46 yr old female with continuing Elevated ALT

[dtg080662]

I have a continuing elevated ALT ranging between 65-75 over the last 9 months.  AST is staying around 40.  I have had blood work drawn four times to monitor my thyroid, pre-diabetes and cholestrol.  Because the ALT has remained elevated I have been sent for additional tests and an ultrasound of the liver.  (I had my gallbladder removed 10 months ago.)  The ultrasound and hepatitis panel has come back ok.  I am still waiting for additional results.  I am 46, 185 lbs, I walk 30 minutes most days, but do not work out.  Daily meds are Synthroid, Niaspan, Fortamet and Calcium.

I suffer from migraines and was on Depakote and Aleve daily for two years probably 10 years ago.  I changed jobs and the migraines are less and I no longer take a daily preventative.  I now only have occasional headaches and take Aleve or Excedrin or Percocet - all of which contain acetametaphin.  I have read that it can cause liver disease.  

Since 75 ALT is not extremely elevated and the Hep panel and liver ultrasound are clear, do I need to be concerned?  If so, what do I need to do to get my ALT back into normal range?

[dtg080662]

Thanks for responding.  I do not have a history of drinking.  An occasional margarita every few months with the girls.  What do you suggest for the pain of migraine?

[whisperwillow]

Normal ALT is 6-40. Have you had a history of drinking since your AST is lower then your ALT?  Depakote is hepatotoxic and I would stay off the acetametaphin which can also cause elevated liver enzymes. Being diabetic and obese can also raise these enzymes. I agree with J could be fatty liver. But get checked out and keep up the exercising and diet control. Losing weight can help with lowering the liver enzymes if you have fatty liver. Keep us posted and I will do the same. I am certainly not a medical expert so be sure to go to a gastro specialist.

[Sir_Osis]

SOme of the drugs you mentioned are hepatotoxic - i/e depakote.  Look at the side effects of all that you have consumed....The liver however can repair and remarkably so...

As for the mildly elevated enzymes - could be the drugs, could be fatty liver, and could be something else....  I would think those levels would only require a 2x annual testing...

Keep up the walking, and unless your about 7 feet tall, dropping maybe 20 lbs *may* help (especially if you have fatty liver)

Cheers

J