Digestive Disorders / Gastroenterology Expert Forum
Liver Enzymes
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Liver Enzymes

I've been a cyclist for 13 years, training 6 days a week. I recently had a blood test that showed my liver enzymes AST at 178 and ALT at 153, GGT was normal, CPK at 1338, LDH at 1727 . Tests for all types of hepatitis were negative. I had a liver biopsy 9 years ago that was also negative. My enzymes have been at this elevated level since they were first tested about 10 years ago. I've read a few journals/articles on the Web (including the MDA site) that say muscle break down releases these enzymes (ALT & AST) into the blood stream making it look like there's something wrong with the liver when there really isn't. Has anyone else ever experienced this reaction (ie - muscle break down causing elevated liver enzymes) ?
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You have had elevated liver enzymes for at least 10 years. All blood tests and Liver biopsy were negative. You should consider another liver biopsy. It is true that muscle tearing and damage can cause an increase in the AST, however, not the ALT. It is possible that these elevations could be a normal variance. This might be normal for you.
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Thank you for your responce Dr. Erik.

Up until recently my diet has been very low in fat (probably about 5% of calories). Could that be causing the enzyme elevation? If not, what else could possibly be causing it? I do not smoke, drink or take an medications.
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Your low fat diet is not causing the elevated liver enzyme levels. Maybe a repeat blood analysis and liver biopsy will show something 9 years later. Consult with a Gastroenterologist.
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I CAN RELATE TO THIS PATIENT WHO HAS HAD LIVER ENZYMES ELEVATED FOR 10 YRS. I TOO HAVE THIS SAME DILEMMA....REPEATED BLOOD WORK SHOWING ELEVATED ALK. PHOSPHATASE, AST, ALT AND IGA FOR OVER 10 YRS.  I HAVE HAD NUMEROUS TESTS....UPPER ENDOSCOPY, COLONOSCOPY,
ABDOMINAL ULTRASOUND AND CAT SCANS, MRI, MRCP, GASTRIC EMPTYING TESTS, SMALL BOWEL SERIES...ALL REVEALING NOTHING ABNORMAL EXCEPT THE ELEVATED LIVER ENZYMES. I HAVE NOT HAD A LIVER BIOPSY YET...IT HAS BEEN RECOMMENDED BY A HEPATOLOGIST BUT NOT BY MY PRIMARY DR. THE SUSPICION IS A POSSIBLE AUTOIMMUNE DISORDER AFFECTING THE LIVER OR AUTOIMMUNE HEPATITIS, ALTHO THE TESTS FOR HEPATITIS A, B & C HAVE BEEN ALL NEGATIVE ALONG WITH A FEW AUTOIMMUNE DISORDER TESTS.  I AM AT A LOSS AT TO WHAT TO DO NEXT, SINCE I HAVE SEVERE UPPER ABDOMINAL DISCOMFORT/SPASMS FOR ALMOST 1 1/2 YRS. AND NO ONE SEEMS TO KNOW THE CAUSE. I AM NOT OVERWEIGHT(THIN FRAME), DONT SMOKE OR DRINK, EAT HEALTHY LOW FAT MEALS. ANY SUGGESTIONS OR INPUT WILL BE APPRECIATED.
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My son is 6 months old and his AST is 138 and ALT 220. All hepatitis markers are negative (HBsAg,HAV IgM&g, HCV, EBV,CMV). Alfa1-antitripsin level is normal. CBC is normal. Sedim, acute phase reactants' level are also normal. There isn't any syptom (symptom).He was born 6 weeks before the expecting birth date but everythings were all right. He used amoksisiline as a prophylactic antibiotic because of an urinary enfection. His urine culture is sterile since 4 months and he finished taking antibiotic since one months.There is nothing to explain this high levels of hepatic enzymes. Pleas help us! Thank you!!!
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Laboratory values may be different for children than with adults. Talk to your pediatrician.
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dear dr.erik...
thank you for your answer...but we'd already talked our pediatrician but they couldn't explain these high levels. They decided to wait and watch the levels of enzymes...we want to know that, is it possible for these levels to be a normal variant? thank you for your kind atttention...bye.
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It is possible for these elevations to be a normal variant.
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WOW!!! I finally found other people with my problem...
Elevated enzyme levels, 352 cholesterol, normal BP and not extremely overweight.  Every test known to man has been done.
My Doctor determined that I have something known as NASH stands for Non Alcoholic Steato Hepatitis (hope spelling is correct). Supposed to be the same liver disease that Alcoholics get only I dont drink, Symptoms are extreme tight swelling in upper abdominal area, especially after eating and constant pain and sometimes a burning censation in the upper right (liver) area it even hurts to bend to the right sometimes, due to swollen or enlarged liver.  They said that my galbladder was ok which I myself am not so sure of, I believe that it is all conected somehow.  If I could get rid of the bloating and upper rt. pain I would be one happy camper. Any one else ever heard of NASH? pleas respond. THank you
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