Elevated liver enzymes

[Merit]

During a routine exam in Sept 2006 my blood work came back indicating my liver enzymes were elevated AST 138 and ALT 78. All other results of the tests were normal. I drank alcohol periodically up to this point. In the past I have drank heavily, but stopped this over 3 years ago. I am a 34 year old male. I have not had any alcohol or tylenol since the September results were returned (over 9 months now. Two weeks after the intial tests I returned for more blood work with Hep A,B,C being ruled out (negative) and my ALT was in normal range and my AST was slighlty elevated at 42 u/l. I also had an ultrasound at this time and my liver was smooth, regular in size, and no evidence of blockage or gall stones. I returned for blood work in January 2007 and both my AST and ALT were in normal range. I just had a 6 month follow (July 2, 2007) to find my AST elevated to 78 u/l and the ALT elevated to 75 u/l. I am shocked as I was sure the problem was related to alcohol, but I have not had any alcohol for over 9 months. I take a men's multivitamin, a vitamin c, and fish oil once daily. I do engage in strenuous excercise and am in good physical condition short of the elevated enzymes. My doctor's recommendation is monitoring my blood levels every 12 months. Should I being doing more?  

[Kevin Pho, MD]

I agree with the recommendation as well as the hepatitis test.  

The ultrasound would rule out many of the major liver diseases.  You can also obtain a ferritin and ANA level to evaluate for hemochromatosis and autoimmune hepatitis respectively.  

Many medications can also lead to elevated enzymes, and this should be screened.

If the tests continue to be negative, serial monitoring of the enzymes is reasonable to ensure they do not elevate.

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.
kevinmd_

[rasticle]

Hey,

I am 26/m and I have gone through the same thing.  For over a year I had my liver enzymes tested because my ALT/AST were elevated. I had all the tests done, including a liver biopsy, which showed normal liver tissue.  I was tested for celiac sprue and for muscle diseases.  Your muscles have the same enzymes in them and if they get inflamed they can fool doctors into thinking you have liver problems.  But anyways, all came back normal for me, seems my liver enzymes are just naturally high.  Sometimes they are normal, other times they are ALT:90 ish and AST:70 ish.  But they have been as high as ALT:195 and AST:80.  

[Merit]

Thank you.