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Elevated SGPT and Exercise Program
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Elevated SGPT and Exercise Program

I am a 30yo white male, 6'1 200 lbs.  From a sample taken on 24 Jan, my SGPT came up high at 58, with SGOT 30, alk phos 73 and total bilirubin .8 (all other blood work normal)

i had been drinking far more regularly than usual since mid-December, with a lot of drinking (for me) during the holidays through January/Feb.

On Feb 10 the doctor showed me the elevated SGPT and suggested it may be alcohol related, so i kind of cut back on the drinking but still drank alot over the weekend of feb 14 to feb 17.  i didn't drink at all from feb 17 to feb 24.

my doctor repeated the SGPT test on Feb 24, and it came back 107! (he didn't run the other liver functions)

we are doing a sonogram of my abdomen to check around (fortunately i have good insurance) and will repeat the liver function tests in 6 weeks and i am TOTALLY abstaining from alcohol during that time.

My question is from the following:  in January I started lifting weights much more regularly (since I gained about 10-15 pounds over the holidays!!!) and I started to cut back my caloric intake.  After initially breaking in my muscles to lifting weights more regularly again, I took things up into much higher intensity, cut back my calories a lot more and did more regular cardio (swimming for 20 minutes nonstop freestyle (crawl) as well as 10-15 minute of cardio machine before every workout).  I just started to slim down and took my cardio up even more to where i do 30 minutes of cardio BEFORE doing a weightlifting workout (either back/bicepts, chest/triceps, legs(squats), shoulders) day in succession, sometimes with a day or two off inbetween.  It looks like i'm burning the fat off, while my pectoral, back and leg muscles are visibly growing from the weight lifting...in short, the exercise program seems to be working.

I have seen some stray reports of burning fat through exercise as possibly a cause of elevated liver enzymes.  Could this also be the case here?  (and it could explain the jump in SGPT but i was still drinking in between tests)  Thanks.
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Hello - thanks for asking your question.

There are many causes of elevated liver enzymes.  You have 2 risk factors that may cause them - heavy exercise and alcohol intake.  Of course, there are many, many causes of elevated liver enzymes including medications, hepatitis, hemochromatosis, alcohol, autoimmune disorders to name a few.  

I will briefly discuss the effects alcohol and exercise on liver enzymes.  

The diagnosis of alcohol abuse is supported by an AST (SGOT) to ALT (SGPT) ratio of 2:1 or greater. In a study of hundreds of patients who had liver biopsy confirmed liver disorders, more than 90 percent of the patients whose AST to ALT ratio was two or greater had alcoholic liver disease. A twofold elevation of the gamma glutamyltransferase (GGT) in patients whose AST to ALT ratio is greater than 2:1 strongly suggests alcohol abuse. However, an elevated GGT by itself is insufficiently specific to establish the diagnosis.

Elevated serum aminotransferases, especially AST, may be caused by disorders that affect organs other than the liver, most commonly striated muscle. Conditions that can cause this include heavy exercise. If striated muscle is the source of increased aminotransferases, serum levels of creatine kinase and aldolase will be elevated at least to the same degree. The creatine kinase or aldolase levels should be determined if other more common hepatic conditions have been ruled out.

I strongly suggest continued followup with your personal physician.

I stress that this answer is not intended as and does not substitute for medical advice - please see your personal physician for further evaluation of your individual case.

Thanks,
Kevin, M.D.
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