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

Answered by
Dr. Kannane Tirou
and medically reviewed by iCliniq medical review team.
This is a premium question & answer published on May 29, 2018

Hello doctor,

I am 55 years old male, height 168 cm, and weight 74 kg. 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.



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

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