Elevated AST and ALT in liver - hypothyroid 25 year old patient
Hello, I just received results from a blood test I had done yesterday. I am hypothyroid and currently taking levothyroxine to maintain my thyroid hormones. I was diagnosed hypothyroid 6 weeks ago when my TSH went up to 53. I gave birth to my son 9 months ago and was told that my thyroid problems are common for postpartum women and hopefully they will go away with time. My blood test results show I do need to increase my dosage as my TSH levels are still high, although they decreased dramatically from my first results 6 weeks ago.
Onto the issue that I'm currently dealing with....6 weeks ago, my doctor told me she'd be monitoring my liver enzymes as my AST came in slightly out of range at 50. My results from yesterday's work show that my AST went up to 53 and my ALT is up to 70 (my ALT was normal 6 weeks ago). I do not drink alcohol at all, have never used drugs, and have been in a monogamous relationship with my husband for the past 5 years. I am a 25 year old female with no history of liver disorders. My doctor told me to come back in 2 weeks for Hepatitis B and C tests as well as more bloodwork. How would one in my situation get Hepatitis considering my background of no needle sharing, drug use, or multiple sexual partners? My husband had a physical a few months ago and his blood tests are normal. The fact that I recently had a baby made me think that I would be in a completely healthy state and now I am freaking out over all these negative results. What else could cause my liver enzymes to go up? I am currently experiencing major discomfort in the right side of my back down to my abdomen and leg. I also experience digestive issues, which I thought stemmed from the thyroid condition, but am worried now this may be caused by the liver?? I know that I should wait until my appointment in 2 weeks but I can't think of anything else. Can someone help explain what's going on with me? Thanks so much!
Enzymes AST and ALT are used for monitoring hepatic function due to its high concentration in hepatocytes. However they are mitochondrial enzymes, and mitochondria are everywhere, especially in muscles. It would be a good idea to also test for direct, indirect and total billirubin, also if it is possible for TBA (Total Bile Acids), in other situation to measure Total Alkaline Phosphatase would be helpful, but it raise up in pregnancy due to fetal isoenzyme. If it is possible to do an Alkaline Phosphatase Isoenzymes quantification it would be very helpful. However Alkaline Phosphatase Isoenzymes quantification and TBA are test that usually are not performed by average Clinical Laboratories. Other test that would help are CPK, CPK-MB, Mioglobin and GGT. Most of the times Hypothyroidism is a manifestation of an autoimmune condition, other autoimmune conditions can attack muscle tissue and raise up those enzymes. Other mechanism less severe is dehydration, when our body doesn't get enough water it start to produce it somehow. When the protein link is broken the a molecule of H2O (water) is produced, the main source of proteins in our body is the plasma (another good idea would be to perform a total protein and albumin test) and the muscle.
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