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As a former heavy drinker, should I be concerned?: AST Level at 98 - ot...
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As a former heavy drinker, should I be concerned?: AST Level at 98 - otherwise normal bloodwork

After a number of years of what I consider incompetent and "everything is anxiety" doctors I finally switched to a new PCP today after going to Urgent Care for a tingling foot.

He ran a full panel of blood tests to check out things that may be causing the tingling, to get a better idea if there is a pinched nerve or something similar.

My AST level came back as 98.  Otherwise all of the blood tests he said were normal.  He attributes this to the fact that until recently Iwas a moderate to heavy drinker for 3-5 years, and said as long as I don't continue drinking alcohol this is nothing to be concerned with.

He's going to run another blood test, this time fasting (I had coffee this morning), next week when he gives me a required new patient physical.

I'm a bit concerned as 98 seems high based on what I've searched online, especially since I've not had but a few drinks the past few months - most recently two last week - and I see a lot of concern over hepatitis and so forth even with AST and ALT (mine I'm guessing was normal) in the 40's.  

So looking for a bit of a second opinion before I go back to see him next week.  Is it possible to have a 98 AST simply due to alcohol after all this time, especially with cutting down?  Is it also possible that working out most of last week could have raised the AST levels?

I worry by nature and don't like elevated results in anything.  If it is caused by alcohol, with abstaining and eating healthy, can my liver recover and go down.. or is this damage done?
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Avatar_m_tn
Also.. I'm a 31 yo male.. and by "former heavy drinker" I mean anywhere from 2-6 drinks a day, most days, for a period of 3-5 years.

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Avatar_m_tn
Last Also.. ;)

I've taken 3 or 4 Naproxen over the past few days.. and wondering if this can elevate AST exclusively?
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1475202_tn?1388955435

Certain medications may cause elevated liver enzymes such as acetaminophen and naproxen, prescription medications for high cholesterol, anti-seizure medications, antibiotics and cardiovascular medications.

I think this is your problem. Stop taking the Naproxen and you will make your liver alot happier! I dont know if this will be enough to get you back in the normal unless you have been taking alot of these but the liver is amazing in the way it can heal itself once the cause for elevated liver enzymes has been completely stopped. Be very careful since you can push it to hard and cause permanent damage. Your AST level should be no higher than 35. Dont take anymore of these pills.

Randy
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Avatar_m_tn
isn't liver damage permanent though?  I think you need to stop drinking as well as unnecessary medications.  I don't even drink but I take a lot of medications and my liver levels are
AST 49(10-40)
ALT 91 (10-45)
I think these indicate the liver is being damaged.
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1475202_tn?1388955435
Liver damage is permanent but the ALT/AST testing is not used to determine liver damage but instead as an indication the liver function is limited and irritated. Cells are being destroyed. This can heal once the souce of what is irritating the liver has been stopped. Liver damage is determined with a CT Scan which can show the amount of scaring in the liver that can no longer be repaired.

For instance I have end stage cirrhosis but my ALT/AST scores are better than yours. Problem is I have only a portion of my liver that is able to filter out the toxins that are harmful to my body due to the amount of scaring I have. So I have other levels that are to high or to low. So because of my liver and its limited abilities my blood stream is contaminated with harmful toxins such as ammonia and mangenese. This then is carried to every organ in my body including my brain and very slowly damaging each organ. Unfortunatley the liver is the only organ in the human body that can repair itself.

This greatly effects my brain causing all kinds of impairments. This is a condition called hepatic encephalopathy (HE).  Well lets just say I can keep going on and on but I think I covered the question way back there somewhere. ha ha

Have you talked with your doctor about alternative medications?

Randy
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Avatar_m_tn
thanks very much!  I'm so sorry to hear about your condition.  is there anyway to filter your blood or medications that you can take?  
What alternative medications are there?  I've read about choline, biotin, milk thistle, liver detox tea but don't know if they harm or help the liver....
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1475202_tn?1388955435
I take milk thistle daily, some doctors say its really helps others laugh about it but I have been taking it since my diagnosis and my recovery has been going well so I can say it doesnt hurt.

There are other medications that help with the ammonia such as Lactulose and Xifaxan. They are both quite helpful but in my case they don't prove to be enough. Diet becomes very important, eating food that are high in anti-oxidents can really help. Also cardio-vascular exercise is very helpful with muscle pain. It helps increase the blood flow to the muscles which become saturated with the toxins.

So there are alot of things that can be done to help. They just aren't quite enough.

Randy
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Avatar_m_tn
I'm so sorry to hear about your disease.  There is a new technology called liver dialysis-

http://en.wikipedia.org/wiki/Liver_dialysis

there may be experimental trials that you can participate in, but I don't know how safe they are since I am not a doctor and only a patient
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Avatar_m_tn
the article says "The overall costs of a SPAD treatment is approximately € 656 - 30% of the costs of an equally efficient MARS therapy session."
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Avatar_m_tn
I would caution that I have no idea if this technology is safe and what serious side effects there are
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Avatar_m_tn
or might be
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1475202_tn?1388955435
Thank you for passing that along. I'll be sure to read up on it. Awe you dont need to feel sorry at all. It was caused from drinking like a crazy man! ha ha Since I have stopped drinking life has never been better. To bad it took cirrhosis to find that out but its alot better then going the rest of my life not knowing.

Thanks again, Randy
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Avatar_f_tn
will morphine create your amonia (ammonia) levels to elevate higher if you already have liver damage and are unable to exercise, pretty much bed ridden and shes stays lathorgic majority of the time, in and out of hospital
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1475202_tn?1388955435
Hello precios and welcome to MedHelp.

