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Normal ALT levels
I recently had some routine blood tests taken only to be informed by my GP that my liver ALT is 851. I am unable to find any results on the internet this high, could i be mistaken? Im a 19 year old female and am unsure if I should be worried. What is the highest recorded ALT?
thanks everyone very much for the replies... lots of good info and advice around here
i do get lab work done every year and ya my ast/alt levels have always been low... also just had my 2nd ultrasound and the new fibro blood test this year, and prob getting 2nd biop next year also...
i will post when i get these fibro results im curious about that test if it tells anything
i do get lab work done every year and ya my ast/alt levels have always been low... also just had my 2nd ultrasound and the new fibro blood test this year, and prob getting 2nd biop next year also...
i will post when i get these fibro results im curious about that test if it tells anything
If your alt/ast has been in the normal range since '04 can I assume you have been getting yearly labs ? If your alt/ast has been normal since '04 with regular yearly labs this would indicate very low viral activity, which is to say very little ongoing damage. When ongoing damage either does, or even barely does, outpace hepatocyte regeneration you can be very stable (normal/near normal ALT/AST) .But it is imperative to get regular bloodwork. At the bare minimum you should have yearly blood labs and an ultrasound.
It is extremely rare for someone to progress from f-2 to -f-4 in just five years and even then, there are generally co-factors present that account for this type of extremely fast progression. For example, other concomitant illnesses or conditions such as autoimmune hepatitis or HIV (among several), or the use of drugs and alcohol, or other types of poisoning from toxic substances to name some.. One thing is for sure: You don't go from a f-2 to cirrhosis in 5 years without alot of damage occurring in between. And with this type of injury occurring to someone's liver to this degree then it can be expected that ALT/AST will be way above the normal. A simple yearly blood lab can alert the doctor to the increased viral activity as indicated by high ALT/AST which could alter someone's watchful waiting position. Watchful waiting does not mean you will wait and watch your health decline. It is a treatment strategy to delay tx safely without harming your odds should you require SOC tx down the road. Since it is a strategy, it follows a PLAN. If a doctor says" we'll keep an eye on it" with a wink and a pat on the back as he leads you to the door, and then adds, "so come back in 5 years for a biopsy." Stop right there. That is not a "watchful waiting" plan.
Stage 2 has traditionally been the stage at which most people have a difficult time in making up their mind concerning tx. Now, with safer (shorter) and more efficacious treatments on the near horizon it may be clearer as to the choice one makes at this point in time.
You are right about G2 and G3 being faster fibrosers but it is not by much. Good luck in your tx decision.
Mr Liver
It is extremely rare for someone to progress from f-2 to -f-4 in just five years and even then, there are generally co-factors present that account for this type of extremely fast progression. For example, other concomitant illnesses or conditions such as autoimmune hepatitis or HIV (among several), or the use of drugs and alcohol, or other types of poisoning from toxic substances to name some.. One thing is for sure: You don't go from a f-2 to cirrhosis in 5 years without alot of damage occurring in between. And with this type of injury occurring to someone's liver to this degree then it can be expected that ALT/AST will be way above the normal. A simple yearly blood lab can alert the doctor to the increased viral activity as indicated by high ALT/AST which could alter someone's watchful waiting position. Watchful waiting does not mean you will wait and watch your health decline. It is a treatment strategy to delay tx safely without harming your odds should you require SOC tx down the road. Since it is a strategy, it follows a PLAN. If a doctor says" we'll keep an eye on it" with a wink and a pat on the back as he leads you to the door, and then adds, "so come back in 5 years for a biopsy." Stop right there. That is not a "watchful waiting" plan.
Stage 2 has traditionally been the stage at which most people have a difficult time in making up their mind concerning tx. Now, with safer (shorter) and more efficacious treatments on the near horizon it may be clearer as to the choice one makes at this point in time.
You are right about G2 and G3 being faster fibrosers but it is not by much. Good luck in your tx decision.
