Liver experts

[Sark]

Hi all, this isn't related to steroids or anything but it is related to bloodwork and the liver, and I know there are some very knowledgeable people here so I hope this is ok to ask

My girlfriend recently got some bloodwork back and the dr (who I'm not too impressed with) exclaims that her liver is damaged based on the results. She's 21 years old, works out regularly, follows a decent diet, and only drinks occasionally.
The doc ordered a bunch of hepatitis tests and another liver panel, but the only thing that was out of range was AST at 95 U/L when it should be 0-45. ALT was normal at 37 U/L. Everything I can read says that usually liver damage will show high ALT and AST, and that it is usually higher numbers such as 10 times the normal range. But this is where my lack of experience shows; is AST at 95 actually high and indicative of some damage? I understand it's above normal, but the way the doctor acted made it seem more serious.

So main question really is, is AST at 95 U/L actually concerning, or just something to watch?
Additionally, they found trace amounts of Ketones in the urine, which kind of surprises me but I don't know much about how common that is. Clarity was also cloudy, as apposed to clear which got flagged by the lab too.

Thanks for any help, if anything at least any answers can hopefully give me a better understanding of the liver and what bloodwork numbers mean.

[kelkel]

If she works out hard the muscular trauma itself can raise liver values temporarily to a highly pathological level. Think 5 x normal values which can last for up to 10 days or so. Maybe there's more to the story or maybe the doc should have retested after a week of rest and talked to her more in depth.

Read the below study. It's done on men but I assume women have livers to!


https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2291230/

[Mr.BB]

ALT is an enzyme present only in liver, while AST also is present in skeletal muscles.

Sorry, the usual diagnostic for a 95 AST and 37 ALT, which makes the AST/ALT ratio greater than 2, is alcoholic liver disease.

You sure she doesn't drink more than what she tells you?

[Sark]

We've lived together for years now and since I don't drink, we don't keep alcohol in our house. She will occasionally drink when we go out to family parties, and I've only ever seen her get completely wasted once, but I suppose I've never really asked her about how much she drank when she was younger. She's only 21 right now so I didn't really think it could have come to this already, even if she had drank a lot when she was younger.

The dr is going to have an ultrasound done on her liver this wednesday, and more blood will be drawn again. I guess I should do some research on alcoholic liver disease. I would have just assumed if she did have something like that, that there would be other symptoms too. But maybe we've just been blind to them, I'll do my research.

I appreciate your input. Blood level interpretations are a complete foreign language to me. Really grateful for this board.

[Mr.BB]

When liver disease symptoms appear there's already significant damage (jaundice).

Maybe its nothing to worry, my interpretation is just the usual, but the human body is always a box full of surprises.

Give it 2-4 weeks and retest.

[Marcus G]

Keep us updated on the out come..

[kelkel]

the human body is always a box full of surprises.

With some boxes better than others.....

[Sark]

I will definitely keep you all updated. I'm pretty worried/stressed now, but I guess not much we can do about it. I just hope she gets a decent ultrasound tech that will actually talk to her about what she's seeing instead of the crap ones that won't say anything besides "your DR will go over this with you." Hopefully her liver looks fine and this was all just a scare. Is it possible a night of drinking could temporarily raise levels? or does something like this take time to build up to?
Her Dr doesn't even want to see her again until the end of the month to go over the new test results, gonna see about changing that.

[Mr.BB]

Its always good to take ultrasound, Im always telling guys here to do it. But the tech will not able to see much on a 21 year old gal.

Yes, sporadic (heavy) drinking can upset transaminases for about 2 weeks.

Don't be worried. ALT and AST values start to be worrying at 5 times over top limit. It is something that should be looked up, but not worth to stress about it.

Do you have GGT, alkaline phosphatase and bilirubin values?

[Sark]

I can't find any results for GGT in her labs, but
alkaline phosphate was 65 IU/L range 52-144
Bilirubin total was 0.6 mg/dl range 0-1.2

I read something about platelets too.
Hers were 210 - range 140-400

So is the best thing to do for now to just keep her diet healthy and hope for the best? The traces of ketones in her urine surprised me, I went back through her diet, shes getting 150-200g carbs a day.

[Bonaparte]

Cloudy urine is generally indicative of UTI/renal infection. A kidney infection could also raise her AST. What were her white cell counts like?
How about her blood glucose level?

