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Elevated AST and ALT
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Elevated AST and ALT

I am a 40 yr old female. My doctor requested a SMACK (sp?) blood test due to turning 40.  Everything was normal except the AST 42 (based on a normal range of 0-35); ALT 60 (based on a normal range of 7-56)and cholesterol was 210. Last year around the same time, I had an blood test for life ins. - cholesterol was 214; AST 16 (ins. normal range 0-33); ALT 9 (ins. normal range 0-45); everything else was normal. I do drink and had been drinking more frequently in the weeks prior to this last blood test. I am worried that the rise in the ast/alt is in indication of liver disease. Also, at the time of this last test, I was unaware that I had acute bronchitis and was diagnosed the next day. My doctor has requested a second blood test in about a month. 1)What can I do to help improve the ast/alt and choslesterol before the next test? 2)Could the bronchitis have played a part in the ast/alt results? 3)Could this level of ast/alt be in indication of fatty liver, fibrosis or cirrhosis?  4)Are there any other symptoms I should be aware of for either the elevated ast/alt or high cholesteral in connection to liver diease? 5)Could they go hand in hand with the drinking?  6)Are ast/alt levels usually higher than mine for fatty liver, fibrosis or cirrhosis? 7)Should I take any liver cleasnsing products?
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To answer your questions:
1) Abstaining from alcohol would be the best way to decrease the liver enzymes.  If they continue to be elevated, further testing - including viral hepatits studies and an ultrasound - can be considered.  Regarding the cholesterol, I would do further studies to check the LDL, HDL and TG level.  If the LDL and TG levels are elevated, then improved diet and increased exercise are the first steps to improved these levels.

2) It would be less likely that bronchitis would increase the levels.

3) It is possible that the elevated liver enzymes are due to fatty liver, fibrosis, or cirrhosis.

4) Advanced liver disease may result in abdominal pain, poor clotting, hemorrhoids, or fluid in the belly.  

5) Yes, alcohol can raise the liver enzymes.

6) The liver enzyme levels are variable for the diseases you mentioned.  A liver ultrasound would be the next step if these diseases are considered.

7) I would do further diagnostic tests before considering any treatment.  

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.
1 Comment
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I used to be a Marine fighter pilot and received routine physicals annually which never indicated a problem of any kind.  I was always in great shape and have been athletic most of my life.

Since I got out I have been in good health and other than the occasional injury, never went to see a doctor until recently when I turned 50 and decided it was time to get a complete physical.  I was told that my cholesterol and liver counts were both high.  HDL came in at 164 and Liver count at 72.  I am pretty sure I know what I need to do about the cholesterol, but the liver count worries me a bit.

I know alcohol consumption can increase the liver count.  Although I typically share a bottle of wine at dinnertime with my wife, or have beer in the summer with burgers and such, I never felt I had an alcohol problem.  However, prior to my blood test, I had not had any alcohol whatsoever for about 40 days because I had given it up for Lent.  And again, even when I am drinking, it is always in moderation and it's certainly not a daily event.

I have been exercising very regularly for about 3 months now and consider myself to be in very good physical shape again.  I started on a high-protein, low-carbohydrate diet in January but not in a crazy way.  I don't follow any of the in-vogue diets.  I still eat fruit and don't go wild on red meats and such, but since I had gained weight the past few years I decided it was time to get back into shape.  I have been very gradually losing weight - from an all-time high of 201 in January to 184 as of today with a target of getting to 170 by mid-summer.

My question is, what may be causing the elevated liver count and what can I do now to mitigate or eliminate the problem?
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My boyfriend has an ast  of 244.  I'm scared.  He does drink too much what can I do to help?
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