I Just Had A Blood Profile And Concerned About Two

Posted on Wed, 11 Mar 2020

Question: I just had a blood profile and concerned about two readings - AST and ALT - everything else was fine - my AST was 35H and my ALT was 63H - how serious is this. My dr hasn't called as he is not there today - should I be concerned. I am 76 yrs old - only drink a little wine once in a while - but not regularly. Would appreciate your expertise. Thank you.

Follow up: Dr. Ramesh Kumar (2 minutes later)

Just wondering what i am doing wrong - been on Lipitor for a long time but never had elevated liver - only drink an occasional glass of wine - thank you.

Answered by Dr. Ramesh Kumar (1 hour later)

Brief Answer:
Need a few more details dear.

Detailed Answer:
Hello and thanks for choosing "Ask A Doctor" service for your query,
I have seen your details and I appreciate your concerns.

Firstly I would like to say that in an otherwise normal person liver enzymes level more than 3 times the upper normal limit is significant.

You have mentioned 35 H and 63 H...However usually the unit of measurement is i.u. (international unit)... So kindly revert back with the normal limit of both the enzymes mentioned by your lab...Otherwise, as said above elevation more than 3 times the upper normal range is significant.

In short, in an asymptomatic patient mild to moderate (less than three times the upper limit of normal range) has no significance.

Secondly, I would like to know why was liver function test was done (Normal body check-up or do you have any symptoms)?

Thirdly, Lipitor or any other statin may cause mild to moderate elevation of liver enzymes(which has no significance).

What potency of Lipitor are you on like 10,20,40 mg?
Are you obese?

Kindly revert back with the details.
Awaiting...

Above answer was peer-reviewed by : Dr. Arnab Banerjee

Follow up: Dr. Ramesh Kumar (46 minutes later)

Ok - think I figured out why - I talked with a pharmacist and I was on nitrofurontoin (generic for Macrobid) 2 weeks ago for UTI 100 mg twice a day and before that on low dose 50 mg 3 x a week due to frequent UTIs - anyway that CAN cause this - I called my urologist and haven't heard from him yet - this is just a routine blood profile - anyway that was the only thing that was out of wack AST 35 and ALT 63. Do you think the same?

Follow up: Dr. Ramesh Kumar (1 minute later)

I have been on Lipitor 40 mg for years and no problem at all so this antibiotic has to be the culprit in my opinion.

Follow up: Dr. Ramesh Kumar (1 minute later)

It is U/L - H stands for high. (twice the usual amount of 31)

Follow up: Dr. Ramesh Kumar (1 hour later)

Why are you not answering my last question - I may have to call your phone number to find out why.

Answered by Dr. Ramesh Kumar (3 hours later)

Brief Answer:
Follow up.

Detailed Answer:
Hi there again,
Sorry was attending a emergency patient,
Nitrofurantoin is a strong antibiotic(old one) and is metabolised by liver.
Therefore your liver functions are slightly elevated as while one this antibiotic you were not taking any liver rejenuvators.

I would suggest you to take Milk of thistle for few days to help your liver cells to recover fast.
Don't worry they would return back to normal in few week(2-4).
Hope I was helpful,
Thanks and feel free to follow up.
Regards!

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Above answer was peer-reviewed by : Dr. Kampana