[Sark]

Thanks for the input.
Her WBC was 5.54 10*3/ul range 3.50-10.30
Glucose was at 88 mg/dl range 60-99

She's been feeling pretty nauseous and tired lately, has thrown up the past two days. It's really stressing me out, I worry about her.
It does make me feel a bit better reading about people who had levels up in the 500-700 range when they first caught wind of it, but still, something is wrong with her and it's worrysome.
She hasn't had much of an appetite either lately. She's been on a diet for awhile, trying to lose weight, and now shes finally losing weight. but now all I want is her to have her appetite back and be eating more so I know everything's ok.

She hasn't been drinking at all, and has been following a relatively healthy diet, but it almost seems like things are getting worse, instead of better.

[Bonaparte]

Whatever it is, it sounds pretty serious. Take her to the hospital if her primary is just dicking around.

[AR's King Silabolin]

Hi all, this isn't related to steroids or anything but it is related to bloodwork and the liver, and I know there are some very knowledgeable people here so I hope this is ok to ask

My girlfriend recently got some bloodwork back and the dr (who I'm not too impressed with) exclaims that her liver is damaged based on the results. She's 21 years old, works out regularly, follows a decent diet, and only drinks occasionally.
The doc ordered a bunch of hepatitis tests and another liver panel, but the only thing that was out of range was AST at 95 U/L when it should be 0-45. ALT was normal at 37 U/L. Everything I can read says that usually liver damage will show high ALT and AST, and that it is usually higher numbers such as 10 times the normal range. But this is where my lack of experience shows; is AST at 95 actually high and indicative of some damage? I understand it's above normal, but the way the doctor acted made it seem more serious.

So main question really is, is AST at 95 U/L actually concerning, or just something to watch?
Additionally, they found trace amounts of Ketones in the urine, which kind of surprises me but I don't know much about how common that is. Clarity was also cloudy, as apposed to clear which got flagged by the lab too.

Thanks for any help, if anything at least any answers can hopefully give me a better understanding of the liver and what bloodwork numbers mean.

put her on 600 mg NAC ed if the docs dont come up with something better....

[Mr.BB]

If new symptoms like nausea, and throwing up, she needs to redo the bloodwork ASAP

Like Bona said, find another doctor if hers is not available.

[MGC101]

Hey Sark!

I have had bloodwork in the past where both AST and ALT were in the low 100s. I was told to get an ultrasound followed by another test (i forget the name of). My doctor told me I have a "fatty liver" but didnt see anything from the tests. Long story short I think the combination of working out, protein shakes, preworkout and the alcohol i drink about once a week really threw it off. I took about 3 weeks off from drinking, no protein shakes or supplements and about the last 5-6 days off from the gym...when re-tested the levels were both in range (still higher but in range). From now on i get it tested like every 6 months or so and just be sure to do that same routine 2-3 weeks before to ensure accurate test

[Sark]

She finally had her follow up with her DR after the ultrasound. The Dr said she has gallbladder sludge, told her to cut out cholesterol and sat fat and hopefully it will go away. If not, and the pain gets too bad, she's told her to go to the hospital and they will have to do surgery.

And it is interesting now that I look back on it, she has been eating 3 eggs every day, and when she started eating the eggs is around the time where this whole thing started to happen.
Either way, we are a lot more relieved now, and she seems to be doing better now that she has cut out the eggs and foods with higher sat. fat, but I still stand by first opinion of her DR that she's a complete idiot for seeing her AST number and instantly saying your liver is in big trouble. Why say something that is just going to worry someone, especially when you're not even sure.

Anyways, I thank you all for the support and information and help, greatly appreciated. Hopefully she'll continue to get better and her liver enzymes will go back to normal.

[Mr.BB]

She finally had her follow up with her DR after the ultrasound. The Dr said she has gallbladder sludge, told her to cut out cholesterol and sat fat and hopefully it will go away. If not, and the pain gets too bad, she's told her to go to the hospital and they will have to do surgery.

And it is interesting now that I look back on it, she has been eating 3 eggs every day, and when she started eating the eggs is around the time where this whole thing started to happen.
Either way, we are a lot more relieved now, and she seems to be doing better now that she has cut out the eggs and foods with higher sat. fat, but I still stand by first opinion of her DR that she's a complete idiot for seeing her AST number and instantly saying your liver is in big trouble. Why say something that is just going to worry someone, especially when you're not even sure.

Anyways, I thank you all for the support and information and help, greatly appreciated. Hopefully she'll continue to get better and her liver enzymes will go back to normal.

She can take UDCA (ursodeoxycholic acid, brand name here is Ursofalk) to help with bile flow.

[Sark]

Thank you for the suggestion, i'll look into it.