Is AST Level Of 53 A Cause For Concern?

Posted on Tue, 29 Aug 2017

Question: I just had my annual physical last week and I have an ast level of 53 and normal alt level. I also was just diagnosed with mild anemia. My Hgb is 12.1. I had high RDW around 19 and my MSV was normal. I am fairly healthy, I work out four days a week three days with weights and one for cardio and maintain a decent diet.

At the end of XXXXXXX i came down with some type of sickness which caused fever, joint, pain, coughing, chills etc. I had that twice in one week. The week of my routine physical I had diarrhea for three days along with stomach cramps and nausea. I have two questions.

1. How concerned should I be with my AST level?
2. How concerning is the mild anemia and is there a correlation between the two.

My doctor told me not to drink for a month, which I rarely do probably about 4-8 beers a month and they would recheck my levels in a month. He is also having me perform fecal tests at home to check for blood in my stool.

Answered by Dr. Ramesh Kumar (1 hour later)

Brief Answer:
Your reports are absolutely fine.

Detailed Answer:
Hello,
Thanks for choosing HealthcareMagic for your query.
Have gone through your details and i appreciate yor concerns.

As per your query.
The blood test for aspartate aminotransferase (AST) is usually used to detect liver damage however AST is normally found in red blood cells, liver, heart, muscle tissue, pancreas, and kidney.So mild elevation doesnot always suggest problem with liver. Typically the range for normal AST is reported between 10 to 40 units per liter.For medical significance level of AST should be atleast 3 times the normal value.
Your AST is mildly elevated and ALT is normal.I don't think it has any clinical significance.

Low iron levels in the blood causes iiron-deficiency anemia. Without iron, your red blood cells may become low in a protein called hemoglobin hence you would have mild anemia.Again mild anemia has no siignificance.Just increase your iron uptake a little bit- Green leafy vegetables and colored fruits.Again mild anemia bears no significance in a clinically normal patient.

Regards.

Above answer was peer-reviewed by : Dr. Raju A.T

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

Thank you for your response. I have one additional question. I actually put this bit of info into the question but for some reason it did not show up. I also have increased bilirubin. My levels run from 2.1-2.5 and have for the past four years since I have been getting annual exams. My bilirubin at this last check was 2.5. With this additional piece of information does this change your answer. Just for context my son and daughter both had severe levels of bilirubin when they were born and required treatment for it and my sister has elevated levels as well.

Thank you.

Answered by Dr. Ramesh Kumar (9 minutes later)

Brief Answer:
No less then 3 bilirubin has no clinical value.

Detailed Answer:
Hello again dear,
Bilirubin less then 3 mg/dl is called subclinical jaundice and has no clinical significance.
However you should go for an ultrasound of hepatobilliary system along with serum direct and indirect bilirubin levels test to find out the exact cause of increased bilirubin.
Actually jaundice is of three types
Pre,Post and intrahepatic and pathology and treatment varies in each type hence results of these basic tests are must before giving any professional suggestion.

Regards.

Above answer was peer-reviewed by : Dr. Raju A.T

Follow up: Dr. Ramesh Kumar (13 minutes later)

Ok, what is typically a cause of increased bilirubin? my Dr thinks I have XXXXXXX Syndrome and that is the cause of it. I also forget to ask, is mild anemia also a cause for low RBC, low act, and low blood platelets? Those values were low in my lab as well.

Answered by Dr. Ramesh Kumar (13 minutes later)

Brief Answer:
follow up.

Detailed Answer:
Hi there,
In gillberts bilirubin does not conjugate (convert) from indirect bilirubin to direct bilirubin at the normal rate and accumulates in the bloodstream.This causes increased unconjugated bilirubin levels in blood..
Increase in total bilirubin with increased levels of unconjugated bilirubin in blood is a feature of gillberts.

Bilirubin is a brownish yellow substance found in bile. It is produced when the liver breaks down old red blood cells. Bilirubin is then removed from the body through the stool.So increase in levels of bilirubin in general is either suggestive of problem with liver or increased blood cell breakdown or problem in excretion of bilrubin.
Anemia can be iron deficiency anemia or hemolytic anemia( increased destruction of blood cells).
As doctor is suspecting gillberts cause in your case can be hemolysis(increased breakdown of red cells).
As RBC are destroyed their level will decrease.

Platelet is not related to it.

Thanks!

Above answer was peer-reviewed by : Dr. Raju A.T

Follow up: Dr. Ramesh Kumar (20 minutes later)

Ok, thank you. So there is no need to get worried over my lab results, but I should have my bilirubin checked out?

Answered by Dr. Ramesh Kumar (11 hours later)

Brief Answer:
followup

Detailed Answer:
yes no need to worry.
Just get it checked.

Thanks

Above answer was peer-reviewed by : Dr. Nagamani Ng

Follow up: Dr. Ramesh Kumar (7 hours later)

Ok, I will follow up with my doctor on Monday to get that test done. Is it common to have continuing elevated bilirubin for a number of years such as myself and have normal labs, with no symptoms such as jaundice, pain in the stomach area, gastointenstial issues, or other issues that maybe indicative of liver disease, issues with the pancreas, or anemia and then all of the sudden have lab results such as mine?

I ask this because my sister had hemolytic anemia for years until it got so severe she had her spleen taken out. Her anemia just kept correcting itself. I know she had higher than normal levels of bilirubin not as high as mine, but she had symptoms such as jaundice and much lower levels of hgb than I do.

Answered by Dr. Ramesh Kumar (2 hours later)

Brief Answer:
follow up..

Detailed Answer:
Hi again dear,

As already explained earlier serum bilirubin concentration less then 3 is called subclinical
jaundice and would never be symptomatic. Symptom appears only when serum bilirubin level is more than 3.

Patients with XXXXXXX are usually asymptomatic and elevated bilirubin levels are there.
For any further suggestion, we need a report of serum Direct and indirect bilirubin.

They are going to differentiate hemolytic from pre hepatic and post hepatic problem.

Regards!

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

Follow up: Dr. Ramesh Kumar (21 hours later)

What could cause the decrease in my platelets? They are normally 150 and I was at 121 would chronic liver disease be a concern? Or would the fact I had two different viral infections one a month before my exam and the other the week of have a negative impact on my lab results? My wbc was normal at 4.5 but down from my usual 7 ranges

Answered by Dr. Ramesh Kumar (16 hours later)

Brief Answer:
follow up.

Detailed Answer:
Helllo again Dear,

See a doctor never treats numbers they treat symptoms.
Our body is a complex system where if one part is effected all systems are effevted.Its very difficult to provide an expalination for variation in different parameters which are not related to each other.

Viral infection also decreases platelet counts therefore recurrent 2 times infection can also be a cause of decrease in platelets.

Frankly speaking mild variation of these parameters in an otherwise normal individual has no significance.
I need a bilirubin report for further suggestions.
Thanks!

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Above answer was peer-reviewed by : Dr. Nagamani Ng