AST, ALT labs went from normal to slighty abnormal to increased in 6 months

I am a 52 yr. old white female, hashimotos hypothyroid, osteopenia, 5'6", 131 lbs
Labs went from normal to slighlty abnormal since 4/15/06
fingerstick , 23 guage needle 4/15/06, labs normal
10/03/06 Bun/Creatinine 25.7H,AST 36H, ALT 44H, HGB 15.8, MCH 33.1
10/24/06 Bun/creatinine went back to normal,AST 43 ALT 78 GFR >60, Hep PNL W/rrfx, acute HAV AB IGM, nonreactive, hep PNL W/RFX, acute HB S AG W/ Reflex conf HB S AG non reactive, HB core AB IGM, non reactive, Hep C AB, HCV ratio 0.06, HCV AB nonreactive
Question:1. MD said that I would have had serconversion by now since the fingerstick so it cannot be HEP C, thought the seroconversion can happen up to 10 years???yes or no,, Elevations ALT, AST sign of impending HCV diagnosis?
2. CAn gallbladder or osteopenia, blocked bile duct cause the change in labs?
3. Can this be a sign of another autoimmune disease or cancer of the liver?
4. Why do the doctors not consider a change in labs, no matter how small to be significant??? Why take labs if not to see the changes?
5. After much convincing on my part,  the MD ordered a liver scan? And they are looking for what?
6. meds I take: synthyroid,no alcohol, no smoking, exercise frequently, take multivitamins and relacore(diet supplement to block cortisol), drink lots of water
7. If not HCV, what other conditons can this change indicate?
8. CAn a change in diet high in nuts and seeds cause the change?
   I eat in extremes so I have been really eating nuts and seeds
   two the three times daily by the cupful?
9. Please do not spare me any grim details of what could be happening as I know something is going on, I have no physical symptoms yet.

[Kevin Pho, MD]

To answer your questions:
1) Hep C is unlikely given the negative antibodies several months after the fingerstick.  

2) It is possible for gallbladder causes to lead to the lab changes.  I am not aware of osteopenia leading to the findings.

3) Autoimmune hepatitis is possible.  An ANA level can be considered.

4) Repeating the labs serially can be considered to ensure the results aren't worsening.

5) An ultrasound or CT scan can be considered to look for liver or gallbladder disease.

6) No question here.

7) Hemochromatosis, gallbladder disease, fatty liver, or autoimmune hepatitis is all possible.  The ultrasound would help with the diagnosis.

8) I am not aware of seeds and nuts leading to these changes.

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.

Kevin, M.D.
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