Worried about elevation in ALT

[arihant]

I went to the doctor last month because I had a piercing abdominal pain and some black stools. Doctor did some blood test and discovered that I Had H. Pilori. I was given treatment for it. Stool test came back negative for blood (this confused me as I was quite sure there was blood there!).

Anyway, I had set up an appointment with a GI at that time. The appointment was last week. I decided to keep it as I was suffering from some serious reflux/heart burn for a couple of days. The GI looked at my blood results and found that my ALT was 57 (normal 0-55). She ordered Hep B test. After enduring some sleepless nights, I learnt from the GI that Hep B was negative. However, my ALT from last week's blood ead 63. The blood work in April (ALT of 57) and last week (ALT of 63) were done in different labs for whatever it is worth.

BTW, I looked at the only other blood report I have in my file which was from march of last year. My ALT then was 37. I mentioned this to the GI as well.

So, to summarize:
March 05: ALT = 37
April 06: ALT = 57
May 06: ALT = 63.
Hep B is negative.
As far as I can tell ALL other blood numbers are well within normal range.

I do not drink alcohol, take pain medication or cholesterol drugs. I am not obese. I am an asian male (from India). As far as I know, I have not lost apetite except out of fear, nor have I lost weight. My weight has been howering in the 155-162 range for several months. However, I lead a sedentary lifestyle the last couple of years and have excercised dring this period.  

The GI plans on doing more tests to start eliminating other possibilities. But, she does not seem very concerned just yet. But, I am.

My question is: Should I be overly concerned about this? What can be going on with my liver? I have read some scary stories.

I am trying to gain more understanding about why my ALT has risen since last year.

Any insight would be greatly appreciated.

[Kevin Pho, MD]

The ALT is only mildly elevated.  The hepatitis B test is reasonable.  I would also test for hepatitis A and C.  

The next test to consider would be an abdominal ultrasound to look at the liver and gallbladder for any signs of anatomical disease or stones.  

If negative, I would continue to monitor the liver enzymes periodically to ensure the ALT isn't rising.  

These options can be discussed with your personal physician.

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_

[arihant]

Clarification about my previous post. I meant to say that I have NOT excercised in the last couple of years.

[guentkla]

I had some blood tests done that revealed an extreme high ALT. I have been experiencing some irregular occurance (once a few weeks) of mild ache on stomach region and severe back pain at kidney area. Went to see the doc to get this looked at and the blood tests revealed the following highlights:
AST 107
ALT 440
Total Bilirubin 49.4
Direct Bilirubin 12.7
Potassium 6.1
Alk Phos 131
GGT 185
There are no signs of acute hepatitis, so there is something very strange going on.

I do not feel sick these days. The symptons described above last for a few hours and my urine change to a rusty or tea colour during that time, but that disappears as quick as the pain.

Any comments to the above description?

[leeac]

guentkla,

your test results are highly elevated in the ALT/AST and bilirubin.  PLEASE follow up with your doctor for next steps to determine what the cause is.  if you are not getting a good response from him, please seek the advice of a gastroenterologist.

leeac

[arihant]

Dear Dr.,

All my Hepatitis tests came back negative and the doctor says my ultrasound of the liver revealed some grease (fat) in the liver. My ALT now shows 68 (up from 57 since April). The doctor is not very concerned. She says I need to lose 10 pounds and the fat in the liver may go away.

I have some confusing questions:
1) How reliable is the ultrasound information? Can the doctor mistake grainy images to fat in liver?

2) I only weigh 155 pounds and am 5'10". I am also vegetarian and do not drink alcohol. How can I have fat in liver? WIll losing 10 pounds help me?

3) Could a high cholestorol cause the elavation in ALT? I had 200 last March a year ago. I have not checked it recently. It might have gone up. The doctor recommended that I have it checked.

4) Can the fat in liver be dissolved using medication?

5) Should I be thinking about getting a biopsy done?

6) Should I take an appointment with a hepatologist?

Any advice will be greatly appreciated as all of this is confusing me and causing great deal of stress.

Sincere Regards,
Arihant.

[ellisdidi]

My ALT result last week was 185. My dr. is going to check again in 2 months, then proceed from there. All my other test results are WNL. I am overweight and need to lose some weight. I don't have any s/s. My grandmother died from liver disease, so you can imagine how scared i am right now.