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Gastroenterology  (Expert Forum)
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AST AND ALT LEVEL'S
Answered by
Kevin Pho, MD - Internal Medicine
Kevin, M.D. Boston - MA
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MedHelp Member's Question

AST AND ALT LEVEL'S

by mjwxzt, Aug 03, 2003 12:00AM
on 05/13/02 i had my blood taken for my life insurance policy my AST level was 18 and my ALT level was 28. On 07/29/03 I went to see the docter for frequent and loose bowl movements he proceeded with rectal exam,stool sample,urine test and blood test.AS for my blood test it came back with AST 24 and ALT 43.all other blood results came back normal. The ALT 43 has the word ABNORMAL next to it and he tells me in the letter i need to schedule an appointment.I am very worried about level's rising in a year's time.IS it something to be concern about?Knowing from the paper work it has something to do with my liver.I am 36 year's old,i was on ACIPHEX for 1 year but stopped taking it 1 month ago.I do not suffer from any pain and my appetite is very well, i  have problem's with irregular bowl movement.I am very worried  about this situation.

thank you
Doctor's Answer

by Kevin Pho, MD, Aug 09, 2003 12:00AM
I agree with Erin's assessment below - your liver function tests are very minimally elevated and I would just continue monitoring it as she has suggested in her answer.



If it continues to rise, I would consider tests for hepatitis and an ultrasound to evaluate for any liver masses or fatty liver which can cause an elevation of liver enzymes.  



Although Aciphex is a safe medication, in rare, rare circumstances, it can cause inflammation of the liver.  I doubt that this applies in your case - however if your ALT continues to rise, it is a consideration.  



Followup with your personal physician is essential.



This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.



Thanks,

Kevin, M.D.

Member Comments (9)

by GI.PA, Aug 03, 2003 12:00AM
You ALT is very minimally elevated and in some labs considered normal.  The flucuation from and ALT of 23 and and ALT of 43 is minimal and the change is no cause for alarm as these numbers tend to flucuate.



The liver tests should be followed by your family doctor to see if the trend is elevated.  They can also screen for viral hepatitis and may get an abdominal ultrasound to look at the structure of the liver.  If the trend is continued elevation over six months, then more extensive laboratory evaluation is indicated to rule out metabolic or congenital liver diseases.  



Erin

GI.PA

by kevinmd, Aug 05, 2003 12:00AM
Hello - I will be on vacation until August 9th. I look forward to answering your question when I return.



Thanks,

Kevin, M.D.

by mjz27, Aug 05, 2003 12:00AM
I too have slightly elevated ALT levels and was wondering if Im getting worried over possibly nothing.  ALT levels were 44(march 2003), 45(April 2003), 49(Aug 2003), all other liver levels were within normal ranges(last blood test in '98, ALT was 36).  My Dr. has scheduled and ultrasound and full Hepatitis workup.  I lead a clean lifestyle, but Im a little concerned over the rising trend in the ALT levels.  Is this something I should be concerned about?



Mike

by GI.PA, Aug 06, 2003 12:00AM
The elevations are very minimal and the work-up will most likey be unrevealing.  But since the elevations have persisted almost six months, your doctor is correct in looking at this further.



I would not worry, but I would follow your docs advise.



Erin

by djv, Aug 08, 2003 12:00AM
You're lucky in that your levels weren't elevated for the insurance test.  I had a yearly physical at the end of May and my AST was 25 and ALT was 27.  Everything else was normal.  Two weeks later I had my exam for life insurance and my levels were 81 and 54, respectively.  Everything else for my exam went very well.  I was hoping for the best class, but now I am only offered standard class.  Is this type of change normal?  I am a 32 year old male (6'-0", 180 lbs).  What can cause this change?  I do drink, but drank very little between the two exams.  I don't smoke.

by djv, Aug 08, 2003 12:00AM
Sorry, 2nd test was 6 weeks later, not 2 weeks.

by mugger, Aug 30, 2003 12:00AM
if you people are worried then find somethibg else to worry about. I caught hepatitis c when i was five from a blood transfusion (15 years ago). my alt count was taken last month and it was 487. however, i feel healthier than i ever have. obviously it gets me down but life goes on. to be honest if you worry about rises of 10 or 15 in your alt levels you really need to find something actually troubling to worry about.

by FrankAlfa, Aug 02, 2007 06:42PM
To: I have Type 2 Diabetes and I just got an ALT of 98
Dear Dr. Pho,

I have had Type 2 Diabetes for the past 5 years.  I am on Metformin (500 mg. > 2 tablets A.M. 2 tablets P.M.  & Glipizide ER 5 mg > 2 tablets A.M. & 2 P.M. I am also aking Diovan HCT 320 mg / 12.5 mg. > 1 tablet A.M. & Metoprolol SUCC ER 12.5 mg > 1 tablet A.M.   My recent Fasting Blood
Test showed glucose of 193 and my ALT 98.  My Trygliserides were 219.  My doctor is concerned with the ALT level of 98.  How bad is this?  What can be done to correct the condition?  I am going for an Ultrasound of my Liver next week.  I am 5'-10" 225 lbs.  My doctor wants me to lose 20 pounds in one month.  I am very concerned about my liver.  

by jeannemc, Aug 05, 2007 02:58AM
My son is scheduled for an mrcp next week.  He has been in and out of the hospital often, with urgent episodes of dehydration and depleted electolytes.  His blood