Mr Liver
Unfortunately, I think when we are younger our bodies immune systems might be better at fighting this stuff down. I partied excessively (and I mean quite excessively) for years and years and never knew I had this at all.
I think as we get older our bodies are more broken down on a cellular level and that might give the disease the big in it needs.
I had an exhusband (died last year) who had this disease way longer than me. God he did more drugs and drinking than anybody I ever met. He was HORRIBLE. Every single time he had his liver enzymes tested they said he was absolutely fine.
Now, I can't understand that at all. You see mine were in the mid-upper 200s when I was diagnosed and I wasn't even drinking at the time anymore. SO, that makes no sense to me at all.
Had he not died I would have gotten him a biopsy eventually. I was always curious to find out. I've always wondered if his autopsy had the results I wanted to know..........what shape was his liver REALLY in?
I just think you gotta be careful. Nobody is saying you have to treat or anything like that but don't let this disease fool you for one second. Get the biopsy it is MUCH more reliable than the fibro. don't take the chance because the one thing I've learned is this disease and it's damage don't make a hill a beans sense and you don't want it to catch you out if it can. And it will try cause it is sneaky!
Be well PJ!
I think as we get older our bodies are more broken down on a cellular level and that might give the disease the big in it needs.
I had an exhusband (died last year) who had this disease way longer than me. God he did more drugs and drinking than anybody I ever met. He was HORRIBLE. Every single time he had his liver enzymes tested they said he was absolutely fine.
Now, I can't understand that at all. You see mine were in the mid-upper 200s when I was diagnosed and I wasn't even drinking at the time anymore. SO, that makes no sense to me at all.
Had he not died I would have gotten him a biopsy eventually. I was always curious to find out. I've always wondered if his autopsy had the results I wanted to know..........what shape was his liver REALLY in?
I just think you gotta be careful. Nobody is saying you have to treat or anything like that but don't let this disease fool you for one second. Get the biopsy it is MUCH more reliable than the fibro. don't take the chance because the one thing I've learned is this disease and it's damage don't make a hill a beans sense and you don't want it to catch you out if it can. And it will try cause it is sneaky!
Be well PJ!
last sentence should have read:
While a controversial subject here, my doctors allowed me to drink socially both prior to treatment (while I was in "watch n' wait" mode) and post treatment, but not *during* treatment.
While a controversial subject here, my doctors allowed me to drink socially both prior to treatment (while I was in "watch n' wait" mode) and post treatment, but not *during* treatment.
PJ: 1 - the worst your side effects from tx, the better it is working to kill the virus
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Not a scientific/proven thesis, but anecdotally it does appear to be the case more times than not, at least to me. Also, others have reported that their medical teams have said the same thing. One reason may be that the severity of anemia has a positive association with side effects as well as being a crude barometer with serum riba levels. There may be other reasons as well. This of course does not mean that if you don't have bad side effects you will not SVR. We all have different bodies, treat at different ages, have different pre-existing constitutions/conditions, etc, etc, etc.
#2 - the higher your v/l and the higher your ast/alt, the more damage you have and the faster its killing your liver
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Viral load does not correlate with alt/ast. Viral load also does not correlate with the amount of liver damage. You could have high viral load and very little liver damage or conversly low viral load and more liver damage. Of interest is that higher pre-treatment ALT seems associated with improved chances of SVR.
#4 - it seems that people with geno 2 and 3 might respond better to tx but they also progress quicker
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I believe geno 3's may progress faster in terms of fibrosis but not sure if that holds up with geno 2's.
#3 - it is possible to have a 'mild' form of hep-c ... minimal damage, slow progression, low v/l, low ast/alt... and these people if they dont drink can definetly afford to WAIT for better tx
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Hep C can progress very slowly in some people, so if you want, you can call this a"mild" form although not a medical term. For this group of people adopting a "watch n' wait" strategy is very reasonable. That said, there is another opinion that people should treat regardless of stage. Personally, I fall into the former camp -- the "watch n' wait" group for those with minimal liver damage. While a controversial subject here, my doctors allowed me to drink socially both prior to treatment (while I was in "watch n' wait" mode) and post treatment, but not after treatment.
