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elevated AST only
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elevated AST only

Hi all

I am looking to see if anyone can relate to my situation. I am 32 and I have slightly elevated AST (50 to 60)for at least the past 3 years. I don't drink not even social don't take any medications, etc. Nobody said anything and all the sudden is a huge concern for one of my doctors(GI) For the past 5 months I have been tested for hepatitis screening, abdominal ultrasound, autoinmune hepatitis, a serial of blood works and many others tests.
Most are normal the except for ca125 came back elevated, which my obgy thinks is endometriosis, because he performed another ultrasound for the uterus and the ovaries with normal results. Low creatinine serum and low vitamin D.
Now my GI wants to perform a liver biopsy and I am hesitating to do it. Could endometrisos elevated liver enzymes? I read that AST could be related to other disease other than the liver? What else should i be tested before going to a biopsy or I should not be concern and just do it?

Thanks

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113538_tn?1207625032
OMG! I just responded to your question about CA-125 and come to find that you have another problem that I had! I've had an elevated AST off and on for as long as I can remember (in the 40-50's range). My doctor did all sorts of tests (same ones as you describe) and also a liver ultrasound. All normal. He stopped short of doing a liver biopsy. They never found out why I occasionally have an elevated AST. I barely drink, and always make sure not to take any Tylenol before I have blood work done.

Some of us just don't fit the mold, I guess.
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Avatar_m_tn
AST is not the most specific liver enzyme. Liver disease or injury usually results in an increased ALT, which is considered to be the most specific liver enzyme. If your ALT and AST were elevated that would point to a liver issue. And isolated AST elevation is not as strong an indication of a liver problem.
Are your ALT, GGT, Bilirubin and Alkaline Phosphatase within the normal range?
Sweetie, you said that your AST elevation is slight and I agree with you. It is not that significant of an elevation that I think you need to panic. But, of course, I would want to know what, if anything, is going on.

I have had Hep C and underwent a liver transplantation is 2000. I have had a lot of biopsies. Generally, they are no big deal. If I were to undergo a liver biopsy I would want to make sure it was ultrasound guided. This makes hitting the right spot much easier than just estimating where to insert the biopsy needle. Some places give you some mild sedation before the procedure and then inject a numbing agent into your skin. It is usually quick and relatively painless. I always say that the anticipation is worse than the event. But, there is a slight risk of bleeding and you will have to remain at the hospital for 2 or 3 hours after the event to insure that there are no complications. The waiting was the worst part for me. I have probably had more than 6 of them and I never had a problem

While AST is considered a liver enzyme AST it is also an enzyme  found in high amounts in heart muscle and liver and skeletal muscle cells. It is also found in lesser amounts in other tissues.

An increase in AST levels may indicate:

    * Acute hemolytic anemia
    * Acute pancreatitis
    * Acute renal failure
    * Cirrhosis
    * Heart attack
    * Hepatitis
    * Hereditary hemochromatosis
    * Infectious mononucleosis
    * Lack of blood flow to the liver (liver ischemia)
    * Liver necrosis
    * Liver tumor
    * Multiple trauma
    * Primary muscle disease
    * Progressive muscular dystrophy
    * Recent cardiac catheterization or angioplasty
    * Recent convulsion
    * Recent surgery
    * Severe deep burn
    * Skeletal muscle trauma
    * Use of drugs that are poisonous to the liver

See: http://www.nlm.nih.gov/medlineplus/ency/article/003472.htm

From: http://en.wikipedia.org/wiki/Liver_function_tests

Aspartate transaminase (AST) also called Serum Glutamic Oxaloacetic Transaminase (SGOT) or aspartate aminotransferase (ASAT) is similar to ALT in that it is another enzyme associated with liver parenchymal cells. It is raised in acute liver damage, but is also present in red blood cells, and cardiac and skeletal muscle and is therefore not specific to the liver. The ratio of AST to ALT is sometimes useful in differentiating between causes of liver damage.[2][3]  Elevated AST levels are not specific for liver damage, and AST has also been used as a cardiac marker.

I wish you both good luck,
Mike
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Avatar_f_tn
I am surprised that the GI wants to do a liver biopsy, most doctors do that after they have exhausted all other tests and options.  I know people who have fought for years to get their doc to do one.  Have you had an abdominal CT scan?  You elevation is very moderate.  Do you have any symptoms or ailments that might be leading him in that direction?
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Avatar_m_tn
I agree with you though I didn't think it was appropriate to disagree with the doctor. Seriously with the information posted I see no need for a liver biopsy...... but then I'm just a patient.

Mike
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Avatar_n_tn
Thanks to all for the replies and information.
Pretty much all my results are normal except for what I mentioned above. Low creatinine serum and low vitamin D and of coures elevated AST and ca125. My ALT is normal and when I asked if something in my pancreas could be elevating the AST he said that the pancreas will not elevated the AST, but I have read that it could be affected by others stuff as mikesimon  mentions in his post. I do have a small problem with a heart valve, I haven't mentioned or asked if that could affect it.
Thanks again
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Avatar_f_tn
I apologize if it seemed that I was disagreeing with doc, I did not mean for my post to come across that way.  Sounds like her doc is trying to be proactive.  I commend him for that.
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Avatar_m_tn
I didn't take it like that at all. I didn't see that much evidence of liver injury so I questioned the appropriateness of a biopsy. But, I did want to state my opinion that a biopsy is not as big a deal as some people make it out to be just in case she did have to undergo the procedure.

I do believe that cardiac issues can be associated with an increased AST but I don't know what effect a valve problem might have. I would definitely discuss that with my doctor. It is always best to disclose all medical conditions even it they seem irrelevant. Sometimes it can really help the doctor figure out what is going on.

Good luck,
Mike
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