alt billirubin elevation

Hello Dr, I have had slightly elevated ALT levels for years range from 60 to 90. I have had numerous ultrasounds two abdominal MRI's and I even had bloodwork done at your hospital, pretaining to my liver (8 pages worth) no hep or anything. I am MZ for alph 1 my level is 90. Recently my blood work which I get every three months has been steady ALT 55 to 60, my problem is my billirubin has creeped up from 0.9 , 1.2 and just last week out of range 1.6. Mylast MRI was in May liver was normal except for a small 2mm non enhancing liver cyst. I do have numerous gallstones, which I think cause me pain from time to time. O nly med is vicodin once at night maybe 5 x a week 7.5 700. What do u think AST 26  alk 80  albium 5.2..... thanks

[Thomas D Schiano, MD]

i am concerned that long-term vicodin use might be a culprit here.  the bilirubin elevation is probably all indirect fraction in nature so i wouldn't worry about it.  If the liver tests are abnormal for some time i think a liver biopsy is indicated.

[loured]

My ALT in july was 55 and most recently (Jan 14) 61. My Alt was in the 90's in May and March. Do you think another MRI w/contrast is warranted (last one in May). Can the Billirubin be from the gallstones?. I also have cholestorol issues, can that have an effect on My liver?.... The vicodin 1 x a night would cause liver issues???...... I am kinda nervous about a liver biopsy, would'nt the MRI'S and US show problems?. Thank you so much for your time you are a gentleman.