Q. Though my total bilirubin level comes down, ALT, AST, and ALP levels remain high. Why?

Answered by
Dr. Goswami Parth Rajendragiri
and medically reviewed by Dr. Vinodhini. J
This is a premium question & answer published on Dec 04, 2020 and last reviewed on: Dec 11, 2020

Hello doctor,

I want to show my LFT report. I was suffering from jaundice. In my first test result total bilirubin was 11.2 mg/dL (D: 2.1, ID: 9.1), and the values of ALT, AST, and ALP are 53, 41, and 162 u/l, respectively. Hepatitis B was negative.

In my second test results, the total bilirubin count has been reduced to 1.29 mg/dl (D: 0.73, ID: 0.56). But ALT, AST, and ALP values are 131, 150, and 267.

Kindly explain if total bilirubin is brought down to 1.29 mg/dL, why ALT AST and ALP are increased? What does it mean? What medications are preffered?



Welcome to

I can understand your concern and the following is my opinion about your asked question.

ALT (alanine transaminase) or SGPT (serum glutamic pyruvic transaminase) is the liver cells' enzyme. So, raised the level of which is suggestive of liver cell (hepatocyte) damage. Your SGPT is elevated to some extent, and conjugated bilirubin are elevated. So, hepatitis or stone in bile canaliculi might be the cause for your elevated SGPT and bilirubin.

Hepatitis could be here in the form of viral hepatitis like hepatitis A or E or some other cause. You can be prescribed ursodeoxycholic acid tablet or syrup for your condition.

Meanwhile, take low-fat foods and drink more fruit juice like apple juice and coconut water. Your investigations need to be done in the form of an ultrasound abdomen, viral hepatitis marker for primary workup.

In hepatitis SGPT and SGOT levels can fluctuate. So do not worry about that. Repeat your SGPT after a few days.

Thank you doctor,

Both hepatitis B and C are negative. So maybe stone in the duct could be a problem. Further, is there any major problem according to you?



Welcome back to

Your bilirubin level is decreased, so it does not suggest major problems. You had jaundice at that time. Hepatitis B is negative, but you can investigate with hepatitis A and E viral marker, which is not done until now.

You can attach any other reports if available.

Revert with repeat SGPT after a few days.

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