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Old 10-03-2012, 04:14 PM   #1
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fatty liver level of damaged by AST/ALT

Hello.

I have fatty liver detected on 2010 but very probably have it since several years. I was wondering, if liver current damaged can be saw on blood AST-ALT test??.

For example if someone has high levels of AST-ALT does this reflect how much damaged currently has someone? (like for example, cirrhosis could be detected if the person has several years with very high liver enzimes?), and in another scenario, if someone has several years with fatty liver showed in ultrasound, but blood test AST-ALT are in normal range (less than 20 points each one) does this means this fatty liver isn't increasing his damaged? Does a fatty liver of 20 years with normal AST-ALT levels means there's no big damaged or cirrhosis?

 
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Old 10-04-2012, 08:18 PM   #2
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Re: fatty liver level of damaged by AST/ALT

Liver enzymes are a very good indicator of how inflamed the liver currently is due to recent injury or disease processes going on, but high enzymes do not indicate how much damage has been done in the past.

If a young man with a healthy pristine liver goes out on his 21st birthday and gets extremely drunk, he will have very high enzymes for a week or so after this with little or no permanent damage done to his liver. If an older man with a long drinking history and substantial fibrosis/damage stops drinking, he may have fairly normal enzymes following a period of sobriety, even though his liver is substantially and permanently damaged.

I know fatty liver is different from alcoholic liver disease, but this is an easy to understand way to view the differences between enzymes and liver damage.

If you've got a fatty liver and normal enzymes, this typically would indicate you're not having a lot of inflammation or damage going on at the moment, but you may be pre-disposed to inflammation and damage in the future.

The fat in fatty livers may not cause problems unless it begins to oxidize through exposure to alcohol, chemicals or drugs (including prescription drugs). Many people have fatty livers for many years without problems, but then run into trouble from medications or toxic exposures that rapidly oxidize the fat in the liver producing inflammation.

I'm not a doctor, but this is simply my understanding of the situation. Hope it helps.

 
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Old 10-05-2012, 12:16 PM   #3
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Re: fatty liver level of damaged by AST/ALT

Thanks for your answer BillinSD.

I though that high liver enzymes was related to how many damaged a liver can have. But, your explanation (and some research online where I saw that even on cirrhosis of the liver, enzymes could be on normal range) so basically there's no way to find out how damaged is my liver already I know you can recommend liver biopsy, but I also read that even liver biopsy is not so accurate like people think, the reason is the person which performs the biopsy could insert the needle in some space of your liver that is not very damaged meanwhile probably on another side of your liver you could have cirrhosis, so someone could be missdiagnose as mild fatty liver and could have earlier cirrhosis...

But with this normal liver enzymes on my side, no doctor is going to prescribe me any liver biopsy anyway. (and since biopsy is not accurate either, is not very usefull).

So, there's no really a good way to know if this fatty liver is very damaged or not which is kind of sad to know.

 
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