A quick question about ALT & AST

Hey, I should know this by now, but do these #s show the RATE that one's liver is being damaged? In other words, do high #s mean the liver is suffering more and rapid damage? Lower #s slower and less damage? thanks, jm

[antman]

hi Orleans. i'm sure someone will come along with a good explanation. but, i just asked my tx-ing Dr. about these tests. he said while it's good if they are low, they don't really tell you how much damage is beaing done to your liver. some people with cirhossis have normal alt, ast #'s. so the biopsy is the only means to determine fibrosis (scarring) and inflamation (inflammation). but with that, it's better if they are low.

[friole]

From the Janis site

http://janis7hepc.com/labs1.htm


ALT -- This is an enzyme made in liver cells. If liver cells are damaged or die, ALT leaks out into the bloodstream

This is the most important test to follow in a person with liver disease. A high ALT may mean a high degree of liver cell damage. However, ALT levels can also vary, and do not always reflect the degree of liver cell damage. A liver cell biopsy will give the most accurate information. The ALT enzyme is a more accurate marker of liver damage than the Ast enzyme. One goal of treatment for hepatitis C is a normal ALT level.

AST -- This is an enzyme made in liver cells, similar to the ALT. It is also made in muscles, and can be released from damaged muscle, heart, kidney, and brain tissue. Therefore, the AST level can be affected by many conditions other than liver disease.

Elevated levels can mean liver damage. Often the AST and ALT levels will elevate at the same time


Also this site that mikesimon gave a couple of weeks ago is good

http://www.patient.co.uk/showdoc/40024562/

[mremeet]

Generally, yes the higher the alt and ast numbers are, the more ongoing damage there is. But remember that just because a person has high liver enzymes, that doesn't mean they have significant liver damage. And conversely, just because someone has normal enzymes, that doesn't mean they don't have significant liver damage. There are plenty of HCV infected people out there with significantly elevated enzymes and very minimal liver damage. There are also those who have perfectly normal enzyme levels, and yet have cirrhosis. It's a similar situation to viral load. A high VL does not predict a large amount of liver damage, and a low VL does not predict minimal liver damage.