Hepatitis for unknown reasons.

[rasticle]

I'll try to keep this as short as possible. I'm a 26 year old male, very physically active I jog between 12-15 miles per week and at a healty weight. I am diagnosed with Anxiety and Hypertension. My liver enzymes ALT and AST have been mildly to moderatly elevated for over a year. They have spiked at alt:195 ast:80, but they typically hover between normal to alt:+-100 ast:+-60. I have had all the blood studies and diagnostic testing done that are normal for the evaluation of elevated LFT including, viral hepatitis panel, ANA, AMA, Ferritin, abdominal ultrasound, etc.(All returned normal) The only abnormal results where the ALT/AST and I had elevated Triglycerides:200 and borderline colesterol:190. From all the information I have researched it would seem to me that the most logical conclusion would be some sort of fatty liver hepatitis. I am seeing a GI, whom other doctors have said to me that he is an very smart man and good GI to see, and he told me that at this point he doesn't see any reason to get a BX. He also told me that normally with fatty liver that the enzymes don't typically flucuate as much as mine do and that nothing is "jumping" out at him with the transferase levels where they are currently. So I guess I just wanted to see what another doctor might say about it.

Thanks!

[Kevin Pho, MD]

You have had a pretty comprehensive evaluation already, ruling out many of the major diseases.  Fatty liver would have been seen on the ultrasound.  Blood tests also rule out many of the common liver causes such as autoimmune hepatitis, viral diseases and hemochromatosis.

If the ALT consistently approaches 200, a biopsy would be considered.  If they are closer to 100, the liver enzymes can be serially monitored.

Another GI opinion could be sought regarding the biopsy - which would give the most definitive diagnosis.

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]

I should add that I have had maybe 3 beers in the last year.  Also I went through a period of maybe 3 months when the doctors took me off of all my meds except Enalipril for my hypertension.  They said that drug shouldn't have any impact on the LFT.  So as of now all I am taking is Lexapro and Enalipril.

[tenaa]

Can anyone please help explain the blood test of
AST (10-40)  94
ALT (20-65)   146
Gamma Glutamyltransferase (10-65)  82

please help.  my doctor didn't say anything.  I'm 44 female.

[rasticle]

I am not a doctor, but from what I have learned doing my own research, your enzyme levels are not extremely high.  All I can tell you is that when the ALT and AST are elevated you are getting inflammation of the hepocytes, which are the main cells that make up the liver.  When those cells get damages, through inflammation or mild irritation they leak the enzymes into the blood stream.  I would ask about follow up blood tests to see if your enzymes are trending down, up or staying level.  You may what to get a second opinion, I had a doctor that neglected to do a follow up blood test for me and luckly my family is a medical family and I was urged to get a second opinion!

[rasticle]

Further more, there are a million reasons your blood studies returned elevated.  Some meds, including acetaminophen(Tylenol), can cause mild liver inflammation and so can drinking alcohol.