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Old 06-25-2010, 10:21 PM   #1
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AST/ALT <1, should I worry about these numbers?

I got my lab results today and noticed my AST/ALT ratio is almost exactly 0.5. My AST is 43 and my ALT is 85. And my white and red blood cell counts were both flagged as low (for as long as I can remember I have been fatigued and generally sluggish, and I am now diagnosed anemic). RBC count was 4.25 and WBC was 3.7. My doctor doesn't seem worried at this point but I'm freaking out thinking my liver is going to shut down at any minute. Am I over-reacting? Are there any useful links between the AST/ALT ratio and the cell counts being low?

 
Old 07-02-2010, 07:35 PM   #2
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Re: AST/ALT <1, should I worry about these numbers?

As I always like to say, I'm not a doctor, nor do I play one on the Internet.

With that out of the way, it sounds to me like your liver still has plenty of miles on it. Your AST is indeed a tad high (for most of the population, that is, although there are some outliers for whom that number might be normal or at nearly-normal). But different factors can make that number rise or fall, so you want to look at your recent reading as a mere snapshot that doesn't tell the whole story of what - if anything - might be going on with your liver. How are your blood protein and albumin levels? More than AST/ALT levels, these indicate if the liver is working properly. Regarding the ratios of AST to ALT, I'm not aware that these have any great significance other than that, in drinkers, if the ratio is >1 and especially in the neighborhood of >2, then alcohol-induced liver damage is the likely cause.

So far as the blood cell counts, I'm not aware of how the liver would interact with red cell production. Low white cell counts could-maybe-possibly-might have to do with liver dysfunction, but if your doctor took a thorough history from you (covering items such as drinking and other drug [prescription or street] usage, exposure to environmental toxins, etc.) and isn't sounding any alarms, it's probably for good reason.

Finally, know that if you *were* having liver issues (and so far, no one is saying you are), the liver is a very forgiving and resilient organ, and generally doesn't give out without *ample* insult and warning.

Has your doctor made any indication about addressing whether your fatigue is stemming from your low RBC, and how this might be addressed?

 
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Old 07-04-2010, 11:14 AM   #3
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Re: AST/ALT <1, should I worry about these numbers?

My doctor has not made any indication about why I'm fatigued. I've seen my doctor twice but probably not even talked to him for 15 minutes; he seems more interested in writing a script for antidepressants for the mental symptoms I've been experiencing and showing me back to the front desk. I think anemia would explain not only my fatigue but my mental symptoms and quite a few other things as well. I came to the conclusion, independently, that my numbers didn't indicate any _serious_ damage (e.g. disease or alcohol damage). My protein is 7.2 and my albumin is 4.6 (both in g/dL). There is a link between the liver and red blood cell production (erythropoietin), so I'm thinking there is a plausible link between liver function and red blood cell production (then again I'm a mathematician and not a biologist). I have a brief history of drugs and drinking which I've shared with my doctor. There is a possibility of environmental toxin, but that was several years ago and I don't remember any time when I had any serious symptoms that would indicate exposure or infection (no fever, vomiting etc). Another possibility is that when I went to college and lived by myself, I did not eat right. If my diet was too high and fat and low in essential nutrients for 2 or 3 years, could that lead to fatty liver? If so, would it take more than another 2 or 3 years of improved diet for my body to correct itself?
I am glad to know that my liver is still in ok shape, but I have started taking milk thistle extract and eating plenty of fresh blueberries to help it.

 
Old 02-04-2011, 10:31 PM   #4
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Re: AST/ALT <1, should I worry about these numbers?

I thought that I would bump this to the top and the numbers appear to be quite similar to my situation for AST/ALT ratio, total protein, and ALT number.

 
Old 02-05-2011, 10:15 AM   #5
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Re: AST/ALT <1, should I worry about these numbers?

Roberto, it's coincidental that you should choose to bump my old thread at this time. I got my blood drawn again last Tuesday and have received my results today. My AST is 20 and my ALT is 19 . I'm still working through fatigue which ranges from mild to severe, but at least I know I have a liver (*edit: I meant a healthy liver). I didn't take for my liver anything besides milk thistle extract, and I stopped taking it a few months ago so I'm not sure how much it really helped or why my numbers were spiked last summer. The liver can and does heal itself though, so I hope you find a way to get yours back down too.

Last edited by tnmsc83; 02-05-2011 at 10:17 AM. Reason: *

 
Old 02-05-2011, 01:40 PM   #6
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Re: AST/ALT <1, should I worry about these numbers?

Thank you.

I was hoping my numbers weren't indicating a possible life threatening situation, but wan't sure. The numbers seem to jump around depending on a lot of things.

My doctor stressed life-style changes and come back in three months for a re-test.

I appreciate the mentoring and will try some milk thisle for a while.

 
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