-------------------
Not a scientific/proven thesis, but anecdotally it does appear to be the case more times than not, at least to me. Also, others have reported that their medical teams have said the same thing. One reason may be that the severity of anemia has a positive association with side effects as well as being a crude barometer with serum riba levels. There may be other reasons as well. This of course does not mean that if you don't have bad side effects you will not SVR. We all have different bodies, treat at different ages, have different pre-existing constitutions/conditions, etc, etc, etc.
#2 - the higher your v/l and the higher your ast/alt, the more damage you have and the faster its killing your liver
----------------------------------------
Viral load does not correlate with alt/ast. Viral load also does not correlate with the amount of liver damage. You could have high viral load and very little liver damage or conversly low viral load and more liver damage. Of interest is that higher pre-treatment ALT seems associated with improved chances of SVR.
#4 - it seems that people with geno 2 and 3 might respond better to tx but they also progress quicker
-------------------------
I believe geno 3's may progress faster in terms of fibrosis but not sure if that holds up with geno 2's.
#3 - it is possible to have a 'mild' form of hep-c ... minimal damage, slow progression, low v/l, low ast/alt... and these people if they dont drink can definetly afford to WAIT for better tx
---------------------
Hep C can progress very slowly in some people, so if you want, you can call this a"mild" form although not a medical term. For this group of people adopting a "watch n' wait" strategy is very reasonable. That said, there is another opinion that people should treat regardless of stage. Personally, I fall into the former camp -- the "watch n' wait" group for those with minimal liver damage. While a controversial subject here, my doctors allowed me to drink socially both prior to treatment (while I was in "watch n' wait" mode) and post treatment, but not after treatment.
im going to the dr on 11/13 to review my last ultrasound and the fibrosure blood test and other blood work i just had done, i am prob getting another biop pretty soon yaaa if not this year, early next year...
its just so weird i cant get my head around it that i have had this for 25+ years, drank and drugged for most of that time ...and now that i stopped, im going to progress in 5 years to cirrosis???? i just do not see that happening... i should be way worse off if this virus was so powerful considering the fact that i binge drank (more than 2-3 drinks at a time) about 3 -4 times a week for like 10-20 years!!! ...
maybe strong immune system might be helping keep it in check or something... i have a pretty good fam history of living long & healthy lives while doing bad (drinking & smoking etc) things lol
its just so weird i cant get my head around it that i have had this for 25+ years, drank and drugged for most of that time ...and now that i stopped, im going to progress in 5 years to cirrosis???? i just do not see that happening... i should be way worse off if this virus was so powerful considering the fact that i binge drank (more than 2-3 drinks at a time) about 3 -4 times a week for like 10-20 years!!! ...
maybe strong immune system might be helping keep it in check or something... i have a pretty good fam history of living long & healthy lives while doing bad (drinking & smoking etc) things lol
#3 - it is possible to have a 'mild' form of hep-c ... minimal damage, slow progression, low v/l, low ast/alt... and these people if they dont drink can definetly afford to WAIT for better tx
I don't think that there is honestly an logic to this because it would be impossible to tell if you have some 'mild' form of hep in the first place (is there such a thing???). Liver damage is NOT linear....it can take you 20 years to go to stage 2 but then go to cirrhosis in just a few years.
I know it's not fair. But some people in her have never done drugs or drank heavily and still they do have advanced liver disease. (Me I drank and did drugs and was already a stage 3 at diagnosis - my own fault admittedly).
Hep isn't a fair disease at all. Definitely you have the perogative to wait - but if you do decide to wait you do have to do vigilant watching as well. I PERSONALLY feel if you are going to wait every two years at absolute most is the longest you should go without a biopsy. Because if you are stage 2 and can get to stage 4 in just a few years...but you wait five years..............well that could just be too long.
It's all a gamble - every single thing we do with this disease. But you really do need a new biopsy to tell you what is going on. As a stage 3 you would have much less leeway or time left and it would show you that you were progressing (or not) more rapidly than thought.
