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ALT & AST & Liver Damage
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ALT & AST & Liver Damage

At what point do I begin to be seriously concerned about my husband.  His bloodwork just came back with AST of 151 and ALT of 193.   Do those number mean serious liver damage and what is the progression of this disease?  He takes no medication, is 72, still goes to the gym and still golfs.  You'd never know he was sick  Thanks
Jan
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High liver enzymes indicate inflammation of the liver.  His numbers are not off the charts but they are high.  It can be caused from a variety of things but you indicated he takes no medication so my next question is does he drink heavily?  That can cause elevated enzymes as well.  Has he ever been diagnosed with hepc?  Many of us have had this disease for years and never knew it.  You can be asymptomatic and have extensive liver damage.  His doctor should be running the necessary tests to determine what exactly is going on with him.  If he is hepc positive, he should have a liver biopsy to determine the health of his liver.  That will tell you everything you need to know and I would be concerned because something is causing the spike with his AST and ALT.
Good Luck
Trinity
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You should (and your husband should) go see his primary doctor now. There is something happening with his liver and he needs to find out what it is. Waiting is not something a 72 year old should want to do.

There could be many reasons for his AST and ALT to be high. You don't mention other blood results so we are limited in what we can surmise. The only way to know what is going on, is to go to the doctor.

I have cirrhosis of the liver and never felt better until someone looked at my blood levels. My options are limited because my illness has progressed so far. You don't want this to happen to your husband believe me.

Etiology of ALT or AST Elevations When Less Than Five Times Normal
--------------------------------------------------------------------------------
Common hepatic causes

Alcohol

Cirrhosis

Hepatitis B (chronic)

Hepatitis C (chronic)

Steatosis/steatohepatitis

Medications/toxins

Acute viral hepatitis

Less common hepatic causes

Autoimmune hepatitis

Hemochromatosis

Alpha1-antitrypsin deficiency

Wilson's disease

Nonhepatic causes

Celiac disease

Hemolysis

Myopathy

Hyperthyroidism

Strenuous exercise

Macro-AST


Best of luck.
Hector

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I am sorry I neglected to Mention, YES, my husband has had hep-c for 20 years.  They told him 20 years ago he would be dead in 5 years.  Hello!  He refuses any medication for this and his viral count continually decreases.  The last decrease was over 1 million.  But his AST and ALT values continue to rise.
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Ok, so he does have the virus.  The reason his enzymes continue to rise is because the virus is attacking his liver.  That is what this virus does.  As I mentioned, without a biopsy there is no way to know what the condition of his liver is.  I will be perfectly honest with you.  If I were 72 years old and still felt good enough to golf and work out  knowing full well I have hepc and what it can potentially do to my liver, I don't think I'd bother to change a thing.  Treatment is very had on the body - the older you are the harder it is.  I'm quite sure he was aware of the options years ago but choose not to treat.  His liver is not going to improve without treatment but personally I just don't think I could handle it at 72 years old.  They may even have a cut off age for treating as well.  Many people improve their liver health with supplements and diet so that might be an option as well.  He really should have a consultation with a liver specialist to let him know what his options are.  Good Luck in whatever path the both of you choose.
Trinity  
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Thank you for responding.  I must agree with you that the treatment for Hepc is rough, even on a young person.  I don't wish for him to got through that and he refuses and I don't blame him.  He also refuses a liver biopsy, although, after his last report, I may be able to talk him in to it.
I have been all over the internet looking for information and what "I" need to watch for in the progression of this disease, so I know when to get concerned, but can't find anything and his MD doesn't know about hepc.  My husband will not go to a specialist (Mainly because they just want to keep putting him on the medication).  Do you have any suggestions as to where I can find DETAILS on the stages of this disease?
Thanks
Yabemom
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Here's a site with lots of information:

http://janis7hepc.com/

One of the difficulties that you may face, with a reluctant hubby, is to find out where he is on the 'continuum' of his condition.  That requires an assessment with a bunch of dignostic tests.  Even then, the progression of the disease in an individual is not necessarily predictable.
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I was going post the same site as FIGUY for helpful information.  Wish you the best and it's always a personal decision whether one wants to treat or not.  I hope at least he will consider a biopsy.
Trin
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