Fatty Liver

Hi Dr.
I'm a 40 years old male. I write you from Bolivia. Six months ago I’ve been diagnosed with fatty liver during a routine tomography. At that time my lab tests showed mild increases on my alt and ast levels (i.e. 39 and 35 respectively). Since then I gave up drinking and lost 20 pounds of weigth. During the last six months I had three more lab tests that showed the following results:
07/10: ALT 19 AST 15 Ui/L Total Bilirrubin 0.8 mg/dL
08/10: ALT 21 AST 20 Ui/L Total Bilirrubin 1.20 mg/dL
11/10 ALT 17 AST 22 Ui/L Total Bilirrubin 1.10 mg/dL

I’m also on treatment for hiperlipidemia with a drug named gemfibrosil. My lasts tests showed a decrease to 141 mg/dL on triglycerides and 194 mg/dL of cholesterol

My doctor said everything was going Ok. I read that an AST/ALT greater than one should be something to concern about. Is that correct? According to my last lab tests this ratio is 1.29 even that both levels are within normal ranges
I truly will appreciate your opinion in order to take further actions or to find another doctor out the country.
Kindly regards

[Thomas D Schiano, MD]

most likely you have an element of fatty liver that has completely responded to weight loss and treatment for your increased lipids.  it is great that the liver tests have normalized.  as long as you continue these lifestyle modifications, you should be OK.  good luck.