I have A Manual of Laboratory Diagnostic Tests book by Frances Fischbach, second edition.. which gives some possible causes for elevated levels of ALT and AST. Are your levels currently flagged as high?
My old book lists causes of elevated ALT as:
"1. Hepatocellular disease (moderate to high increase)
2. Active cirrhosis (mild increase)
3. Metastatic liver tumor (mild increase)
4. Obstructive jaundice/biliary obstruction (mild to moderate increase)
5. Infection or toxic hepatitis
6. Liver congestion
7. Pancreatitis (mild increase)
8. Hepatic injury in myocardial infarction complicated by shock"
(that last one let me do a little interpreting- liver injury in a heart attack)
It says AST always goes up ith an acute heart attack, but the ALT won't alway go up proportionately. It also mentions ALT/SGPT is typically up by more than AST with extrahepatic biliary obstruction that's acute.
It lists causes of elevated AST (normal level reference range lower in women then men) as (excerpts):
"1. Myocardial infarction (MI)" (says it may be up four to ten times normal)
"2. Liver disease" (says it may be up ten to a hundred times normal)
"3. Other diseases associated with elevated AST/SGOT levels
(a) Acute pancreatitis (f) Cardiac catherterization
(b) Trauma and irradiation of skeletal muscle with angioplasty
(c) Acute hemolytic anemia (g) Recent brain trauma with
(d) Acute renal disease brain necrosis
(e) Severe burns (h) Crushing injuries
(i) Progressive muscular
With both ALT and AST, it tells there are a number of drugs that can cause elevated levels too, so are you taking anything? Even vitamin A evidently can increase AST.
If your doctor is concerned about your liver, why not ask them first, before going to the biopsy if you can get some further diagnostic tests? I have liver lesions and slow gallbladder emptying myself. I've had an abdominal ultrasound, cancer marker blood tests, a HIDA scan with ejection fraction, an MRCP looking at all my duct work (including pancreatic, liver & gall bladder), and have been following up on the lesions with MRI (don't want CT- more radiation and MRI is more sensitive for accurate diagnosing of hemangioma, which I have either one (for sure) or two (not sure because too small) of.
Also, they've checked your cholesterol, but have they done a echocardiogram to take a look at your heart structures and how your heart is functioning?