ALT Levels-disappointed

I just got back my 4th week and was disappointed
      Pretreatment was 180
                   wk 1 56
                   wk 2 46
                   wk 3 36
                   wk 4 47

CBC has all gone back to normal ranges. Is it normal for the alt to go up and down?  Does that mean that TX isn't working?  Does anyone know of a site where I can learn to interpret the labs? I hate not understading what is going on.

[FlGuy]

Don't get worried about alt while on tx.  It's the virus eradication that counts.  I'm in week 22 and ast/alt both higher than pre-tx, I think 57 / 92 now.  I've been und since week 2.  Take you meds on schedule, get your pcrs taken, focus on the tx.

[mremeet]

Many people's enzymes fluctaute up and down above normal range during treatment, and many go on to SVR just fine. It does not mean the drugs aren't working and it does not mean you will not achieve SVR after completing treatment. For instance, I'm in week 32 and my enzymes have been all over the place, even with an ALT as high as 120 at one point. And I've been UND (<10 IU/ml) since day 15. So as you can see enzymes can move up and down and all around, but the drugs can be working just fine.

[Jakied]

alt level of 47 is usually considered the high end of normal.  Usually, alt normal range is 0 to 55.

normal ast is 0 to 40.

alt of 47 sounds Ok to me.

[mikesimon]

I am curious about where you get your labs. I have gone to a lot of different labs and I have seen different normal ranges for liver enzymes but I have never seen a low normal of 0 for AST, ALT or GGT on any sheet I have seen.
Quest normal ranges are:
AST 10-35
ALT  9-60
GGT  3-85

Mike

[mikesimon]

I forgot to mention that I agree with mremeet that you shouldn't worry about your ALT. It can and does fluctuate and this type of change isn't significant. Mike

[TashaZZ]

The lab report stated that 47 was high.   I realize that 7 points above the normal range (0 - 40) that the lab uses is better than the original 180 but it concerned that it is going in the wrong direction. I guess I shouldn't have been as happy or confident when the alt was in the normal range last week. I thought that meant that it was working.

[TashaZZ]

The lab report stated that 47 was high.   I realize that 7 points above the normal range (0 - 40) that the lab uses is better than the original 180 but it concerned that it is going in the wrong direction. I guess I shouldn't have been as happy or confident when the alt was in the normal range last week. I thought that meant that it was working.

[TashaZZ]

I go to Quest in FL to get my labs.  On the report it has a reference range from 6 - 40 as normal. I thought it started at 0 but it starts at 6.  They highligted the 47 ALT and put high in the "Out of Range" column.

An AST test on is not on the report.  I now am going to get labs done 1 time a month. Is that routine for everyone else? Thanks

[mikesimon]

The difference in the ranges may be attributable to gender and age. I am male and 57 years of age. Mike

[ladybug52]

One thing my Pa told me on Tuesday was that normal liver enzyme ranges take into account size. I was happy because mine were in the teens and had always been high range of normal. She said that mine should have been in the teens since the ranges were including a 5' woman to a 6'5" guy. She said I had his normal liver enzymes, but for me they were high.

[mikesimon]

I get them every 2 weeks but I hope it will be monthly soon. Mike

[GoofyDad]

My alt dropped into the 20's then climbed up into the 40's on tx. Then dropped again after stopping, then bounced back up a bit. One part of the bounce seems to be a new assay at the hospital lab - it bumped everyone up, and I think they increased normal range. It's like the gonerment and the economy, they recalibrate the measuring devices once they take the reading (they already know what the reading will be, they just have to adjust to get the correct results).  

Sign me,
Goof the SVR'ed Cynic

[jmjm530]

The difference in your enzyme values are insignificant. What you need is a viral load test. You should take it the day before your next shot and get the answers to the main question that matters now -- "are the treatment drugs working?" Request a sensitive test like "Heptimax" by Quest Diagnostics. Everything else is guessing.

-- Jim

[TashaZZ]

Ranges based on age and gender seeems logical. Do you get your labs done weekly?

[mikesimon]

I must say that I have never heard or read anything like that before. On my lab sheet it has a space for age and gender but nothing about weight or height. My enzymes are in the teens also and I'm 5'11" and weigh about 180. Mike

[ladybug52]

Well, I'm just quoting her, she could be wrong. It's not like she's been on the cutting edge since I started tx with her. And I hope you know I meant my P.A. not my dad (Pa)

[mikesimon]

I knew you meant PA. I just never heard anything like that anywhere. I question my doctors on occasion so I figure PAs are fair game as well. I didn't mean to question you Janice just the PA. Mike

[ladybug52]

Oh, I know! We all need to question our medical team and pass around info to each other. That's why I threw it out there. I had never heard of it and I was trying to decide if I believed her or not.
Thanks,
Janice

[TashaZZ]

My Dr. ordered  the next viral load test at 10 weeks, 2 weeks before my 3 month visit with him. At that time he said if my viral load wasn't below 800 that would indicate that TX is not working and I would have to stop TX.  Is this typical? If I had more energy I would be very anxious about all of this waiting. Thanks for your input