Should I Be Concerned?

[LindaJoy]

Me again. Got a question about lab results. I've been getting a lot of them done the past year, at least one full panel per month. Usually my ALT and AST are normal, but last November, my ALT got up around 200, then came back down. Lately, my AST got a little higher, now it's down to 46 while my ALT is rising again. It was around 58 two weeks ago, then a week ago, 100. (normal is only up to 45, I think.) I've never had a high ALT before, except last November, and I was on coumadin then, for blood clots. It's usually low.

Should I be concerned? They found cyst-like things on my liver at OSU in May. My aunt died of liver cancer, so this concerns me. Does it have to mean liver problems? What else can cause high ALT? I've researched it, but I don't understand a lot of it.

Thanks.

Lindajoy

[Guest Eliza]

LindaJoy,

I don't know much about these tests and what the normal ranges are but I certainly would not ignore it if this is different than YOUR normal. I know that many medications can affect the liver, are you on any meds that could be the cause? If you have a family history of liver problems then I would NOT HESITATE AT ALL to have it checked out. It is better to be safe than sorry. I can't imagine any doctor would think you were over reacting with this situation. You have to think of yourself first and take care of you.

The only thing that I am aware of causing abnormal liver tests (other than meds) is gallbladder disease or gallstones. BUT, again I don't know much about this. Sorry, I wish I could help more. Hopefully others have more knowledge!

[pat57]

See a gastroenterologist- if you can. Those are not normal. There are a number of hepatitis strains, most likely the Dr. would feel your liver and spleen to see if there is inflammation. Perhaps run blood tests for the known strains.

Obviously you need clarification re the cyst-like things- also.

to my knowledge both ALT as AST are effected simultaneously , with hepatitis. You seemed to indicate that both were high. Whatever else might do that, I can't speak too.

[Guest Eliza]

Ok LindaJoy, I just did a search on increased ALT and this is what I found:

Causes of INCREASED ALT can be: Hepatitis, cirrhosis, liver metastases, obstructive jaundice, infectious mononucleosis, hepatic congestion, pancreatitis, renal disease, ethanol ingestion

I am sure there can also be less severe reasons for the increase especially if the numbers are going up and then back down. I just wanted to post what I found when I did a search on it. I hope it helps.

[LindaJoy]

Thank you, everyone. Thanks, Eliza. I just had an ERCP for a bile duct narrowing problem that caused some pancreatitis (this was done in July). The doc said I had minimal chronic pancreatitis. I know I still have pain, terrible smelly gas (sorry), fatty stools, etc., that come with pancreatitis.

Again, thanks. I just hate this!

Lindajoy

[Guest Eliza]

LindaJoy,

Well it does sound like your chronic pancreatitis could be the cause of the labwork being high but of course you might want to just make sure that is the problem and ask your doctors opinion. I cannot imagine having pancreatitis, you must be in TONS of pain. I have heard that can be miserable to deal with. I sure hope things get better for you!

[Sunfish]

linda et al -

while it's never a bad idea to ask your doctor about abnormal blood work, i wouldn't worry TOO much about it in the moment. there are a LOT of reasons for elevated liver enzymes, and while it's not something to ignore, more times than not it's not something that is dangerous in the short-term. and it definitely could be part of the pancreatitis issue. i've had high liver enzymes for most of the past two years - ranging from slightly elevated to dangerously so - for various reasons. my reasons have included an adverse reaction to IVIG treatment (this raised my numbers the most dangerously), sepsis (which can wreck havoc on pretty much anything in the body), pancreatitis (in march & in august), & long-term TPN (IV nutrition) use (known for the stress it puts on the liver).

the liver can put up with A LOT though, so despite all of my elevations, i actually currently have normal enzyme levels & all in all a healthy liver. i'm not telling you this to keep you from asking your doc about it but just to keep you from stressing about it in the meantime. more times than not elevated liver enzymes are indicative of something going on in the body (& thus the liver's reaction to that something) rather than an isolated problem with the liver itself. but the "something" may or may not be something of great concern. most of the time my high enzymes were simply followed...they really only raised huge alarms when they were over 50 times normal values, but even then they prompted only stopping the suspected instigator of the elevation, additional bloodwork & a watch & wait approach for several weeks wherein if they hadn't started to fall we would have proceeded with a liver biopsy.

hope this helps,

melissa