SLIGHTLY ELEVATED AST/ALT

I AM A 29 YR OLD MALE, 6'3" 200 LBS, W/ ELEVATED ALT/AST. MY BROTHER HAS CRYPT LIVER DISEASE THAT WAS FOUND IN FEB 2000. SINCE THEN I HAVE HAD A LIVER PANEL DONE AT MY YEARLY PHYSICAL. THE LAST NUMBERS ON 10/23/03 WERE SLIGHTLY ELEVATED AST=47 ALT=99. MY MAIN CONCERN IS THAT THEY HAVE STEADILY GONE UP SINCE I HAVE STARTED TO WATCH THEM. 4/00 AST=23 ALT=30
6/01 AST=36  ALT= 64     10/02 AST=43   ALT= 63
10/03 AST=47   ALT=99
I DO NOT DRINK NOR DO I TAKE ANY OTHER MEDICATION THAT WOULD AFFECT THE LIVER. WHAT DO YOU THINK? IS THERE A TREND DEVELOPING THAT I SHOULD TAKE A CLOSER LOOK AT? OR ARE THESE NORMAL READINGS FOR A 29 YR OLD IN OTHERWISE GOOD HEALTH.
I STARTED THE ATKINS DIET SEPT 1, 2003 BUT HAVE BEEN UP TO ABOUT 80-100 CARBS A DAY SINCE EARLY OCTOBER. I LOST 20 LBS.
COULD THAT BE THE CAUSE OF THE LATEST SPIKE?
THANKS

[Kevin Pho, MD]

Your liver tests are mildly elevated.  There are many causes why this can happen.  The most common would be medications and alcohol - but you state that you don't drink or take any hepato-toxic medications.  

The next step would be a hepatitis A, B, and C screen as well as an ultrasound.  An ultrasound can evaluate for any masses or fatty liver that can raise the liver function.

If those tests are negative, you can continue to observe the liver function to ensure they do not continue to elevate.  If it does, you can consider more specialized testing including a biopsy, or tests for Wilson's disease or hemachromatosis.  You may want to discuss these options with your personal physician.

Regarding the relation with Atkin's diet and liver enzymes - I am not aware of a specific correlation, although I have had several patients where their enzymes rose after starting the Atkin's diet.  

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.