Elevated AST and ALT -- frightened

Hello,

I am a 23 year-old male.  A couple of months ago, I had a routine metabolic panel done.  My physician told me everything looked fine, except for a very low cholesterol level (which he said was a good thing), and my AST and ALT levels, which he said were both "slightly elevated" (2 or 3 points above the upper limit of the normal range).  He assured me that he ran into this sort of thing all the time, and told me to wait a month and be screened for Hepatitis B and C, "just to be on the safe side".

The problem is that I am a hypochondriac, and all it takes is the slightest suggestion of there being something abnormal with my health to send me up the wall.  The day before I had my panel done, I did a heavy amount of drinking (2 mixed drinks, a beer, a glass of wine, and 3 or 4 glasses of wine upon returning home for bed, before which I took a 3 mg pill of melatonin).  I do not normally drink this muc; I usually only have 2 glasses of wine a day.  I also lifted weights the day before the test.

I am scared to death to go back for my follow-up blood draw, because I am afraid of what the results might be.  I have been vaccinated against Hep A and B, and have never had a blood transfusion, shot up drugs, or practiced unsafe sex.  I would like to know if anything I did the day before the test could have influenced the results of the first test.

Thank your for your help.

[Kevin Pho, MD]

First, there are many benign causes of mild elevation in liver enzymes.  Indeed, alcohol and a variety of medications would transiently raise the liver enzymes.

If they continue to be persistantly elevated - despite abstaining from alcohol - you may want to consider testing for hepatitis (A, B and C) as your physician suggested.  Another test to consider would be an ultrasound of the liver to look for fatty liver or an anatomical abnormality of the liver or gall bladder that can raise the enzymes.  

I would repeat the liver enzyme test off alcohol and if it normalizes, then continue to watch it.  If it continues to be elevated, then you may want to consider the aforementioned tests.

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.

[janscar]

The doc will tell you to relax on the drinking, if not stop it altogether.  I had levels higher than what you speak of, and I am slowly working them down as I try and cut down on the drinking.  I would not worry about it too much.  Like you, I had a panic attack and thought the worse...tell your doc you are worried and s/he should calm your fears.

[Caroline5]

Drinking that much can certainly cause the results you experienced. Don't be afraid. Stop all that drinking and re-test.

[nurse12hr]

You need to not drink for AT LEAST 2 weeks before retesting to get any kind of accurate answer as to the enzymes.  The test for hepatitis will be accurate regardless.

[red 25]

2 weeks ago i had taken 16 depression because i have problems
sleeping do to my mother death 3 years ago and so i ended up the
emergency room for a overdose. now my s.g.p.t are very high 447
and my s.g.o.t. are 112 yet when i was in the hospital they went
high but went back down so they gave me sayriqul 100mg but now they
went to 447 im not feeling any pain or anything abnormal. in the hospital my sgpt wher about 116 or so now they are so ski high
that its causing fear in my life i went to the doctors on 2 13 04
so my results was in the same day they told me i need to go back
on 2 19 04 because
my sgpt are high and my sgot also.
my results are calcium 10.1   total protein 7.1  albumin 4.5
bilirubin total.8  alk phos50.  sgpt 447 sgot 112
could anybody please help out here to understand my results?
              thank you!!!

[kurtz]

I take two regular strength vicodin a day for the last year and
   a half.about a year ago I had elevated alt level about 37
I stopped taking any tylenol for about a week. I tested again
It was normal. A month ago I took blood test It was alt 43.
I went for ultrasound have not went to my doc yet for results,
I feel fine.
                 kurtz