Elevated ALT Level and Alcohol

Recent routine blood test revealed elevations not encountered before.  Specifically, an ALT level of 69 (normal range AST) and elevated cholesterol markers.  There were no other levels outside the normal range.  The blood was drawn about a week after a vacation when I drank alcohol daily and with amounts exceeding my normal usage (which has been usually confined to weekends, 2 to 3 drinks).  I am 50 and 6'6" with a 239# weight which is up 15 pounds from a year ago.

My questions are:
1.  Could the increased short-term drinking result in the ALT elevation?  If so, how much alcohol is typically needed over what span of time to elevate these enzymes and endanger the liver?
2.  Could the weight gain with perhaps increase of fat in the diet also contribute?  There is no heart disease in the family.
3.  Is there a relationship between the elevation of the ALT and the cholesterol markers and, if so, what might it be?

Thank you very much.

[Kevin Pho, MD]

To answer your questions:
1) Alcohol can result in an elevation in ALT.  However, the AST is typically elevated more often.  As to the amount, that would vary from patient to patient.

2) Obesity and weight gain is associated with NASH (non-alcoholic steatohepatitis) which can then lead to an elevation of the enzymes.  A liver ultrasound is advised for further evaluation.

3) Although possible, I am not aware of a direct connection between elevated liver enzymes and cholesterol.  It is well-known that many of the cholesterol-lowering medications can elevate the liver enzymes.  

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.