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Kindly explain about the AST and ALT levels in blood report.

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Patient's Query

Hello doctor,

I am 55 years old male, height 5 feet 5 inches, and weight 163 lbs. I do not drink or smoke. Presently, I am not under any medications. Previously, I took medicines for suspected acid reflux symptoms for six months but stopped since one year. I used to undergo comprehensive blood tests on a yearly basis. The query is about results of lab reports taken from two different labs. I am worried about the values of SGOT (AST) and SGPT (ALT). Does it indicate the damage to the liver? (The level of AGST and SGPT were normal up to last year). You are requested to advise me regarding the future course of action on this query.

Answered by Dr. Kannane Tirougnanassambandare

Hi,

Welcome to icliniq.com.

I note that your query is related to abnormal LFTs (blood liver function tests) SGOT (AST- aspartate transaminase) and SGPT (ALT- alanine transaminase). From the information you provided (attachment removed to protect patient identity), I understand that:

  1. You are asymptomatic (currently no symptoms) and that the abnormal blood results were picked up incidentally on the routine annual checkup.
  2. You are not on any medications currently or recently (within last three months).

There are many possible causes of transaminitis (raised ALT/AST) and identification of the underlying cause in you requires a detailed medical history and a series of blood tests.

The Probable causes

The most important usual cause of hepatitis (inflammation in the liver cells) are: 1. Viral hepatitis. 2. Drug (medication) induced, including allopathic or herbal medicines or supplements. 3. Fatty liver (NASH or Non-alcoholic steato-hepatitis). 4. Alcoholic hepatitis. 5. Auto-immune hepatitis, etc.

Investigations to be done

I will recommend that you see a hepatologist or medical gastroenterologist. The initial steps to be taken are as follows: 1. Repeat blood tests for LFTs (liver function tests) in a standard laboratory. 2. Ultrasound abdomen. If the blood tests LFTs are still abnormal, a further blood test to evaluate the cause for this will include: 1. Hepatitis A IgM to check for hepatitis A infection. 2. HBsAg, HBcAg (IgM) for hepatitis B infection. 3. HCV Antibodies to check for hepatitis C infection. 4. Liver autoantibodies (ANA anti-nuclear antibody, ASMA anti-smooth muscle antibody, AMA anti-mitochondrial antibody), etc. Based on the above results, further evaluation may be required like a liver fibroscan or a liver biopsy.

Differential diagnosis

1. Viral hepatitis.

2. Drug induced hepatitis.

Treatment plan

Make a note of all the medicines you could have taken in the last few months including allopathic drugs, eg., statins (cholesterol medication), painkillers (Paracetamol, NSAIDs- non-steroidal anti-inflammatory drugs), herbal remedies or any other supplements. Discuss this with your doctor or write back to me if you have any further queries.

Regarding follow up

For more information consult a medical gastroenterologist online.--->https://www.icliniq.com/ask-a-doctor-online/medical-gastroenterologist

Patient's Query

Hello doctor,

Thanks for your response.

The results of the tests undergone are attached for your valuable advice.

Thank you.

Answered by Dr. Kannane Tirougnanassambandare

Hello,

Welcome back to icliniq.com.

Your Ultrasound scan suggests you have fatty liver. The medical term is a non-alcoholic fatty liver disease (NAFLD) or non-alcoholic steatohepatitis (NASH). The blood tests show that you do not have diabetes and do not have hepatitis B or C infection.

I suggest you do a fibroscan, repeat the blood tests for liver function, including aspartate transaminase and alanine transaminase, and blood tests to estimate your complete lipid profile, including cholesterol and triglycerides.

Lifestyle modifications can be done. For example, go for a brisk walk for 45 minutes (even a minimal weight loss of two to three kilograms will help). Avoid consuming alcohol. Check your cholesterol levels and take medications if it is high. Since your body mass index (BMI) is high, I recommend a low-fat diet.

Fatty liver is reversible, but any fibrosis damage that has already occurred is not. Fibrosacn will help assess the level of fibrosis present.

Thank you.

Investigations to be done

Do a fibro scan, repeat blood tests for liver function, including aspartate transaminase and alanine transaminase, and blood test to assess the complete lipid profile, including cholesterol and triglycerides.

Probable diagnosis

Non-alcoholic steatohepatitis (NASH).

Treatment plan

Lifestyle modifications can be done. For example, go for a brisk walk for 45 minutes (even a minimal weight loss of two to three kilograms will help). Avoid consuming alcohol. Check your cholesterol levels and take medications if it is high.

Preventive measures

Since your body mass index (BMI) is high, I recommend a low-fat diet.

Regarding follow up

Fatty liver is reversible, but any fibrosis damage that has already occurred is not. Fibro scan will help assess the level of fibrosis present.

Answered by

Dr. Kannane Tirougnanassambandare

Medically reviewed byiCliniq medical review team

Published At May 29, 2018
Reviewed AtFebruary 17, 2024

Same symptoms don't mean you have the same problem. Consult a doctor now!

Dr. Kannane Tirougnanassambandare

Dr. Kannane Tirougnanassambandare

Medical Gastroenterology
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