High AST/ALT levels very scared, had gallbladder disease with removal in 2009. I am 27

[lily1313]

I am terrified. I had the stomach flu this past week with a high fever. I had taken tylenol twice on top of my normal Flovent HFA and Albuterol HFA inhalers as needed. My whole family was ill, with 3/5 of us in the hospital for dehydration from vomiting so much. Three weeks back I had a Z pack for bacterial laryngitis and took tylenol then too. Those are the only medications I have taken. I do not drink, smoke, or do drugs.

In 2009 I had my gallbladder removed due to gallbladder disease. Other than Asthma I have been healthy. Today in the ER my lab results came back:

Protein (H) 8.4 range 6.2-8.2
Albumin 4.2 range 3.2-4.7
Billirubin total 1.0 range <1.1
Billirubin (H) 0.5 range 0.0-0.3
Alkaline Phosphate 197 (H) range 26-137
AST (H) 523 range 0-37
ALT (H) 340 range 15-65

Sodium, Potassium, Chloride, C02, Anion Gap, Glucose, BUN, Creatinine, EGFR= Normal.
WBC and RBC = Normal.
Hemogoblin (H) 15.9 range 12.0-15.5
Hematocrit, MCV, MCH, MCHC, RDW, Platlet = Normal
Neutrophil (H) 87 range 49-74
Lymphocites (L) 5 range 26-46
Monocyte, Eosinophil, Basophil, ABs Neutrophil = Normal
ABS Lymphocyte (L) 0.4 range 1-5.1
Monocyte Abs, Eosinophil ABS, and ABS Basophil = Normal.


Could a stone in my bile duct be the cause of this? The hospital didn't investigate and sent me home after asking me over and over if I drink. I have actually never drank in my life. I am very anti-drugs and alcohol. I am afraid thinking I am dying. I feel fine though at the moment. I almost want to believe they made a mistake on the test...

[lily1313]

My levels declined rapidly within 4 days after the test they were down to near normal values after I had a repeat blood test and ultrasound. I was given a hep. panel and the doctor believed I could have had viral hep. A, but alas the panel came back needing more blood for the test and he never re-ordered it. I continue to have no symptoms and since my values were near normal about 4 days after the test they have not retested since. I was given an Ultrasound and was clear of any visible liver or kidney issues, and my bile tract was clean.

[Paderla Anitha, DNB]

Hello and hope you are doing well.

The normal range of values for AST (SGOT) is from 5 to 40 units per liter of serum and the normal range of values for ALT (SGPT) is from 7 to 56 units per liter of serum. Elevated levels can occur with liver disease, but other causes for the enzyme elevation could be muscle disease or injury. Some medications can also raise these levels. Since you have no symptoms of liver disease like jaundice, nausea, vomiting, abdominal pain or fever, I would advise you to wait for now and repeat the test after two weeks to see how the levels are progressing.

Hope this helped and do keep us posted.

[femmy29]

Your ALT is very high.  I hope you found some answers from the doctors by now.  I just had a liver panel done and my ALT was 56 and the normal range is 5-50.  My doctor told me that it is likely not a concern and that he gets concerned when he sees ALT numbers that in the 200 to 300 range.  I asked for further testing and we found that I have gall bladder disease and I am going in for surgery next Thursday to have it removed.  

High ALT values can be attributed to excessive tylenol use but typically the single dose would need to be more than 1,000 mg and the total daily dose more than 4,000 mg.  Do you recall how much tylenol in mg you ingested?  Keep in mind that there is tylenol also in many cold/flu products so you could have been triple dosing on tylenol without being aware of it.  Are you having gall bladder attack type symptoms?  Have you or do you have yellowing of the eyes or skin?

A stone could very well being blocking the bile duct but you should have noticed yellowing of the eyes and skin as the bile has no where to go but into the blood stream.  You will need a special X-ray done to determine if that is the case.  If that is the case, they can remove the stone using ERCP.

Please post if you can and let us know how you are doing.

femmy