ALT Elevated for 1 Year

Dr. Doctor:

This isn't transplant related, but I was hoping that you could answer my question.  I am 27 years old and in good shape.  One year ago I applied for life insurance and was required to take a blood test.  The results were all normal except my ALT was elevated at 72.   Since then I have had numerous blood tests for various reasons.  In each one my ALT has been elevated, ranging from 52 to 83.   All other results in the blood tests were within normal ranges.  My most recent test showed that my ALT was 83 and my AST was 35.  This is the highest result I've had on both of those reading.  I do drink alcohol, but at moderate levels (usually only on weekends socially).  For each of my past two blood tests I abstained from drinking for 2-3 weeks.  The only symptoms of anything that I have are that I have a runny nose often (don't know if it's allergy related) that requires me to blow my nose a lot.  On occassion, I get a slight bloody nose in the same nostril that resolves quickly (probably from constantly blowing my nose).  Also, I have some undiagnosed IBS symptoms that cause indigestion and 2-3 bowel movements daily (never serious enough to seek medical help).  Other than that, I have no history of health problems (two shoulder surgeries for HS football injuries, but probably irrelevant).

My doctor has scheduled an ultrasound for next week.  What is the likelihood that this is a serious liver disease?

P.S.  I didn't have a blood test for 6-7 years before my life insurance tests so I don't really know how long my ALT has been elevated.

Thank you in advance for your answer

[Thomas D Schiano, MD]

this elevation is not worrisome.  It may be a touch of fatty liver related to the alcohol use, even if you are not overweight.  Let's see what the ultrasound shows.

[nd102]

As a follow-up, I should mention that I have been tested for Hepatitis B and C twice, 6 months apart.  In both tests I was non-reactive.  Also, I am not overweight.  I am 5'10, 165 pounds.  If anything, I have more trouble gaining weight that losing it.  

Also, everything in my CBC was normal.  

[nd102]

Doctor:

I had an ultrasound performed.  The doctor told me that everything looks normal -- gallbladder, pancraes (sp.), liver, etc...  

What should my next steps be, if any?

Thank you for your last answer

[Thomas D Schiano, MD]

i would repeat the liver tests in 3 months and see if the changes have resolved.  i think everything will be OK.