“Please help me interpret my AST and ALT lab results?”
I have been a very heavy drinker for many years, (stopped cold turkey a month ago). My primary care physician "missed" the big red "H" next to my recent AST level on my last labs. I discovered it myself but decided not to mention it to her.
I have searched online for some info, but have found some conflicting answers. My AST was 78, my ALT was 46. I have had only two symptoms of liver/kidney damage, BUN/creatinine level of 28, resulting in urine that, in a couple of hours in the bowl, smells very bad, and the body itching. The itching was never frequent and has been absent for six months.
One website said this about AST levels:
- Mild elevation = less than 5 times the upper reference limit.
- Moderate elevation = 5–10 times the upper reference limit.
- Marked elevation = over 10 times the upper reference limit.
This does not seem correct. How disastrous is my level of 78? Will my complete abstinence ameliorate the damage? Is it too late? (I knew this was coming, so, no surprise here.) Can you give me some encouragement? I am not afraid to die, but I don't want to die of cirrhosis; my family will blame themselves for not noticing the extent of my habit.
Please find a specialist who can give me an answer.
I have searched online for some info, but have found some conflicting answers. My AST was 78, my ALT was 46. I have had only two symptoms of liver/kidney damage, BUN/creatinine level of 28, resulting in urine that, in a couple of hours in the bowl, smells very bad, and the body itching. The itching was never frequent and has been absent for six months.
One website said this about AST levels:
- Mild elevation = less than 5 times the upper reference limit.
- Moderate elevation = 5–10 times the upper reference limit.
- Marked elevation = over 10 times the upper reference limit.
This does not seem correct. How disastrous is my level of 78? Will my complete abstinence ameliorate the damage? Is it too late? (I knew this was coming, so, no surprise here.) Can you give me some encouragement? I am not afraid to die, but I don't want to die of cirrhosis; my family will blame themselves for not noticing the extent of my habit.
Please find a specialist who can give me an answer.
Male | 76 years old
Complaint duration: 2 MONTHS
Medications: Nifedipine, atenolol, Venlafaxine, Buspirone, Finasteride,
4 Answers
HepatologistDoctor
ALT stand for alanine transaminase is a liver enzyme as well as AST which strands for aspartate transaminase. High level of alt represents liver damage form hepatitis, infection, cirrhosis, liver cancer as well as other liv er diseases. The normal range is 7 – 55uj/L (units per liter) but varies depending on the laboratory. Increasing fiber intake, reducing saturated fats and processed food, and eating vegetable and fruits would help to reduce and repair the liver function. Obviously, when you stopped the alcohol consumption was a great decision. AST strands for aspartate transaminase. Increase AST has the same connotation as ALT. Elevation means liver injury and disease. And the AST/ALT ratio is an indicator for hepatocellular injury. A typical ast/alt ratio is less than 1. Sometimes minor increments in ast/alt ratio are seen with vigorous exercise and skeletal muscle injury. The four warning signs of liver damage are skin and eyes that appear yellow, abdominal pain and swelling, itchy skin, chronic fatigue, dark urine color. I recommend to you to see a Hepatologist, a doctor specialized on liver diseases. Please go and see him/she and they will help you. Thank you.
The elevated AST is not a harbinger of death, please relax a bit. Abstinence is highly recommended. There’s nothing good about alcohol. You don’t need it. That said, you are also on several medications, some of which could also be injurious to the liver. Maybe you should see a geriatrician and try to trim down your meds.
Yes. The liver enzyme elevations are mild and reversible. A liver ultrasound is warranted to assess the texture of the liver. One consideration is alcohol-induced liver enzyme elevation. A second consideration is fatty liver from carbohydrate and fatty acid storage. Both are reversible. A liver biopsy is not essential. A hematologist can provide expert advice.
Please do not panic, but stay off the alcohol. The best thing would be to check again in a few months and avoid Tylenol also, which can elevate the AST or ALT. It is true that numbers much higher are what we are alarmed about for patients, and suggest more serious diseases. If your numbers remain a bit up then seeing a gastroenterologist would be a good next step, for further evaluations. I hope that is helpful.
