine fluctuate though & bounce all over. Seems every time I get them down I get covid & they skyrocket back up. I'm newer to this & don't understand what's happening to my own body, I just wanted to let you know you're not alone.
Something has to be causing our enzymes to do this, hopefully someone here will have some ideas that will help . Hang in there.
I was also sick with Covid when mine first began. I’ve often wondered if it’s related.
I discovered quite a few articles on covid & liver enzymes last year, you may find something that helps. Mine originally started b4 covid, but long haulers & more infections surely haven't helped. Please Let me know if you figure anything out.
No fibrosis 
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Covid and elevated AST / ALT
