AST ALT Ratio

[AQuickQuestion1]

As of now, I haven't been tested for Hep C because I don't have risk factors (I know that doesn't matter). I learned that growing up my mother used drugs and my grandfather is an African American vet who I lived with both growing up. I'm sure we probably used the same toenail clippers and such. I recently received my bloodworm back from my CMP and these are my numbers. They seem low, but I am very concerned as the alt is higher than the ast. My alt is 15 and my ast is 13. This places my ratio <1. Should I be concerned? I am pregnant and suffer from iron deficiency anemia as well. I'm light skinned and my eyes looked kind of yellow, but I figured I couldn't have jaundice is my bilirubin is only 0.2. Is that correct? Thanks for your time.

[HectorSF]

"My alt is 15 and my ast is 13. "
* As others have pointed out that means your ALT and AST are both NORMAL. That's as good as it gets!

The ALT/AST ratio is only used when a person has high ALT and AST blood levels and has liver disease. It is sometimes used to predict if someone has the last stage of liver disease. Cirrhosis of the liver. Which is usually takes 20-40 years after being chronically infected with hepatitis C to occur.

"I'm light skinned and my eyes looked kind of yellow, but I figured I couldn't have jaundice is my bilirubin is only 0.2. Is that correct?"
* Yes, most persons need a blood level of total bilirubin over 3.0 (more than 10x the amount of bilirubin you have) for their eyes or skin to appear yellow. You do not have jaundice.

The only way to know if you are infected with hepatitis C is to get tested. It is simple and well worth the piece of mind.
Then you can concentrate on your pregnancy and your new baby!

Good luck to you and your baby!!!
Hector

[willbb]

They seem low, but I am very concerned as the alt is higher than the ast. My alt is 15 and my ast is 13. This places my ratio <1. Should I be concerned?
but I figured I couldn't have jaundice is my bilirubin is only 0.2. Is that correct?
---------------------

These are perfectly normal liver enzyme numbers,including the bili level which when high is the reason one would be jaundice.

IMO everyone should be tested for HCV,even tho from your blood markers there is no indication of such.

best ...
Will

[AQuickQuestion1]

Thanks you all. I appreciate it. I know I am worrying like crazy. My anxiety at the end of this pregnancy is getting to me. My mother had me at 15 and that was before she used drugs,etc. so I am not really worried about being given hep c at birth. I just feel like at this point it's my luck to have it and not know it. Hopefully I can get over my fears and take an antibody test soon. Thanks again!

[nursehepc]

I agree with pooh. You are concerned.  The only way to address your concerns is to get tested.

[pooh55811]

If your mother was a drug user, she may have had Hepatitis C. If she had Hepatitis C, she could have passed it to you when she delivered you. There is about a 5% chance of the mother passing the Hepatitis C to her child during delivery if the mother has Hepatitis C. Of course, these are ifs and I don't know if your mother had Hepatitis C.

If it was me, I would get a Hepatitis antibody panel run to see if you carry the antibodies. If you do not carry the Hepatitis C antibodies, then you will know that you do not have Hepatitis C. If you do carry the the antibodies, then you can be tested to see if you have chronic Hepatitis C or if you cleared it on your own (which happens in 20-25% of the cases). In any event, it is useful to know if one is infected or not, especially since you are pregnant.

Best of luck.

[nursehepc]

Bottom line: Simply stated, if you had an elevated ALT level (above the normal range-which you don't) - greater than your AST, it may be indicative of hepatitis (e.g., from drugs, alcohol, fatty liver, viral etiology - A, B, C,....). If you have elevated levels (or not...and your AST is greater than your ALT), it may (or may not) be indicative of cirrhosis/alcoholic liver disease (AST elevations greater than ALT can also be an indication of skeletal muscle injury and other non-liver related injury - AST is not liver specific, ALT is). If you are truly concerned you should be asking your doctor these questions (I would hate for you to worry needlessly).

[nursehepc]

Its true that the ALT is higher in liver disease, but it is also normally higher in the absence of liver disease. No offense...

[AQuickQuestion1]

No offense at all, but are you sure? I have read in several places that in most types of liver disease the alt is higher than the ratio between the two is less than one with AST:ALT.

[nursehepc]

ALT is generally higher than the AST (and both are great). A ratio greater than 1 (AST > ALT) with elevated enzymes is SOMETIMES reason for concern (not less than 1), but not always. Your bili is only 0.2, These blood results would not be a reason for concern.

[AQuickQuestion1]

Just to add. I am a 24 year old African American female, 8 months pregnant. And my alk phos was 114 if that matters.