Reliability of ALT/AST readings?

03-13-2005, 12:19 PM

Hi all,

I think this is an early phase question, or perhaps prompted by my ongoing disbelief at what may be happening to me...

I am a 36 year old male, don't smoke or do drugs, drink a slight amount (perhap one a week, two a week), and while I don't work out frequently, am generally healthy (go to the gym one/twice a week, carry probably 5-8lbs above my ideal weight). Because my wife is expecting our first child in July, I went to the doctor to have my cholesterol checked (something I do every few years, as we have a family history of high cholesterol).

The cholesterol levels were fine (a touch towards the high end of the spectrum, but they're always like that) but the doctor noted that my AST and ALT levels were very high. AST was 46 and ALT was 102 - both are high but the doctor said the ALT was materially high. He ordered an ultrasound scan of my liver, which I'm having tomorrow AM.

As most people do when faced with something new, I did a bit of reading, mostly on this forum. I guess I realize that a high ALT is not good news at all if it is a true indicator of a problem. However, the night before the blood test, I did have a drink with a friend while sitting in a smoky bar. I also take a daily yoghurt drink with plant sterols added to reduce cholesterol (available in the supermarket here in the UK). I may have taken an aceteminophen tablet when I got home (which I now realize is a terrible mistake), but can't remember for sure. I know that these things could throw the test a bit, but can anyone comment on the ongoing reliability of the ALT/AST tests in general... do they vary that much? Do multiple tests produce a wide range of results? What percent of people have a follow-up test with normal results, or is a high reading a strong indicator of a problem? I really have to say that I don't have any other symptoms (no jaundice, pain, blotchy skin, swelling etc.... really just nothing), but I know that's not conclusive.

I don't believe in self-diagnosis or panicking before getting full info, but with our first child due in 3 months.... I'm pretty scared.

Any input is appreciated. Thanks.

03-13-2005, 06:33 PM

Quote:

Originally Posted by LBJ

Hi all,

I think this is an early phase question, or perhaps prompted by my ongoing disbelief at what may be happening to me...

I am a 36 year old male, don't smoke or do drugs, drink a slight amount (perhap one a week, two a week), and while I don't work out frequently, am generally healthy (go to the gym one/twice a week, carry probably 5-8lbs above my ideal weight). Because my wife is expecting our first child in July, I went to the doctor to have my cholesterol checked (something I do every few years, as we have a family history of high cholesterol).

The cholesterol levels were fine (a touch towards the high end of the spectrum, but they're always like that) but the doctor noted that my AST and ALT levels were very high. AST was 46 and ALT was 102 - both are high but the doctor said the ALT was materially high. He ordered an ultrasound scan of my liver, which I'm having tomorrow AM.

As most people do when faced with something new, I did a bit of reading, mostly on this forum. I guess I realize that a high ALT is not good news at all if it is a true indicator of a problem. However, the night before the blood test, I did have a drink with a friend while sitting in a smoky bar. I also take a daily yoghurt drink with plant sterols added to reduce cholesterol (available in the supermarket here in the UK). I may have taken an aceteminophen tablet when I got home (which I now realize is a terrible mistake), but can't remember for sure. I know that these things could throw the test a bit, but can anyone comment on the ongoing reliability of the ALT/AST tests in general... do they vary that much? Do multiple tests produce a wide range of results? What percent of people have a follow-up test with normal results, or is a high reading a strong indicator of a problem? I really have to say that I don't have any other symptoms (no jaundice, pain, blotchy skin, swelling etc.... really just nothing), but I know that's not conclusive.

I don't believe in self-diagnosis or panicking before getting full info, but with our first child due in 3 months.... I'm pretty scared.

Any input is appreciated. Thanks.

I have had high alt and ast readings during the past 2 years. If I refrain from alcohol for a week or two prior to my physical, the alt and ast are fine.

03-14-2005, 03:50 AM

Follow-up to the first post....

I had an ultrasound scan this morning. The good news - no signs of tumours or cirrhosis of the liver or associated organs. The bad news - definite signs of fatty liver (liver brighter than normal on the scan). Early diagnosis is NASH or NAFLD. My GP is currently reviewing the test results, and a decision will be made as to whether to do a biopsy. The specialist who did the scan didn't think it would be necessary, and that it seemed to be a pretty clear cut case of fatty liver.

I had an awful weekend worrying about this, particularly worrying about my wife and unborn child. I guess that can be put aside for now - the next question (assuming the NAFLD/NASH diagnosis is correct), is looking at long-term management and monitoring of these conditions.

The little information I have suggests that these should, with careful monitoring of diet and exercise, be manageable. Indeed, there are even some cases where it spontaneously reverses (I'm not hoping for miracles though).

Any thoughts on management/monitoring, or prognosis with NASH are much appreciated.

Thanks.

Reliability of ALT/AST readings?

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