Abnormal Liver Function (Elevated ALT/AST)

Hi I'm a 29 year old caucasion male. I'm 6'0 and 207 lbs.

I had bloodwork for an Arthritis Screening October 29th due to some pain and family history. The results came back normal but my liver function is abnormal.

AST = 92 (normal < 40)
ALT = 199 (normal < 40)

I am scheduled to have an ultra sound and a nonfasting blood check (for Hepatitis) on Veteran's Day.


Remarks that may or may not be related:
* MAIN- I have been a moderate drinker for years, but the nurses and the internet tell me that this points away from alcohol. I average probably 5-6 ounces of liquor a night. Of course I will never drink again after this. Also I would take 1 "Two Way" (ephedrine 20mg I think) a day from the time I was 18 until early this year to stay awake at school or because I couldn't breath well. I have been a smoker since age 17. For the past 3 years I've been down to half a pack or less per day. I use patches in the morning.

* I have terrible eating habits. I never eat green leafy vegetables and I usually eat fast food at least once a day. The fast food habit has been on and off my entire life. I am a "meat and potatoes" person I guess.

* At 14 I was prescribed Accutane

* I was jaundiced for a few months at age 17. I had dropped a lot of weight though and never went to the doctor.

* When I was 19 I was tested for Mononucleosis, Leukemia and Strep. All tests came back negative. The doctor gave me prednizone and I was better in 2 weeks. He said that it was likely mono because the test was not accurate in 10% of people.

I have a 13 month old son and a wonderful wife. I've been with her going on 11 years. I want to cut the bad habits and begin living.

Is this something potentially fatal or is this likely fatty liver brought on by my eating habits? What tests do I need?

Thanks,
Jon

[Kevin Pho, MD]

I agree with the ultrasound as the next step.  It will determine if there are any anatomical causes for the elevated liver enzymes, as well as exclude fatty liver.

Serial measurements of the enzymes can be considered to ensure they don't continue to rise.  A liver biopsy would be the definitive test, and can be considered if the diagnosis remains elusive.

I also agree with the blood tests to evaluate for viral hepatitis.

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 Pho, M.D.
www.kevinmd.com
www.twitter.com/kevinmd

[Strype]

Sorry one more thing, I have been diagnosed with ADHD. I started Focaline in June. I am taking 20mg right now. I never drink until a few hours after it's worn off. My doctor says the ADHD would explain the cigarette addiction (and I'm sure the others)

[Strype]

Hepatitis negative

My doctor suspects Hemochromatosis. I suspect Focaline XR.

[patsy56er]

An Ultrasound definitely.  There are several conditions that would cause your liver enzymes to rise.  You could have developed fatty liver, for one.  You might have developed an auto-immune disease that could be an issue.  Before you consent to a liver biopsy, ask the doctor to test your AMA to rule out Primary Billiary Cirhosis.  Ask him for a short term run on Prednisone to see if that brings the enzimes down, he might consider Auto-immune Hepatitis, which is non- viral and not contagious.  

Patsy

[Strype]

Thanks for the help ladies and gentlemen.


My doctor and my specialist both agree that it looks like Hemochromatosis. I am scheduled for a liver biopsy monday, Dec 1. I will begin phlebotomies the following friday.

I'm awaiting genetic testing results.

[Banned1]

Good luck and Godspeed with your liver biopsy today, Strype!  Let everyone know what your diagnosis is if you get one?
Take care of yourselves and each other!

[kroaprea]

Hey Strype.
Good luck on your exam dude.  Hope you hear good news.
My results were very similar to yours (AST=118, ALT =175).  In this range, it's so difficult to diagnose the causes, without ultra-sound or biopsy.