Either way - I hope you are a stage 2 and it doesn't matter yet.
After 4 years I really hope you consider the new biopsy. Be on the safe side because it's better to be safe rather than sorry.
I don't think that there is honestly an logic to this because it would be impossible to tell if you have some 'mild' form of hep in the first place (is there such a thing???). Liver damage is NOT linear....it can take you 20 years to go to stage 2 but then go to cirrhosis in just a few years.
I know it's not fair. But some people in her have never done drugs or drank heavily and still they do have advanced liver disease. (Me I drank and did drugs and was already a stage 3 at diagnosis - my own fault admittedly).
Hep isn't a fair disease at all. Definitely you have the perogative to wait - but if you do decide to wait you do have to do vigilant watching as well. I PERSONALLY feel if you are going to wait every two years at absolute most is the longest you should go without a biopsy. Because if you are stage 2 and can get to stage 4 in just a few years...but you wait five years..............well that could just be too long.
It's all a gamble - every single thing we do with this disease. But you really do need a new biopsy to tell you what is going on. As a stage 3 you would have much less leeway or time left and it would show you that you were progressing (or not) more rapidly than thought.
Either way - I hope you are a stage 2 and it doesn't matter yet.
After 4 years I really hope you consider the new biopsy. Be on the safe side because it's better to be safe rather than sorry.
thanks very much for that info ...
like i said i have near normal ALT/AST levels, they have always been just 'slightly elevated' and biop 4 years ago showed stage 2... and now 4 years later, after quitting drinking etc and taking milk thistle they are now normal... also my vl is low always was also around 600,000...
i am debating whether to try tx again and im leaning towards NO ... not for a few years anyway... i did treat with peg and virimadin on a phase iii trial, it did not work, i had very mild side effects
alot of the post arounder here confuse the hell out of me LOL but after reading for the past few months i have come to some conclusions about this virus ....
#1 - the worst your side effects from tx, the better it is working to kill the virus
#2 - the higher your v/l and the higher your ast/alt, the more damage you have and the faster its killing your liver
#4 - it seems that people with geno 2 and 3 might respond better to tx but they also progress quicker
#3 - it is possible to have a 'mild' form of hep-c ... minimal damage, slow progression, low v/l, low ast/alt... and these people if they dont drink can definetly afford to WAIT for better tx
just my opinion
like i said i have near normal ALT/AST levels, they have always been just 'slightly elevated' and biop 4 years ago showed stage 2... and now 4 years later, after quitting drinking etc and taking milk thistle they are now normal... also my vl is low always was also around 600,000...
i am debating whether to try tx again and im leaning towards NO ... not for a few years anyway... i did treat with peg and virimadin on a phase iii trial, it did not work, i had very mild side effects
alot of the post arounder here confuse the hell out of me LOL but after reading for the past few months i have come to some conclusions about this virus ....
#1 - the worst your side effects from tx, the better it is working to kill the virus
#2 - the higher your v/l and the higher your ast/alt, the more damage you have and the faster its killing your liver
#4 - it seems that people with geno 2 and 3 might respond better to tx but they also progress quicker
#3 - it is possible to have a 'mild' form of hep-c ... minimal damage, slow progression, low v/l, low ast/alt... and these people if they dont drink can definetly afford to WAIT for better tx
just my opinion
"how could someone have normal ast/alt levels and be cirrotic??? "
Liver enzymes are normally found in liver cells. When liver cells are injured, enzymes leak out of the cells and end up in the blood.....(and a blood test can measure the amount). So when a blood test shows high liver enzymes, then you know that something is hurting the liver.