Blood ammonia comes primarily from the bacterial breakdown of unabsorbed dietary protein in the intestine. Intestinal ammonia passes into the bloodstream and travels to the liver, which converts ammonia into urea. Urea subsequently passes from the body through the urine. High blood ammonia levels can occur with various forms of chronic liver disease, acute liver failure and gastrointestinal bleeding. Elevated blood ammonia levels adversely affect brain function. Early diagnosis and treatment of an elevated blood ammonia level helps reduce the risk of potentially life-threatening complications.

Read more: http://www.livestrong.com/article/228000-what-are-the-causes-of-high-blood-ammonia-level/#ixzz265sfxCCJ
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This article very well explains elevated ammonia levels, the effects on the brain and the condition of the liver. Please pay particular attention to the explanation of decompensated liver disease. If you have any other questions please feel welcome to ask. From what I have read morphine works quite well for patients with decompensated cirrhosis. I'm really sorry to hear of the condition of your friend/loved one. Has she been registered with the transplant hospital?

Randy
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Avatar_m_tn
Randy, would you mind telling me how gradual your drinking came about and at what age? I know it's easy for people to slowly increase their drinking without realizing it. Can drinking heavy 1-2 nights a week rather than daily be just as bad, or does the week of recovery rather than daily insult make a difference?
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1475202_tn?1388955435
Drinking excessively is never a good thing and it's likely to get out of control in time. The more alcohol you consume the more damage that is being done, how long it takes for that damage to be repaired itself is different for everyone. Drinking smaller quantities and less often is your safest bet.

Everything we ingest kills liver cells but this is okay because of the livers amazing ability to heal itself but when we abuse alcohol massive amounts of liver cells are killed off and the liver is unable to replenish them quick enough so scar tissue is formed. We call this fibrosis and in severe cases cirrhosis. The scar tissue causes the liver to harden and restrict blood flow and the livers ability to filter toxins also creating portal hypertension.

This process takes many years as in my case 20+ years. I started out drinking casually then more and more. Eventually I found myself drinking daily. The sad thing is for years you do it thinking it’s fun but eventually that changes, dependency becomes so strong you do it just to feel normal. At the age of 38 I received my diagnosis. Keep in mind when comparing your own situation to mine that everyone is different.

I hope this will help you out.

Randy
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Avatar_m_tn
Randy I just want to thank you for sharing not only your knowledge but your experience in recovery.  I just found you guys trying to get some info on the results of some test I had this week.  I will share those later but now I just want to commend those of you who have knowledge and take the time to share.  Every medical journal I tried to access online wanted a subscription fee.

God Bless you all
Barb
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1475202_tn?1388955435
Barb you are very welcome, it is my pleasure to help anytime I can oh and welcome to MedHelp! MedHelp has a lot of very knowledgeable members in all of their communities. Take a look around and explore, MedHelp also offers Doctor Forums for your more critical concerns. Please feel welcome to message me if there is anything I can help you figure out, I will do my best :) Take care.

Randy
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Avatar_f_tn
Sorry to be nosy- just wondering how you were diagnosed?  From enzyme levels at first?  Over the past 6 yrs I've had my liver tested about 10x- once in 2005 the AST was high approximately double the normal range ALT which I know is bad.  Then normal a couple of yrs and around this time last yr AST slightly raised; ALT high but normal.  December normal but now AST is 57 and ALT 42.  In 2006 they saw mild fatty liver on ultrasound done for unrelated reasons.  I have crazier nights but nothing like the past at all when I drank very heavily for at least 15 yrs, maybe 20.  I'm female (39) & a worrier and hoping that if I moderate the damage is already done.  My father's father passed from misdiagnosed cirrhosis caused by alcohol almost certainly- I'm also not sure, and I know it's different for everyone, but wondering if cirrhosis at all hereditary.  My mom is a very light drinker, yet my dad a VERY heavy one all his life & he has other health issues, but his digestion and liver are not among them.  I was recently diagnosed with UC after being diagnosed with that around 2003, then told in 2006 that diagnosis was wrong, now they say I do have & it likely was just in remission & original diagnosis was right.  I'm wondering if I am overstressing or walking around damage done.  Oh, & I work out like crazy now- particularly hard where I was really sore in weeks leading up to test, but not that same morning.  Sorry to go on!  I'm just curious if when I see my Dr. to discuss I should let them biopsy or anything and trying to deal with UC which I have seen may increase chances of liver disease.
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Avatar_m_tn
after surgery and anesthesia my liver levels were 80/260 and I have NAFLD.  maybe the anesthesiologist gave me too many drugs?
I think I had a lot of liver damage from that and took 72g of NAC and choline, milk thistle.  I read that arginine can also help move ammonia out of the body?  
can NAC prevent liver damage?  
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Avatar_m_tn
NAC is given in the ER for tyenol overdose and you can get it at GNC or with a doctor's script, n acetyl cysteine.  it is also used for non tyenol overdose according to one study and raises levels of glutathione
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Avatar_n_tn
I also want to thank you for sharing your life with all of us.  I went in for my 50 year check up and my AST level was 37 and labled high.  I also have been binge drinking for the past 6 years and am terrified it has all caught up with me:-(  I am hoping it is nothing to serious, but I know I have done my body damage, and now I am trying to eat more healthy and drink way less...Why does it take a test reading to make us all realize we have messed up our own bodies...Thank you again:-) Kerry
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