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What Causes Elevated ALT Levels After C-section?
Question: I just had a baby (c-section) three months ago. I had a spinal and was on norco (sparingly) and 600 mg of ibuprofen 3x a day for close to six weeks. I was then in a car accident right after my 6 week doctor visit and took a little more ibuprofen. The stress of the car accident caused me to drink alcohol only in the evenings when I was no longer taking the ibuprofen. I was also eating very high fat foods. I just got my bloodwork done because I was having severe anxiety and my ALT was 60 and AST 16. Five months prior while I was seven months pregnant my ALT was 16 and AST was 16. Since the ibuprofen, alcohol and high fat foods were all so close together in proximity have I done permanent damage to my liver or will it heal if I don't drink and eat better?
Brief Answer:
Elevated ALT
Detailed Answer:
Hello,
Congratulations on your baby! Now about that elevated ALT, here are a few things to consider:
1. ALT rises in the period of time immediately after delivery, particularly by C-section. So it may actually have been higher and is coming down.
If you are interested, here is an article about increased liver enzymes after delivery. If you don't want to read it all, consider reading the conclusion: http://onlinelibrary.wiley.com/store/10.1111/j.1471-0528.2000.tb11659.x/asset/j.1471-0528.2000.tb11659.x.pdf;jsessionid=EA73A613DE5D9856B2C05596EE81CA59.f02t01?v=1&t=iwctacg5&s=e296a0000d5020f657aed9fffa3648e3e0471
2. An ALT of 60, while it is higher than your previous level, is not a concerning level. It is just over the upper range of normal. If it were in the mid to upper hundreds, I would be concerned.
3. An ALT of 60 should not cause you long term damage.
4. It can take a couple of months after there has been something that upsets the liver cells for them to regenerate. So if the mild increase has not decreased in one month, recheck in another couple of months.
So - I do not think you have anything to worry about.
If, however, your ALT and other liver enzymes show a progressive increase when checked again, then it would be advisable for you to have a liver ultrasound.
I hope this information helps. Please let me know if I can provide further information or clarification.
Elevated ALT
Detailed Answer:
Hello,
Congratulations on your baby! Now about that elevated ALT, here are a few things to consider:
1. ALT rises in the period of time immediately after delivery, particularly by C-section. So it may actually have been higher and is coming down.
If you are interested, here is an article about increased liver enzymes after delivery. If you don't want to read it all, consider reading the conclusion: http://onlinelibrary.wiley.com/store/10.1111/j.1471-0528.2000.tb11659.x/asset/j.1471-0528.2000.tb11659.x.pdf;jsessionid=EA73A613DE5D9856B2C05596EE81CA59.f02t01?v=1&t=iwctacg5&s=e296a0000d5020f657aed9fffa3648e3e0471
2. An ALT of 60, while it is higher than your previous level, is not a concerning level. It is just over the upper range of normal. If it were in the mid to upper hundreds, I would be concerned.
3. An ALT of 60 should not cause you long term damage.
4. It can take a couple of months after there has been something that upsets the liver cells for them to regenerate. So if the mild increase has not decreased in one month, recheck in another couple of months.
So - I do not think you have anything to worry about.
If, however, your ALT and other liver enzymes show a progressive increase when checked again, then it would be advisable for you to have a liver ultrasound.
I hope this information helps. Please let me know if I can provide further information or clarification.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Brief Answer:
Not advanced liver disease
Detailed Answer:
Hi - I looked at your labs, and they look good. You liver is not causing the ammonia smell. To give some perspective to your elevated ALT, people with liver diseases such as hepatitis or cirrhosis may have an ALT of 800, not 60. Some labs use 56 as the upper end of normal range for ALT, so you can see that yours is just barely elevated.
I can say with 100 percent certainty that you do not have advanced hepatitis or cirrhosis. Not only are your current labs good (including albumin and bilirubin, which would be off if there was liver disease), but your ALT a few months ago was normal, and cirrhosis does not happen in that short a period of time.