But when the liver is cirrhotic, that means that the liver tissue is very scarred and hardened.....and liver enzymes are not able to leak out into the blood. So you can have normal liver enzymes but still have lots of damage.
i understand what you're saying and i know it could happen - stage 2 to cirrosis in 5 years but .. .but i just cant believe that ... i quit drinking/drugs when i found out about this, so what im saying is i used iv drugs for 4 years, then intranasal drugs snorting a ton of coke and crank and drank on an almost daily basis for like 20 years , then i find out and quit everything and THEN i get cirrosis???
how ******* unfair would that be???? hahaha
ya, i know, life isnt fair....
i just think my alt/ast levels being normal is a good thing, plus the fact that i feel completely fine otherwise... and i know you were stage 3 and felt fine also, but you dont know if you were around the corner from cirrosis or 10-20 years away or not either not really
very very strange thing this virus...
how ******* unfair would that be???? hahaha
ya, i know, life isnt fair....
i just think my alt/ast levels being normal is a good thing, plus the fact that i feel completely fine otherwise... and i know you were stage 3 and felt fine also, but you dont know if you were around the corner from cirrosis or 10-20 years away or not either not really
very very strange thing this virus...
PS 851 is very high and shows that something is going on. If you haven't had the hepc test yet please do it right away. Mine were very high and only in the mid-200s - it is how the doc knew that I probably did have hep in the first place - I had no clue or symptoms until then.
i can't imagine that you are having extremely frequent liver panels run - ie: constant bi-weekly or month which would be the only way that you would be able to tell what they are doing. Someone at stage 2 could go over to cirrhosis in a quick enough amount of time, which is why you need to always WATCH with the watch and wait program.
5 years from one biopsy to the next - the answer is yes it is possible that it could have happened. Just because it takes 20 years to get from 0 to 2 doesn't mean it's going to take 20 years to get to 4.
I would think a stage 2 would need much more frequent biopsies than every five years - but that just might be me.............I certainly would aim for the farthest being every two years but I'm sure others disagree. You could go from 2 to cirrhosis in five years for CERTAIN.
5 years from one biopsy to the next - the answer is yes it is possible that it could have happened. Just because it takes 20 years to get from 0 to 2 doesn't mean it's going to take 20 years to get to 4.
I would think a stage 2 would need much more frequent biopsies than every five years - but that just might be me.............I certainly would aim for the farthest being every two years but I'm sure others disagree. You could go from 2 to cirrhosis in five years for CERTAIN.
im so confused...
i have read on here people saying their ast/alt normal and then they got a biop and it showed cirrosis
my ast/alt are just about normal also they were never very high always just slightly elevated, last blood test showed they are normal... my last biop was 4 years ago stage 2 grade 2, im planning on getting another biop next year (5 year from dx) i only treated on peg and virimadine phase iii trial for 6 months in '04 they dropped me just said it 'wasnt working'...
so my question is, if my ast/alt levels are fairly normal that is very good right??? how could someone have normal ast/alt levels and be cirrotic???
pls reply anyone thanks
i have read on here people saying their ast/alt normal and then they got a biop and it showed cirrosis
my ast/alt are just about normal also they were never very high always just slightly elevated, last blood test showed they are normal... my last biop was 4 years ago stage 2 grade 2, im planning on getting another biop next year (5 year from dx) i only treated on peg and virimadine phase iii trial for 6 months in '04 they dropped me just said it 'wasnt working'...
so my question is, if my ast/alt levels are fairly normal that is very good right??? how could someone have normal ast/alt levels and be cirrotic???
pls reply anyone thanks
ALT is an enzymes found in the liver and other tissues, it released to bloodstream due to injury or disease affecting the liver. Abnormal high levels in the blood indicates liver disease or damage.
You need to see a hepatologist right away.
Make sure you follow up on that. If the reading is correct, which I hope a doctor will test again to confirm, you should see a good gastro or liver specialist. It could be from vitamin supplements, herbal supplements, drugs you take for any medical problems, or could be many kinds of infections. Because AST is located in many places in the body, high levels of AST alone don't suggest liver disease (a notable, but rare, exception is Wilson's disease). However, the ratio of AST to ALT, or the level of AST compared to the level of ALT, provides many clues to what's going on inside. Based on these ratios, doctors can focus their attention on a particular kind of liver disease.
Really, you need to follow up on this.
Trinity
Really, you need to follow up on this.
Trinity
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