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ALT/AST elevations from binge drinking

My 19 year old daughter is home for the summer from her first year of college.  She had her labs done at a physical checkup the first week home.  Everything was normal except for her AST (102) and ALT (67), both being elevated.  She had done some heavy drinking the last weekend there and her fair share of drinking and partying during the entire school year.  She then went 1 month with no drinking and had them repeated.  They are now back to normal, so it was determined this elevation was alcohol related.  

Our family history is such that my father died of alcoholism at age 52 and my mother, age 79, is currently being treated for  primary biliary cirrhosis and has had this diagnosis for the past 20 years.  She is stable at this point.  Her cirrhosis is thought to be from taking the drug INH and also from drinking, though she is not an alcoholic and has ceased all drinking in the last few years.  

What would your recommendations be regarding the amount of drinking my daughter would be able to safely do, if at all.  How long can a liver take abuse before showing signs or symptoms of disease and what would these signs or symptoms be besides the elevated lab tests?  It is hard for me to get her to understand the ramifications of what she does today will have on her in the future.  

Thank you for your recommendations/advice.  

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The AST/ALT pattern is already showing signs of alcohol use.  There is no "safe" recommendation for drinking (although at age 19, note that she is underage in the United States).  The length of time it takes before more permanent damage varies from person to person, but she is already doing damage with the elevated AST/ALT.  

Other possible symptoms would include right upper quadrant pain, fever, jaundice or anorexia.

I would encourage that she obtain counselling on alcohol as well as a discussion of the effects of alcohol with her personal physician.

Followup with your personal physician is essential.

This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.

Kevin, M.D.
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