What do elevated ALT and CRP mean for my early pregnancy?

Question

Hello doctor,

I am 32 years old and currently five weeks and two days pregnant.

My pregnancy history includes a miscarriage at seven weeks, a healthy pregnancy a few years back, and a miscarriage at 10 weeks a year ago, which was found to be a triploid (69XXX) pregnancy. Understandably, I am feeling very anxious during this pregnancy.

My doctor initially requested blood tests because I was worried about toxoplasmosis. The results showed a CRP of 14, which decreased to seven this week, though I had the flu during this period.

My ALT was initially around 56 U/L and appears slightly higher now, possibly around 70 U/L. At first, my doctor said this was normal in pregnancy, but now further investigations are being advised.

All other blood markers are reportedly normal, and my Hepatitis B testing earlier this year was negative. I have been taking progesterone 400 mg twice daily for the past month, and I do not consume alcohol.

I am feeling very stressed and uncertain about what the elevated ALT and CRP might mean for my pregnancy, and would appreciate guidance.

Kindly help.

Answer 1

Hello,

Welcome to icliniq.com

I have read your query and understand your concerns. It is normal to feel worried about a rising alanine aminotransferase (ALT) and C-reactive protein (CRP) during pregnancy. ALT can increase slightly as pregnancy progresses.

However, it is important to rule out other causes of elevated ALT, such as hepatitis, cholelithiasis (gallstones), medication-induced liver changes, or excessive vomiting in pregnancy.

Since your hepatitis B screening is negative, your doctors may check for other types of hepatitis, such as A, C, and E, and may also recommend an abdominal ultrasound to rule out gallstones. This is why additional tests are being advised.

It is also worth noting that Progesterone, especially when taken for a prolonged period, can cause mild elevations in ALT. Since you are currently on progesterone to support your pregnancy, it is most likely the cause of your elevated ALT.

There is usually no need for concern, as ALT levels typically return to normal after completing the course of progesterone.

Regarding CRP, the fact that it is dropping is reassuring. A mildly elevated CRP can have many causes, including minor infections or inflammation, and is not uncommon during pregnancy.

It is recommended that you continue healthy living, stay well hydrated, and take your progesterone and prenatal vitamins as advised. With proper care and monitoring, you are likely to be fine.

I hope this helps you.

Thanks and regards.

Answer 2

Hello,

Welcome back to icliniq.com.

I read your query and understood your concern.

Hepatitis and cholelithiasis can be managed safely during pregnancy. In these conditions, multiple liver markers are usually elevated, although sometimes ALP may be particularly high.

Since your ALT is the only abnormal marker, it is most likely due to Cyclogest (progesterone) and your pregnancy itself. The additional tests are being done as a standard protocol whenever ALT is elevated.

Overall, you are expected to be fine.

I hope this helps you

Thank you

Answer 3

Hello,

Welcome back to icliniq.com.

I read your query and understood your concern.

You should continue taking Cyclogest twice a day, as it is essential for supporting your pregnancy. It will typically be stopped between 12 and 14 weeks of gestation. For now, please continue your current dose.

I hope this helps you

Thank you

Answer 4

Hello,

Welcome back to icliniq.com.

I read your query and understood your concern.

Triploidy pregnancies can sometimes be associated with elevated ALT. However, in your case, there is an obvious factor (Cyclogest or progesterone and pregnancy itself) that can explain the elevated ALT you are currently experiencing.

Therefore, it is most likely not related to triploidy. You should continue to be closely monitored for ALT levels.

Regarding nausea, most women start experiencing nausea and vomiting around this stage of pregnancy, so it is not uncommon for you to feel this now. Every pregnancy is different, so the fact that you did not have nausea during your pregnancy with your son does not mean your current symptoms are unusual.

Continue to let your doctors monitor your ALT and blood pressure closely. By 10 to 12 weeks, the cause of any elevated ALT should become clearer.

I hope that this answers your query.

Kindly follow up if you have more doubts.

Thank you.