Sudden Drastic Change in AST and ALT

[GhostHunter]

As of the beginning of 2018 I had the ALP, AST and ALT somewhat stabilized and under control with Urso. The ALP (normal 33-130) was running in the 300’s, but that was a far cry from the 750 it started out at when diagnosed 2 yrs ago. The AST (normal 10-35) has been within “Normal” range, but was in the 80’s 2 yrs ago, and the ALT (normal 6-29) has been within “Normal” range, but was in the 130’s 2 yrs ago.

All of a sudden I became deathly sick so I had my labs redone and the numbers came back:

ALP 315 which is where it has been running, however, the AST 828 and ALT 822. What makes the AST and ALT skyrocket like that? The Primary Care said I was in Acute Liver Failure and sent me to the ER, however the ER doctor said I really need to consult with my Transplant Hepatologist. I have not had that app’t yet, but what can throw you into acute liver failure that quickly? I do not drink alcohol, soda, smoke, I try to avoid all chemicals and preservatives and I have become Vegan for the most part, so I try to avoid anything which will cause additional stress on my liver. I am at a loss... not to mention sick and worried 😞

[4pjx__]

Dang! Sounds like in spite of your healthy lifestyle your liver still wants to complain. I hope you can get to the hepatolagist soon. Are you already on the transplant list? I'll send my best prayers out for you.

Pam

[GhostHunter in reply to 4pjx__]

Thank you for the prayers! I had a liver biopsy done in Jan 2018 which said I was starting into Stage III, so I am not at the stage yet to be on the Transplant list. However in light of these recent events, I am really getting worried. I also lost my medical insurance as of Jan 1st because Blue Cross Blue Shield claims my insurance renewal application mysteriously disappeared from their computer system and as open enrollment had already closed when they gave me this news... they said it was too late and they would not insure me! They found a way to drop me if you can believe that... even though it is illegal! So the bottom line is I do not even have insurance at this point in time!

[4pjx__ in reply to GhostHunter]

Oh man, when it rains , it pours! I think you should still be able to get health insurance. It could cost a bundle but somebody has to insure you. Maybe some kind of plan with a high deductible?

I was diagnosed a year ago with stage 3, severe fibrosis. So your story kind of freaks me out.

[Yankeerose3 in reply to 4pjx__]

Same here... I just received news that I'm stage 3 fibrosis but blood work is all normal which I don't understand how that is but I'll take it.

[Gjt777]

I am so sorry to hear you are dealing with this. That sounds very scary. I wonder if you could have caught some virus or even autoimmune overlap? I wish I could be more helpful. Please keep us updated when you can. My thoughts and prayers are with you. XX

[GhostHunter in reply to Gjt777]

I thought about that too... the auto-immune overlap. I was originally tested for that which was negative, however, things are obviously changing now.

[Melwoods]

My alp had been as high as 1200 and sits around the 700 mark

It’s just the way it goes sometimes

I’ve been told I will need a transplant within 3-5 years

Numbers don’t always go hand in hand with stages and symptoms etc

I hope you have a good hep consultant

Hugs x

[butterflyEi]

Hi GhostHunter

It is so difficult to know why these things happen especially when our lifestyle is designed to help the liver. I think the advice of an expert is needed to steer you in the right direction. It would seem you need a full blood panel and some other investigations to get a better idea of what is going on. I hope you do not have to wait long for an appointment.

keep us posted

best wishes

[Ballymahon2]

I dont know anything about ast but your alt is very high i think that indicates problem with the liver think normal is 35 what is your bilirubin like

[GhostHunter in reply to Ballymahon2]

My total Biliruben is over 7 and the Normal is 0.5 - 1.2 mg/dL. Monocytes and Immature Granulocytes are High, Glucose and RDW is High, and Urobilinogen is high in my urine which is biliruben leaking from the liver. I definitely have Jaundice.

[Liverette]

It could be you developed Auto Immune Hepatitis and that could be treated with high doses of Prednisone initially, along with Imuran. My mom has AIH and when she was first diagnosed, she was in an acute liver failure with ALT and AST in 4000s... and after being hospitalized for a month preparing her for transplant, her numbers slowly went down with high doses of Prednisone and she is doing relatively well now with the medication Imuran and not needing a transplant. Please see a hepatologist at a Transplant Hospital, since they are specialized to deal with different cases. And please don’t despair. We have great medical doctors here and you’ll be in good hands.

BTW, we’re in Los Angeles.

All the best to you!

[GhostHunter in reply to Liverette]

When I was originally diagnosed 2 years ago with PBC, I tested Negative for the AIH overlap. However, I also thought that maybe I have developed the AIH overlap after all. My mother also has PBC and now my daughter is in the process of being diagnosed with it. I have had signs of PBC and liver disease for the past 25 years, however, the GI’s who previously treated me neglected to catch it. It sounds like a lot of people have PBC run in their family.

PS... I was accepted into the Tampa General Transplant Program in Tampa Florida.

[kauthement in reply to GhostHunter]

Dx'd with PBC 2 years ago, just recently went into acute hepatitis with jaundice, bilirubin over 12, high everything all of a sudden. After biopsy and 6 day stay in hospital dx'd with AIH/PBC overlap. It only affects like less than 10% of PBCer's, so really rare I guess. I'm now on Prednisone, Ursodiol and Azathioprine. And my numbers are coming down, however the side effects of the Pred are awful. I now have high glucose at 259, kidney tests are all in the red. I only started this regimen a lil over a month ago. Staged at 2 with a moderate activity level of 3 out of 4 from biopsy. My understanding is that, your numbers might look better but he inflammation still goes on in the liver for 3-6 mths after starting meds.

[Ballymahon2]

Good advice liverette

[My-life]

So sorry to hear. I have been told my numbers are up. I would get in at least so they could have a donor ready. Be praying.

[Sachin1234]

Diet has nothing to do this disease but healthy diet is always good good health !

For your unexpected abnormal result retest all the labs and check your kidney and all digestive system and. May be overlapping with aih now🤗

Good luck

[LorraineLouise]

I too am finding out that the labs don’t always correspond to what’s going on with our livers. Also a healthy lifestyle is always good but does not keep our disease from progressing. Also it does run in families. My mother passed away from liver Fido when I was 17. They didn’t have a name for it back then. My sister also has PBC. I wish you well and hope that this is just a temporary set back for you and you come back strong.