The ammonia smell can be from something you ate, or it can be from some colonization of bacteria in the bladder (such as an early bladder infection). If you are not having other signs or symptoms of a bladder infection (burning with urinating, urgency, pain) then I suggest increasing your water intake, and cranberry too. You can avoid the excessive amount of sugar that is in commercially made cranberry juice such as Ocean Spray by buying cranberry juice concentrate (I think Knudsen Farm sells it in bottles) and reconstituting it with water and a little apple juice (because it is very tart).
Not advanced liver disease
Detailed Answer:
Hi - I looked at your labs, and they look good. You liver is not causing the ammonia smell. To give some perspective to your elevated ALT, people with liver diseases such as hepatitis or cirrhosis may have an ALT of 800, not 60. Some labs use 56 as the upper end of normal range for ALT, so you can see that yours is just barely elevated.
I can say with 100 percent certainty that you do not have advanced hepatitis or cirrhosis. Not only are your current labs good (including albumin and bilirubin, which would be off if there was liver disease), but your ALT a few months ago was normal, and cirrhosis does not happen in that short a period of time.
The ammonia smell can be from something you ate, or it can be from some colonization of bacteria in the bladder (such as an early bladder infection). If you are not having other signs or symptoms of a bladder infection (burning with urinating, urgency, pain) then I suggest increasing your water intake, and cranberry too. You can avoid the excessive amount of sugar that is in commercially made cranberry juice such as Ocean Spray by buying cranberry juice concentrate (I think Knudsen Farm sells it in bottles) and reconstituting it with water and a little apple juice (because it is very tart).
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thank you! Last question and I'm attaching my latest labwork. My ALT went down to 20 and AST to 17. I didn't eat for 24 hours before the test. I've been eating super healthy and completely forgot to eat dinner the night before and went straight to the doctor in the morning without eating. Could that have caused my ALT to drop down lower than it actually is? Could i actually still have a high ALT number and it lowered because there was no food processing in there? I assume the low glucose level of 56 and ketones in my urine of negative 3 is because i didnt eat but just wanted to make sure that hasnothing to do with my liver. Thanks so much for everything! You've always made me feel better.
Brief Answer:
Fasting can cause the low glucose and pos. ketones; won't affect liver test
Detailed Answer:
Hi -
Fasting for 1 day would not significantly affect the liver enzymes. It can affect glucose level, urinary ketones, lipid (cholesterol) panels, electrolytes (potassium, sodium), hematocrit (how concentrated your hemoglobin is in your blood), BUN (blood urea nitrogen), cortisol level, and a few other things. But your liver enzymes are a function of whether your liver cells (hepatocytes) are inflamed and irritated. That is a good question - but eating the day of your test, or not, won't make a difference.
As you had a C-section, your liver enzymes were probably highest at around 5 days post partum and have progressively decreased back to normal. So I don't think there is much you did, unless your drinking was heavy, to have affected it. And you are ok now.
Your second lab report didn't upload. But I can say that prolonged fasting and dehydration can cause ketones to show up in your urine. It isn't a function of how your liver is doing. And the low blood sugar - also from fasting.
I know you are busy with a little baby, but please eat and take care of yourself too!
Fasting can cause the low glucose and pos. ketones; won't affect liver test
Detailed Answer:
Hi -
Fasting for 1 day would not significantly affect the liver enzymes. It can affect glucose level, urinary ketones, lipid (cholesterol) panels, electrolytes (potassium, sodium), hematocrit (how concentrated your hemoglobin is in your blood), BUN (blood urea nitrogen), cortisol level, and a few other things. But your liver enzymes are a function of whether your liver cells (hepatocytes) are inflamed and irritated. That is a good question - but eating the day of your test, or not, won't make a difference.
As you had a C-section, your liver enzymes were probably highest at around 5 days post partum and have progressively decreased back to normal. So I don't think there is much you did, unless your drinking was heavy, to have affected it. And you are ok now.
Your second lab report didn't upload. But I can say that prolonged fasting and dehydration can cause ketones to show up in your urine. It isn't a function of how your liver is doing. And the low blood sugar - also from fasting.
I know you are busy with a little baby, but please eat and take care of yourself too!
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
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